Single-source chest-abdomen-pelvis cancer staging on a third generation dual-source CT system: comparison of automated tube potential selection to second generation dual-source CT

Cancer Imaging - Tập 16 - Trang 1-7 - 2016
Clara Park1, Tatjana Gruber-Rouh1, Doris Leithner1, Amelie Zierden1, Mortiz H. Albrecht1, Julian L. Wichmann1, Boris Bodelle1, Mohamed Elsabaie1, Jan-Erik Scholtz1, Moritz Kaup1, Thomas J. Vogl1, Martin Beeres1
1Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany

Tóm tắt

Evaluation of latest generation automated attenuation-based tube potential selection (ATPS) impact on image quality and radiation dose in contrast-enhanced chest-abdomen-pelvis computed tomography examinations for gynaecologic cancer staging. This IRB approved single-centre, observer-blinded retrospective study with a waiver for informed consent included a total of 100 patients with contrast-enhanced chest-abdomen-pelvis CT for gynaecologic cancer staging. All patients were examined with activated ATPS for adaption of tube voltage to body habitus. 50 patients were scanned on a third-generation dual-source CT (DSCT), and another 50 patients on a second-generation DSCT. Predefined image quality setting remained stable between both groups at 120 kV and a current of 210 Reference mAs. Subjective image quality assessment was performed by two blinded readers independently. Attenuation and image noise were measured in several anatomic structures. Signal-to-noise ratio (SNR) was calculated. For the evaluation of radiation exposure, CT dose index (CTDIvol) values were compared. Diagnostic image quality was obtained in all patients. The median CTDIvol (6.1 mGy, range 3.9–22 mGy) was 40 % lower when using the algorithm compared with the previous ATCM protocol (median 10.2 mGy · cm, range 5.8–22.8 mGy). A reduction in potential to 90 kV occurred in 19 cases, a reduction to 100 kV in 23 patients and a reduction to 110 kV in 3 patients of our experimental cohort. These patients received significantly lower radiation exposure compared to the former used protocol. Latest generation automated ATPS on third-generation DSCT provides good diagnostic image quality in chest-abdomen-pelvis CT while average radiation dose is reduced by 40 % compared to former ATPS protocol on second-generation DSCT.

Tài liệu tham khảo

Albert JM. Radiation Risk From CT: Implications for Cancer Screening. AJR Am J Roentgenol. 2013;201:W81–87. Shah KH, Slovis BH, Runde D, Godbout B, Newman DH, Lee J. Radiation exposure among patients with the highest CT scan utilization in the emergency department. Emerg Radiol. 2013;20:485–91. Saika K, Machii R. Five-year Relative Survival Rate of Cancer in the USA, Europe and Japan. Jpn J Clin Oncol. 2013;43:1053–4. Cancer statistics. JAMA: the journal of the American Medical Association. 2013;310:982. Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N Engl J Med. 2007;357:2277–84. Bucher AM, Kerl MJ, Albrecht MH, Beeres M, Ackermann H, Wichmann JL, Vogl TJ, Bauer RW, Lehnert T. Systematic Comparison of Reduced Tube Current Protocols for High-pitch and Standard-pitch Pulmonary CT Angiography in a Large Single-center Population. Acad Radiol. 2016;23:619–27. Fleischmann D, Boas FE. Computed tomography--old ideas and new technology. Eur Radiol. 2011;21:510–7. Greess H, Nomayr A, Wolf H, Baum U, Lell M, Bowing B, Kalender W, Bautz WA. Dose reduction in CT examination of children by an attenuation-based on-line modulation of tube current (CARE Dose). Eur Radiol. 2002;12:1571–6. Gies M, Kalender WA, Wolf H, Suess C. Dose reduction in CT by anatomically adapted tube current modulation. I. Simulation studies. Med Phys. 1999;26:2235–47. Kalender WA, Wolf H, Suess C. Dose reduction in CT by anatomically adapted tube current modulation. II. Phantom measurements. Med Phys. 1999;26:2248–53. Kalra MK, Maher MM, Toth TL, Schmidt B, Westerman BL, Morgan HT, Saini S. Techniques and applications of automatic tube current modulation for CT. Radiology. 2004;233:649–57. McCollough CH, Bruesewitz MR, Kofler Jr JM. CT dose reduction and dose management tools: overview of available options. Radiographics. 2006;26:503–12. Scholtz JE, Wichmann JL, Husers K, Albrecht MH, Beeres M, Bauer RW, Vogl TJ, Bodelle B. Third-generation dual-source CT of the neck using automated tube voltage adaptation in combination with advanced modeled iterative reconstruction: evaluation of image quality and radiation dose. Eur Radiol. 2016;26:2623–31. Frellesen C, Stock W, Kerl JM, Lehnert T, Wichmann JL, Nau C, Geiger E, Wutzler S, Beeres M, Schulz B, et al. Topogram-based automated selection of the tube potential and current in thoraco-abdominal trauma CT - a comparison to fixed kV with mAs modulation alone. Eur Radiol. 2014;24:1725–34. Scholtz JE, Husers K, Kaup M, Albrecht MH, Beeres M, Bauer RW, Schulz B, Vogl TJ, Wichmann JL. Evaluation of image quality and dose reduction of 80 kVp neck computed tomography in patients with suspected peritonsillar abscess. Clin Radiol. 2015;70:e67–73. Scholtz JE, Wichmann JL, Husers K, Beeres M, Nour-Eldin NE, Frellesen C, Vogl TJ, Lehnert T. Automated tube voltage adaptation in combination with advanced modeled iterative reconstruction in thoracoabdominal third-generation 192-slice dual-source computed tomography: effects on image quality and radiation dose. Acad Radiol. 2015;22:1081–7. Beeres M, Romer M, Bodelle B, Lee C, Gruber-Rouh T, Mbalisike E, Kerl JM, Wichmann JL, Schulz B, Vogl TJ, Bauer RW. Chest-abdomen-pelvis CT for staging in cancer patients: dose effectiveness and image quality using automated attenuation-based tube potential selection. Cancer Imaging. 2014;14:28. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47. Winklehner A, Goetti R, Baumueller S, Karlo C, Schmidt B, Raupach R, Flohr T, Frauenfelder T, Alkadhi H. Automated attenuation-based tube potential selection for thoracoabdominal computed tomography angiography: improved dose effectiveness. Invest Radiol. 2011;46:767–73. Eller A, May MS, Scharf M, Schmid A, Kuefner M, Uder M, Lell MM. Attenuation-based automatic kilovolt selection in abdominal computed tomography: effects on radiation exposure and image quality. Invest Radiol. 2012;47:559–65. Gnannt R, Winklehner A, Eberli D, Knuth A, Frauenfelder T, Alkadhi H. Automated tube potential selection for standard chest and abdominal CT in follow-up patients with testicular cancer: comparison with fixed tube potential. Eur Radiol. 2012;22:1937–45. Gordic S, Desbiolles L, Stolzmann P, Gantner L, Leschka S, Husarik DB, Alkadhi H. Advanced modelled iterative reconstruction for abdominal CT: qualitative and quantitative evaluation. Clin Radiol. 2014;69:e497–504.