Estimation of Observer Performance for Reduced Radiation Dose Levels in CT
| Autor: | Lifeng Yu, Darin White, Naoki Takahashi, Shuai Leng, Vance T. Lehman, Jeff L. Fidler, David R. Holmes, Sudhakar K. Venkatesh, Adam C. Bartley, Joel G. Fletcher, Alicia Y. Toledano, Amy L. Kotsenas, Rickey E. Carter, Cynthia H. McCollough, Rebecca M. Lindell, Anne Marie G. Sykes, Norbert G. Campeau, David L. Levin, David R. DeLone, David M. Hough |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Receiver operating characteristic business.industry Image quality Radiation dose Ct technology Iterative reconstruction Reduced dose 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Observer performance Medicine Radiology Nuclear Medicine and imaging Radiology business Nuclear medicine Jackknife resampling |
| Zdroj: | Academic Radiology. 24:876-890 |
| ISSN: | 1076-6332 |
| DOI: | 10.1016/j.acra.2016.12.017 |
| Popis: | Rationale and Objectives This study aims to estimate observer performance for a range of dose levels for common computed tomography (CT) examinations (detection of liver metastases or pulmonary nodules, and cause of neurologic deficit) to prioritize noninferior dose levels for further analysis. Materials and Methods Using CT data from 131 examinations (abdominal CT, 44; chest CT, 44; head CT, 43), CT images corresponding to 4%–100% of the routine clinical dose were reconstructed with filtered back projection or iterative reconstruction. Radiologists evaluated CT images, marking specified targets, providing confidence scores, and grading image quality. Noninferiority was assessed using reference standards, reader agreement rules, and jackknife alternative free-response receiver operating characteristic figures of merit. Reader agreement required that a majority of readers at lower dose identify target lesions seen by the majority of readers at routine dose. Results Reader agreement identified dose levels lower than 50% and 4% to have inadequate performance for detection of hepatic metastases and pulmonary nodules, respectively, but could not exclude any low dose levels for head CT. Estimated differences in jackknife alternative free-response receiver operating characteristic figures of merit between routine and lower dose configurations found that only the lowest dose configurations tested (ie, 30%, 4%, and 10% of routine dose levels for abdominal, chest, and head CT examinations, respectively) did not meet criteria for noninferiority. At lower doses, subjective image quality declined before observer performance. Iterative reconstruction was only beneficial when filtered back projection did not result in noninferior performance. Conclusion Opportunity exists for substantial radiation dose reduction using existing CT technology for common diagnostic tasks. |
| Databáze: | OpenAIRE |
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