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European Radiology

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01-10-2019 | Tuberculosis | Chest

Ultralow-dose CT with knowledge-based iterative model reconstruction (IMR) in evaluation of pulmonary tuberculosis: comparison of radiation dose and image quality

Authors: Chenggong Yan, Chunyi Liang, Jun Xu, Yuankui Wu, Wei Xiong, Huan Zheng, Yikai Xu

Published in: European Radiology | Issue 10/2019

Abstract

Objectives

To evaluate the image quality of ultralow-dose computed tomography (ULDCT) reconstructed with knowledge-based iterative model reconstruction (IMR) in patients with pulmonary tuberculosis (TB).

Methods

This IRB-approved prospective study enrolled 59 consecutive patients (mean age, 43.9 ± 16.6 years; F:M 18:41) with known or suspected pulmonary TB. Patients underwent a low-dose CT (LDCT) using automatic tube current modulation followed by an ULDCT using fixed tube current. Raw image data were reconstructed with filtered-back projection (FBP), hybrid iterative reconstruction (iDose), and IMR. Objective measurements including CT attenuation, image noise, and contrast-to-noise ratio (CNR) were assessed and compared using repeated-measures analysis of variance. Overall image quality and visualization of normal and pathological findings were subjectively scored on a five-point scale. Radiation output and subjective scores were compared by the paired Student t test and Wilcoxon signed-rank test, respectively.

Results

Compared with FBP and iDose, IMR yielded significantly lower noise and higher CNR values at both dose levels (p < 0.01). Subjective ratings for pathological findings including centrilobular nodules, consolidation, tree-in-bud, and cavity were significantly better with ULDCT IMR images than those with LDCT iDose images (p < 0.01), but blurred edges were observed. With IMR implementation, a 59% reduction of the mean effective dose was achieved with ULDCT (0.28 ± 0.02 mSv) compared with LDCT (0.69 ± 0.15 mSv) without impairing image quality (p < 0.001).

Conclusions

IMR offers considerable noise reduction and improvement in image quality for patients with pulmonary TB undergoing chest ULDCT at an effective dose of 0.28 mSv.

Key Points

• Radiation dose is a major concern for tuberculosis patients requiring repeated follow-up CT.

• IMR allows substantial radiation dose reduction in chest CT without compromising image quality.

• ULDCT reconstructed with IMR allows accurate depiction of CT features of pulmonary tuberculosis.

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Title: Ultralow-dose CT with knowledge-based iterative model reconstruction (IMR) in evaluation of pulmonary tuberculosis: comparison of radiation dose and image quality
Authors: Chenggong Yan
Chunyi Liang
Jun Xu
Yuankui Wu
Wei Xiong
Huan Zheng
Yikai Xu
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: Tuberculosis
Tuberculosis
Published in: European Radiology / Issue 10/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06129-4

At a glance: The STEP trials

Springer Medicine

Ultralow-dose CT with knowledge-based iterative model reconstruction (IMR) in evaluation of pulmonary tuberculosis: comparison of radiation dose and image quality

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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