Association of Tube Current-Time Product with Quantitative CT Image Quality in Bone Scan SPECT/CT

Authors

  • Fransischa Ramona Department of Physics, Faculty of Mathematics and Natural Sciences, Universitas Andalas, Padang, 25163, Indonesia
  • Afdhal Muttaqin Department of Physics, Faculty of Mathematics and Natural Sciences, Universitas Andalas, Padang, 25163, Indonesia
  • Yola Despriani Nuclear Medicine Sub-Division, Department of Radiology, Radiotherapy, and Nuclear Medicine, Dr. M. Djamil Hospital, Padang, 25217, Indonesia

Keywords:

automatic exposure control, bone scan, computed tomography, signal-to-noise ratio, tube current-time product

Abstract

In bone scan single-photon emission computed tomography/computed tomography (SPECT/CT), the CT provides the anatomical reference for localizing scintigraphic findings. Because automatic exposure control (AEC) modulates the tube current–time product (mAs) according to patient attenuation, CT image quality may differ between examinations. This study quantified CT image quality and examined its association with AEC-selected mAs. CT datasets from 72 patients at the Nuclear Medicine Unit of Dr. M. Djamil Hospital, Padang, were analyzed retrospectively. Mean CT number and image noise were measured in a hepatic region of interest to derive signal-to-noise ratio (SNR), and data were evaluated using correlation and simple linear regression. Mean mAs, liver CT attenuation, image noise, and SNR were 58.35 ± 16.24, 56.66 ± 8.55 HU, 2.14 ± 0.49 HU, and 27.57 ± 6.59, respectively. Body mass index (BMI) correlated positively with mAs (r = 0.642, p < 0.001). Moderate negative correlations were found between mAs and SNR (r = −0.468, p < 0.001) and between mAs and liver CT attenuation (ρ = −0.444, p < 0.001), whereas mAs and image noise were not significantly associated (ρ = 0.209, p = 0.078). Under AEC, mAs alone cannot adequately explain variability in quantitative CT image quality.

Downloads

Download data is not yet available.

References

Alezzi, M., Kotbi, O., Hammid, G., Fouda, A., & Zabarmawi, Y. (2026). Optimization of CT parameters to reduce radiation dose in SPECT/CT bone scans while preserving diagnostic quality. Applied Radiation and Isotopes, 231, 1–7. https://doi.org/10.1016/j.apradiso.2026.112524

Alrehily, F., & Alshamrani, A. F. (2023). Estimation of radiation dose associated with bone SPECT/CT and establishing local diagnostic reference levels using size-specific dose estimate. Journal of Radiation Research and Applied Sciences, 16. https://doi.org/10.1016/j.jrras.2023.100527

Anthon, R., Intifadhah, S. H., & Putri, E. R. (2025). Radiation dose and image quality of bladder cancer patients analysis on abdominal CT-Scan examinations. Atom Indonesia, 51(1), 27–33. https://doi.org/10.55981/aij.2025.1526

Arjah, H., Osman, N. D., Almasri, H., Anam, C., & Aziz, M. E. (2026). Image quality assessment of Hybrid Statistical Iterative Reconstruction (H/SIR) in comparison to Filtered Back Projection (FBP). Atom Indonesia, 52(1), 23–28. https://doi.org/10.55981/aij.2026.1528

Bartel, T. B., Kuruva, M., Gnanasegaran, G., Beheshti, M., Cohen, E. J., Weissman, A. F., & Yarbrough, T. L. (2018). SNMMI procedure standard for bone scintigraphy 4.0. Journal of Nuclear Medicine Technology, 46(4), 398–404.

Ben-Rejeb, N., & Ben-Sellem, D. (2022). Estimation of additional dosimetry from low-dose CT scan to 99mTc-HMDP SPECT/CT. Journal of Medical Imaging and Radiation Sciences, 53(1), 87–92. https://doi.org/10.1016/j.jmir.2021.10.008

Bouchareb, Y., Alsaadi, A., Zabah, J., Jain, A., Al-jabri, A., Phiri, P., Shi, J. Q., Delanerolle, G., & Sirasanagandla, S. R. (2024). Technological advances in SPECT and SPECT/CT imaging. Diagnostics, 14. https://doi.org/10.3390/diagnostics14131431

Dance, D. R., Christofides, S., Mclean, I. D., & Ng, K. H. (2014). Diagnostic radiology physics: a handbook for teachers and student. IAEA.

