Image quality assessment of the CARE kV for pediatric CT angiography: A feasibility study of over 50% effective dose reduction

To evaluate whether the application of CARE kV automatic tube voltage modulation technology can reduce the radiation dose required for CT angiography (CTA) in children rapidly, conveniently, and effectively while maintaining image quality. 57 pediatric abdominal CTA were enrolled in the study and control groups. The tube voltage was automatically modulated using CARE kV. Dose-saving optimization indices used for the study and control groups were 12 (preference for a lower tube voltage) and 3 (preference for a higher tube voltage), respectively. Tube voltage and effective dose (ED) were recorded for the two groups, and a multiple linear regression analysis was used to scrutinize factors influencing voltage selection and radiation dose. Two reviewers subjectively evaluated the image quality using a 5-point Likert scale (3 points: qualified; 5 points: best), and the contrast-to-noise ratio (CNR) was calculated. The most commonly selected tube voltage was 70 kV (36/57, 63.16%) and 100 kV (30/57, 52.63%) in the study and control groups, respectively ( p < 0.001). The ED of the study group was 1.58 ± 1.05 mSv, which was 57.07% lower than that in the control group ( p < 0.001). Both voltage selection and ED exhibited a negative correlation with the DI value. The small artery display ability of the two groups was 4.05 ± 0.64 and 4.11 ± 0.65 ( p = 0.31). No statistically significant difference was found for the aortic CNR between the two groups ( p = 0.15). CARE kV is a rapid, convenient, and effective way to reduce the radiation dose in CTA by >50% in children. • CARE kV is a rapid, convenient, and effective way to reduce radiation dose while maintaining image quality. • The use of CARE kV conduct voltage selection and ED exhibited a negative correlation with the DI value. • The use of CARE kV conduct voltage selection and ED exhibited a negative correlation with the DI value.CARE kV enables a lower scanning voltage, resulting in a 50% reduction in the effective dose for CTA in children.