Added copper filtration in digital paediatric double-contrast colon examinations: effects on radiation dose and image quality

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Abstract
Paediatric double-contrast barium enema examinations are usually performed at high tube voltage, 102–105 kV. The aim of this study was to investigate how much the effective dose to the child could be reduced by increasing the X-ray energy further by adding copper filter in the beam, and if this dose reduction could be achieved without endangering image quality. Organ doses to an anthropomorphic phantom simulating a 1-year-old child was measured using thermoluminescence dosimetry for assessment of the effective dose and this value was compared with the energy imparted which was obtained from kerma-area product measurements. To verify that the image quality achieved with this added filtration was still diagnostically acceptable, the study included 15 patient examinations. Since the increased X-ray energy will most probably affect low-contrast objects, image quality was also evaluated with two different phantoms containing low-contrast objects. Effective dose for a complete examination can be decreased 44 % and energy imparted 77 % when a 0.3-mm copper filter is inserted in the beam at tube voltage 102 kV. The patient study did not show any significant deterioration of image quality, whereas phantom measurements of contrast-detail resolution and signal-to-noise ratio was marginally impaired by the added copper filtration. This technique is now in clinical practice for paediatric colon examinations.

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