Danielsson, M., Persson, M., & Sjölin, M. (2021). Photon-counting x-ray detectors for CT. Physics in Medicine & Biology, 66, 1–35. https://doi.org/10.1088/1361-6560/abc5a5

Gupta, S. K., Trethewey, S., Brooker, B., Rutherford, N., Diffey, J., & Attia, J. (2017). Radionuclide bone scan SPECT-CT : lowering the dose of CT significantly reduces radiation dose without impacting CT image quality. American Journal of Nuclear Medicine and Molecular Imaging, 7(2), 63–73. PMID: 28533938; PMCID: PMC5435612.

Hoeijmakers, E. J. I., Martens, B., Wildberger, J. E., Flohr, T. G., & Jeukens, C. R. L. P. N. (2025). Objective assessment of diagnostic image quality in CT scans : what radiologists and researchers need to know. Insights into Imaging, 16(154). https://doi.org/10.1186/s13244-025-02037-y

Inoue, Y., Ohkubo, Y., Nagahara, K., Uehara, A., Takano, M., & Dlp, E. D. C. (2022). Conversion from dose length product to effective dose for the CT component of whole ‑ body PET/CT. Annals of Nuclear Medicine, 36(4), 411–419. https://doi.org/10.1007/s12149-022-01720-0

Inoue, Y., Nagahara, K., Kudo, H., & Itoh, H. (2018). Effects of the scan range on radiation dose in the computed tomography component of oncology positron emission tomography/computed tomography. Radiation Protection Dosimetry, 185(1), 1–6. https://doi.org/10.1093/rpd/ncy210

Jaruvongvanich, V., Muangsomboon, K., & Teerasamit, W. (2024). Optimizing computed tomography image reconstruction for focal hepatic lesions : Deep learning image reconstruction vs iterative reconstruction. Heliyon, 10(15), e34847. https://doi.org/10.1016/j.heliyon.2024.e34847

Lee, N., & Joo, M. W. (2025). Current position of nuclear medicine imaging in primary bone tumors. Diagnostics, 15(2786), 1–23. https://doi.org/10.3390/diagnostics15212786

Lin, C., Shen, X., Gu, Y., Qiao, Z., & Peng, W. (2024). A cross-sectional study on the correlation of image quality, effective dose, and body composition with thyroid, chest, and abdominal computed tomography scans. Quantitative Imaging in Medicine and Surgery, 14(6), 4031–4040. https://doi.org/10.21037/qims-23-1731

Martin, C. J., & Sookpeng, S. (2016). Setting up computed tomography automatic tube current modulation systems. Journal of Radiological Protection, 36. https://doi.org/10.1088/0952-4746/36/3/R74

McMillan, K., Bostani, M., Cagnon, C. H., Yu, L., Leng, S., McCollough, C. H., & McNitt-Gray, M. F. (2017). Estimating patient dose from CT exams that use automatic exposure control: Development and validation of methods to accurately estimate tube current values. Med. Phys, 44(8), 4262–4275. https://doi.org/10.1002/mp.12314

Sadia, R. T., Chen, J., & Zhang, J. (2024). CT image denoising methods for image quality improvement and radiation dose reduction. Journal of Applied Clinical Medical Physics, 25, 1–17. https://doi.org/10.1002/acm2.14270

Sookpeng, S., & Butdee, C. (2017). Signal-to-noise ratio and dose to the lens of the eye for computed tomography examination of the brain using an automatic tube current modulation system. Emerg Radiol, 24, 233–239. https://doi.org/10.1007/s10140-016-1470-6

Sookpeng, S., Martin, C. J., Gentle, D. J., & Lopez-Gonzalez, M. R. (2014). Relationships between patient size , dose and image noise under automatic tube current modulation systems. Journal of Radiological Protection, 34, 103–123. https://doi.org/10.1088/0952-4746/34/1/103

Sulayman, M. K., U, F. K., Bashiru, L., Khalis, M., Abdul, K., M, N. A., Kamal, I., C, C. A., R, J. M., & Mazliana, A. K. (2025). Radiation dose of abdominal and lung computed tomography based on body mass index as an indicator. Malays J Med Sci, 32(4), 156–169. https://doi.org/10.21315/mjms-04-2025-280

Tsalafoutas, I. A. (2024). The impact of automatic tube current modulation related settings of a modern GE CT scanner on image quality and patient dose; details do matter. Journal of Applied Clinical Medical Physical, 25, 1–19. https://doi.org/10.1002/acm2.14356

Tulik, M., Tulik, P., & Kowalska, T. (2020). On the optimization of bone SPECT / CT in terms of image quality and radiation dose. Journal of Applied Clinical Medical Physics, 21(11), 237–246. https://doi.org/10.1002/acm2.13069

Vañó, E., Miller, D. L., Martin, C. J., Rehani, M. M., Kang, K., Rosenstein, M., Ortiz-Lopez, P., Mattsson, S., Padovani, R., & Rogers, A. (2017). Diagnostic Reference Levels in Medical Imaging (Vol. 46, Issue 1). ICRP Publication 135.

