Introduction: PET/CT systems play a key role in modern diagnostics by enabling quantification of metabolic activity and structural tissue analysis. Despite technological advancements, reducing radiation dose remains a challenge—especially for patients requiring repeated imaging. This study focuses on optimizing CT parameters to lower radiation dose while maintaining image quality. Purpose: The aim of the study is to assess the impact of different tube voltage (kV) and tube current (mAs) values on SUV, image quality parameters (CNR and CRC), and radiation dose indicators (CTDIvol and DLP). Methods: Measurements were carried out using the NEMA phantom on a Siemens Biograph mCT system at the UMC Ljubljana. Various combinations of tube voltage (70–140 kV) and current (30–130 mAs) were tested at activity ratios of 1:10, 1:5, and 1:3. The monitored parameters included SUV, CNR, CRC, CTDIvol and DLP. Statistical analysis was performed using IBM SPSS Statistics to evaluate the correlation between radiation dose, image quality, and SUV quantification accuracy. Results: Results are presented for all background-to-sphere ratios (1:10, 1:5, 1:3) and all analyzed spheres. Pearson correlation analysis showed a very strong positive correlation between radiopharmaceutical concentration (kBq/ml) and SUV values at all ratios (r = 0.979; 0.945; 0.891; p < 0.001). ANOVA indicated that variations in CT parameters (kV, mAs) had no statistically significant effect on SUV or on CNRmax, CNRmean, or CRCmax. Trend analysis showed no significant changes in mean SUV values with increased dose (CTDIvol and DLP). Discussion and conclusion: The results confirm that CT parameter optimization is feasible without compromising image quality. Adjusting CT settings enabled dose reductions of 52.63% (CTDIvol) and 56.76% (DLP), without affecting SUV values (up to 1.74% deviation) or image quality (CNR, CRC). Comparison with previous studies shows that dose can be reduced while maintaining diagnostic image value. This has important clinical implications, especially for patients undergoing frequent scans. Further research should include a broader patient population to confirm these findings.
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