256-MDCT for evaluation of urolithiasis: Iterative reconstruction allows for a significant reduction of the applied radiation dose while maintaining high subjective and objective image quality

TY - JOUR

T1 - 256-MDCT for evaluation of urolithiasis: Iterative reconstruction allows for a significant reduction of the applied radiation dose while maintaining high subjective and objective image quality

AU - Veldhoen, Simon

AU - Laqmani, Azien

AU - Derlin, Thorsten

AU - Karul, Murat

AU - Hammerle, Diego

AU - Buhk, Jan-Hendrik

AU - Sehner, Susanne

AU - Nagel, Hans D

AU - Chun, Felix

AU - Adam, Gerhard

AU - Regier, Marc

N1 - © 2014 The Royal Australian and New Zealand College of Radiologists.

PY - 2014/6/1

Y1 - 2014/6/1

N2 - PURPOSE: Multidetector CT (MDCT) is the established imaging modality in diagnostics of urolithiasis. The aim of iterative reconstruction (IR) is to allow for a radiation dose reduction while maintaining high image quality. This study evaluates its performance in MDCT for assessment of urolithiasis.MATERIALS AND METHODS: Fifty-two patients underwent non-contrast abdominal MDCT. Twenty-six patients were referred to MDCT under suspicion of urolithiasis, and examined using a dose-reduced scan protocol (RDCT). Twenty-six patients, who had undergone standard-dose MDCT, served as reference for radiation dose comparison. RDCT images were reconstructed using an IR system (iDose4™, Philips Healthcare, Cleveland, OH, USA). Objective image noise (OIN) was recorded and five radiologists rated the subjective image quality independently. Radiation parameters were derived from the scan protocols.RESULTS: The CTDIvol could be reduced by 50% to 5.8 mGy (P < 0.0001). The same reduction was achieved for DLP and effective dose to 253 ± 27 mGy*cm (P < 0.0001) and 3.9 ± 0.4 mSv (P < 0.0001). IR led to a reduction of the OIN of up to 61% compared with classic filtered back projection (FBP) (P < 0.0001). The OIN declined with increasing IR levels. RDCT with FBP showed the lowest scores of subjective image quality (2.32 ± 0.04). Mean scores improved with increasing IR levels. iDose6 was rated with the best mean score (3.66 ± 0.04).CONCLUSION: The evaluated IR-tool and protocol may be applied to achieve a considerable radiation dose reduction in MDCT for diagnostics of urolithiasis while maintaining a confident image quality. Best image quality, suitable for evaluation of the entire abdomen concerning differential diagnoses, was achieved with iDose6.

AB - PURPOSE: Multidetector CT (MDCT) is the established imaging modality in diagnostics of urolithiasis. The aim of iterative reconstruction (IR) is to allow for a radiation dose reduction while maintaining high image quality. This study evaluates its performance in MDCT for assessment of urolithiasis.MATERIALS AND METHODS: Fifty-two patients underwent non-contrast abdominal MDCT. Twenty-six patients were referred to MDCT under suspicion of urolithiasis, and examined using a dose-reduced scan protocol (RDCT). Twenty-six patients, who had undergone standard-dose MDCT, served as reference for radiation dose comparison. RDCT images were reconstructed using an IR system (iDose4™, Philips Healthcare, Cleveland, OH, USA). Objective image noise (OIN) was recorded and five radiologists rated the subjective image quality independently. Radiation parameters were derived from the scan protocols.RESULTS: The CTDIvol could be reduced by 50% to 5.8 mGy (P < 0.0001). The same reduction was achieved for DLP and effective dose to 253 ± 27 mGy*cm (P < 0.0001) and 3.9 ± 0.4 mSv (P < 0.0001). IR led to a reduction of the OIN of up to 61% compared with classic filtered back projection (FBP) (P < 0.0001). The OIN declined with increasing IR levels. RDCT with FBP showed the lowest scores of subjective image quality (2.32 ± 0.04). Mean scores improved with increasing IR levels. iDose6 was rated with the best mean score (3.66 ± 0.04).CONCLUSION: The evaluated IR-tool and protocol may be applied to achieve a considerable radiation dose reduction in MDCT for diagnostics of urolithiasis while maintaining a confident image quality. Best image quality, suitable for evaluation of the entire abdomen concerning differential diagnoses, was achieved with iDose6.

U2 - 10.1111/1754-9485.12159

DO - 10.1111/1754-9485.12159

M3 - SCORING: Journal article

C2 - 24581030

VL - 58

SP - 283

EP - 290

JO - J MED IMAG RADIAT ON

JF - J MED IMAG RADIAT ON

SN - 1754-9477

IS - 3

ER -