Dataset Information

The Impact of Iterative Reconstruction on Computed Tomography Radiation Dosimetry: Evaluation in a Routine Clinical Setting.

ABSTRACT:

Purpose

To evaluate the effect of introduction of iterative reconstruction as a mandated software upgrade on radiation dosimetry in routine clinical practice over a range of computed tomography examinations.

Methods

Random samples of scanning data were extracted from a centralised Picture Archiving Communication System pertaining to 10 commonly performed computed tomography examination types undertaken at two hospitals in Western Australia, before and after the introduction of iterative reconstruction. Changes in the mean dose length product and effective dose were evaluated along with estimations of associated changes to annual cancer incidence.

Results

We observed statistically significant reductions in the effective radiation dose for head computed tomography (22-27%) consistent with those reported in the literature. In contrast the reductions observed for non-contrast chest (37-47%); chest pulmonary embolism study (28%), chest/abdominal/pelvic study (16%) and thoracic spine (39%) computed tomography. Statistically significant reductions in radiation dose were not identified in angiographic computed tomography. Dose reductions translated to substantial lowering of the lifetime attributable risk, especially for younger females, and estimated numbers of incident cancers.

Conclusion

Reduction of CT dose is a priority Iterative reconstruction algorithms have the potential to significantly assist with dose reduction across a range of protocols. However, this reduction in dose is achieved via reductions in image noise. Fully realising the potential dose reduction of iterative reconstruction requires the adjustment of image factors and forgoing the noise reduction potential of the iterative algorithm. Our study has demonstrated a reduction in radiation dose for some scanning protocols, but not to the extent experimental studies had previously shown or in all protocols expected, raising questions about the extent to which iterative reconstruction achieves dose reduction in real world clinical practice.

SUBMITTER: Moorin RE

PROVIDER: S-EPMC4575140 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

The Impact of Iterative Reconstruction on Computed Tomography Radiation Dosimetry: Evaluation in a Routine Clinical Setting.

Moorin Rachael E RE Gibson David A J DA Forsyth Rene K RK Fox Richard R

PloS one 20150918 9

<h4>Purpose</h4>To evaluate the effect of introduction of iterative reconstruction as a mandated software upgrade on radiation dosimetry in routine clinical practice over a range of computed tomography examinations.<h4>Methods</h4>Random samples of scanning data were extracted from a centralised Picture Archiving Communication System pertaining to 10 commonly performed computed tomography examination types undertaken at two hospitals in Western Australia, before and after the introduction of ite ...[more]

PMID: 26381145

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Project description:ObjectiveTo evaluate the impact of iterative reconstruction (IR) on the assessment of diffuse interstitial lung disease (DILD) using CT.Materials and methodsAn American College of Radiology (ACR) phantom (module 4 to assess spatial resolution) was scanned with 10-100 effective mAs at 120 kVp. The images were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), with blending ratios of 0%, 30%, 70% and 100%, and model-based iterative reconstruction (MBIR), and their spatial resolution was objectively assessed by the line pair structure method. The patient study was based on retrospective interpretation of prospectively acquired data, and it was approved by the institutional review board. Chest CT scans of 23 patients (mean age 64 years) were performed at 120 kVp using 1) standard dose protocol applying 142-275 mA with dose modulation (high-resolution computed tomography [HRCT]) and 2) low-dose protocol applying 20 mA (low dose CT, LDCT). HRCT images were reconstructed with FBP, and LDCT images were reconstructed using FBP, ASIR, and MBIR. Matching images were randomized and independently reviewed by chest radiologists. Subjective assessment of disease presence and radiological diagnosis was made on a 10-point scale. In addition, semi-quantitative results were compared for the extent of abnormalities estimated to the nearest 5% of parenchymal involvement.ResultsIn the phantom study, ASIR was comparable to FBP in terms of spatial resolution. However, for MBIR, the spatial resolution was greatly decreased under 10 mA. In the patient study, the detection of the presence of disease was not significantly different. The values for area under the curve for detection of DILD by HRCT, FBP, ASIR, and MBIR were as follows: 0.978, 0.979, 0.972, and 0.963. LDCT images reconstructed with FBP, ASIR, and MBIR tended to underestimate reticular or honeycombing opacities (-2.8%, -4.1%, and -5.3%, respectively) and overestimate ground glass opacities (+4.6%, +8.9%, and +8.5%, respectively) compared to the HRCT images. However, the reconstruction methods did not differ with respect to radiologic diagnosis.ConclusionThe diagnostic performance of LDCT with MBIR was similar to that of HRCT in typical DILD cases. However, caution should be exercised when comparing disease extent, especially in follow-up studies with IR.

