Technical Note: Increased Photon Starvation Artifacts At Low Helical Pitch In Ultra-Low-Dose Ct

Purpose: The aim of this study was to demonstrate that a low helical pitch causes increased photon starvation artifacts at ultra-low-dose CT. Methods: A cylindrical water phantom with a diameter of 30 cm was scanned on two different generation CT scanners: a 64-slice scanner (Sensation 64, Siemens Healthcare) and a 192-slice scanner (Somatom Force, Siemens Healthcare) at multiple effective mAs levels (mAs/pitch = 200, 100, 50, 25, and 12). The corresponding CTDIvol values were 4.1, 2.0, 1.0, 0.5 mGy, on the 64-slice scanner and 3.8, 1.9, 1.0, 0.5 mGy on the 192-slice scanner, for the selected effective mAs values. For each dose setting, the scan was repeated at four helical pitches: 1.2, 0.9, 0.6, and the lowest achievable pitch on each scanner. The tube current was automatically adjusted by the scanner so that the effective mAs, and thus CTDIvol, were kept the same for different pitches. All CT data sets were reconstructed with a slice thickness of 3mm and a medium smooth kernel. Images acquired at the same dose level but different helical pitches were visually inspected to assess photon starvation artifacts and noise levels. Results: At the same radiation dose, image noise increased with the decreasing helical pitch. The increase was more severe on the old-generation 64-slice scanner. Photon starvation artifacts were evident at 200 effective mAs on the 64-slice scanner at 80 kV. On the 192-slice scanner there was no visible photon starvation artifacts at both 200 and 50 effective mAs (CTDIvol = 4.1 mGy and 1.0 mGy, respectively); nor was there a visible impact from the lower helical pitch. Only when the dose was lowered to be extremely low (similar to 0.26 mGy, achievable at 70 kV), did photon starvation artifacts become evident. Conclusions: A low helical pitch may increase image noise and photon starvation artifacts compared to a higher pitch for the same dose level, particularly at ultra-low dose CT. (C) 2019 American Association of Physicists in Medicine