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European Radiology

16-05-2024 | Computed Tomography

Low tube voltage and deep-learning reconstruction for reducing radiation and contrast medium doses in thin-slice abdominal CT: a prospective clinical trial

Authors: Kenichiro Yoshida, Yasunori Nagayama, Yoshinori Funama, Soichiro Ishiuchi, Toshihiko Motohara, Toshiro Masuda, Takeshi Nakaura, Takatoshi Ishiko, Toshinori Hirai, Toru Beppu

Published in: European Radiology

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Abstract

Objectives

To investigate the feasibility of low-radiation dose and low iodinated contrast medium (ICM) dose protocol combining low-tube voltage and deep-learning reconstruction (DLR) algorithm in thin-slice abdominal CT.

Methods

This prospective study included 148 patients who underwent contrast-enhanced abdominal CT with either 120-kVp (600 mgL/kg, n = 74) or 80-kVp protocol (360 mgL/kg, n = 74). The 120-kVp images were reconstructed using hybrid iterative reconstruction (HIR) (120-kVp-HIR), while 80-kVp images were reconstructed using HIR (80-kVp-HIR) and DLR (80-kVp-DLR) with 0.5 mm thickness. Size-specific dose estimate (SSDE) and iodine dose were compared between protocols. Image noise, CT attenuation, and contrast-to-noise ratio (CNR) were quantified. Noise power spectrum (NPS) and edge rise slope (ERS) were used to evaluate noise texture and edge sharpness, respectively. The subjective image quality was rated on a 4-point scale.

Results

SSDE and iodine doses of 80-kVp were 40.4% (8.1 ± 0.9 vs. 13.6 ± 2.7 mGy) and 36.3% (21.2 ± 3.9 vs. 33.3 ± 4.3 gL) lower, respectively, than those of 120-kVp (both, p < 0.001). CT attenuation of vessels and solid organs was higher in 80-kVp than in 120-kVp images (all, p < 0.001). Image noise of 80-kVp-HIR and 80-kVp-DLR was higher and lower, respectively than that of 120-kVp-HIR (both p < 0.001). The highest CNR and subjective scores were attained in 80-kVp-DLR (all, p < 0.001). There were no significant differences in average NPS frequency and ERS between 120-kVp-HIR and 80-kVp-DLR (p ≥ 0.38).

Conclusion

Compared with the 120-kVp-HIR protocol, the combined use of 80-kVp and DLR techniques yielded superior subjective and objective image quality with reduced radiation and ICM doses at thin-section abdominal CT.

Clinical relevance statement

Scanning at low-tube voltage (80-kVp) combined with the deep-learning reconstruction algorithm may enhance diagnostic efficiency and patient safety by improving image quality and reducing radiation and contrast doses of thin-slice abdominal CT.

Key Points

  • Reducing radiation and iodine doses is desirable; however, contrast and noise degradation can be detrimental.
  • The 80-kVp scan with the deep-learning reconstruction technique provided better images with lower radiation and contrast doses.
  • This technique may be efficient for improving diagnostic confidence and patient safety in thin-slice abdominal CT.
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Metadata
Title
Low tube voltage and deep-learning reconstruction for reducing radiation and contrast medium doses in thin-slice abdominal CT: a prospective clinical trial
Authors
Kenichiro Yoshida
Yasunori Nagayama
Yoshinori Funama
Soichiro Ishiuchi
Toshihiko Motohara
Toshiro Masuda
Takeshi Nakaura
Takatoshi Ishiko
Toshinori Hirai
Toru Beppu
Publication date
16-05-2024
Publisher
Springer Berlin Heidelberg
Published in
European Radiology
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-024-10793-6