Dose Reduction in CT while Maintaining Diagnostic Confidence: Diagnostic Reference Levels at Routine Head, Chest, and Abdominal CT—IAEA-coordinated Research Project

Tsapaki, Virginia; Aldrich, John E.; Sharma, Raju; Staniszewska, Maria Anna; Krisanachinda, Anchali; Rehani, Madan M.; Hufton, Alan; Triantopoulou, Chariklia; Maniatis, Petros; Papailiou, John; Prokop, Mathias

doi:10.1148/radiol.2403050993

Cited by 128 publications

(71 citation statements)

References 19 publications

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“…In the HPS mode, the heart absorbed the highest doses among all thoracic organs, but the absorbed dose was only 10.0 mGy, which was less than that absorbed during a routine chest C T. 26 , 27 However, the absorbed organ doses were considerably higher for the other two acquisition modes, especially for the heart, which received approximately 200 mGy in the LPS mode. However, we did not use ECG modulation for LPS mode in this study.…”

Section: Discussionmentioning

confidence: 91%

Radiation dose and physical image quality in 128‐section dual‐source computed tomographic coronary angiography: a phantom study

Matsubara¹,

Koshida²,

Sakuta³

et al. 2012

J Applied Clin Med Phys

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One‐hundred‐and‐twenty‐eight–section dual X‐ray source computed tomography (CT) systems have been introduced into clinical practice and have been shown to increase temporal resolution. Higher temporal resolution allows low‐dose spiral mode at a high pitch factor during CT coronary angiography. We evaluated radiation dose and physical image qualities in CT coronary angiography by applying high‐pitch spiral, step‐and‐shoot, and low‐pitch spiral modes to determine the optimal acquisition mode for clinical situations. An anthropomorphic phantom, small dosimeters, a calibration phantom, and a microdisc phantom were used to evaluate the radiation doses absorbed by thoracic organs, noise power spectrums, in‐plane and z‐axis modulation transfer functions, slice sensitivity profiles, and number of artifacts for the three acquisition modes. The high‐pitch spiral mode had the advantage of a small absorbed radiation dose, but provided low image quality. The low‐pitch spiral mode resulted in a high absorbed radiation dose of approximately 200 mGy for the heart. Although the absorbed radiation dose was lower in the step‐and‐shoot mode than in the low‐pitch spiral mode, the noise power spectrum was inferior. The quality of the in‐plane modulation transfer function differed, depending on spatial frequency. Therefore, the step‐and‐shoot mode should be applied initially because of its low absorbed radiation dose and superior image quality.PACS numbers: 87.57.‐s; 87.57.C‐; 87.57.cf; 87.57.cm; 87.57.cp; 87.57.Q‐; 87.57.qp; 87.57.uq

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Section: Discussionmentioning

confidence: 91%

Radiation dose and physical image quality in 128‐section dual‐source computed tomographic coronary angiography: a phantom study

Matsubara¹,

Koshida²,

Sakuta³

et al. 2012

J Applied Clin Med Phys

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“…Over the last decade, chest radiologists have considerably modified their CTprotocols and thus, reduced the radiation dose distributed from CT examinations with no loss in the diagnostic quality of examinations [1][2][3]. These changes started with the understanding that high-quality examinations, devoid of perceptible image noise, could be obtained at lower doses by selecting weight-adapted protocols and/or using automatic tube current modulation systems [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Chest computed tomography using iterative reconstruction vs filtered back projection (Part 2): image quality of low-dose CT examinations in 80 patients

et al. 2010

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Purpose To evaluate the image quality of an iterative reconstruction algorithm (IRIS) in low-dose chest CT in comparison with standard-dose filtered back projection (FBP) CT. Materials and methods Eighty consecutive patients referred for a follow-up chest CT examination of the chest, underwent a low-dose CT examination (Group 2) in similar technical conditions to those of the initial examination, (Group 1) except for the milliamperage selection and the replacement of regular FBP reconstruction by iterative reconstructions using three (Group 2a) and five iterations (Group 2b). Results Despite a mean decrease of 35.5% in the doselength-product, there was no statistically significant difference between Group 2a and Group 1 in the objective noise, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios and distribution of the overall image quality scores. Compared to Group 1, objective image noise in Group 2b was significantly reduced with increased SNR and CNR and a trend towards improved image quality. Conclusion Iterative reconstructions using three iterations provide similar image quality compared with the conventionally used FBP reconstruction at 35% less dose, thus enabling dose reduction without loss of diagnostic information. According to our preliminary results, even higher dose reductions than 35% may be feasible by using more than three iterations.

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“…There is renewed concern in the medical community and lay press about the long-term effects of increased radiation burden from diagnostic X-rays, particularly from CT exams of the head, chest, abdomen, and pelvis in young patients, which sometimes occur several times a year (24,25). In one study, an unenhanced two-sequence single-shot MR examination of the upper abdomen was superior to contrast-enhanced CT for detection of disease in six out of eight anatomical categories in the upper abdomen (26).…”

Section: Discussionmentioning

confidence: 99%

Rapid multiplanar abdominal survey using MRI with the steady‐state free‐precession technique

Dutka

Bergin

O’Kane

et al. 2007

Magnetic Resonance Imaging

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Purpose: To retrospectively evaluate the sensitivity, specificity, and positive and negative predictive values of steadystate free-precession (SSFP) survey MRI of the abdomen. Materials and Methods:A total of 375 consecutive outpatients underwent abdominal MRI at 1.5T. Excluding diffuse metastatic disease, 110 patients had at least one other clinically important finding. The SSFP survey included contiguous 5-mm-thick axial, sagittal, and coronal slices (total 90 slices) obtained during a total of 90 seconds of free breathing. Studies were reviewed by two experienced MRI readers independently, randomized, blinded, and at different sittings. The chi-squared test was used to compare SSFP to full MRI for showing clinically important findings. In a subset of 30 patients, confidence intervals (CI) were calculated to compare the accuracy of SSFP and full MRI as predictors of biopsy result.Results: SSFP detected 87.3% of clinically important findings and 93.3% of malignancies reported on the full MRI, with a 1.5% false-positive rate. Significant association was shown between SSFP and full MRI for clinically important findings (P Ͻ 0.0001). Compared to biopsy, accuracy of SSFP was high (85% Ϯ 12.7%), though not as high as full MRI (93.3% Ϯ 8.8%).Conclusion: SSFP provides a rapid survey of the abdomen, with good sensitivity and few false positives.

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Dose Reduction in CT while Maintaining Diagnostic Confidence: Diagnostic Reference Levels at Routine Head, Chest, and Abdominal CT—IAEA-coordinated Research Project

Abstract: Comparison of CT results with diagnostic reference levels revealed the need for revisions, partly because the newer scanners have improved technology that facilitates lower patient doses.

Cited by 128 publications

References 19 publications

Radiation dose and physical image quality in 128‐section dual‐source computed tomographic coronary angiography: a phantom study

Radiation dose and physical image quality in 128‐section dual‐source computed tomographic coronary angiography: a phantom study

Chest computed tomography using iterative reconstruction vs filtered back projection (Part 2): image quality of low-dose CT examinations in 80 patients

Rapid multiplanar abdominal survey using MRI with the steady‐state free‐precession technique

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