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European Radiology
Published in: European Radiology 1/2018

Open Access 01-01-2018 | Computed Tomography

Radiation dose reduction for CT assessment of urolithiasis using iterative reconstruction: A prospective intra-individual study

Authors: Annemarie M. den Harder, Martin J. Willemink, Pieter J. van Doormaal, Frank J. Wessels, M. T. W. T. Lock, Arnold M. R. Schilham, Ricardo P. J. Budde, Tim Leiner, Pim A. de Jong

Published in: European Radiology | Issue 1/2018

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Abstract

Objective

To assess the performance of hybrid (HIR) and model-based iterative reconstruction (MIR) in patients with urolithiasis at reduced-dose computed tomography (CT).

Methods

Twenty patients scheduled for unenhanced abdominal CT for follow-up of urolithiasis were prospectively included. Routine dose acquisition was followed by three low-dose acquisitions at 40%, 60% and 80% reduced doses. All images were reconstructed with filtered back projection (FBP), HIR and MIR. Urolithiasis detection rates, gall bladder, appendix and rectosigmoid evaluation and overall subjective image quality were evaluated by two observers.

Results

74 stones were present in 17 patients. Half the stones were not detected on FBP at the lowest dose level, but this improved with MIR to a sensitivity of 100%. HIR resulted in a slight decrease in sensitivity at the lowest dose to 72%, but outperformed FBP. Evaluation of other structures with HIR at 40% and with MIR at 60% dose reductions was comparable to FBP at routine dose, but 80% dose reduction resulted in non-evaluable images.

Conclusions

CT radiation dose for urolithiasis detection can be safely reduced by 40 (HIR)–60 (MIR) % without affecting assessment of urolithiasis, possible extra-urinary tract pathology or overall image quality.

Key Points

• Iterative reconstruction can be used to substantially lower the radiation dose.
• This allows for radiation reduction without affecting sensitivity of stone detection.
• Possible extra-urinary tract pathology evaluation is feasible at 40–60% reduced dose.
Appendix
Available only for authorised users
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Metadata
Title
Radiation dose reduction for CT assessment of urolithiasis using iterative reconstruction: A prospective intra-individual study
Authors
Annemarie M. den Harder
Martin J. Willemink
Pieter J. van Doormaal
Frank J. Wessels
M. T. W. T. Lock
Arnold M. R. Schilham
Ricardo P. J. Budde
Tim Leiner
Pim A. de Jong
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4929-2

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