How far can the radiation dose be lowered in head CT with iterative reconstruction? Analysis of imaging quality and diagnostic accuracy
Tóm tắt
To evaluate the imaging quality of head CT at lowered radiation dose by combining filtered back projection (FBP) and iterative reconstruction (IR) algorithms. Experimental group A (n = 66) underwent CT with 43 % tube current reduction, and group B (n = 58) received an equivalent reduced dose by lowering the tube voltage. An age- and sex-matched control group (n = 72) receiving the conventional radiation dose was retrospectively collected. Imaging for the control group was reconstructed by FBP only, while images for groups A and B were reconstructed by FBP and IR. The signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs), sharpness, number of infarcts and severity of subcortical arteriosclerotic encephalopathy (SAE) were compared to assess imaging quality and diagnostic accuracy. There were no significant differences in SNRs and CNRs between group A and the control group. There were significantly decreased SNRs and increased CNRs in group B. Image sharpness decreased in both groups. Correlations between detected infarcts and severity of SAE across FBP and IR were high (r = 0.73-0.93). Head diameter was the only significant factor inversely correlated with infratentorial imaging quality. Head CT with 43 % reduced tube current reconstructed by IR provides diagnostic imaging quality for outpatient management. • Cranial CT using iterative reconstruction provides diagnostic images with 43 % mAs reduction.
• Blurring of infratentorial images becomes evident using low-radiation head CT.
• Head diameter was inversely correlated with imaging quality in the infratentorium.
• Lowering tube kilovoltage requires a higher radiation dose to maintain image quality.
Tài liệu tham khảo
Brenner DJ (2010) Slowing the increase in the population dose resulting from CT scans. Radiat Res 174:809–815
Brenner D, Elliston C, Hall E, Berdon W (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. Am J Roentgenol 176:289–296
Kalra MK, Maher MM, Toth TL et al (2004) Techniques and applications of automatic tube current modulation for CT. Radiology 233:649–657
Kalra MK, Maher MM, Toth TL et al (2004) Strategies for CT radiation dose optimization. Radiology 230:619–628
Mullins ME, Lev MH, Bove P et al (2004) Comparison of image quality between conventional and low-dose nonenhanced head CT. Am J Neuroradiol 25:533–538
Xu J, Mahesh M, Tsui BMW (2009) Is iterative reconstruction ready for MDCT? J Am Coll Radiol 6:274–276
Rapalino O, Kamalian S, Kamalian S et al (2012) Cranial CT with adaptive statistical iterative reconstruction: improved image quality with concomitant radiation dose reduction. Am J Neuroradiol 33:609–615
Kilic K, Erbas G, Guryildirim M, Arac M, Ilgit E, Coskun B (2011) Lowering the dose in head CT using adaptive statistical iterative reconstruction. Am J Neuroradiol 32:1578–1582
Korn A, Fenchel M, Bender B et al (2012) Iterative reconstruction in head CT: image quality of routine and low-dose protocols in comparison with standard filtered back-projection. Am J Neuroradiol 33:218–224
Noël PB, Fingerle AA, Renger B, Münzel D, Rummeny EJ, Dobritz M (2011) Initial performance characterization of a clinical noise-suppressing reconstruction algorithm for MDCT. Am J Roentgenol 197:1404–1409
Kligerman S, Mehta D, Farnadesh M, Jeudy J, Olsen K, White C (2012) Use of a hybrid iterative reconstruction technique to reduce image noise and improve image quality in obese patients undergoing computed tomographic pulmonary angiography. J Thorac Imag 28:49–59
Funama Y, Taguchi K, Utsunomiya D et al (2011) Combination of a low-tube-voltage technique with hybrid iterative reconstruction (iDose) algorithm at coronary computed tomographic angiography. J Comput Assist Tomo 35:480–485
Schulte-Geers C, Obert M, Schilling RL et al (2011) Age and gender-dependent bone density changes of the human skull disclosed by high-resolution flat-panel computed tomography. Int J Legal Med 125:417–425
Yamada K, Endo S, Yoshioka S, Hatazawa J, Yamaura H, Matsuzawa T (1982) Age-related changes of the cranial bone mineral: a quantitative study with computed tomography. J Am Geriatr Soc 30:756–763
McNitt-Gray MF (2002) AAPM/RSNA physics tutorial for residents: topics in CT. Radiation dose in CT. Radiographics 22:1541–1553
European Study Group of Radiologists and Physicists (2008) European guidelines on quality criteria for computed tomography. Avaiable via http://www.drs.dk/guidelines/ct/quality/mainindex.htm Accessed 18 Nov 2012
van Swieten JC, Hijdra A, Koudstaal PJ, van Gijn J (1990) Grading white matter lesions on CT and MRI: a simple scale. J Neurol Neurosur Ps 53:1080–1083
Lotz P, Ballinger W Quisling R (1986) subcortical arteriosclerotic encephalopathy: CT spectrum and pathologic correlation. Am J Roentgenol 147:1209–1214
Gervaise A, Osemont B, Lecocq S et al (2012) CT image quality improvement using adaptive iterative dose reduction with wide-volume acquisition on 320-detector CT. Eur Radio 22:295–301
Lin Y, Luo H, Dobbins JT et al (2012) An image-based technique to assess the perceptual quality of clinical chest radiographs. Med Phys 39:7019–7031
Marin D, Nelson RC, Schindera ST et al (2010) Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm–initial clinical experience. Radiology 254:145–153
Takahashi N, Lee Y, Tsai D-Y et al (2008) Improvement of detection of hypoattenuation in acute ischemic stroke in unenhanced computed tomography using an adaptive smoothing filter. Acta Radiol 49:816–826
Siemund R, Love A, van Westen D, Stenberg L, Petersen C, Bjorkman-Burtscher I (2012) Radiation dose reduction in CT of the brain: can advanced noise filtering compensate for loss of image quality? Acta Radiol 53:468–472
Wong S-T, Yiu G, Poon Y-M, Yuen M-K, Fong D (2012) Reducing radiation exposure from computed tomography of the brain in children—report of a practical approach. Child Nerv Syst 28:681–689
