Cardiopulmonary resuscitation training to improve out-of-hospital cardiac arrest survival: addressing potential health inequalities

Many studies have addressed the modulation of computed tomography (CT) parameters, and particularly of tube current, to obtain a good compromise between the X-ray dose to the patient and the image quality for diagnostic applications. This study aimed at evaluating the influence of dose reduction by means of tube current reduction on the CT-based subject-specific finite element (FE) modeling. To this aim, CT scans at stepwise reduced values of tube current from 180mAs to 80mAs were performed on: (i) a densitometric phantom, to quantify the changes in the calibration equation; (ii) a fresh-frozen, water submersed, human cadaver femur, to quantify changes in geometry reconstruction and material mapping from CT, as well as strain prediction accuracy, based on the in vitro strain measurements available; (iii) a fresh-frozen human cadaver thigh with soft tissues attached, to quantify FE results changes in conditions similar to those found in vivo. The results showed that the tube current reduction does not affect the 3D modeling and the femur FE analysis. Our pilot study highlights the possibility of performing CT scans with reduced dose to generate biomechanical models, although a confirmation by performing larger studies with clinical CT data is needed.