Evaluation of an iterative model–based reconstruction algorithm for low-tube-voltage (80 kVp) computed tomography angiography

Noël, Peter B.; Köhler, Thomas; Fingerle, Alexander A.; Brown, Kevin M.; Žabić, Stanislav; Münzel, Daniela; Haller, Bernhard; Baum, Thomas; Henninger, Martin; Meier, Reinhard; Rummeny, Ernst J.; Dobritz, Martin

doi:10.1117/1.jmi.1.3.033501

Cited by 18 publications

(16 citation statements)

References 21 publications

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“…Previous studies proved that images reconstructed with iDose present much better image quality than images reconstructed with FBP, making lower tube currents with a maintained high diagnostic confidence possible [22]. This study confirms these results regarding iDose-images with focus on subjective and objective image criteria.…”

Section: Discussionsupporting

confidence: 85%

Ultra Low Dose CT Pulmonary Angiography with Iterative Reconstruction

et al. 2016

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ObjectiveEvaluation of a new iterative reconstruction algorithm (IMR) for detection/rule-out of pulmonary embolism (PE) in ultra-low dose computed tomography pulmonary angiography (CTPA).MethodsLower dose CT data sets were simulated based on CTPA examinations of 16 patients with pulmonary embolism (PE) with dose levels (DL) of 50%, 25%, 12.5%, 6.3% or 3.1% of the original tube current setting. Original CT data sets and simulated low-dose data sets were reconstructed with three reconstruction algorithms: the standard reconstruction algorithm “filtered back projection” (FBP), the first generation iterative reconstruction algorithm iDose and the next generation iterative reconstruction algorithm “Iterative Model Reconstruction” (IMR). In total, 288 CTPA data sets (16 patients, 6 tube current levels, 3 different algorithms) were evaluated by two blinded radiologists regarding image quality, diagnostic confidence, detectability of PE and contrast-to-noise ratio (CNR).ResultsiDose and IMR showed better detectability of PE than FBP. With IMR, sensitivity for detection of PE was 100% down to a dose level of 12.5%. iDose and IMR showed superiority to FBP regarding all characteristics of subjective (diagnostic confidence in detection of PE, image quality, image noise, artefacts) and objective image quality. The minimum DL providing acceptable diagnostic performance was 12.5% (= 0.45 mSv) for IMR, 25% (= 0.89 mSv) for iDose and 100% (= 3.57 mSv) for FBP. CNR was significantly (p < 0.001) improved by IMR compared to FBP and iDose at all dose levels.ConclusionBy using IMR for detection of PE, dose reduction for CTPA of up to 75% is possible while maintaining full diagnostic confidence. This would result in a mean effective dose of approximately 0.9 mSv for CTPA.

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Section: Discussionsupporting

confidence: 85%

Ultra Low Dose CT Pulmonary Angiography with Iterative Reconstruction

et al. 2016

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“…IMA is not uncommon, accounting for approximately 25% of the total number of patients with IC rupture; however, it can cause severe SAH. CTA has been clinically used as a routine means of diagnosing IA owing to its high speed and effective diagnosis ; ‐ ; however, it is also controversial because of its radiation problems, as well as the detection rate of IMA . It is therefore necessary to further discuss the feasibility of L‐CTA in displaying IMA.…”

Section: Discussionmentioning

confidence: 99%

“…Although magnetic resonance angiography (MRA) is a radiation‐free alternative for the diagnosis of IA, and MRA imaging has been developed in recent years, its results may be affected owing to long acquisition times, flow empty phenomena, and SAH patients' disturbance‐induced movement artifacts. Computed tomography angiography (CTA) plays an increasingly important role in screen suspected IA patients, and has been widely used as a routine diagnostic tool for IA . However, the accuracies of CTA in diagnosing intracranial micro‐aneurysms (IMA) vary from 61% to 98.2%; moreover, the detection rate of IMA when CTA is utilized is controversial, yet the detection rate of IMA is an important indicator for judging CTA's sensitivity.…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography angiography (CTA) plays an increasingly important role in screen suspected IA patients, and has been widely used as a routine diagnostic tool for IA . However, the accuracies of CTA in diagnosing intracranial micro‐aneurysms (IMA) vary from 61% to 98.2%; moreover, the detection rate of IMA when CTA is utilized is controversial, yet the detection rate of IMA is an important indicator for judging CTA's sensitivity. In addition, the radiation dose of CT scanning is also a matter of concern .…”

Section: Introductionmentioning

confidence: 99%

“… To the best of the authors' knowledge, there are no L‐CTA reports on IMA ≤3 mm. As IMA accounts for approximately a quarter of IA cases, this study compared I–L‐CTA with 3D rotational angiography (3DRA), aiming to investigate the coincidence rate of L‐CTA with 3DRA in detecting IMA.…”

Section: Introductionmentioning

confidence: 99%

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Control study of low tube voltage computed tomography angiography (CTA) and digital subtraction angiography (DSA) in diagnosing intracranial micro‐aneurysm

Duan

Liu

et al. 2017

Int J Imaging Syst Tech

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The aim of this study was to investigate the diagnostic values of low tube voltage cerebral computed tomography (CT) angiography (L‐CTA, 100 kV) of intracranial micro‐aneurysms (IMA, maximum diameter ≤3 mm). The clinical and imaging data of a total of 59 IMA patients confirmed by 3D rotational angiography (3DRA) or surgery were retrospectively analyzed; their L‐CTA data were compared with those of IMA and 3DRA so as to investigate the diagnostic sensitivity, specificity, and accuracy of IMA, as well as to objectively evaluate the related radiation dose. Based on the results of 3DRA, 65 cases of IMA and a total of 70 aneurysms, including 65 micro‐aneurysms, were found in the 59 cases. L‐CTA detected a total of 64 IMA, including six multiple cases of IMA, as well as three false positive cases and four missed cases. Compared with the 3DRA (gold standard), the diagnostic sensitivity, specificity, and accuracy of L‐CTA toward IMA were 93.85%, 99.56%, and 99.08%, respectively, and the associations of aneurysm size measured by L‐CTA and 3DRA were good. Compared with conventional CTA, the effective dose of L‐CTA was reduced by 36.23%. L‐CTA has high diagnostic sensitivity toward IMA, and can effectively reduce the radiation dose, so it is worth implementing.

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