Model-Based Iterative Reconstruction in CT Enterography

Murphy, Kevin P.; Crush, Lee; Twomey, Maria; McLaughlin, Patrick D.; Mildenberger, Iris; Moore, Niamh; Bye, Jackie; O’Connor, Owen J.; McSweeney, Sean; Shanahan, Fergus; Maher, Michael M.

doi:10.2214/ajr.14.13321

Cited by 18 publications

(18 citation statements)

References 34 publications

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“…Technical and anthropomorphic phantoms provide a safe, objective and reproducible method of assessing the image quality of different reconstruction algorithms over a range of radiation dose levels. Preliminary phantom experiments with MBIR report a significant reduction in image noise and streak artefact, with significant improvements in image quality compared to FBP and ASIR …”

Section: Introductionmentioning

confidence: 99%

“…However, patient studies to assess the performance of reconstruction algorithms at different dose levels can often be problematic to implement, as imaging large numbers of patients at different dose settings introduces confounding factors in addition to ethical challenges. To date, clinical studies assessing the use of MBIR in abdominopelvic CT are limited …”

Section: Introductionmentioning

confidence: 99%

“…Preliminary phantom experiments with MBIR report a significant reduction in image noise and streak artefact, with significant improvements in image quality compared to FBP and ASIR. 23,24 Many phantom models do not accurately reflect the complex relationship that exists between anatomical variability and image quality, and results of phantom studies may not be entirely applicable to the clinical setting. However, patient studies to assess the performance of reconstruction algorithms at different dose levels can often be problematic to implement, as imaging large numbers of patients at different dose settings introduces confounding factors in addition to ethical challenges.…”

Section: Introductionmentioning

confidence: 99%

“…To date, clinical studies assessing the use of MBIR in abdominopelvic CT are limited. 13,23 The use of radiological images acquired from cadavers for research, 24 teaching 25 and training 26 purposes has been well described in the literature. Cadavers also provide an excellent model with which to compare reconstruction algorithms by facilitating the repeated scanning of one subject over a range of radiation dose settings without movement artefact or dose concerns.…”

Section: Introductionmentioning

confidence: 99%

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Determination of a suitable low‐dose abdominopelvic CT protocol using model‐based iterative reconstruction through cadaveric study

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Determination of a suitable low‐dose abdominopelvic CT protocol using model‐based iterative reconstruction through cadaveric study

et al. 2018

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“…There have been huge strides made recently in the attempts to reduce the radiation exposure to patients from CT. Dose reduction techniques include automatic tube current modulation [ 63 ], truncated protocols with fewer images [ 64 ], increasing acceptable image noise [ 65 ], reduced mA and kV scanning, and clinical use of new iterative reconstruction techniques [ 66 , 67 ]. There is a fine balance to be struck between reducing individual patient radiation exposure and maintaining sufficient image quality to allow an accurate diagnosis to be made, and this is an area of intensive research.…”

Section: Computed Tomographymentioning

confidence: 99%

Low-Dose Computed Tomography for the Optimization of Radiation Dose Exposure in Patients with Crohn’s Disease

Kavanagh

O’Grady

Carey

et al. 2018

Gastroenterology Research and Practice

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Magnetic resonance imaging (MRI) is the mainstay method for the radiological imaging of the small bowel in patients with inflammatory bowel disease without the use of ionizing radiation. There are circumstances where imaging using ionizing radiation is required, particularly in the acute setting. This usually takes the form of computed tomography (CT). There has been a significant increase in the utilization of computed tomography (CT) for patients with Crohn's disease as patients are frequently diagnosed at a relatively young age and require repeated imaging. Between seven and eleven percent of patients with IBD are exposed to high cumulative effective radiation doses (CEDs) (>35–75 mSv), mostly patients with Crohn's disease (Newnham E 2007, Levi Z 2009, Hou JK 2014, Estay C 2015). This is primarily due to the more widespread and repeated use of CT, which accounts for 77% of radiation dose exposure amongst patients with Crohn's disease (Desmond et al., 2008). Reports of the projected cancer risks from the increasing CT use (Berrington et al., 2007) have led to increased patient awareness regarding the potential health risks from ionizing radiation (Coakley et al., 2011). Our responsibilities as physicians caring for these patients include education regarding radiation risk and, when an investigation that utilizes ionizing radiation is required, to keep radiation doses as low as reasonably achievable: the “ALARA” principle. Recent advances in CT technology have facilitated substantial radiation dose reductions in many clinical settings, and several studies have demonstrated significantly decreased radiation doses in Crohn's disease patients while maintaining diagnostic image quality. However, there is a balance to be struck between reducing radiation exposure and maintaining satisfactory image quality; if radiation dose is reduced excessively, the resulting CT images can be of poor quality and may be nondiagnostic. In this paper, we summarize the available evidence related to imaging of Crohn's disease, radiation exposure, and risk, and we report recent advances in low-dose CT technology that have particular relevance.

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Visceral adipose tissue volume effect in Crohn's disease using reduced exposure CT enterography

Hunter,

Baker,

Ream

et al. 2023

J Applied Clin Med Phys

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PurposeThe purpose of this investigation was to assess the effect of visceral adipose tissue volume (VA) on reader efficacy in diagnosing and characterizing small bowel Crohn's disease using lower exposure CT enterography (CTE). Secondarily, we investigated the effect of lower exposure and VA on reader diagnostic confidence.MethodsProspective paired investigation of 256 CTE, 129 with Crohn's disease, were reconstructed at 100% and simulated 50% and 30% exposure. The senior author provided the disease classification for the 129 patients with Crohn's disease. Patient VA was measured, and exams were evaluated by six readers for presence or absence of Crohn's disease and phenotype using a 0–10‐point scale. Logistic regression models assessed the effect of VA on sensitivity and specificity.ResultsThe effect of VA on sensitivity was significantly reduced at 30% exposure (odds radio [OR]: 1.00) compared to 100% exposure (OR: 1.12) (p = 0.048). There was no statistically significant difference among the exposures with respect to the effect of visceral fat on specificity (p = 0.159). The study readers’ probability of agreement with the senior author on disease classification was 60%, 56%, and 53% at 100%, 50%, and 30% exposure, respectively (p = 0.004). When detecting low severity Crohn's disease, readers’ mean sensitivity was 83%, 75%, and 74% at 100%, 50%, and 30% exposure, respectively (p = 0.002). In low severity disease, sensitivity also tended to increase as visceral fat increased (ORs per 1000 cm3 increase in visceral fat: 1.32, 1.31, and 1.18, p = 0.010, 0.016, and 0.100, at 100%, 50%, and 30% exposure).ConclusionsWhile the interaction is complex, VA plays a role in detecting and characterizing small bowel Crohn's disease when exposure is altered, particularly in low severity disease.

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Model-Based Iterative Reconstruction in CT Enterography

Abstract: Low-dose CT enterography with MBIR yields images that are comparable to or superior to conventional images.

Cited by 18 publications

References 34 publications

Determination of a suitable low‐dose abdominopelvic CT protocol using model‐based iterative reconstruction through cadaveric study

Determination of a suitable low‐dose abdominopelvic CT protocol using model‐based iterative reconstruction through cadaveric study

Low-Dose Computed Tomography for the Optimization of Radiation Dose Exposure in Patients with Crohn’s Disease

Visceral adipose tissue volume effect in Crohn's disease using reduced exposure CT enterography

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