Computed Tomography Protocol Optimisation for Pediatric Head Trauma: Radiation Dose and Image Quality Assessment

Purpose: Children are sometimes examined with Computed Tomography protocols designed for adults, leading to radiation doses higher than necessary. Lack of optimisation could lead to image quality higher than what is needed for diagnostic purposes with associated high doses to patients. Optimising the protocols for paediatric head trauma CT imaging will reduce radiation dose. Objective: The study aimed to optimise radiation dose and assess the image quality for a set of protocols by evaluating noise, a contrast to noise ratio, modulation transfer function and noise power spectrum. Methods: Somaton Sensation 64 was used to scan the head of an anthropomorphic phantom with a set of protocols. ImageJ software was used to analyse the paediatric head image from the scanner. IMPACTSCAN dosimeter software was used to evaluate the radiation dose to the various organs in the head. MATLAB was used to analyse the Modulation Transfer Function and the Noise Power. Results: The estimated Computed Tomography Dose Index volume (CTDIvol) increased with increasing tube current and tube voltage. The high pitch of 0.9 gave a lower dose than the 0.5 pitch. The eye lens received the highest radiation dose (39.2 mGy) whiles the thyroid received the least radiation dose (13.7 mGy). There was an increase in noise (62.46) when the H60 kernel was used and a lower noise (8.829) was noticed when the H30 kernel was used. Conclusion: The results obtained show that the H30 kernel (smooth kernel) gave higher values for noise and contrast to noise ratio (CNR) than the H60 kernel (sharp kernel). The H60 kernel produced high values for the modulation transfer function (MTF) and noise power spectrum (NPS). The eye lens received the highest radiation dose.

Low-radiation and high image quality coronary computed tomography angiography in “real-world” unselected patients

AIM To determine the radiation dose and image quality in coronary computed tomography angiography(CCTA)using state-of-the-art dose reduction methods in unselected"real world"patients.METHODS In this single-centre study,consecutive patients in sinus rhythm underwent CCTA for suspected coronary artery disease(CAD)using a 320-row detector CT scanner.All patients underwent the standard CT acquisition protocol at our institute(Morriston Hospital)a combination of dose saving advances including prospective electrocardiogram-gating,automated tube current modulation,tube voltage reduction,heart rate reduction,and the most recent novel adaptive iterative dose reconstruction 3D(AIDR3D)algorithm.The cohort comprised real-world patients for routine CCTA who were not selected on age,body mass index,or heart rate.Subjective image quality was graded on a 4-point scale(4=excellent,1=non-diagnostic).RESULTS A total of 543 patients were included in the study with a mean body weight of 81±18 kg and a pre-scan mean heart rate of 70±11 beats per minute(bpm).When indicated,patients received rate-limiting medication with an oral beta-blocker followed by additional intravenous beta-blocker to achieve a heart rate below 65 bpm.The median effective radiation dose was 0.88 mSv(IQR,0.6-1.4 mSv)derived from a Dose Length Product of61.45 mGy.cm(IQR,42.86-100.00 mGy.cm).This also includes what we believe to be the lowest ever-reported radiation dose for a routine clinical CCTA(0.18 mSv).The mean image quality(SD)was 3.65±0.61,with a subjective image quality score of 3("good")or above for 93%of patient CCTAs.CONCLUSION Combining a low-dose scan protocol and AIDR3D with a 320-detector row CT scanner can provide high quality images at exceptionally low radiation dose in unselected patients being investigated for CAD.

