Computed Tomography of the Head: A Systematic Review on Acquisition and Reconstruction Techniques to Reduce Radiation Dose

Michael Dieckmeyer, Nico Sollmann, Karina Kupfer, Maximilian T. Löffler, Karolin J. Paprottka, Jan S. Kirschke, Thomas Baum

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

In 1971, the first computed tomography (CT) scan was performed on a patient’s brain. Clinical CT systems were introduced in 1974 and dedicated to head imaging only. New technological developments, broader availability, and the clinical success of CT led to a steady growth in examination numbers. Most frequent indications for non-contrast CT (NCCT) of the head include the assessment of ischemia and stroke, intracranial hemorrhage and trauma, while CT angiography (CTA) has become the standard for first-line cerebrovascular evaluation; however, resulting improvements in patient management and clinical outcomes come at the cost of radiation exposure, increasing the risk for secondary morbidity. Therefore, radiation dose optimization should always be part of technical advancements in CT imaging but how can the dose be optimized? What dose reduction can be achieved without compromising diagnostic value, and what is the potential of the upcoming technologies artificial intelligence and photon counting CT? In this article, we look for answers to these questions by reviewing dose reduction techniques with respect to the major clinical indications of NCCT and CTA of the head, including a brief perspective on what to expect from current and future developments in CT technology with respect to radiation dose optimization.

Original languageEnglish
Pages (from-to)591-610
Number of pages20
JournalClinical Neuroradiology
Volume33
Issue number3
DOIs
StatePublished - Sep 2023
Externally publishedYes

Keywords

  • CT angiography
  • Dose reduction
  • Head CT
  • Iterative reconstruction
  • Low dose
  • Radiation exposure

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