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High-pitch, 120 kVp/30 mAs, low-dose dual-source chest CT with iterative reconstruction: Prospective evaluation of radiation dose reduction and image quality compared with those of standard-pitch low-dose chest CT in healthy adult volunteers.

ABSTRACT: PURPOSE:Objective of this study was to evaluate the effectiveness of the iterative reconstruction of high-pitch dual-source chest CT (IR-HP-CT) scanned with low radiation exposure compared with low dose chest CT (LDCT). MATERIALS AND METHODS:This study was approved by the institutional review board. Thirty healthy adult volunteers (mean age 44 years) were enrolled in this study. All volunteers underwent both IR-HP-CT and LDCT. IR-HP-CT was scanned with 120 kVp tube voltage, 30 mAs tube current and pitch 3.2 and reconstructed with sinogram affirmed iterative reconstruction. LDCT was scanned with 120 kVp tube voltage, 40 mAs tube current and pitch 0.8 and reconstructed with B50 filtered back projection. Image noise, and signal to noise ratio (SNR) of the infraspinatus muscle, subcutaneous fat and lung parenchyma were calculated. Cardiac motion artifact, overall image quality and artifacts was rated by two blinded readers using 4-point scale. The dose-length product (DLP) (mGy?cm) were obtained from each CT dosimetry table. Scan length was calculated from the DLP results. The DLP parameter was a metric of radiation output, not of patient dose. Size-specific dose estimation (SSDE, mGy) was calculated using the sum of the anteroposterior and lateral dimensions and effective radiation dose (ED, mSv) were calculated using CT dosimetry index. RESULTS:Approximately, mean 40% of SSDE (2.1 ± 0.2 mGy vs. 3.5 ± 0.3 mGy) and 34% of ED (1.0 ± 0.1 mSv vs. 1.5 ± 0.1 mSv) was reduced in IR-HP-CT compared to LDCT (P < 0.0001). Image noise was reduced in the IR-HP-CT (16.8 ± 2.8 vs. 19.8 ± 3.4, P = 0.0001). SNR of lung and aorta of IR-HP-CT showed better results compared with that of LDCT (22.2 ± 5.9 vs. 33.0 ± 7.8, 1.9 ± 0.4 vs 1.1 ± 0.3, P < 0.0001). The score of cardiac pulsation artifacts were significantly reduced on IR-HP-CT (3.8 ± 0.4, 95% confidence interval, 3.7?4.0) compared with LDCT (1.6 ± 0.6, 95% confidence interval, 1.3?1.8) (P < 0.0001). SNR of muscle and fat, beam hardening artifact and overall subjective image quality of the mediastinum, lung and chest wall were comparable on both scans (P ? 0.05). CONCLUSION:IR-HP-CT with 120 kVp and 30 mAs tube setting in addition to an iterative reconstruction reduced cardiac motion artifact and radiation exposure while representing similar image quality compared with LDCT.

SUBMITTER: Lim HK

PROVIDER: S-EPMC6345490 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Project description:ObjectiveTo investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose.Materials and methodsThis prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared. The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared.ResultsNo significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0-232.28) and C (median, 60.25; IQR, 0-195.20) (p = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0-120.73) was significantly underestimated compared with that for protocol A (p < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, p < 0.001) from that associated with the standard 120 kVp mode.ConclusionThe Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.

Project description:ObjectiveFew studies have explored the clinical feasibility of using deep-learning reconstruction to reduce the radiation dose of CT. We aimed to compare the image quality and lung nodule detectability between chest CT using a quarter of the low dose (QLD) reconstructed with vendor-agnostic deep-learning image reconstruction (DLIR) and conventional low-dose (LD) CT reconstructed with iterative reconstruction (IR).Materials and methodsWe retrospectively collected 100 patients (median age, 61 years [IQR, 53-70 years]) who received LDCT using a dual-source scanner, where total radiation was split into a 1:3 ratio. QLD CT was generated using a quarter dose and reconstructed with DLIR (QLD-DLIR), while LDCT images were generated using a full dose and reconstructed with IR (LD-IR). Three thoracic radiologists reviewed subjective noise, spatial resolution, and overall image quality, and image noise was measured in five areas. The radiologists were also asked to detect all Lung-RADS category 3 or 4 nodules, and their performance was evaluated using area under the jackknife free-response receiver operating characteristic curve (AUFROC).ResultsThe median effective dose was 0.16 (IQR, 0.14-0.18) mSv for QLD CT and 0.65 (IQR, 0.57-0.71) mSv for LDCT. The radiologists' evaluations showed no significant differences in subjective noise (QLD-DLIR vs. LD-IR, lung-window setting; 3.23 ± 0.19 vs. 3.27 ± 0.22; P = .11), spatial resolution (3.14 ± 0.28 vs. 3.16 ± 0.27; P = .12), and overall image quality (3.14 ± 0.21 vs. 3.17 ± 0.17; P = .15). QLD-DLIR demonstrated lower measured noise than LD-IR in most areas (P < .001 for all). No significant difference was found between QLD-DLIR and LD-IR for the sensitivity (76.4% vs. 72.2%; P = .35) or the AUFROCs (0.77 vs. 0.78; P = .68) in detecting Lung-RADS category 3 or 4 nodules. Under a noninferiority limit of -0.1, QLD-DLIR showed noninferior detection performance (95% CI for AUFROC difference, -0.04 to 0.06).ConclusionQLD-DLIR images showed comparable image quality and noninferior nodule detectability relative to LD-IR images.

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.

Dataset Information

High-pitch, 120 kVp/30 mAs, low-dose dual-source chest CT with iterative reconstruction: Prospective evaluation of radiation dose reduction and image quality compared with those of standard-pitch low-dose chest CT in healthy adult volunteers.

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