Paediatric computed tomography radiation dose: A review of the global dilemma

Computed tomography(CT)has earned a well-deserved role in diagnostic radiology,producing crosssectional and three-dimensional images which permit enhanced diagnosis of many pathogenic processes.The speed,versatility,accuracy,and non-invasiveness of this procedure have resulted in a rapid increase in its use.CT imaging,however,delivers a substantially higher radiation dose than alternative imaging methodologies,particularly in children due to their smaller body dimensions.In addition,CT use in children produces an increased lifetime risk of cancer,as children’s developing organs and tissues are inherently more vulnerable to cellular damage than those of adults.Though individual risks are small,the increasing use of CT scans in children make this an important public health problem.Various organizations have recommended measures to minimize unnecessary exposures to radiation through CT scanning.These include elimination of multiple or medically unnecessary scans,development of patientspecific dosing guidelines,and use of alternative radiographic methodology wherever possible.Another important factor in excessive CT exposures,however,is a documented lack of awareness among medical practitioners of the doses involved in CT usage as well as itssignificant potential dangers.This review examines the effects of paediatric CT radiation,discusses the level of medical practitioner awareness of these effects,and offers recommendations on alternative diagnostic methods and practitioner education.

Temporal Trends in Radiation Dose Associated with Coronary Computed Tomography Angiography

Background: In 2010, the International Atomic Energy Agency launched the “3A’s campaign” as an effective tool for primary cancer prevention. In 2011, the American Association of Physicists in Medicine recommended the size specific dose estimate (SSDE). Objectives: To audit doses of Coronary CT Angiography (Coronary CTA) in tertiary care referral center. Methods: We reviewed 998 consecutive Coronary CTA (from 2007 to 2012). Doses (CTDIvol mGy), DLP (mGy*cm), effective dose (DLP*0.014, mSv) were on-line archived. SSDE was estimated retrospectively. Appropriateness score was evaluated for exams performed from the 2010. Results: Overall median dose per Coronary CTA was 49.7 mGy for CTDIvol, 55.5 mGy for SSDE, 994.96 mGy*cm for DLP, 13.9 mSv for effective dose. Median DLP decreased over time (1452.94 in 2007, 1605.56 in 2008, 1113.49 in 2009, 759.99 in 2010, 448.61 in 2011 and 497.88 mGy*cm in 2012, p < 0.0001). SSDE was proportional to the size dependent factor (SDF);in patients with SDF > 1 (88%) CTDIvol underestimated SSDE (48.49 vs 57.19 mGy), whilst in patients with SDF < 1 (12%) CTDIvol overestimated SSDE (56.46 vs 50.3 mGy). Scans were appropriate in 58%, uncertain in 24%, and inappropriate in 18% of cases. Doses were similar in appropriate, uncertain or inappropriate examinations and in excellent-to-good (81%) vs. sufficient-to-poor (19%) image quality exams. Conclusions: Coronary CTA reference doses can be very misleading. SSDE can allow individual technique optimization. The dose is similar in appropriate and inappropriate examinations, and unrelated to image quality. The rate of inappropriate examinations is still too high even after dissemination of guidelines.

Computed tomography colonography and radiation risk:How low can we go?

Computed tomography colonography(CTC)has become a key examination in detecting colonic polyps and colorectal carcinoma(CRC).It is particularly useful after incomplete optical colonoscopy(OC)for patients with sedation risks and patients anxious about the risks or potential discomfort associated with OC.CTC's main advantages compared with OC are its non-invasive nature,better patient compliance,and the ability to assess the extracolonic disease.Despite these advantages,ionizing radiation remains the most significant burden of CTC.This opinion review comprehensively addresses the radiation risk of CTC,incorporating imaging technology refinements such as automatic tube current modulation,filtered back projections,lowering the tube voltage,and iterative reconstructions as tools for optimizing low and ultra-low dose protocols of CTC.Future perspectives arise from integrating artificial intelligence in computed tomography machines for the screening of CRC.

