Effect of reduced z-axis scan coverage on diagnostic performance and radiation dose of neck computed tomography in patients with suspected cervical abscess

by Jakob Weiss, Michael Maurer, Dominik Ketelsen, Mike Notohamiprodjo, Dominik Zinsser, Julian L. Wichmann, Konstantin Nikolaou, Fabian Bamberg, Ahmed E. Othman

To evaluate the effect of reduced z-axis scan coverage on diagnostic performance and radiation dose of neck CT in patients with suspected cervical abscess.

Fifty-one patients with suspected cervical abscess were included and underwent contrast-enhanced neck CT on a 2^nd or 3^rd generation dual-source CT system. Image acquisition ranged from the aortic arch to the upper roof of the frontal sinuses (CT_std). Subsequently, series with reduced z-axis coverage (CT_red) were reconstructed starting at the aortic arch up to the orbital floor. CT_std and CT_red were independently assessed by two radiologists for the presence/absence of cervical abscesses and for incidental and alternative findings. In addition, diagnostic accuracy for the depiction of the cervical abscesses was calculated for both readers. Furthermore, DLP (dose-length-product), effective dose (ED) and organ doses were calculated and compared for CT_red and CT_std, using a commercially available dose management platform.

A total of 41 abscesses and 3 incidental/alternative findings were identified in CT_std. All abscesses and incidental/alternative findings could also be detected on CT_red resulting in a sensitivity and specificity of 1.0 for both readers. DLP, ED and organ doses of the brain, the eye lenses, the red bone marrow and the salivary glands of CT_red were significantly lower than for CT_std (p<0.001).

Reducing z-axis coverage of neck CT allows for a significant reduction of effective dose and organ doses at similar diagnostic performance as compared to CT_std.