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Hello List, In reviewing some high(er) dose CT exams at our Children’s Hospital, we noticed a few body exams performed on the Siemens FORCE that used 150 kVp without a tin filter under single-energy FLASH scanning. These were seen for</div>
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<p class="MsoNormal">Hello List,<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">In reviewing some high(er) dose CT exams at our Children’s Hospital, we noticed a few body exams performed on the Siemens FORCE that used 150 kVp without a tin filter under single-energy FLASH scanning. These were seen for larger patients,
typically with suboptimal positioning (arms down, off-center, etc.). CarekV was active with dose modulation set to Standard/Normal and the slider bar at 7. I have personally never seen a study acquired with 150 kVp, so I was surprised by this and our radiologists
raised mild concern about dose. Our group is hesitant to cap kVp to a fixed lower value, seeing as the CarekV algorithm is optimized for the scanner. However, we wanted to see if others have experience in this area.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Have you seen and/or recommended 150 kVp outside of a dual-energy context, especially for pediatric patients (granted these were closer to adult size)? If so, is this mostly a limitation of tube current for the fast-scanning requirements
of FLASH? Does anyone have insights on the tradeoffs between dose and image quality for 150 vs 140/120 kVp?<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Any experience and/or wisdom would be appreciated.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Kindly,<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><b><span style="color:black">Joseph Wishart, MS, DABR</span></b><o:p></o:p></p>
<p class="MsoNormal"><img width="33" height="23" style="width:.3458in;height:.2375in" id="Picture_x0020_11" src="cid:image001.png@01DD50B8.81A79130" alt=""><o:p></o:p></p>
<p class="MsoNormal" style="line-height:10.8pt"><b><span style="font-size:9.0pt;color:black">Medical Physicist</span></b><b><span style="font-size:8.0pt;font-family:"Open Sans SemiBold",sans-serif;color:black"><br>
</span></b><span style="font-size:9.0pt;color:black">Diagnostic Physics Section | Radiology</span><span style="font-size:9.0pt;color:#505050"> |
</span><b><span style="font-size:9.0pt;color:black">UW Medicine</span></b><o:p></o:p></p>
<p class="MsoNormal" style="line-height:10.8pt"><span style="font-size:9.0pt;color:#505050">1959 NE Pacific Street. | Box 357987 | Seattle, WA, 98195-7987</span><span style="font-size:7.5pt;font-family:"Open Sans",sans-serif;color:black"><br>
</span><b><span style="font-size:7.5pt;color:#505050">OFFICE</span></b><span style="font-size:9.0pt;color:#505050">: 206-685-1831
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<a href="mailto:wishartj@uw.edu"><span style="color:#3366CC;text-decoration:none">wishartj@uw.edu</span></a><o:p></o:p></span></p>
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