CT dose and image quality in the last three scanner generations

AIM: To compare the computed tomography(CT) dose and image quality with the filtered back projection against the iterative reconstruction and CT with a minimal electronic noise detector. METHODS: A lung phantom(Chest Phantom N1 by Kyoto Kagaku) was scanned with 3 different CT scanners: the Somatom Sensation, the Definition Flash and the Definition Edge(all from Siemens, Erlangen, Germany). The scan parameters were identical to the Siemens presetting for THORAX ROUTINE(scan length 35 cm and FOV 33 cm). Nine different exposition levels were examined(reference mAs/peek voltage): 100/120, 100/100, 100/80, 50/120, 50/100, 50/80, 25/120, 25/100 and 25 mAs/80 kVp. Images from the SOMATOM Sensation were reconstructed using classic filtered back projection. Iterative reconstruction(SAFIRE, level 3) was performed for the two other scanners. A Stellar detector was used with the Somatom Definition Edge. The CT doses were represented by the dose length products(DLPs)(mGycm) provided by the scanners. Signal, contrast, noise and subjective image quality were recorded by two different radiologists with 10 and 3 years of experience in chest CT radiology. To determine the average dose reduction between two scanners, the integral of the dose difference was calculated from the lowest to the highest noise level. RESULTS: When using iterative reconstruction(IR) instead of filtered back projection(FBP), the average dose reduction was 30%, 52% and 80% for bone, soft tissue and air, respectively, for the same image quality(P 【 0.0001). The recently introduced Stellar detector(Sd) lowered the radiation dose by an additional 27%, 54% and 70% for bone, soft tissue and air, respectively(P 【 0.0001). The benefit of dose reduction was larger at lower dose levels. With the same radiation dose, an average of 34%(22%-37%) and 25%(13%-46%) more contrast to noise was achieved by changing from FBP to IR and from IR to Sd, respectively. For the same contrast to noise level, an average of 59%(46%-71%) and 51%(38%-68%) dose reduction was produced for IR and Sd, respectively. For the same subjective image quality, the dose could be reduced by 25%(2%-42%) and 44%(33%-54%) using IR and Sd, respectively. CONCLUSION: This study showed an average dose reduction between 27% and 70% for the new Stellar detector, which is equivalent to using IR instead of FBP.

Radiation dose reduction with application of non-linear adaptive filters for abdominal CT

AIM:To evaluate the effect of non-linear adaptive filters (NLAF) on abdominal computed tomography (CT) images acquired at different radiation dose levels.METHODS:Nineteen patients (mean age 61.6 ± 7.9 years,M:F=8:11) gave informed consent for an Institutional Review Board approved prospective study involving acquisition of 4 additional image series (200,150,100,50 mAs and 120 kVp) on a 64 slice multidetector row CT scanner over an identical 10 cm length in the abdomen.The CT images acquired at 150,100 and 50 mAs were processed with the NLAF.Two radiologists reviewed unprocessed and processed images for image quality in a blinded randomized manner.CT dose index volume,dose length product,patient weight,transverse diameters,objective noise and CT numbers wererecorded.Data were analyzed using Analysis of Variance and Wilcoxon signed rank test.RESULTS:Of the 31 lesions detected in abdominal CT images,28 lesions were less than 1 cm in size.Subjective image noise was graded as unacceptable in unprocessed images at 50 and 100 mAs,and in NLAF processed images at 50 mAs only.In NLAF processed images,objective image noise was decreased by 21% (14.4 ± 4/18.2 ± 4.9) at 150 mAs,28.3% (15.7 ± 5.6/21.9 ± 4) at 100 mAs and by 39.4% (18.8 ± 9/30.4 ± 9.2) at 50 mAs compared to unprocessed images acquired at respective radiation dose levels.At 100 mAs the visibility of smaller structures improved from suboptimal in unprocessed images to excellent in NLAF processed images,whereas diagnostic confidence was respectively improved from probably confident to fully confident.CONCLUSION:NLAF lowers image noise,improves the visibility of small structures and maintains lesion conspicuity at down to 100 mAs for abdominal CT.

