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Abstract：
The introduction of the first whole-body CT scanner in 1974 marked the beginning of cross-sectional spine imaging. In the last decades, the technological advancement, increasing availability and clinical success of CT led to a rapidly growing number of CT examinations, also of the spine. After initially being primarily used for trauma evaluation, new indications continued to emerge, such as assessment of vertebral fractures or degenerative spine disease, preoperative and postoperative evaluation, or CT-guided interventions at the spine; however, improvements in patient management and clinical outcomes come along with higher radiation exposure, which increases the risk for secondary malignancies. Therefore, technical developments in CT acquisition and reconstruction must always include efforts to reduce the radiation dose. But how exactly can the dose be reduced? What amount of dose reduction can be achieved without compromising the clinical value of spinal CT examinations and what can be expected from the rising stars in CT technology: artificial intelligence and photon counting CT? In this article, we try to answer these questions by systematically reviewing dose reduction techniques with respect to the major clinical indications of spinal CT. Furthermore, we take a concise look on the dose reduction potential of future developments in CT hardware and software.
摘要：
1974年第一台全身CT扫描仪的推出标志着脊柱横断面成像的开始。在过去的几十年里，技术进步,CT的可用性和临床成功率的提高导致CT检查的数量迅速增加，也是脊柱。在最初主要用于创伤评估之后，新的适应症不断涌现，如椎骨骨折或脊柱退行性疾病的评估，术前和术后评估，或CT引导的脊柱介入治疗；然而，患者管理和临床结果的改善伴随着更高的辐射暴露，这增加了继发性恶性肿瘤的风险。因此,CT采集和重建的技术发展必须始终包括减少辐射剂量的努力。但是究竟如何减少剂量呢？在不损害脊柱CT检查的临床价值的情况下，可以实现多少剂量减少，以及CT技术中的后起之秀可以期待什么：人工智能和光子计数CT？在本文中，我们试图通过系统地回顾脊柱CT的主要临床适应症的剂量减少技术来回答这些问题。此外，我们将简要介绍CT硬件和软件未来发展的剂量减少潜力。
