Achieving Routine Submillisievert CT Scanning: Report from the Summit on Management of Radiation Dose in CT

McCollough, Cynthia H.; Chen, Guang Hong; Kalender, Willi A.; Leng, Shuai; Samei, Ehsan; Taguchi, Katsuyuki; Wang, Ge; Yu, Lifeng; Pettigrew, Roderic I.

doi:10.1148/radiol.12112265

Cited by 249 publications

(167 citation statements)

References 86 publications

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“…[9][10][11]14,18 Temporal bone CT requires a high radiation dose relative to other diagnostic CT examinations; for example, temporal bone CT by using the standard technique at our institution (zUHR) results in a volume CT dose index of 88 mGy, compared with 38 -69 mGy for a routine head CT examination. Given that radiation reduction can adversely affect image quality, techniques that allow dose reduction without sacrificing image resolution would be exceedingly useful in this area of CT imaging.…”

Section: Discussionmentioning

confidence: 99%

“…8 A recent focus of CT imaging has been to reduce patient exposure to ionizing radiation, following the as low as reasonably achievable principle. [9][10][11][12][13] However, the consequent reduction in photons can adversely affect image quality and present a great challenge when imaging small, anatomically complex structures embedded in attenuating bone, such as those of the middle and inner ear. Iterative reconstruction (IR) is a promising reconstruction technique that is superior to standard filtered back-projection reconstructions and theoretically can be used to improve resolution at standard radiation doses or to maintain current resolution by using a reduced radiation dose.…”

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confidence: 99%

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Temporal Bone CT: Improved Image Quality and Potential for Decreased Radiation Dose Using an Ultra-High-Resolution Scan Mode with an Iterative Reconstruction Algorithm

Leng¹,

Diehn²,

Lane³

et al. 2015

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Temporal Bone CT: Improved Image Quality and Potential for Decreased Radiation Dose Using an Ultra-High-Resolution Scan Mode with an Iterative Reconstruction Algorithm

Leng¹,

Diehn²,

Lane³

et al. 2015

AJNR Am J Neuroradiol

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“…The CT literature has frequently proposed methods with which to reduce radiation dose levels and improve image quality 1 , 2 . However, due to the nature of academic publishing, little to no guidance is given on how to best apply the findings to a particular scanner.…”

Section: Introductionmentioning

confidence: 99%

Compliance with AAPM Practice Guideline 1.a: CT Protocol Management and Review — from the perspective of a university hospital

Szczykutowicz

Bour

Pozniak

et al. 2015

J Applied Clin Med Phys

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The purpose of this paper is to describe our experience with the AAPM Medical Physics Practice Guideline 1.a: “CT Protocol Management and Review Practice Guideline”. Specifically, we will share how our institution's quality management system addresses the suggestions within the AAPM practice report. We feel this paper is needed as it was beyond the scope of the AAPM practice guideline to provide specific details on fulfilling individual guidelines. Our hope is that other institutions will be able to emulate some of our practices and that this article would encourage other types of centers (e.g., community hospitals) to share their methodology for approaching CT protocol optimization and quality control. Our institution had a functioning CT protocol optimization process, albeit informal, since we began using CT. Recently, we made our protocol development and validation process compliant with a number of the ISO 9001:2008 clauses and this required us to formalize the roles of the members of our CT protocol optimization team. We rely heavily on PACS‐based IT solutions for acquiring radiologist feedback on the performance of our CT protocols and the performance of our CT scanners in terms of dose (scanner output) and the function of the automatic tube current modulation. Specific details on our quality management system covering both quality control and ongoing optimization have been provided. The roles of each CT protocol team member have been defined, and the critical role that IT solutions provides for the management of files and the monitoring of CT protocols has been reviewed. In addition, the invaluable role management provides by being a champion for the project has been explained; lack of a project champion will mitigate the efforts of a CT protocol optimization team. Meeting the guidelines set forth in the AAPM practice guideline was not inherently difficult, but did, in our case, require the cooperation of radiologists, technologists, physicists, IT, administrative staff, and hospital management. Some of the IT solutions presented in this paper are novel and currently unique to our institution.PACS number: 87.57.Q

