• Jing Chi, Dongfeng Xu, Shengnan Yin, Man Li, Li Shen, Ning Ding, Xiaofang Chen, and Yiding Ji.
• Department of Radiology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu, PR China.
• Medicine (Baltimore). 2020 Aug 21; 99 (34): e21886.

BackgroundAs the gold standard for imaging sinus disease, the main disadvantage of computed tomography (CT) of the pediatric paranasal sinus is radiation exposure. Because of this, 1 protocol for CT should reduce radiation dose while maintaining image quality. The aim of this study is to evaluate the image quality of dose-reduced paranasal sinus computed tomography (CT) using an ultralow tube voltage (70 kVp) combined with iterative reconstruction (IR) in children.MethodsCT scans of the paranasal sinus were performed using different protocols [70 kVp protocols with IR, Group A, n = 80; 80 kVp protocols with a filtered back projection algorithm, Group B, n = 80] in 160 pediatric patients. Then, the volume-weighted CT dose index, dose-length product, and effective dose were estimated. Image noise, the signal-to-noise ratio and the diagnostic image quality were also evaluated.ResultsFor the radiation dose, the volume-weighted CT dose index, dose-length product and effective dose values were significantly lower for the 70 kVp protocols than for the 80 kVp protocols (P < .001). Compared with the 80 kVp protocols, the 70 kVp protocols had significantly higher levels of image noise (P = .001) and a lower signal-to-noise ratio (P = .002). No significant difference in the overall subjective image quality grades was observed between these 2 groups (P = .098).ConclusionThe ultralow tube voltage (70 kVp) technique combined with IR enabled a significant dose reduction in CT examinations performed in the pediatric paranasal sinus while maintaining diagnostic image quality with clinically acceptable image noise.

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