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The aim of this study was to develop a method of obtaining the same levels of CT image noise for patients of various sizes to minimize radiation dose. Two CT systems were evaluated regarding noise characteristics using phantoms and dosimetric measurements. Both CT systems performed well at dose levels used in normal clinical imaging, but only one was found to be suitable for low radiation dose applications. The CT system with the lowest noise level was used for further detailed studies. A simple strategy for manual selection of patient-specific scan parameters, considering patient size and required image quality, was implemented and verified on 11 volunteers. Images were obtained with at least the prescribed image quality at significantly reduced radiation dose levels compared with standard scan parameters. Depending on the diameter of the tomographic section, i.e. size of the subject, the dose levels could be reduced to 1-45% of the radiation dose with standard scan parameters (120 kV, 250 mAs, 10 mm). The results indicate a general potential for dose reduction in CT for slim patients. For tissue volume determination, large dose reductions can be achieved by adjusting the scan parameters for each individual. The concept of patient-specific scan parameters could be fully automated in the CT system design, but would require the scan to be specified in terms of image quality rather than X-ray tube load.

Purpose: To evaluate MR imaging for tissue volume measurements., Material and Methods: Imaging was done with a spoiled gradient echo technique using the human lower leg as a simple model and CT as the reference technique. Areas of adipose tissue, muscle plus skin and bone tissue were evaluated in 5 volunteers using signal intervals (MR) and attenuation intervals (CT) defined by histograms. Volumes were determined from 7 images (MR-7, CT-7), from 70 contiguous images (MR-70), and also from a commercially-available 3D program based on a seeding technique applied according to the operators' judgment (MR-op)., Results: The sum of bone tissue, muscle plus skin and adipose tissue were similar for CT and MR. Compared to CT-7, MR-7 and MR-70 overestimated adipose tissue (0-8%) and muscle plus skin (11-15%), while bone tissue was underestimated (61-78%). Determinations based on the contiguous images or the 7 images were similar (standard error 2-5%). MR-op resulted in pronounced underestimation of muscle plus skin and bone tissue and a minor underestimation of adipose tissue., Conclusion: Valid determinations of adipose tissue volume are possible with MR but further technical development is required for other tissue volumes. The technique applied according to the operators' judgement, as used for 3D surface rendition, is unreliable for tissue volume determinations.

Purpose: To study the potential for radiation dose reduction in computed tomographic (CT) determination of adipose and muscle tissue area and volume, which is an application in which lower spatial resolution or higher image noise can be accepted., Materials and Methods: Measurements in vivo (in a healthy man aged 52 years; weight, 80 kg) and in phantoms were performed with two standard clinical CT scanners. Tissue areas were determined, and measurement uncertainties were analyzed. Comparisons were made with simulated and theoretic data., Results: A 25-fold reduction in radiation dose was achieved and resulted in an effective dose of 13 microSv per section; an accuracy of greater than 5% in area measurements was maintained. The dose savings achieved in this study were close to those that are theoretically possible., Conclusion: Further dose reduction to about 1 microSv may be possible for this application. Large dose reductions are possible in CT determinations of tissue area and volume, which makes this application available also in large randomized studies in which high-performance clinical standard scanners are used. This work demonstrates that modern CT technology may have a large potential for dose reduction in specific applications.

The purpose was to obtain reliable measures of fat and muscle tissue areas with CT at a reduced radiation dose level. Repeated CT-scans with four different levels of reduced radiation dose were perfomed on a water phantom and a volunteer at the L4-L5 level. Dose measurements were performed in a phantom and free in air. A histogram model function for fat, muscle and partial volume affected voxels was proposed and used in the analysis of image noise. The result was at most a 25-fold reduction in radiation dose with an image noise of 40 HU but only a minor influence on the tissue area determination [corrected].

The objective of this study was to develop a body composition method based on computerized tomography (CT) which would make it possible to divide the body into multiple compartments at the tissue and organ level. Eight healthy males (21-42 years old) with BMIs ranging from 18.6 to 25.3 kg/m2 were used for the methodological development. Areas of tissues, organs and air/gas were measured in 28 cross-sectional scans having defined and identical positions in all examined subjects. The area determinations were performed with the following attenuation intervals (given in Hounsfield units, HU): air, gas and lungs: -1001 to -191 HU; adipose tissue (AT): -190 to -30 HU; all other soft tissues and organs: -29 to +151 HU; skeleton: 152 to 2500 HU. Various tissue and organ areas in the -29 to +151 HU interval were obtained by means of cursor circumscriptions, while area determinations in other intervals were based on the number of pixels fulfilling given attenuation criteria. Volumes of tissues, organs and gas were obtained from corresponding areas and the distances between the scans. The body was divided into 12 main volumes of tissues, organs and gas that could be further subdivided by region. The main volumes observed (in litres; mean +/- s.d.) were: skeleton (subdivisible into dense skeleton, red and yellow bone marrow): 8.7 +/- 0.9; skeletal muscle: 31.9 +/- 5.1; visceral AT (subdivisible into intra- and retroperitoneal, cardiac, other thoracic AT): 3.0 +/- 1.7; intra- and retroperitoneal organs other than AT: 4.6 +/- 0.8; gastrointestinal gas: 0.25 +/- 0.09; heart: 0.61 +/- 0.12; lungs and bronchial air: 5.1 +/- 1.1; other thoracic organs: 0.32 +/- 0.08; mammary glands: 0.001 +/- 0.004; CNS (subdivisible into brain and contents of spinal channel): 1.6 +/- 0.15; air in sinuses and trachea: 0.19 +/- 0.05; subcutaneous AT: 11.6 +/- 2.8; skin: 2.4 +/- 0.39. Precision errors as determined from double analyses of different tissue volumes ranged from 0.01 to 0.3 litres. For validation purposes, CT-estimated organ weights were obtained by multiplying organ volumes by their assumed densities. The sums of all organ weights were then compared with the measured body weights. The error calculated from the individual differences between these weights was 0.6 kg (0.85%). The multicompartmentation technique described has a high validity and reproducibility and is applicable over a wide range of medical fields which require body composition measurements at the tissue and organ level.