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“…3 With increased use, ionizing radiation dose from CT has become a concern. [4][5][6] In fact, CT now contributes the greatest per capita medical radiation exposure of all medical imaging procedures. 7 Fortunately, CT iterative reconstruction algorithms enable lower dose scanning protocols for clinical use.…”

Section: Introductionmentioning

confidence: 99%

Computational and human observer image quality evaluation of low dose, knowledge‐based CT iterative reconstruction

et al. 2015

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Purpose: Aims in this study are to (1) develop a computational model observer which reliably tracks the detectability of human observers in low dose computed tomography (CT) images reconstructed with knowledge-based iterative reconstruction (IMR™, Philips Healthcare) and filtered back projection (FBP) across a range of independent variables, (2) use the model to evaluate detectability trends across reconstructions and make predictions of human observer detectability, and (3) perform human observer studies based on model predictions to demonstrate applications of the model in CT imaging. Methods: Detectability (d ′ ) was evaluated in phantom studies across a range of conditions. Images were generated using a numerical CT simulator. Trained observers performed 4-alternative forced choice (4-AFC) experiments across dose (1.3, 2.7, 4.0 mGy), pin size (4, 6, 8 mm), contrast (0.3%, 0.5%, 1.0%), and reconstruction (FBP, IMR), at fixed display window. A five-channel Laguerre-Gauss channelized Hotelling observer (CHO) was developed with internal noise added to the decision variable and/or to channel outputs, creating six different internal noise models. Semianalytic internal noise computation was tested against Monte Carlo and used to accelerate internal noise parameter optimization. Model parameters were estimated from all experiments at once using maximum likelihood on the probability correct, P C . Akaike information criterion (AIC) was used to compare models of different orders. The best model was selected according to AIC and used to predict detectability in blended FBP-IMR images, analyze trends in IMR detectability improvements, and predict dose savings with IMR. Predicted dose savings were compared against 4-AFC study results using physical CT phantom images. Results: Detection in IMR was greater than FBP in all tested conditions. The CHO with internal noise proportional to channel output standard deviations, Model-k4, showed the best trade-off between fit and model complexity according to AIC c . With parameters fixed, the model reasonably predicted detectability of human observers in blended FBP-IMR images. Semianalytic internal noise computation gave results equivalent to Monte Carlo, greatly speeding parameter estimation. Using Model-k4, the authors found an average detectability improvement of 2.7 ± 0.4 times that of FBP. IMR showed greater improvements in detectability with larger signals and relatively consistent improvements across signal contrast and x-ray dose. In the phantom tested, Model-k4 predicted an 82% dose reduction compared to FBP, verified with physical CT scans at 80% reduced dose. Conclusions: IMR improves detectability over FBP and may enable significant dose reductions. A channelized Hotelling observer with internal noise proportional to channel output standard deviation agreed well with human observers across a wide range of variables, even across reconstructions with drastically different image characteristics. Utility of the model observer was demonstrated by predicting the effect of im...

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Achieving Routine Submillisievert CT Scanning: Report from the Summit on Management of Radiation Dose in CT

Cited by 249 publications

References 86 publications

Temporal Bone CT: Improved Image Quality and Potential for Decreased Radiation Dose Using an Ultra-High-Resolution Scan Mode with an Iterative Reconstruction Algorithm

Temporal Bone CT: Improved Image Quality and Potential for Decreased Radiation Dose Using an Ultra-High-Resolution Scan Mode with an Iterative Reconstruction Algorithm

Compliance with AAPM Practice Guideline 1.a: CT Protocol Management and Review — from the perspective of a university hospital

Computational and human observer image quality evaluation of low dose, knowledge‐based CT iterative reconstruction

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