Low-dose computed tomography with 4th-generation iterative reconstruction algorithm in assessment of oncologic patients

AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients. METHODS Fifty-one patients with known malignant diseases which underwent, during clinical follow-up, both standarddose and low-dose whole-body CT scans were enrolled. Low-dose CT was performed on 256-row scanner, with 120 kV and automated m A modulation, and iterative reconstruction algorithm. Standard-dose CT was performed on 16-rows scanner, with 120 kV, 200-400 m As(depending on patient weight). We evaluated density values and signal-to-noise ratio, along with image noise(SD), sharpness and diagnostic quality with 4-point scale.RESULTS Density values in liver, spleen and aorta were higher in lowdose images(liver 112.55 HU vs 103.90 HU, P < 0.001), as SD values in liver and spleen(liver 16.81 vs 14.41). Volumetric-Computed-Tomographic-Dose-Index(CTDIvol) and Dose-Length-Product(DLP) were significantly lower in low-dose CT as compared to standard-dose(DLP 1025.6 m Gy*cm vs 1429.2 m Gy*cm, P < 0.001) with overall dose reduction of 28.9%. Qualitative analysis did not reveal significant differences in image noise and diagnostic quality.CONCLUSION Automatic tube-current modulation combined with hybriditerative algorithm allows radiation dose reduction of 28.9% without loss of diagnostic quality, being useful in reducing dose exposure in oncologic patients.

Nondestructive Skeletal Imaging of Hyla suweonensis Using Micro-Computed Tomography

We successfully obtained 3D skeletal images of Hyla suweonensis, employing a nondestructive method by applying appropriate anesthesia and limiting the radiation dose. H. suweonensis is a tree frog endemic to Korea and is on the list of endangered species. Previous studies have employed caliper-based measurements and two-dimensional （2D） X-ray imaging for anatomical analyses of the skeletal system or bone types of H. suweonensis. In this work we reconstructed three-dimensional （3D） skeletal images of H. suweonensis, utilizing a nondestructive micro-computed tomography （micro-CT） with a short scan and low radiation dose （i.e. 4 min and 0.16 Gy）. Importantly, our approach can be applied to the imaging of 3D skeletal systems of other endangered frog species, allowing both versatile and high contrast images of anatomical structures without causing any significant damages to the living animal.

Effects of oral contrast on dose in abdominopelvic computed tomography with pure iterative reconstruction

AIM To assess the effect of neutral(NC) and positive(PC) oral contrast use on patient dose in low-dose abdominal computed tomography(CT).METHODS Low-dose clinically indicated CTs were performed on 79 Crohn's patients(35 = PC, 1 L 2% gastrografin; 44 = NC, 1.5 L polyethylene glycol). Scanner settings for both acquisitions were identical apart from 25 s difference in intravenous contrast timing. Body mass index(BMI), scan-ranges, dose-length product and size-specific dose estimated were recorded. Data was reconstructed with pure model-based iterative reconstruction. Image quality was objectively and subjectively analysed. Data analysis was performed with Statistical Package for Social Scientists.RESULTS Higher doses were seen in neutral contrast CTs(107.60 ± 78.7 m Gy.cm, 2.47 ± 1.21 m Gy vs 85.65 ± 58.2 m Gy.cm, 2.18 ± 0.96 m Gy). The differencehad both NC and PC investigations. Image-quality assessment yielded 6952 datapoints. NC image quality was significantly superior(P < 0.001)(objective noise, objective signal to noise ratio, subjective spatial resolution, subjective contrast resolution, diagnostic acceptability) at all levels. NC bowel distension was significantly(P < 0.001) superior.CONCLUSION The use of polyethylene glycol as a neutral OC agent leads to higher radiation doses than standard positive contrast studies, in low dose abdominal CT imaging. This is possibly related to the osmotic effect of the agent resulting in larger intraluminal fluid volumes and resultant increased overall beam attenuation.

Reduction of the Radiation Dose by Decreasing the Tube Current without Degradation of Low-Contrast Detectability on Abdominal Multi-Detector Row CT: A Phantom-Based Study

As use of the lowest acceptable radiation dose during routine diagnostic imaging is important, we determined the optimal tube current without degradation of low-contrast detectability on abdominal multi-detector row CT (MDCT). CT scanning was performed with a Catphan&#174;?500 phantom. The optimal tube current was 300 mA on 64-MDCT and 160 mA on 8-MDCT, with a fixed voltage of 120 kV. Reduction of the radiation dose in abdominal CT scanning by lowering the tube current proved to be feasible.

