Influence of Different Arm Positions in the Localizer Radiograph(s) on Patient Dose during Exposure-Controlled CT Examinations of the Neck to Pelvis

Our aim was to examine the impact of different arm positions during imaging of the localizer radiograph(s) on effective dose for exposure-controlled computed tomography (CT) (Siemens/Canon) scans of the neck to pelvis. An anthropomorphic whole-body phantom was scanned from the neck to pelvis with the arms positioned in three different ways during the acquisition of the localizer radiograph: (i) above the head, (ii) alongside the trunk, and (iii) along the trunk with the hands placed on the abdomen. In accordance with clinical routines, the arms were not included in the subsequent helical scans. Effective doses were computed to a standard-sized patient (male/female) using a dedicated system-specific Monte Carlo-based software. Effective doses for the Canon CT scanner for the different alternatives (male/female) were (a) 5.3/6.62 mSv, (b) 5.62/7.15 mSv and (c) 5.92/7.44 mSv. For the Siemens CT scanner, effective doses were (a) 4.47/5.59 mSv, (b) 5.4/6.69 mSv and (c) 5.7/6.99 mSv. Arms placed above the head during localizer radiograph imaging in the current CT procedures substantially reduced the total effective dose to the patient.