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01-04-2019 | Original Article

Low-dose CT imaging of the acute abdomen using model-based iterative reconstruction: a prospective study

Authors: Fiachra Moloney, Karl James, Maria Twomey, David Ryan, Tyler M. Grey, Amber Downes, Richard G. Kavanagh, Niamh Moore, Mary Jane Murphy, Jackie Bye, Brian W. Carey, Sean E. McSweeney, Conor Deasy, Emmett Andrews, Fergus Shanahan, Michael M. Maher, Owen J. O’Connor

Published in: Emergency Radiology | Issue 2/2019

Abstract

Objectives

Performance of a modified abdominopelvic CT protocol reconstructed using full iterative reconstruction (IR) was assessed for imaging patients presenting with acute abdominal symptoms.

Materials and methods

Fifty-seven patients (17 male, 40 female; mean age of 56.5 ± 8 years) were prospectively studied. Low-dose (LD) and conventional-dose (CD) CTs were contemporaneously acquired between November 2015 and March 2016. The LD and CD protocols imparted radiation exposures approximating 10–20% and 80–90% those of routine abdominopelvic CT, respectively. The LD images were reconstructed with model-based iterative reconstruction (MBIR), and CD images with hybrid IR (40% adaptive statistical iterative reconstruction (ASIR)). Image quality was assessed quantitatively and qualitatively. Independent clinical interpretations were performed with a 6-week delay between reviews.

Results

A 74.7% mean radiation dose reduction was achieved: LD effective dose (ED) 2.38 ± 1.78 mSv (size-specific dose estimate (SSDE) 3.77 ± 1.97 mGy); CD ED 7.04 ± 4.89 mSv (SSDE 10.74 ± 5.5 mGy). LD-MBIR images had significantly lower objective and subjective image noise compared with CD-ASIR (p < 0.0001). Noise reduction for LD-MBIR studies was greater for patients with BMI < 25 kg/m² than those with BMI ≥ 25 kg/m² (5.36 ± 3.2 Hounsfield units (HU) vs. 4.05 ± 3.1 HU, p < 0.0001). CD-ASIR studies had significantly better contrast resolution, and diagnostic acceptability (p < 0.0001 for all). LD-MBIR studies had significantly lower streak artifact (p < 0.0001). There was no difference in sensitivity for primary findings between the low-dose and conventional protocols with the exception of one case of enteritis.

Conclusions

Low-dose abdominopelvic CT performed with MBIR is a feasible radiation dose reduction strategy for imaging patients presenting with acute abdominal pain.

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Title: Low-dose CT imaging of the acute abdomen using model-based iterative reconstruction: a prospective study
Authors: Fiachra Moloney
Karl James
Maria Twomey
David Ryan
Tyler M. Grey
Amber Downes
Richard G. Kavanagh
Niamh Moore
Mary Jane Murphy
Jackie Bye
Brian W. Carey
Sean E. McSweeney
Conor Deasy
Emmett Andrews
Fergus Shanahan
Michael M. Maher
Owen J. O’Connor
Publication date: 01-04-2019
Publisher: Springer International Publishing
Published in: Emergency Radiology / Issue 2/2019
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-018-1658-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Low-dose CT imaging of the acute abdomen using model-based iterative reconstruction: a prospective study

Abstract

Objectives

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

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