Highly reduced-dose CT of the lumbar spine in a human cadaver model

TY - JOUR

T1 - Highly reduced-dose CT of the lumbar spine in a human cadaver model

AU - Warncke, Malte Lennart

AU - Wiese, Nis Jesper

AU - Tahir, Enver

AU - Sehner, Susanne

AU - Heinemann, Axel

AU - Regier, Marc

AU - Püschel, Klaus

AU - Adam, Gerhard

AU - Weinrich, Julius Matthias

AU - Laqmani, Azien

PY - 2020/10/8

Y1 - 2020/10/8

N2 - PURPOSE: Feasibility of a highly reduced-dose lumbar spine CT protocol using iterative reconstruction (IR) in a human cadaver model.MATERIALS AND METHODS: The lumbar spine of 20 human cadavers was repeatedly examined using three different reduced-dose protocols (RDCT) with decreasing reference tube current-exposure time products (RDCT-1: 50 mAs; RDCT-2: 30 mAs; RDCT-3: 10 mAs) at a constant tube voltage of 140 kV. A clinical standard-dose protocol (SDCT) served as the reference (reference tube current-exposure time product: 70 mAs; tube voltage: 140 kV). Images were reconstructed using filtered back projection (FBP) and two increasing levels of IR: IRL4 and IRL6. A five-point scale was used by two observers to assess the diagnostic quality of anatomical structures (cortical and trabecular bone, intervertebral foramina, pedicles and intervertebral joints, spinous and transverse processes). Objective image noise (OIN) was measured. Results were interpreted using a linear mixed-effects regression model.RESULTS: RDCT-2 with IRL6 (1.2 ± 0.5mSv) was the lowest reduced-dose protocol which provided diagnostically acceptable and equivalent image quality compared to the SDCT (2.3 ± 1.1mSV) with FBP (p > 0.05). All RDCT protocols achieved a significant reduction of the mean (±SD) effective radiation doses (RDCT-1: 1.7±0.9mSv; RDCT-2: 1.2±0.5mSv; RDCT-3: 0.4±0.2mSv; p < 0.05) compared to SDCT. OIN was lower in all RDCT protocols with the application of IRL4 and IRL6, compared to the SDCT with FBP (p < 0.05).CONCLUSION: Highly reduced-dose lumbar spine CT providing diagnostically acceptable image quality is feasible using IR in this cadaver model and may be transferred into a clinical setting.

AB - PURPOSE: Feasibility of a highly reduced-dose lumbar spine CT protocol using iterative reconstruction (IR) in a human cadaver model.MATERIALS AND METHODS: The lumbar spine of 20 human cadavers was repeatedly examined using three different reduced-dose protocols (RDCT) with decreasing reference tube current-exposure time products (RDCT-1: 50 mAs; RDCT-2: 30 mAs; RDCT-3: 10 mAs) at a constant tube voltage of 140 kV. A clinical standard-dose protocol (SDCT) served as the reference (reference tube current-exposure time product: 70 mAs; tube voltage: 140 kV). Images were reconstructed using filtered back projection (FBP) and two increasing levels of IR: IRL4 and IRL6. A five-point scale was used by two observers to assess the diagnostic quality of anatomical structures (cortical and trabecular bone, intervertebral foramina, pedicles and intervertebral joints, spinous and transverse processes). Objective image noise (OIN) was measured. Results were interpreted using a linear mixed-effects regression model.RESULTS: RDCT-2 with IRL6 (1.2 ± 0.5mSv) was the lowest reduced-dose protocol which provided diagnostically acceptable and equivalent image quality compared to the SDCT (2.3 ± 1.1mSV) with FBP (p > 0.05). All RDCT protocols achieved a significant reduction of the mean (±SD) effective radiation doses (RDCT-1: 1.7±0.9mSv; RDCT-2: 1.2±0.5mSv; RDCT-3: 0.4±0.2mSv; p < 0.05) compared to SDCT. OIN was lower in all RDCT protocols with the application of IRL4 and IRL6, compared to the SDCT with FBP (p < 0.05).CONCLUSION: Highly reduced-dose lumbar spine CT providing diagnostically acceptable image quality is feasible using IR in this cadaver model and may be transferred into a clinical setting.

U2 - 10.1371/journal.pone.0240199

DO - 10.1371/journal.pone.0240199

M3 - SCORING: Journal article

C2 - 33031418

VL - 15

SP - e0240199

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 10

ER -