Vaz, S. C., Oliveira, F., & Herrmann, K. (2020). Nuclear medicine and molecular imaging advances in the 21st century. British Journal of Radiology, 93(1110). https://doi.org/10.1259/ bjr. 20200095

Verfaillie, G., Franck, C., De Crop, A., Beels, L., D’Asseler, Y., & Bacher, K. (2023). A systematic review and meta-analysis on the radiation dose of computed tomography in hybrid nuclear medicine imaging. EJNMMI Physics, 10(1). https://doi.org/10.1186/s40658-023-00553-8

Wyngaert, T. Van Den, Strobel, K., Kampen, W. U., & Kuwert, T. (2016). The EANM practice guidelines for bone scintigraphy. European Journal of Nuclear Medicine and Molecular Imaging, 1723–1738. https://doi.org/10.1007/s00259-016-3415-4

Yoon, H., Kim, J., Lim, H. J., & Lee, M. J. (2021). Image quality assessment of pediatric chest and abdomen CT by deep learning reconstruction. BMC Medical Imaging, 21(146), 1–11. https://doi.org/10.1186/s12880-021-00677-2

Ziessman, H. A., O’Malley, J. P., & Thrall, J. H. (2014). The requisites nuclear medicine (4th ed.). Elsevier.

Downloads

Published

2026-11-07

How to Cite

Ramona, F., Muttaqin, A., & Despriani, Y. (2026). Association of Tube Current-Time Product with Quantitative CT Image Quality in Bone Scan SPECT/CT. JURNAL ILMU FISIKA | UNIVERSITAS ANDALAS, 19(1), 29–39. Retrieved from https://jif.fmipa.unand.ac.id/index.php/jif/article/view/893

Issue

Vol. 19 No. 1 (2027): March 2027 (Forthcoming Issue)

Section

Research Article

Citation Check

License

Copyright (c) 2026 Fransischa Ramona, Afdhal Muttaqin, Yola Despriani

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Please find the rights and licenses in JIF (Jurnal Ilmu Fisika).

1. License

The non-commercial use of the article will be governed by the Creative Commons Attribution license as currently displayed on Creative Commons Attribution-NonCommercial 4.0 International License.

2. Author's Warranties

The author warrants that the article is original, written by stated author(s), has not been published before, contains no unlawful statements, does not infringe the rights of others, is subject to copyright that is vested exclusively in the author and free of any third party rights, and that any necessary written permissions to quote from other sources have been obtained by the author(s).

3. User Rights

JIF's spirit is to disseminate articles published are as free as possible. Under the Creative Commons license, JIF permits users to copy, distribute, display, and perform the work for non-commercial purposes only. Users will also need to attribute authors and JIF on distributing works in the journal.

4. Rights of Authors

Authors retain the following rights:

  • Copyright, and other proprietary rights relating to the article, such as patent rights,
  • The right to use the substance of the article in future own works, including lectures and books,
  • The right to reproduce the article for own purposes, provided the copies are not offered for sale,
  • The right to self-archive the article.

5. Co-Authorship

If the article was jointly prepared by other authors, the signatory of this form warrants that he/she has been authorized by all co-authors to sign this agreement on their behalf, and agrees to inform his/her co-authors of the terms of this agreement.

6. Termination

This agreement can be terminated by the author or JIF upon two months's notice where the other party has materially breached this agreement and failed to remedy such breach within a month of being given the terminating party's notice requesting such breach to be remedied. No breach or violation of this agreement will cause this agreement or any license granted in it to terminate automatically or affect the definition of JIF.

7. Royalties

This agreement entitles the author to no royalties or other fees. To such extent as legally permissible, the author waives his or her right to collect royalties relative to the article in respect of any use of the article by JIF or its sublicensee.

8. Miscellaneous

JIF will publish the article (or have it published) in the journal if the article's editorial process is successfully completed and JIF or its sublicensee has become obligated to have the article published. JIF may conform the article to a style of punctuation, spelling, capitalization, referencing and usage that it deems appropriate. The author acknowledges that the article may be published so that it will be publicly accessible and such access will be free of charge for the readers.