Assessment of sub-milli-sievert abdominal computed tomography with iterative reconstruction techniques of different vendors

AIM: To assess diagnostic image quality of reduced dose(RD) abdominal computed tomography(CT) with 9 iterative reconstruction techniques(IRTs) from 4 different vendors to the standard of care(SD) CT.METHODS: In an Institutional Review Board approved study, 66 patients(mean age 60 ± 13 years, 44 men, and 22 women) undergoing routine abdomen CT on multi-detector CT(MDCT) scanners from vendors A, B, and C(≥ 64 row CT scanners)(22 patients each) gave written informed consent for acquisition of an additional RD CT series. Sinogram data of RD CT was reconstructed with two vendor-specific and a vendor-neutral IRTs(A-1, A-2, A-3; B-1, B-2, B-3; and C-1, C-2, C-3) and SD CT series with filtered back projection. Subjective image evaluation was performed by two radiologists for each SD and RD CT series blinded and independently. All RD CT series(198) were assessed first followed by SD CT series(66). Objective image noise was measured for SD and RD CT series. Data were analyzed by Wilcoxon signed rank, kappa, and analysis of variance tests.RESULTS: There were 13/50, 18/57 and 9/40 missed lesions(size 2-7 mm) on RD CT for vendor A, B, and C, respectively. Missed lesions includes liver cysts, kidney cysts and stone, gall stone, fatty liver, and pancreatitis. There were also 5, 4, and 4 pseudo lesions(size 2-3 mm) on RD CT for vendor A, B, and C, respectively. Lesions conspicuity was sufficient for clinical diagnostic performance for 6/24(RD-A-1), 10/24(RD-A-2), and 7/24(RD-A-3) lesions for vendor A; 5/26(RD-B-1), 6/26(RD-B-2), and 7/26(RD-B-3) lesions for vendor B; and 4/20(RD-C-1) 6/20(RD-C-2), and 10/20(RD-C-3) lesions for vendor C(P = 0.9). Mean objective image noise in liver was significantly lower for RD A-1 compared to both RD A-2 and RD A-3 images(P < 0.001). Similarly, mean objective image noise lower for RD B-2(compared to RD B-1, RD B-3) and RD C-3(compared to RD C-1 and C-2)(P = 0.016).CONCLUSION: Regardless of IRTs and MDCT vendors, abdominal CT acquired at mean CT dose index volume 1.3 m Gy is not sufficient to retain clinical diagnostic performance.

Non-enhanced Low-tube-voltage High-pitch Dual-source Computed Tomography with Sinogram Affirmed Iterative Reconstruction Algorithm of the Abdomen and Pelvis

