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Diagnostics
Volume 16
Issue 2
10.3390/diagnostics16020256
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Balancing Radiation Dose and Image Quality: Protocol Optimization for Mobile Head CT in Neurointensive Care Unit Patients

by
Damian Mialkowskyj
1,
Robert Stahl
1,
Suzette Heck
2,
Konstantinos Dimitriadis
2,
Thomas David Fischer
1,
Thomas Liebig
1,
Christoph G. Trumm
3,
Tim Wesemann
1 and
Robert Forbrig
1,*
1
Institute for Diagnostic and Interventional Neuroradiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
2
Department of Neurology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
3
Radiologie Augsburg Friedberg ÜBAG, Hermanstraße 15, 86150 Augsburg, Germany
*
Author to whom correspondence should be addressed.
Diagnostics 2026, 16(2), 256; https://doi.org/10.3390/diagnostics16020256
Submission received: 19 December 2025 / Revised: 7 January 2026 / Accepted: 12 January 2026 / Published: 13 January 2026
(This article belongs to the Special Issue Optimization of Clinical Imaging: From Diagnosis to Prognosis, 2nd Edition)
Versions Notes

Abstract

Objective: Mobile head CT enables bedside neuroimaging in critically ill patients, reducing risks associated with intrahospital transport. Despite increasing clinical use, evidence on dose optimization for mobile CT systems remains limited. This study evaluated whether an optimized CT protocol can reduce radiation exposure without compromising diagnostic image quality in neurointensive care unit patients. Methods: In this retrospective single-center study, twenty-two non-contrast head CT examinations were acquired with a second-generation mobile CT scanner between March and May 2023. Patients underwent either a default (group A, n = 14; volumetric computed tomography dose index (CTDIvol) 44.1 mGy) or low-dose CT protocol (group B, n = 8; CTDIvol 32.1 mGy). Regarding dosimetry analysis, we recorded dose length product (DLP) and effective dose (ED). Quantitative image quality was assessed by manually placing ROIs at the basal ganglia and cerebellar levels to determine signal, noise, signal-to-noise ratio, and contrast-to-noise ratio. Two neuroradiologists independently rated qualitative image quality using a four-point Likert scale. Statistical comparisons were performed using a significance threshold of 0.05. Results: Median DLP and ED were significantly lower for group B (592 mGy·cm, 1.12 mSv) than for group A (826 mGy·cm, 1.57 mSv; each p < 0.0001). Quantitative image quality parameters did not differ significantly between groups (p > 0.05). Qualitative image quality was rated excellent (median score 4). Conclusions: The optimized mobile head CT protocol achieved a 28.7% reduction in radiation exposure while maintaining high diagnostic image quality. These findings support the adoption of low-dose strategies in mobile CT imaging in line with established radiation protection standards.
Keywords: brain; image quality; mobile computed tomography; neurocritical care; radiation exposure brain; image quality; mobile computed tomography; neurocritical care; radiation exposure

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MDPI and ACS Style

Mialkowskyj, D.; Stahl, R.; Heck, S.; Dimitriadis, K.; Fischer, T.D.; Liebig, T.; Trumm, C.G.; Wesemann, T.; Forbrig, R. Balancing Radiation Dose and Image Quality: Protocol Optimization for Mobile Head CT in Neurointensive Care Unit Patients. Diagnostics 2026, 16, 256. https://doi.org/10.3390/diagnostics16020256

AMA Style

Mialkowskyj D, Stahl R, Heck S, Dimitriadis K, Fischer TD, Liebig T, Trumm CG, Wesemann T, Forbrig R. Balancing Radiation Dose and Image Quality: Protocol Optimization for Mobile Head CT in Neurointensive Care Unit Patients. Diagnostics. 2026; 16(2):256. https://doi.org/10.3390/diagnostics16020256

Chicago/Turabian Style

Mialkowskyj, Damian, Robert Stahl, Suzette Heck, Konstantinos Dimitriadis, Thomas David Fischer, Thomas Liebig, Christoph G. Trumm, Tim Wesemann, and Robert Forbrig. 2026. "Balancing Radiation Dose and Image Quality: Protocol Optimization for Mobile Head CT in Neurointensive Care Unit Patients" Diagnostics 16, no. 2: 256. https://doi.org/10.3390/diagnostics16020256

APA Style

Mialkowskyj, D., Stahl, R., Heck, S., Dimitriadis, K., Fischer, T. D., Liebig, T., Trumm, C. G., Wesemann, T., & Forbrig, R. (2026). Balancing Radiation Dose and Image Quality: Protocol Optimization for Mobile Head CT in Neurointensive Care Unit Patients. Diagnostics, 16(2), 256. https://doi.org/10.3390/diagnostics16020256

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