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- Title
Prior iterative reconstruction (PIR) to lower radiation dose and preserve radiologist performance for multiphase liver CT: a multi-reader pilot study.
- Authors
Mohammadinejad, Payam; Ehman, Eric C.; Vasconcelos, Rogerio N.; Venkatesh, Sudhakar K.; Hough, David M.; Lowe, Ryan; Lee, Yong Suk; Nehra, Avinash; Dirks, Shane; Holmes III, David R.; Carter, Rickey E.; Schmidt, Bernard; Halaweish, Ahmed F.; McCollough, Cynthia H.; Fletcher, Joel G.
- Abstract
Purpose: Prior iterative reconstruction (PIR) spatially registers CT image data from multiple phases of enhancement to reduce image noise. We evaluated PIR in contrast-enhanced multiphase liver CT. Methods: Patients with archived projection CT data with proven malignant or benign liver lesions, or without lesions, by reference criteria were included. Lower-dose PIR images were reconstructed using validated noise insertion from multiphase CT exams (50% dose in 2 phases, 25% dose in 1 phase). The phase of enhancement most relevant to the diagnostic task was selected for evaluation. Four radiologists reviewed routine-dose and lower-dose PIR images, circumscribing liver lesions and rating confidence for malignancy (0 to 100) and image quality. JAFROC Figures of Merit (FOM) were calculated. Results: 31 patients had 60 liver lesions (28 primary hepatic malignancies, 6 hepatic metastases, 26 benign lesions). Pooled JAFROC FOM for malignancy for routine-dose CT was 0.615 (95% CI 0.464, 0.767) compared to 0.662 for PIR (95% CI 0.527, 0.797). The estimated FOM difference between the routine-dose and lower-dose PIR images was + 0.047 (95% CI − 0.023, + 0.116). Pooled sensitivity/specificity for routine-dose images was 70%/68% compared to 73%/66% for lower-dose PIR. Lower-dose PIR had lower diagnostic image quality (mean 3.8 vs. 4.2, p = 0.0009) and sharpness (mean 2.3 vs. 2.0, p = 0.0071). Conclusions: PIR is a promising method to reduce radiation dose for multiphase abdominal CT, preserving observer performance despite small reductions in image quality. Further work is warranted.
- Subjects
RADIATION doses; RADIOLOGISTS; LIVER metastasis; IMAGE intensifiers; PILOT projects; LIVER
- Publication
Abdominal Radiology, 2020, Vol 45, Issue 1, p45
- ISSN
2366-004X
- Publication type
Article
- DOI
10.1007/s00261-019-02280-0