Objective To investigate the image quality, radiation dose and diagnostic value of the low-tube-voltage high-pitch dual-source computed tomography(DSCT) with sinogram affirmed iterative reconstruction(SAFIRE) for non-enhanced abdominal and pelvic scans. Methods This institutional review board-approved prospective study included 64 patients who gave written informed consent for additional abdominal and pelvic scan with DSCT in the period from November to December 2012. The patients underwent standard non-enhanced CT scans(protocol 1) [tube voltage of 120 k Vp/pitch of 0.9/filtered back-projection(FBP) reconstruction] followed by high-pitch non-enhanced CT scans(protocol 2)(100 k Vp/3.0/SAFIRE). The total scan time, mean CT number, signal-to-noise ratio(SNR), image quality, lesion detectability and radiation dose were compared between the two protocols. Results The total scan time of protocol 2 was significantly shorter than that of protocol 1(1.4±0.1 seconds vs. 7.6±0.6 seconds, P<0.001). There was no significant difference between protocol 1 and protocol 2 in mean CT number of all organs(liver, 55.4±6.3 HU vs. 56.1±6.8 HU, P=0.214; pancreas, 43.6±5.9 HU vs. 43.7±5.8 HU, P=0.785; spleen, 47.9±3.9 HU vs. 49.4±4.3 HU, P=0.128; kidney, 32.2±2.3 HU vs. 33.1±2.3 HU, P=0.367; abdominal aorta, 44.8±5.6 HU vs. 45.0±5.5 HU, P=0.499; psoas muscle, 50.7±4.1 HU vs. 50.3±4.5 HU, P=0.279). SNR on images of protocol 2 was higher than that of protocol 1(liver, 5.0±1.2 vs. 4.5±1.1, P<0.001; pancreas, 4.0±1.0 vs. 3.6±0.8, P<0.001; spleen, 4.7±1.0 vs. 4.1±0.9, P<0.001; kidney, 3.1±0.6 vs. 2.8±0.6, P<0.001; abdominal aorta, 4.1±1.0 vs. 3.8±1.0, P<0.001; psoas muscle, 4.5±1.1 vs. 4.3±1.2, P=0.012). The overall image noise of protocol 2 was lower than that of protocol1(9.8±3.1 HU vs. 11.1±3.0 HU, P<0.001). Image quality of protocol 2 was good but lower than that of protocol 1(4.1±0.7 vs. 4.6±0.5, P<0.001). Protocol 2 perceived 229 of 234 lesions(97.9%) that were detected in protocol 1 in the abdomen and pelvis. Radiation dose of protocol 2 was lower than that of protocol 1(4.4±0.4 m Sv vs. 7.3±2.4 m Sv, P<0.001) and the mean dose reduction was 41.4%. Conclusion The high-pitch DSCT with SAFIRE can shorten scan time and reduce radiation dose while preserving image quality in non-enhanced abdominal and pelvic scans.

Optimization of Exposure Conditions for Computed Radiology Exams in Neonatal Intensive Care

This paper performs a review of existing literature about neonatal imaging in intensive care;we notice that the multiplicity of approaches results in different and sometimes conflicting solutions to optimize acquisition technique of X-ray images. European Guidelines still refer to screen-film combinations used in past decades, current usage of digital technology requires an additional effort to reduce dose to infants and to optimize the sensor’s response exploiting their properties. In this work we investigate response changes of digital medium (computed radiography plates), due to alterations of the beam through incubators components. All combinations in use in our Hospital were tested for evaluating dosimetry and image quality and new exposure solutions were devised to optimize radiology exams, taking into account solutions suggested by the equipments makers. Dose measured was compared with dose levels suggested by European Guidelines, evaluating radiation-induced risk too. Image quality was evaluated in a double-blind comparison by radiologists. An easily repeatable optimization procedure is proposed intended to reduce delivered dose well below European guidelines. The proposed study allowed us to instruct the technologists on the most appropriate methodology for performing the radiology exam, by standardizing the approach to Neonatal Intensive Care Units. We have demonstrated also to radiologic technologists reluctant to use the X-ray tray, as it may optimize imaging in the incubator. We were also able to reduce dose—and radiation-induced risk too—of 37% - 67% depending on the previously used operating mode.

Reproducibility of 3 mm-Slice-Thick Reconstruction of Paranasal Sinus Computed Tomography Scans

Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this prospective study was to evaluate whether this study method might be eligible in studies aiming at radiation dose reduction. Sinus CT scans were chosen as a model because of the high variation of the radiological anatomy of surgically important sinonasal structures. We hypothesized that 3 mm-slice-thick reconstruction CT had poor reproducibility. Methods: 59 CRS patients underwent routine multi-detector sinus CT (CTMD). CT3mm was reconstructed from CTMD data-sets. Lund-Mackay (LM) scores and 43 other structural parameters were analyzed blinded. Agreement was studied between CTMD and CT3mm (intra-observer reproducibility), and between three observers (inter-observer reproducibility) by using Cohen’s kappa. Results: The inter-observer agreement was moderate (kappa 0.4 - 0.6, p < 0.01) in the majority of structures of CT3mm scans. The intra-observer reproducibility of CT3mm scans was very good in most structures, however, it was poor in important structures such as frontal and spheno-ethmoid recess, lamina papyracae, and location of optic nerve or anterior ethmoidal artery. The grade of surgeon’s confidence of CT3mm in comparison to CTMD was lower (kappa 0.2 - 0.4, P < 0.05). Conclusion: This methodology might have some use in studies aiming at radiation dose reduction. As was expected, 3 mm-slice-thick reconstruction CT had poor reproducibility and surgeon’s confidence. More recent methods such as cone beam computed tomography scans have nowadays more relevant dose reduction potential.

