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PURPOSE
To evaluate image quality and radiation dose in third-generation dual-source computed tomography (DSCT) of the neck using automated tube voltage adaptation (TVA) with advanced modelled iterative reconstruction (ADMIRE) algorithm.

METHODS
One hundred and sixteen patients were retrospectively evaluated. Group A (n = 59) was examined on second-generation DSCT with automated TVA and filtered back projection. Group B (n = 57) was examined on a third-generation DSCT with automated TVA and ADMIRE. Age, body diameter, attenuation of several anatomic structures, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), radiation dose (CTDIvol) and size-specific dose estimates (SSDE) were assessed. Diagnostic acceptability was rated by three readers.

RESULTS
Age (p = 0.87) and body diameter (p = 0.075) did not differ significantly. Tube voltage in Group A was set automatically to 100 kV for all patients (n = 59), and to 70 kV (n = 2), 80 kV (n = 5), and 90 kV (n = 50) in Group B. Noise was reduced and CNR was increased significantly (p < 0.001). Diagnostic acceptability was rated high in both groups, with better ratings in Group B (p < 0.001). SSDE was reduced by 34 % in Group B (20.38 ± 1.63 mGy vs. 13.04 ± 1.50 mGy, p < 0.001).

CONCLUSION
Combination of automated TVA and ADMIRE in neck CT using third-generation DSCT results in a substantial radiation dose reduction with low noise and increased CNR.

KEY POINTS
• Third-generation DSCT provides automated tube voltage adaptation with an increment of 10 kV. • 10 kV increment optimizes scans to the patient's neck anatomy. • TVA combined with ADMIRE significantly lower radiation dose in contrast-enhanced neck CT. • TVA in combination with ADMIRE reduces noise and increases SNR and CNR. • Image analysis quoted less noise and better diagnostic acceptability in third-generation DSCT.