Evolution in Computed Tomography The Battle for Speed and Dose

Michael M. Lell*, Joachim E. Wildberger, Hatem Alkadhi, John Damilakis, Marc Kachelriess

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The advent of computed tomography (CT) has revolutionized radiology. Starting as head-only scanners, modern CT systems are now capable of performing whole-body examinations within a couple of seconds in isotropic resolution. Technical advancements of scanner hardware and image reconstruction techniques are reviewed and discussed in their clinical context. These improvements have led to a steady increase of CT examinations in all age groups for a number of reasons. On the one hand, it is very easy today to obtain whole-body data for oncologic staging and follow-up or for trauma imaging. On the other hand, new examinations such as cardiac imaging, virtual colonoscopy, gout imaging, and whole-organ perfusion imaging have widened the application profile of CT. The increasing awareness of risks associated with radiation exposure triggered the development of a variety of dose reduction techniques. Effective dose values below 1 mSv, less than the annual natural background radiation (3.1 mSv/year on average in the United States), are now routinely possible for a number of dedicated examinations, even for coronary CT angiography.
Original languageEnglish
Pages (from-to)629-644
JournalInvestigative Radiology
Issue number9
Publication statusPublished - Sept 2015


  • computed tomography
  • dose reduction
  • iterative reconstruction
  • dual-energy CT
  • metal artifact reduction
  • perfusion CT
  • dynamic contrast-enhanced CT
  • detector technology
  • CT angiography
  • low kV

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