[Intl_DxMedPhys] Higher doses (CTDIvol) for Prospective Cardiac scans on Siemens Force CT

[Yue Zhang]

Hi List,

We are experiencing higher doses (CTDIvol) for Prospective Cardiac scans on
Siemens Force CT. I am trying to figure out the reason.

This was a prospective cardiac acquisition (DS_Cor Seq) that exceeded the
60 mGy limit, reaching 121.49 mGy. Our prospective cardiac scan is done in
the sequential mode. CarekV is on. The DICOM tag for pitch, (0018, 9311) is
0.  Patient Weight = 227 lb. The patient was not very big, from our point
of view.

Unfortunately no ECG on PACS, I can't see the exact heart beat pattern. But
from PACS, Cardiac Series showed 63, 59, 57, 60 bpm, and 1935 mA
constantly. From the scout, the heart position is a little higher on the
table. What do you think?

Why did the scanner choose to use such high mA? The only things I can think
of that might trick the AEC in a wrong way, are the wires on the patient,
or the jewelry or metals on the side of cheek (red arrows in the 3rd pic).
But, can those little things trigger the AEC to choose such high mA during
the acquisition?

[image: Radimetrics Screenshot.jpg]

[image: PACS Patient Protocol Screenshot.jpg]

[image: Scout AP.JPG]

[image: Scout Lateral.JPG]

[image: Cardiac image screenshot.JPG]

[image: 20250319_134417 v2.jpg]
In the above picture, the cardiac CARE Dose curve was changed in June 2023
from the default average to the current ones. Because the radiologists
complained about image quality. We don't know how Siemens defines Adult
slim or obese.

My question is, what could be the reason to cause such a high dose in
prospective cardiac scans? Thank you very much.

-- 
*Yue*
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