{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:45:10Z","timestamp":1788788710302,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["KA 1678\/24"],"award-info":[{"award-number":["KA 1678\/24"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["LE 2763\/3"],"award-info":[{"award-number":["LE 2763\/3"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["MA 4898\/15"],"award-info":[{"award-number":["MA 4898\/15"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Modern CT scanners use automatic exposure control (AEC) techniques, such as tube current modulation (TCM), to reduce dose delivered to patients while maintaining image quality. In contrast to conventional approaches that minimize the tube current time product of the CT scan, referred to as mAsTCM in the following, we herein propose a new method referred to as riskTCM, which aims at reducing the radiation risk to the patient by taking into account the specific radiation risk of every dose\u2010sensitive\u00a0organ.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For current mAsTCM implementations, the mAs product is used as a surrogate for the patient dose. Thus, they do not take into account the varying dose sensitivity of different organs. Our riskTCM framework assumes that a coarse CT reconstruction, an organ segmentation, and an estimation of the dose distribution can be provided in real time, for example, by applying machine learning techniques. Using this information, riskTCM determines a tube current curve that minimizes a patient risk measure, for example, the effective dose, while keeping the image quality constant. We retrospectively applied riskTCM to 20 patients covering all relevant anatomical regions and tube voltages from 70 to 150 kV. The potential reduction of effective dose at same image noise is evaluated as a figure\u00a0of merit and compared to mAsTCM and to a situation with a constant tube current referred to as\u00a0noTCM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Anatomical regions like the neck, thorax, abdomen, and the pelvis benefit from the proposed riskTCM. On average, a reduction of effective dose of about 23% for the thorax, 31% for the abdomen, 24% for the pelvis, and 27% for the neck has been evaluated compared to today's state\u2010of\u2010the\u2010art mAsTCM. For the head, the resulting reduction of effective dose is lower, about 13% on average compared to\u00a0mAsTCM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>With a risk\u2010minimizing TCM, significant higher reduction of effective dose compared to mAs\u2010minimizing TCM is\u00a0possible.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.15673","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T16:13:40Z","timestamp":1649952820000},"page":"4391-4403","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Patient\u2010specific radiation risk\u2010based tube current modulation for diagnostic CT"],"prefix":"10.1002","volume":"49","author":[{"given":"Laura","family":"Klein","sequence":"first","affiliation":[{"name":"Division of X\u2010Ray Imaging and CT German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"Department of Physics and Astronomy Ruprecht\u2010Karls\u2010University Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"Pattern Recognition Lab Friedrich\u2010Alexander University Erlangen\u2010N\u00fcrnberg Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Steidel","sequence":"additional","affiliation":[{"name":"Division of X\u2010Ray Imaging and CT German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"Department of Physics and Astronomy Ruprecht\u2010Karls\u2010University Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Enzmann","sequence":"additional","affiliation":[{"name":"Division of X\u2010Ray Imaging and CT German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"Department of Physics and Astronomy Ruprecht\u2010Karls\u2010University Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Knaup","sequence":"additional","affiliation":[{"name":"Division of X\u2010Ray Imaging and CT German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Sawall","sequence":"additional","affiliation":[{"name":"Division of X\u2010Ray Imaging and CT German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"Medical Faculty Ruprecht\u2010Karls\u2010University Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Maier","sequence":"additional","affiliation":[{"name":"Pattern Recognition Lab Friedrich\u2010Alexander University Erlangen\u2010N\u00fcrnberg Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lell","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine Klinikum N\u00fcrnberg Paracelsus Medical University N\u00fcrnberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joscha","family":"Maier","sequence":"additional","affiliation":[{"name":"Division of X\u2010Ray Imaging and CT German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Kachelrie\u00df","sequence":"additional","affiliation":[{"name":"Division of X\u2010Ray Imaging and CT German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"Medical Faculty Ruprecht\u2010Karls\u2010University Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s003300050674"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.598779"},{"key":"e_1_2_10_4_1","unstructured":"Centre for Evidence\u2010based Purchasing (CEP).64 Slice CT Scanner Technical Specifications Comparative Specifications. 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