X-ray tube voltage and image quality in adult and pediatric CT

The purpose of this study was to investigate how tissue x-ray attenuation coefficients, and their uncertainties, vary with x-ray tube voltage in different sized patients. Anthropomorphic phantoms (newborn, 10 year old, adult) were scanned a GE LightSpeed scanner at four x-ray tube voltages. Measurements were made of tissue attenuation in the head, chest and abdomen regions, as well as the corresponding noise values. Tissue signal to noise ratios (SNR) were obtained by dividing the average attenuation coefficient by the corresponding standard deviation. Soft tissue attenuation coefficients, relative to water, showed little variation with patient location or x-ray voltage (< 0.5%), but increasing the x-ray tube voltage from 80 to 140 kV reduced bone x-ray attenuation by ~14%. All tissues except adult bone showed a reduction of noise with increasing x-ray tube voltage (kV); the noise was found to be proportional to kVn and the average value of n for all tissues was -1.19 ± 0.57. In pediatric patients at a constant x-ray tube voltage, SNR values were approximately independent of the body region, but the adult abdomen soft tissue SNR values were ~40% lower than the adult head. SNR values in the newborn were more than double the corresponding SNR soft tissue values in adults. SNR values for lung and bone were generally lower than those for soft tissues. For soft tissues, increasing the x-ray tube voltage from 80 to 140 kV increased the SNR by an average of ~90%. Data in this paper can be used to help design CT imaging protocols that take into account patient size and diagnostic imaging task.