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X-ray computed tomography is a powerful medical imaging device. It allows high-resolution 3-D visualization of the human body. However, one drawback is the health risk associated with ionizing radiation. Simply downscaling the radiation intensities over the entire scan results in increased quantum noise. This paper proposes the concept of computer-assisted scan protocol and reconstruction. More specifically, we propose a method to compute patient and task-specific intensity profiles that achieve an optimal tradeoff between radiation dose and image quality. Therefore, reasonable image variance and dose metrics are derived. Conventional third-generation systems as well as inverted geometry concepts are considered. Two dose/noise minimization problems are formulated and solved by an efficient algorithm providing optimized milliampere (mA)-profiles. Thorax phantom simulations demonstrate the promising advantage of this technique: in this particular example, the dose is reduced by 53% for third-generation systems and by 86% for an inverted geometry in comparison to a sinusoidal mA-profile at a constant upper noise limit.