Comparison of radiation dose and image quality between contrast-enhanced single- and dual-energy abdominopelvic computed tomography in children as a function of patient size

Widespread adoption of dual-energy computed tomography (DECT) requires evidence it does not cause higher radiation dose than conventional single-energy CT (SECT). While a few publications involving pediatric patients exist, most have focused on small cohorts. Hence, there is still a need for studies that ascertain what radiation doses are expected in larger populations that include representative ranges of patient sizes and ages. To compare radiation dose and image quality of DECT and SECT abdominopelvic examinations in children as a function of patient size. This retrospective study included 860 children (age range: 12.3±5.3 years) who underwent contrast-enhanced abdominopelvic exams on second-generation dual-source CT in a five-year period. Two groups, SECT and DECT, consisting of 430 children each, were matched by 5 effective diameters. Volume CT dose index (CTDIvol) and size-specific dose estimate (SSDE) were analyzed as a function of effective diameter. Objective image quality was compared between the groups. DECT SSDEs were lower across all effective patient diameters compared with SECT (mean: 8.5±1.8 mGv vs. 9.3±2.0 mGv, respectively, P≤0.001). DECT CTDIvol was lower compared to SECT (mean: 5.6±2.4 mGv vs. 6.1±2.7 mGv, respectively, P≤0.001) except in the smallest diameter group ( 0.05). In children, regardless of effective diameter, contrast-enhanced abdominopelvic DECT can be performed with a similar or lower dose and similar image quality compared with SECT examinations.