BackgroundX-ray is the fundamental imaging technique in diagnosis and follow up of rheumatic diseases. As patients often require sequential X-rays, dose reduction is of great importance. New advanced noise reduction algorithms allow for a dose reduction of up to 50%.ObjectivesThe aim of this study was to evaluate, whether the application of an advanced noise reduction algorithms is feasible in the context of imaging of rheumatic diseases.MethodsA total of 298 patients were enrolled prospectively into three tiers: 80%, 64% and 50% dose reduction groups. All patients received imaging of one hand (laterality randomly assigned) with low-dose technique and of the contralateral side with standard protocol. All images were evaluated by two blinded independent readers who scored (on a scale of 1 to 5) the visualisation of bony cortex, trabeculae and joint spaces of fingers and wrist separately as well as soft tissue and overall contrast. Score values were analysed using T-tests for paired samples.ResultsOverall image quality (expressed by mean sum scores out of 40) of the 50% low-dose images was 31.52 (SD 1.94) vs. 31.66 (SD 1.82) for standard images (p=0.217). Bony contours as well as trabeculae was equally well visualized in both image sets. An image example is given in Fig. 1 (Left hand: 50%-dose image; right hand: standard-dose image). Soft tissue visualization was slightly lower for low-dose compared to standard images (mean score of 3.81 vs. 3.88; p=0.001).ConclusionOverall image quality of low dose images was not inferior to standard dose images. Therefore, application of low-dose technology based on advanced noise estimation algorithms in the context of imaging of rheumatic diseases is feasible.Disclosure of Interests Katharina Ziegeler: None declared, Stefan Siepmann: None declared, Alexander Beck: None declared, Alexander Lembcke: None declared, Bernd Hamm Grant/research support from: Siemens, GE, Bayer, Samsung, Canon, Guerbet, Kay Geert A. Hermann Speakers bureau: AbbVie, MSD, Pfizer, UCB, Samsung
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