Optimization of the Scan Protocol for the Reduction of Diaphragmatic Motion Artifacts Depicted on CT Angiography: a Phantom Study Simulating Pediatric Patients with Free Breathing

ABSTRACT

OBJECTIVE: This study was designed to optimize the scan protocol of CT angiography to reduce diaphragmatic motion artifacts in pediatric patients with free-breathing. MATERIALS AND METHODS: A phantom with twelve tubes with different diameters was constructed. To simulate free-breathing, the phantom was connected to a motor, and the phantom moved along the axis of scan. Scans were performed under several conditions different pitch (1, 1.5) and gantry rotation time (0.37 and 0.75 sec), and different movement range (1 cm, 3 cm) and rates (20/min, 40/min). For CT scanning, a 16-channel CT scanner was used and fixed factors of the CT protocol were as follows 100 effective mAs, 80 kVp, reconstruction with a soft-algorithm, beam collimation 16x75 mm, reconstruction thickness of 1 mm, and an interval of 0.5 mm. CT scans were repeated five times. Each tube was evaluated with the use of a grading system (0 for images where tubes were not discriminable and 2 for images where tubes were clearly discriminable). RESULTS: A higher pitch and shorter gantry rotation time produced images with a higher grade. Average grades for the higher pitch (1.5) and faster gantry rotation time (0.37 sec) for each combination of movement were as follows 1.94 (range 1 cm and rate 20/min), 1.42 (range 1 cm and rate 40/min), 0.86 (range 3 cm and rate 20/min) and 0.52 (range 3 cm and rate 40/min). Average grades for the lower pitch (1) and slower gantry rotation time (0.75 sec) for each combination of movement were 1.08, 0.56, 0.32 and 0.08, respectively. CONCLUSION: The scanning speed and especially the pitch are important parameters for CT scans to overcome a respiratory motion artifact.