Volume CT dose index (CTDIvol) and dose–length product (DLP) values were recorded from the patient’s protocols, which were available in our picture archiving and communication system (PACS). Mean scan acquisition length in centimeters was measured as the ratio of DLP and CTDIvol. As differences in scan acquisition length might have an impact on radiation exposure and to ensure reliable comparisons among the four study groups, an overall mean scan acquisition length of 27 cm for head and neck CT was used, based on all included examinations. This value was calculated by measuring and averaging the scan acquisition length of all included examinations. For both, SECT and DECT acquisition, DLP was multiplied with the International Commission on Radiological Protection conversion factor k for head and neck CT of 0.0058 (mSv / mGy x cm) to calculate effective dose (ED).15
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