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01-02-2014 | Computed Tomography

Radiation dose reduction in cerebral CT perfusion imaging using iterative reconstruction

Authors: Joris M. Niesten, Irene C. van der Schaaf, Alan J. Riordan, Hugo W. A. M. de Jong, Alexander D. Horsch, Daniel Eijspaart, Ewoud J. Smit, Willem P. T. M. Mali, Birgitta K. Velthuis

Published in: European Radiology | Issue 2/2014

Abstract

Objectives

To investigate whether iterative reconstruction (IR) in cerebral CT perfusion (CTP) allows for 50 % dose reduction while maintaining image quality (IQ).

Methods

A total of 48 CTP examinations were reconstructed into a standard dose (150 mAs) with filtered back projection (FBP) and half-dose (75 mAs) with two strengths of IR (middle and high). Objective IQ (quantitative perfusion values, contrast-to-noise ratio (CNR), penumbra, infarct area and penumbra/infarct (P/I) index) and subjective IQ (diagnostic IQ on a four-point Likert scale and overall IQ binomial) were compared among the reconstructions.

Results

Half-dose CTP with high IR level had, compared with standard dose with FBP, similar objective (grey matter cerebral blood volume (CBV) 4.4 versus 4.3 mL/100 g, CNR 1.59 versus 1.64 and P/I index 0.74 versus 0.73, respectively) and subjective diagnostic IQ (mean Likert scale 1.42 versus 1.49, respectively). The overall IQ in half-dose with high IR level was scored lower in 26–31 %. Half-dose with FBP and with the middle IR level were inferior to standard dose with FBP.

Conclusion

With the use of IR in CTP imaging it is possible to examine patients with a half dose without significantly altering the objective and diagnostic IQ. The standard dose with FBP is still preferable in terms of subjective overall IQ in about one quarter of patients.

Key points

• Computed tomography perfusion (CTP) is increasingly important in ischaemia imaging.

• Radiation exposure of CTP is a drawback.

• Iterative reconstruction (IR) allows reduction of radiation dose in unenhanced head CT.

• CTP IR enables 50 % dose reduction without altering objective and diagnostic quality.

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Title: Radiation dose reduction in cerebral CT perfusion imaging using iterative reconstruction
Authors: Joris M. Niesten
Irene C. van der Schaaf
Alan J. Riordan
Hugo W. A. M. de Jong
Alexander D. Horsch
Daniel Eijspaart
Ewoud J. Smit
Willem P. T. M. Mali
Birgitta K. Velthuis
Publication date: 01-02-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-3042-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Radiation dose reduction in cerebral CT perfusion imaging using iterative reconstruction

Abstract

Objectives

Methods

Results

Conclusion

Key points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key points

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