双源CT 70与120 kV不同CARE Dose 4D预设值下图像质量的对比研究

目的:探讨双源CT不同管电压和CARE Dose 4D预设值下的辐射剂量与图像质量相关性,为低剂量扫描方案奠定基础。方法:使用西门子FLASH双源CT对水模进行图像采集。根据管电压分为A、B 2组,A组:管电压70 kV,B组:管电压120 k V。每组CARE Dose 4D预设值均为150、200、250、300、350和400 m As,其他参数不变。采用SPSS 18.0软件对CT值、图像信噪比(signal noise ratio,SNR)、剂量长度乘积(dose length produce,DLP)、容积CT剂量指数(CT dose index volumes,CTDIvol)进行统计分析,以P<0.05为差异有统计学意义。结果:在A组中,不同预设值间CT值无统计学差异(F=0.832,P=0.537>0.05),CT值标准差具有统计学差异(F=6.115,P=0.001<0.05);在B组中,不同预设值间CT值无统计学差异(F=0.880,P=0.506>0.05),CT值标准差具有统计学差异(F=9.470,P=0.000<0.05)。在相同预设值150 mAs下,A组和B组间CT值和SNR值无统计学差异(P>0.05),B组的CTDIvol和DLP是A组的4.4倍。结论:在相同的管电压下,随着CARE Dose 4D预设值增加,辐射剂量增大,噪声降低,图像质量提高;在相同的CARE Dose4D预设值下,70 k V下降低了辐射剂量,但与120 k V下图像质量没有统计学差异。

体质量指数结合iDose^4迭代重建算法在低剂量冠状动脉CT成像中的应用

目的探讨基于受检者体质量指数(BMI)并应用前瞻性心电门控结合iDose4迭代重建技术降低冠状动脉CT成像(CTCA)辐射剂量的可行性。方法选取120例CTCA受检者,根据不同BMI将其分为4组,A组(BMI≤21kg/m2)、B组(21kg/m2<BMI≤24kg/m2)、C组(24kg/m2<BMI<28kg/m2)、D组(BMI≥28kg/m2),每组各30例。预设A组、B组、C组、D组管电流分别为100、150、200、250mAs,应用前瞻性心电门控技术进行扫描,之后采用iDose4迭代重建算法对图像分别进行标准滤波反投影(FBP)、iDose4-3、iDose4-5重建。由2名放射科医师采用4分制对图像质量进行主观评估,测量图像的客观噪声。记录4组的CT剂量指数(CTDIvol)、剂量长度乘积(DLP),并估算有效剂量(ED)。结果各组中3种重建图像的客观噪声差异有统计学意义(P<0.001)。与FBP相比,iDose4-3和iDose4-5的图像客观噪声分别平均降低23.11%和35.61%,且应用iDose4-3和iDose4-5重建算法获得的CTCA图像主观评分≥3分的比率高于FBP(P<0.05),但iDose4-3和iDose4-5之间的差异无统计学意义。4组受检者ED均值分别为(1.36±0.10)mSV、(1.98±0.10)mSV、(2.67±0.21)mSV和(3.33±0.24)mSV。结论应用前瞻性心电门控技术结合iDose4迭代重建技术,根据受检者BMI采用不同扫描参数,可有效减低CTCA辐射剂量。

