Image Quality and Patient-Specific Organ Doses in Stone Protocol CT: A Comparison of Traditional CT to Low Dose CT with Iterative Reconstruction.

Autor: Pai R; Department of Urology, University of Florida, Gainesville, FL, USA., Modh R; Department of Urology, University of Florida, Gainesville, FL, USA., Lamoureux RH; Department of Radiology, University of New Mexico, Albuquerque, NM, USA., Deitte L; Department of Radiology, University of Florida, Gainesville, FL, USA., Wymer DC; Department of Radiology, University of Florida, Gainesville, FL, USA., Mench A; Department of Radiology, University of Florida, Gainesville, FL, USA.; Division of Clinical Radiological Physics, University of Florida, Gainesville, FL, USA., Lipnharski I; Department of Radiology, University of Florida, Gainesville, FL, USA.; Division of Clinical Radiological Physics, University of Florida, Gainesville, FL, USA., Henriksen C; Department of Urology, University of Florida, Gainesville, FL, USA., Arreola M; Department of Radiology, University of Florida, Gainesville, FL, USA.; Division of Clinical Radiological Physics, University of Florida, Gainesville, FL, USA., Canales BK; Department of Urology, University of Florida, Gainesville, FL, USA.
Jazyk: angličtina
Zdroj: BioMed research international [Biomed Res Int] 2018 Sep 27; Vol. 2018, pp. 5120974. Date of Electronic Publication: 2018 Sep 27 (Print Publication: 2018).
DOI: 10.1155/2018/5120974
Abstrakt: Objective: To compare organ specific radiation dose and image quality in kidney stone patients scanned with standard CT reconstructed with filtered back projection (FBP-CT) to those scanned with low dose CT reconstructed with iterative techniques (IR-CT).
Materials and Methods: Over a one-year study period, adult kidney stone patients were retrospectively netted to capture the use of noncontrasted, stone protocol CT in one of six institutional scanners (four FBP and two IR). To limit potential CT-unit use bias, scans were included only from days when all six scanners were functioning. Organ dose was calculated using volumetric CT dose index and patient effective body diameter through validated conversion equations derived from previous cadaveric, dosimetry studies. Board-certified radiologists, blinded to CT algorithm type, assessed stone characteristics, study noise, and image quality of both techniques.
Results: FBP-CT (n=250) and IR-CT (n=90) groups were similar in regard to gender, race, body mass index (mean BMI = 30.3), and stone burden detected (mean size 5.4 ± 1.2 mm). Mean organ-specific dose (OSD) was 54-62% lower across all organs for IR-CT compared to FBP-CT with particularly reduced doses (up to 4.6-fold) noted in patients with normal BMI range. No differences were noted in radiological assessment of image quality or noise between the cohorts, and intrarater agreement was highly correlated for noise (AC2=0.873) and quality (AC2=0.874) between blinded radiologists.
Conclusions: Image quality and stone burden assessment were maintained between standard FBP and low dose IR groups, but IR-CT decreased mean OSD by 50%. Both urologists and radiologists should advocate for low dose CT, utilizing reconstructive protocols like IR, to reduce radiation exposure in their stone formers who undergo multiple CTs.
Databáze: MEDLINE
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