The effects of gantry tilt on breast dose and image noise in cardiac CT.
PURPOSE
This study investigated the effects of tilted-gantry acquisition on image noise and glandular breast dose in females during cardiac computed tomography (CT) scans. Reducing the dose to glandular breast tissue is important due to its high radiosensitivity and limited diagnostic significance in cardiac CT scans.


METHODS
Tilted-gantry acquisition was investigated through computer simulations and experimental measurements. Upon IRB approval, eight voxelized phantoms were constructed from previously acquired cardiac CT datasets. Monte Carlo simulations quantified the dose deposited in glandular breast tissue over a range of tilt angles. The effects of tilted-gantry acquisition on breast dose were measured on a clinical CT scanner (CT750HD, GE Healthcare) using an anthropomorphic phantom with MOSFET dosimeters in the breast regions. In both simulations and experiments, scans were performed at gantry tilt angles of 0°-30°, in 5° increments. The percent change in breast dose was calculated relative to the nontilted scan for all tilt angles. The percent change in noise standard deviation due to gantry tilt was calculated in all reconstructed simulated and experimental images.


RESULTS
Tilting the gantry reduced the breast dose in all simulated and experimental phantoms, with generally greater dose reduction at increased gantry tilts. For example, at 30° gantry tilt, the dosimeters located in the superior, middle, and inferior breast regions measured dose reductions of 74%, 61%, and 9%, respectively. The simulations estimated 0%-30% total breast dose reduction across the eight phantoms and range of tilt angles. However, tilted-gantry acquisition also increased the noise standard deviation in the simulated phantoms by 2%-50% due to increased pathlength through the iodine-filled heart. The experimental phantom, which did not contain iodine in the blood, demonstrated decreased breast dose and decreased noise at all gantry tilt angles.


CONCLUSIONS
Tilting the gantry reduced the dose to the breast, while also increasing noise standard deviation. Overall, the noise increase outweighed the dose reduction for the eight voxelized phantoms, suggesting that tilted gantry acquisition may not be beneficial for reducing breast dose while maintaining image quality.