8.4.

CT NUMBER ACCURACY, IMAGE NOISE, UNIFORMITY AND IMAGE ARTEFACTS

8.4.1. Introduction
Much information can be gained on the quality of the scanners imaging capability from
a simple scan of a water filled test object (or phantom containing a uniform material),
including the measurement of CT number, image noise and uniformity, and a visual
assessment of artefacts.
8.4.2. Scope
Objectives: To ensure: (a) CT number accuracy; (b) Noise levels of CT images being
within the tolerances with respect to their reference values; (c) Uniformity of CT number
and image noise across the FOV (i.e. proper system calibration); (d) Minimal image
artefacts.
References: [4, 7, 67].
Frequency: Monthly.
8.4.3. Equipment, materials and instrumentation
Phantom as described in Section I.1.1. (The phantom used may be the manufacturers
phantom, a commercial phantom, or a simple phantom made using plastic pipe with
end caps (Fig. 21).)
8.4.4. Scan protocol
As specified by the physicist at commissioning. It should be noted that if the scanner
has a software driven QC procedure, the pre-programmed settings should be used.
8.4.5. Methodology
(1) Centre the phantom in the tomographic plane. 14 (2) Select scan relevant protocol.
(3) Scan phantom in axial mode. (4) Repeat for additional scan protocols as specified
above.
8.4.6. Analysis
(1) Measurement of CT number accuracy, image noise and uniformity, and check for
absence of image artefacts are performed on the same phantom images. For MDCT
scanners, all quantitative measurements are performed using a centrally located image
slice. (2) CT number and image noise are measured in a centrally placed circular ROI of
appropriate diameter as specified at commissioning. (3) ROI size is critical. The ROI
diameter should be specified by the physicist at commissioning. If using CT
implemented QC software, the specified ROI diameter must be used. (4) The CT number
is the measured ROI mean value and the noise is the ROI standard deviation. (5)
Uniformity is measured as the absolute difference of CT numbers between a centrally
placed ROI with each of four ROIs placed on the edge. Each of these four values should
be compared with the given tolerance (see Section 9.7 for ROI placement definitions).

(6) All images acquired during the noise test should be visually inspected for image
artefacts. Thus, for MDCT scanners, this means examining all image slices in the
acquisition, not just the central image slice.

8.4.7. Interpretation of results

8.4.8. Recommendations and corrective actionsI

increased image noise can result from several factors, including:
Selection of inappropriately low kV or mAs, or both; Malfunction of scanner
hardware and/or software; Artefacts inside the ROI being used for measurement of

standard deviation. If the measured values are out of tolerance or the images exhibit
artefacts, or both, user calibrations of the scanner should be performed and the
measurements repeated. If the problem persists, corrective actions should be initiated.