Reduction of the radiation dose and the amount of contrast material in hepatic dynamic CT using low tube voltage and adaptive iterative dose reduction 3-dimensional

Abstract

The purpose of this study was to prospectively evaluate the image quality and the diagnostic ability of low tube voltage and reduced contrast material dose hepatic dynamic computed tomography (CT) reconstructed with adaptive iterative dose reduction 3-dimensional (AIDR 3D).Eighty-nine patients underwent hepatic dynamic CT using one of the 2 protocols: tube voltage of 120 kVp, contrast dose of 600 mgI/kg, and filtered back projection in Protocol A (n = 46), and tube voltage of 100 kVp, contrast dose of 500 mgI/kg, and AIDR 3D in Protocol B (n = 43). The volume CT dose index (CTDIvol) and size-specific dose estimates (SSDEs) were compared between the 2 groups. Objective image noise and tumor to liver contrast-to-noise ratio (CNR) were also compared. Three radiologists independently reviewed image quality. The jackknife alternative free-response receiver-operating characteristic (JAFROC) analysis was performed to compare diagnostic performance.The mean CTDIvol and SSDE of Protocol B (14.3 and 20.2, respectively) were significantly lower than those of Protocol A (22.1 and 31.4, P < .001). There were no significant differences in either objective image noise or CNR. In the qualitative analysis, 2 readers assigned significant lower scores to images of Protocol B for at least one of the 3 phases regarding overall image quality (P < .05). There was no significant difference in the JAFROC1 figure of merit between protocols.Low tube voltage CT with AIDR 3D yielded a reduction in radiation dose and in the amount of contrast material while maintaining diagnostic performance.

Towards Personalised Contrast Injection: Artificial-Intelligence-Derived Body Composition and Liver Enhancement in Computed Tomography

“…Future prospective studies could investigate the impact of personalised dosing on liver enhancement and diagnostic properties, which should also take tube voltage into account [14]. Many studies already investigated the potential of low kVp settings (e.g., 70, 80, and 100 kVp) [2,14,[29][30][31][32] or virtual monochromatic imaging with low kV reconstruction [33][34][35][36][37] in combination with a reduced amount of injected iodine in a more lightweight population using CT angiography protocols, wherein only the signal during the first pass of contrast media is crucial [29]. However, this has not properly been investigated for abdominal protocols yet, which rely on longer contrast media boluses to provide homogeneous enhancement of parenchymal organs, such as the liver.…”

The potential for reduced radiation dose from deep learning-based CT image reconstruction

“…Furthermore, lower tube voltage increases the X-ray absorption of iodine which improves iodine enhancement and potentially decreases the amount of contrast material used. [ 28 ] Conventionally, tube voltage of 120 kV has been widely used for abdominal CTs for optimal soft-tissue imaging. [ 29 ] However, in contrast-enhanced abdominal CTs, the desire to lower the tube voltage in order to obtain better image contrast for the higher attenuation of iodine as well as decreased radiation dose exists.…”

Reliability of standardized reporting system of acute appendicitis in adults at low-dose 320-rows CT

“…The CT images are reconstructed with ADIR-3D which improves spatial resolution and reduction of the noise levels and the radiation dose. The ADIR-3D is a reconstruction algorithm to improve the image noise and has shown to reduce the radiation dose in clinical practice [[31], [32], [33], [34]].…”