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European Radiology

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01-11-2014 | Chest

Reducing radiation dose in the diagnosis of pulmonary embolism using adaptive statistical iterative reconstruction and lower tube potential in computed tomography

Authors: David Kaul, Ulrich Grupp, Johannes Kahn, Pirus Ghadjar, Edzard Wiener, Bernd Hamm, Florian Streitparth

Published in: European Radiology | Issue 11/2014

Abstract

Objectives

To assess the impact of ASIR (adaptive statistical iterative reconstruction) and lower tube potential on dose reduction and image quality in chest computed tomography angiographies (CTAs) of patients with pulmonary embolism.

Materials and methods

CT data from 44 patients with pulmonary embolism were acquired using different protocols—Group A: 120 kV, filtered back projection, n = 12; Group B: 120 kV, 40 % ASIR, n = 12; Group C: 100 kV, 40 % ASIR, n = 12 and Group D: 80 kV, 40 % ASIR, n = 8. Normalised effective dose was calculated; image quality was assessed quantitatively and qualitatively.

Results

Normalised effective dose in Group B was 33.8 % lower than in Group A (p = 0.014) and 54.4 % lower in Group C than in Group A (p < 0.001). Group A, B and C did not show significant differences in qualitative or quantitative analysis of image quality. Group D showed significantly higher noise levels in qualitative and quantitative analysis, significantly more artefacts and decreased overall diagnosability. Best results, considering dose reduction and image quality, were achieved in Group C.

Conclusions

The combination of ASIR and lower tube potential is an option to reduce radiation without significant worsening of image quality in the diagnosis of pulmonary embolism.

Key Points

• Iterative algorithms and lowering of tube potential reduce radiation without compromising interpretability

• 40 % ASIR and 100 kV tube potential led to a 54.4 % dose reduction

• 40 % ASIR and 80 kV tube potential led to significantly worse image quality

Huisman MV, Klok FA (2013) How I diagnose acute pulmonary embolism. Blood 121:4443–4448PubMedCrossRef

Hall EJ, Brenner DJ (2008) Cancer risks from diagnostic radiology. Br J Radiol 81:362–378PubMedCrossRef

Berrington de Gonzalez A, Mahesh M, Kim KP et al (2009) Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med 169:2071–2077PubMedCrossRef

Kalender WA, Wolf H, Suess C (1999) Dose reduction in CT by anatomically adapted tube current modulation. II. Phantom measurements. Med Phys 26:2248–2253PubMedCrossRef

McCollough CH, Bruesewitz MR, Kofler JM Jr (2006) CT dose reduction and dose management tools: overview of available options. Radiographics 26:503–512PubMedCrossRef

Willemink MJ, Leiner T, de Jong PA et al (2013) Iterative reconstruction techniques for computed tomography part 2: initial results in dose reduction and image quality. Eur Radiol 23:1632–1642PubMedCrossRef

Willemink MJ, de Jong PA, Leiner T et al (2013) Iterative reconstruction techniques for computed tomography Part 1: technical principles. Eur Radiol 23:1623–1631PubMedCrossRef

Ridge CA, Litmanovich D, Bukoye BA et al (2013) Computed tomography angiography for suspected pulmonary embolism: comparison of 2 adaptive statistical iterative reconstruction blends to filtered back-projection alone. J Comput Assist Tomogr 37:712–717PubMedCrossRef

Sigal-Cinqualbre AB, Hennequin R, Abada HT, Chen X, Paul JF (2004) Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology 231:169–174PubMedCrossRef

10.

Szucs-Farkas Z, Verdun FR, von Allmen G, Mini RL, Vock P (2008) Effect of X-ray tube parameters, iodine concentration, and patient size on image quality in pulmonary computed tomography angiography: a chest-phantom-study. Invest Radiol 43:374–381PubMedCrossRef

11.

Niemann T, Henry S, Faivre JB et al (2013) Clinical evaluation of automatic tube voltage selection in chest CT angiography. Eur Radiol 23:2643–2651PubMedCrossRef

12.

Kovacs G, Avian A, Olschewski A, Olschewski H (2013) Zero reference level for right heart catheterisation. Eur Respir J 42:1586–1594PubMedCrossRef

13.

Qi LP, Li Y, Tang L et al (2012) Evaluation of dose reduction and image quality in chest CT using adaptive statistical iterative reconstruction with the same group of patients. Br J Radiol 85:e906–e911PubMedCrossRefPubMedCentral

14.

Smith-Bindman R, Lipson J, Marcus R et al (2009) Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 169:2078–2086PubMedCrossRef

15.

Lee Y, Jin KN, Lee NK (2012) Low-dose computed tomography of the chest using iterative reconstruction versus filtered back projection: comparison of image quality. J Comput Assist Tomogr 36:512–517PubMedCrossRef

16.

Baumueller S, Winklehner A, Karlo C et al (2012) Low-dose CT of the lung: potential value of iterative reconstructions. Eur Radiol 22:2597–2606PubMedCrossRef

17.

Bjorkdahl P, Nyman U (2010) Using 100- instead of 120-kVp computed tomography to diagnose pulmonary embolism almost halves the radiation dose with preserved diagnostic quality. Acta Radiol 51:260–270PubMedCrossRef

Title: Reducing radiation dose in the diagnosis of pulmonary embolism using adaptive statistical iterative reconstruction and lower tube potential in computed tomography
Authors: David Kaul
Ulrich Grupp
Johannes Kahn
Pirus Ghadjar
Edzard Wiener
Bernd Hamm
Florian Streitparth
Publication date: 01-11-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 11/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3290-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reducing radiation dose in the diagnosis of pulmonary embolism using adaptive statistical iterative reconstruction and lower tube potential in computed tomography

Abstract

Objectives

Materials and methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Key Points

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