iDose^4迭代重建技术和滤波反投影技术在冠状动脉CT成像中的应用

目的:探讨在冠状动脉CT成像中,与传统的滤波反投影技术(FBP)比较,应用iDose4迭代技术提高图像质量和降低辐射剂量的可行性。方法:将60例接受256层螺旋CT冠状动脉成像的患者随机分成2组,每组30例,一组采用120kV管电压并分别采用滤波反投影技术(FBP-120kV组)和iDose4迭代技术重建(iDose4-120kV组);另一组采用100kV管电压和iDose4迭代技术重建(iDose4-100kV组)。将FBP-120kV组的图像质量分别与iDose4-120kV组及iDose4-100kV组进行比较,并比较FBP-120kV组和iDose4-100kV组的射线剂量。结果:图像质量主观评价中,FBP-120kV组图像质量评分均值为(3.29±0.61)分,iDose4-120kV组为(3.43±0.51)分,组间比较差异无统计学意义(t=-1.47,P=0.17);iDose4-100kV组图像质量评分均值为(3.21±0.43)分,与FBP-120kV组比较差异无统计学意义(t=0.58,P=0.58)。iDose4-120kV组信号噪声比(SNR)及对比度噪声比(CNR)均高于FBP-120kV组(P<0.05);iDose4-100kV组SNR及CNR均低于FBP-120kV组,但差异无统计学意义(P>0.05)。iDose4-100kV组有效剂量(ED)明显低于FBP-120kV组(P<0.001)。结论:冠状动脉CT成像中,与滤波反投影技术比较,采用iDose4迭代重建技术可以提高图像质量,且在保证图像质量不变的情况下适当降低管电压可降低射线剂量。

冠状动脉CT血管成像iDose4迭代重建与滤波反投影重建图像质量和辐射剂量比较

目的比较iDose4迭代重建与滤波反投影(FBP)重建在冠状动脉CT血管成像(CCTA)的图像质量和辐射剂量,评价iDose4迭代重建的临床应用价值。资料与方法所有患者采用FBP和iDose4两种重建方法行64层CCTA检查。对采用iDose4重建的患者根据体重指数(BMI)分为管电压120kV组和100kV组;FBP组重建时管电压固定为120kV。采用四分法评价图像质量,并计算图像信噪比(SNR)和对比噪声比(CNR)。结果 iDose4120kV组和FBP120kV组图像质量评分分别为(3.2±0.8)分和(3.0±0.7)分,SNR分别为16.5±3.8和13.8±3.9,CNR分别为21.6±6.8和17.6±6.6,辐射剂量分别为(5.5±1.6)mSv和(8.5±1.4)mSv,差异均有统计学意义(P<0.05),其中辐射剂量下降36%。iDose4100kV组和FBP120kV组图像评分分别为(3.1±0.6)分和(3.0±0.8)分,SNR分别为16.8±3.0和17.1±4.4;CNR分别为24.6±6.8和19.8±6.2,辐射剂量为(4.2±1.1)mSv和(8.6±1.2)mSv,差异均有统计学意义(P<0.05),其中辐射剂量下降51%。结论管电压固定为120kV时iDose4迭代重建较FBP重建可显著提高图像质量,并降低辐射剂量;低管电压(100kV)的iDose4迭代重建与高管电压(120kV)的FBP重建图像质量无显著差异,但可以显著降低辐射剂量。

应用iDose^4软件对低剂量胸部CT增强扫描图像质量的影响

目的评价将iDose4迭代重建(IR)技术用于胸部低剂量增强扫描的可行性。方法选取71例体质量指数(BMI)正常(18.5≤BMI<25.0kg/m2)且接受胸部CT增强扫描的患者,随机分为A组(120kVp,100 mAs)、B组(80kVp,100mAs)、C组(120kVp,50mAs),分别采用iDose4 IR技术和FBP进行重建,记录各组的噪声、SNR、CNR和有效剂量(ED)。按1～3分评价各组总体图像质量,并对3组结果进行比较。结果比较同一个患者的FBP和IR图像,IR技术明显降低了图像的噪声,提高了图像的SNR、CNR。B、C组IR后的图像噪声、SNR和CNR与A组FBP图像比较差异均无统计学意义(P均>0.05)。B、C组IR后的图像总体质量与A组FBP重建图像质量差异无统计学意义(P>0.05)。结论运用IR技术进行低剂量胸部CT增强扫描可获得满足诊断要求的图像。