Pure Iterative Reconstruction Improves Image Quality in Computed Tomography of the Abdomen and Pelvis Acquired at Substantially Reduced Radiation Doses in Patients With Active Crohn Disease

McLaughlin, Patrick D.; Murphy, Kevin P.; Twomey, Maria; O’Neill, Siobhán; Moloney, Fiachra; O’Connor, Owen J.; O’Regan, Kevin; McSweeney, Sean; McGarrigle, Anne Marie; Moore, Niamh; Bye, Jackie; Shanahan, Fergus; Maher, Michael M.

doi:10.1097/rct.0000000000000358

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…The advent of low-dose CT has assisted in the assessment of acutely unwell patients with IBD who are at increased risk of high cumulative radiation exposure from diagnostic imaging [ 39 ]. This is the first paper to examine the roles of both sarcopenia and myosteatosis, as measured by CT, in patients with IBD with respect to postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

The impact of sarcopenia and myosteatosis on postoperative outcomes in patients with inflammatory bowel disease

et al. 2018

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BackgroundInflammatory bowel disease (IBD) is a relatively common disorder with significant associated morbidity. Sarcopenia and myosteatosis are associated with adverse postoperative outcomes. This study investigated outcomes in IBD patients undergoing surgical resection relative to the presence of sarcopenia and myosteatosis.MethodsA retrospective analysis of a prospectively maintained surgical database was conducted. All patients undergoing elective or emergency resection for IBD between 2011 and 2016, with a contemporaneous perioperative computed tomography (CT) scan, were included. Patient demographics, clinical and biochemical measurements were collected. Skeletal muscle index and attenuation were measured on perioperative CT scans using Osirix version 5.6.1. Univariate and multivariate regression analysis was used to identify risk factors for adverse postoperative outcomes.ResultsSeventy-seven patients (46 male, 31 female; mean age 42 years, range 20–80 years) were included. Thirty patients (30%) had sarcopenia and 26 (34%) had myosteatosis. Myosteatosis was significantly associated with increased hospital stay postoperatively (9 versus 13 days). Sarcopenia and myosteatosis were associated with hospital readmission within 30 days on univariate analysis. Multivariate regression analysis demonstrated an independent association between myosteatosis and hospital readmission. Sixteen patients (21%) had a clinically relevant postoperative complication, but an association with sarcopenia and myosteatosis was not observed. A neutrophil-lymphocyte ratio greater than 5 was predictive of clinically relevant postoperative complications on multivariate regression analysis.ConclusionsMyosteatosis was associated with increased hospital stay and increased 30-day hospital readmission rates on multivariate regression analysis. Sarcopenia and myosteatosis in IBD were not associated with clinically relevant postoperative complications.

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Section: Discussionmentioning

confidence: 99%

The impact of sarcopenia and myosteatosis on postoperative outcomes in patients with inflammatory bowel disease

et al. 2018

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“…In a previous clinical study of the same patient cohort at our institution, we assessed the diagnostic accuracy and image quality of a modified low‐dose abdominopelvic CT protocol reconstructed using MBIR in patients with Crohn's disease . Although we observed perfect agreement between MP‐MBIR studies and a conventional dose protocol reconstructed using ASiR 40 for the detection of extramural complications, diagnostic acceptability, spatial resolution and contrast resolution scores were significantly lower and subjective noise scores were significantly higher for the low‐dose studies.…”

Section: Discussionmentioning

confidence: 83%

Accurate tissue characterization in low‐dose CT imaging with pure iterative reconstruction

et al. 2016

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“…Numerous studies have documented high radiation exposure in the IBD patient population, principally from CT [56–61]. There are clear recommendations to minimise patient dose by optimisation of tube voltage [62] and tube current, together with routine use of iterative reconstruction techniques [50, 52, 63–68] which are increasingly available and capable of producing high image quality. For example, a tube voltage in the range of 80-100 kV can reduce radiation dose and increase contrast resolution [64].…”

Section: Discussionmentioning

confidence: 99%

The first joint ESGAR/ ESPR consensus statement on the technical performance of cross-sectional small bowel and colonic imaging

et al. 2016

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ObjectivesTo develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease.MethodsAn expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols.ResultsOne hundred and fifty-seven statements were scored for agreement by the panel of which 129 statements (82 %) achieved immediate consensus with a further 19 (12 %) achieving consensus after appropriate modification. Nine (6 %) statements were rejected as consensus could not be reached.ConclusionsThese expert consensus recommendations can be used to help guide cross-sectional radiological practice for imaging the small bowel and colon.Key points• Cross-sectional imaging is increasingly used to evaluate the bowel • Image quality is paramount to achieving high diagnostic accuracy • Guidelines concerning patient preparation and image acquisition protocols are provided

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Pure Iterative Reconstruction Improves Image Quality in Computed Tomography of the Abdomen and Pelvis Acquired at Substantially Reduced Radiation Doses in Patients With Active Crohn Disease

Abstract: Modified protocol CT using pure IR is feasible for assessment of active CD.

Cited by 7 publications

References 30 publications

The impact of sarcopenia and myosteatosis on postoperative outcomes in patients with inflammatory bowel disease

The impact of sarcopenia and myosteatosis on postoperative outcomes in patients with inflammatory bowel disease

Accurate tissue characterization in low‐dose CT imaging with pure iterative reconstruction

The first joint ESGAR/ ESPR consensus statement on the technical performance of cross-sectional small bowel and colonic imaging

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