Project description:PurposeThe purpose of this study was to evaluate the image quality and radiation dose in computed tomography urography (CTU) images acquired with a low kilovoltage peak (kVp) in combination with an adaptive statistical iterative reconstruction (ASiR) algorithm.MethodsA total of 45 subjects (18 women, 27 men) who underwent CTU with kV assist software for automatic selection of the optimal kVp were included and divided into two groups (A and B) based on the kVp and image reconstruction algorithm: group A consisted of patients who underwent CTU with a 80 or 100 kVp and whose images were reconstructed with the 50% ASiR algorithm (n=32); group B consisted of patients who underwent CTU with a 120 kVp and whose images were reconstructed with the filtered back projection (FBP) algorithm (n=13). The images were separately reconstructed with volume rendering (VR) and maximum intensity projection (MIP). Finally, the image quality was evaluated using an image score, CT attenuation, image noise, the contrast-to-noise ratio (CNR) of the renal pelvis-to-abdominal visceral fat and the signal-to-noise ratio (SNR) of the renal pelvis. The radiation dose was assessed using volume CT dose index (CTDIvol), dose-length product (DLP) and effective dose (ED).ResultsFor groups A and B, the subjective image scores for the VR reconstruction images were 3.9±0.4 and 3.8±0.4, respectively, while those for the MIP reconstruction images were 3.8±0.4 and 3.6±0.6, respectively. No significant difference was found (p>0.05) between the two groups' image scores for either the VR or MIP reconstruction images. Additionally, the inter-reviewer image scores did not significantly differ (p>0.05). The mean attenuation of the bilateral renal pelvis in group A was significantly higher than that in group B (271.4±57.6 vs. 221.8±35.3 HU, p<0.05), whereas the image noise in group A was significantly lower than that in group B (7.9±2.1 vs. 10.5±2.3 HU, p<0.05). The CNR and SNR in group A were both significantly higher than those in group B (53.61±24.74 vs. 32.30±6.52 for CNR; 38.13±19.86 vs. 21.76±4.85 for SNR; all p<0.05). The CTDIvol, DLP and ED in group A were significantly lower than those in group B (9.26±2.77 vs. 16.19±5.60 mGy for CTDIvol; 368.86±119.38 vs. 674.38±239.37 mGy×cm-1 for DLP; 5.53±1.79 vs. 10.12±3.59 mSv for ED; all p<0.05).ConclusionsThe low kVp CTU images with 50% ASiR reconstruction exhibit sufficient image quality and facilitate up to a 44% radiation dose reduction.

Project description:ObjectiveTo compare image qualities between vendor-neutral and vendor-specific hybrid iterative reconstruction (IR) techniques for abdominopelvic computed tomography (CT) in young patients.Materials and methodsIn phantom study, we used an anthropomorphic pediatric phantom, age-equivalent to 5-year-old, and reconstructed CT data using traditional filtered back projection (FBP), vendor-specific and vendor-neutral IR techniques (ClariCT; ClariPI) in various radiation doses. Noise, low-contrast detectability and subjective spatial resolution were compared between FBP, vendor-specific (i.e., iDose1 to 5; Philips Healthcare), and vendor-neutral (i.e., ClariCT1 to 5) IR techniques in phantom. In 43 patients (median, 14 years; age range 1-19 years), noise, contrast-to-noise ratio (CNR), and qualitative image quality scores of abdominopelvic CT were compared between FBP, iDose level 4 (iDose4), and ClariCT level 2 (ClariCT2), which showed most similar image quality to clinically used vendor-specific IR images (i.e., iDose4) in phantom study. Noise, CNR, and qualitative imaging scores were compared using one-way repeated measure analysis of variance.ResultsIn phantom study, ClariCT2 showed noise level similar to iDose4 (14.68-7.66 Hounsfield unit [HU] vs. 14.78-6.99 HU at CT dose index volume range of 0.8-3.8 mGy). Subjective low-contrast detectability and spatial resolution were similar between ClariCT2 and iDose4. In clinical study, ClariCT2 was equivalent to iDose4 for noise (14.26-17.33 vs. 16.01-18.90) and CNR (3.55-5.24 vs. 3.20-4.60) (p > 0.05). For qualitative imaging scores, the overall image quality ([reader 1, reader 2]; 2.74 vs. 2.07, 3.02 vs. 2.28) and noise (2.88 vs. 2.23, 2.93 vs. 2.33) of ClariCT2 were superior to those of FBP (p < 0.05), and not different from those of iDose4 (2.74 vs. 2.72, 3.02 vs. 2.98; 2.88 vs. 2.77, 2.93 vs. 2.86) (p > 0.05).ConclusionVendor-neutral IR technique shows image quality similar to that of clinically used vendor-specific hybrid IR technique for abdominopelvic CT in young patients.

Dataset Information

The Impact of Iterative Reconstruction on Computed Tomography Radiation Dosimetry: Evaluation in a Routine Clinical Setting.

Purpose

Methods

Results

Conclusion

Publications

The Impact of Iterative Reconstruction on Computed Tomography Radiation Dosimetry: Evaluation in a Routine Clinical Setting.

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