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- Title
Low-dose CT imaging of the acute abdomen using model-based iterative reconstruction: a prospective study.
- Authors
Moloney, Fiachra; James, Karl; Twomey, Maria; Ryan, David; Grey, Tyler M.; Downes, Amber; Kavanagh, Richard G.; Moore, Niamh; Murphy, Mary Jane; Bye, Jackie; Carey, Brian W.; McSweeney, Sean E.; Deasy, Conor; Andrews, Emmett; Shanahan, Fergus; Maher, Michael M.; O'Connor, Owen J.
- Abstract
<bold>Objectives: </bold>Performance of a modified abdominopelvic CT protocol reconstructed using full iterative reconstruction (IR) was assessed for imaging patients presenting with acute abdominal symptoms.<bold>Materials and Methods: </bold>Fifty-seven patients (17 male, 40 female; mean age of 56.5 ± 8 years) were prospectively studied. Low-dose (LD) and conventional-dose (CD) CTs were contemporaneously acquired between November 2015 and March 2016. The LD and CD protocols imparted radiation exposures approximating 10-20% and 80-90% those of routine abdominopelvic CT, respectively. The LD images were reconstructed with model-based iterative reconstruction (MBIR), and CD images with hybrid IR (40% adaptive statistical iterative reconstruction (ASIR)). Image quality was assessed quantitatively and qualitatively. Independent clinical interpretations were performed with a 6-week delay between reviews.<bold>Results: </bold>A 74.7% mean radiation dose reduction was achieved: LD effective dose (ED) 2.38 ± 1.78 mSv (size-specific dose estimate (SSDE) 3.77 ± 1.97 mGy); CD ED 7.04 ± 4.89 mSv (SSDE 10.74 ± 5.5 mGy). LD-MBIR images had significantly lower objective and subjective image noise compared with CD-ASIR (p < 0.0001). Noise reduction for LD-MBIR studies was greater for patients with BMI < 25 kg/m2 than those with BMI ≥ 25 kg/m2 (5.36 ± 3.2 Hounsfield units (HU) vs. 4.05 ± 3.1 HU, p < 0.0001). CD-ASIR studies had significantly better contrast resolution, and diagnostic acceptability (p < 0.0001 for all). LD-MBIR studies had significantly lower streak artifact (p < 0.0001). There was no difference in sensitivity for primary findings between the low-dose and conventional protocols with the exception of one case of enteritis.<bold>Conclusions: </bold>Low-dose abdominopelvic CT performed with MBIR is a feasible radiation dose reduction strategy for imaging patients presenting with acute abdominal pain.
- Subjects
LONGITUDINAL method; ACUTE abdomen; NOISE control; RADIATION doses; RADIATION exposure; ABDOMINAL pain
- Publication
Emergency Radiology, 2019, Vol 26, Issue 2, p169
- ISSN
1070-3004
- Publication type
journal article
- DOI
10.1007/s10140-018-1658-z