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01-11-2020 | Urolithiasis | Original Article

Substantial radiation dose reduction with consistent image quality using a novel low-dose stone composition protocol

Authors: Georg Apfaltrer, Anja Dutschke, Pascal A. T. Baltzer, Christian Schestak, Mehmet Özsoy, Christian Seitz, Julian Veser, Elisabeth Petter, Thomas H. Helbich, Helmut Ringl, Paul Apfaltrer

Published in: World Journal of Urology | Issue 11/2020

Abstract

Purpose

To assess a novel low-dose CT-protocol, combining a 150 kV spectral filtration unenhanced protocol (Sn150 kVp) and a stone-targeted dual-energy CT (DECT) in patients with urolithiasis.

Methods

232 (151 male, 49 ± 16.4 years) patients with urolithiasis received a low-dose non-contrast enhanced CT (NCCT) for suspected urinary stones either on a third-generation dual-source CT system (DSCT) using Sn150 kVp (n = 116, group 1), or on a second-generation DSCT (n = 116 group 2) using single energy (SE) 120 kVp. For group 1, a subsequent dual-energy CT (DECT) with a short stone-targeted scan range was performed. Objective and subjective image qualities were assessed. Radiation metrics were compared.

Results

534 stones (group 1: n = 242 stones; group 2: n = 292 stones) were found. In group 1, all 215 stones within the stone-targeted DECT-scan range were identified. DE analysis was able to distinguish between UA and non-UA calculi in all collected stones. 11 calculi (5.12%) were labeled as uric acid (UA) while 204 (94.88%) were labeled as non-UA calculi. There was no significant difference in overall Signal-to-noise-ratio between group 1 and group 2 (p = 0.819). On subjective analysis both protocols achieved a median Likert rating of 2 (p = 0.171). Mean effective dose was significantly lower for combined Sn150 kVp and stone-targeted DECT (3.34 ± 1.84 mSv) compared to single energy 120 kVp NCCT (4.45 ± 2.89 mSv) (p < 0.001), equaling a 24.9% dose reduction.

Conclusion

The evaluated novel low-dose stone composition protocol allows substantial radiation dose reduction with consistent high diagnostic image quality.

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Title: Substantial radiation dose reduction with consistent image quality using a novel low-dose stone composition protocol
Authors: Georg Apfaltrer
Anja Dutschke
Pascal A. T. Baltzer
Christian Schestak
Mehmet Özsoy
Christian Seitz
Julian Veser
Elisabeth Petter
Thomas H. Helbich
Helmut Ringl
Paul Apfaltrer
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keyword: Urolithiasis
Published in: World Journal of Urology / Issue 11/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03082-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Substantial radiation dose reduction with consistent image quality using a novel low-dose stone composition protocol

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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