Evaluation of image quality and radiation dose saving comparing knowledge model-based iterative reconstruction on 80-kV CT pulmonary angiography (CTPA) with hybrid iterative reconstruction on 100-kV CT.

Autor: Ippolito D; Department of Diagnostic Radiology, 'San Gerardo' Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy. davide.atena@tiscalinet.it.; School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy. davide.atena@tiscalinet.it., De Vito A; Department of Diagnostic Radiology, 'San Gerardo' Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.; School of Medicine, University of Milano-Bicocca, Milan, MI, Italy., Franzesi CT; Department of Diagnostic Radiology, 'San Gerardo' Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.; School of Medicine, University of Milano-Bicocca, Milan, MI, Italy., Riva L; Department of Diagnostic Radiology, 'San Gerardo' Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.; School of Medicine, University of Milano-Bicocca, Milan, MI, Italy., Pecorelli A; Department of Diagnostic Radiology, 'San Gerardo' Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.; School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy., Corso R; Department of Diagnostic Radiology, 'San Gerardo' Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy., Crespi A; School of Medicine, University of Milano-Bicocca, Milan, MI, Italy.; Department of Medical Physics, 'San Gerardo' Hospital, Monza, MB, Italy., Sironi S; School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy.; Department of Diagnostic Radiology, H Papa Giovanni XIII, Piazza OMS 1, 24127, Bergamo, BG, Italy.
Jazyk: angličtina
Zdroj: Emergency radiology [Emerg Radiol] 2019 Apr; Vol. 26 (2), pp. 145-153. Date of Electronic Publication: 2018 Nov 10.
DOI: 10.1007/s10140-018-1653-4
Abstrakt: Objectives: To evaluate dose reduction and image quality of 80-kV CT pulmonary angiography (CTPA) reconstructed with knowledge model-based iterative reconstruction (IMR), and compared with 100-kV CTPA with hybrid iterative reconstruction (iDose 4 ).
Materials and Methods: One hundred and fifty-one patients were prospectively investigated for pulmonary embolism; a study group of 76 patients underwent low-kV setting (80 kV, automated mAs) CTPA study, while a control group of 75 patients underwent standard CTPA protocol (100 kV; automated mAs); all patients were examined on 256 MDCT scanner (Philips iCTelite). Study group images were reconstructed using IMR while the control group ones with iDose 4 . CTDIvol, DLP, and ED were evaluated. Region of interests placed in the main pulmonary vessels evaluated vascular enhancement (HU); signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated.
Results: Compared to iDose 4 -CTPA, low-kV IMR-CTPA presented lower CTDIvol (6.41 ± 0.84 vs 9.68 ± 3.5 mGy) and DLP (248.24 ± 3.2 vs 352.4 ± 3.59 mGy × cm), with ED of 3.48 ± 1.2 vs 4.93 ± 1.8 mSv. Moreover, IMR-CTPA showed higher values of attenuation (670.91 ± 9.09 HU vs 292.61 ± 15.5 HU) and a significantly higher SNR (p < 0.0001) and CNR (p < 0.0001).The subjective image quality of low-kV IMR-CTPA was also higher compared with iDose 4 -CTPA (p < 0.0001).
Conclusions: Low-dose CTPA (80 kV and automated mAs modulation) reconstructed with IMR represents a feasible protocol for the diagnosis of pulmonary embolism in the emergency setting, achieving high image quality with low noise, and a significant dose reduction within adequate reconstruction times(≤ 120 s).
Databáze: MEDLINE
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