A Prospective Evaluation of Dose Reduction and Image Quality in Chest CT Using Adaptive Statistical Iterative Reconstruction

Leipsic, Jonathon; Nguyen, Giang D.; Brown, J.; Sin, Don D.; Mayo, John R.

doi:10.2214/ajr.09.4050

Cited by 216 publications

(131 citation statements)

References 13 publications

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“…The rationale for having different levels of experience was to find out if confirmed habits might influence the perception of the IR reconstructions and hence the subjective scores. Scoring was performed by applying a precisely defined 4-point scale with regard to artifact load, gray-white matter differentiation and overall image impression (1 = worst, 4 = best), in analogy to former work on the same topic [9, 12,23]. The particular criteria for image evaluation as used in the current study are summar- Table 2.…”

Section: Subjective Image Evaluationmentioning

confidence: 99%

Intraindividual Evaluation of the Influence of Iterative Reconstruction and Filter Kernel on Subjective and Objective Image Quality in Computed Tomography of the Brain

Buhk

Laqmani

Schultzendorff

et al. 2013

Fortschr Röntgenstr

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Objectives: To intraindividually evaluate the potential of 4th generation iterative reconstruction (IR) on brain CT with regard to subjective and objective image quality. Methods: 31 consecutive raw data sets of clinical routine native sequential brain CT scans were reconstructed with IR level 0 (=?filtered back projection), 1, 3 and 4; 3 different brain filter kernels (smooth/standard/sharp) were applied respectively. Five independent radiologists with different levels of experience performed subjective image rating. Detailed ROI analysis of image contrast and noise was performed. Statistical analysis was carried out by applying a random intercept model. Results: Subjective scores for the smooth and the standard kernels were best at low IR levels, but both, in particular the smooth kernel, scored inferior with an increasing IR level. The sharp kernel scored lowest at IR 0, while the scores substantially increased at high IR levels, reaching significantly best scores at IR 4. Objective measurements revealed an overall increase in contrast-to-noise ratio at higher IR levels, which was highest when applying the soft filter kernel. The absolute grey-white contrast decreased with an increasing IR level and was highest when applying the sharp filter kernel. All subjective effects were independent of the raters? experience and the patients? age and sex. Conclusion: Different combinations of IR level and filter kernel substantially influence subjective and objective image quality of brain CT.

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Section: Subjective Image Evaluationmentioning

confidence: 99%

Intraindividual Evaluation of the Influence of Iterative Reconstruction and Filter Kernel on Subjective and Objective Image Quality in Computed Tomography of the Brain

Buhk

Laqmani

Schultzendorff

et al. 2013

Fortschr Röntgenstr

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“…In contrast to the highest levels of IR, however, the authentic CT image appearance, which the readers were used to from daily practice, was preserved at a low and medium level of IR. In a previous study using less advanced IR algorithms, differences in image appearance due to higher levels of IR have already been discussed [30]. Compared to FBP, CT images reconstructed using iterative algorithms may appear more "artificial" or "plastic" mainly due to a general smoothing effect and a loss of granular image appearance.…”

mentioning

confidence: 99%

Impact of Increasing Levels of Advanced Iterative Reconstruction on Image Quality in Low-Dose Cardiac CT Angiography

Kröpil

Bigdeli

Nagel

et al. 2014

Fortschr Röntgenstr

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Purpose: To investigate the effects of an advanced iterative reconstruction (IR) technique on subjective and objective image quality (IQ) in low-dose cardiac CT angiography (CCTA). Materials and Methods: 30 datasets of prospectively triggered ?step-and-shoot? CCTA scans acquired on a 256-slice CT scanner with optimized exposure settings were processed on a prototype IR system using filtered back-projection (FBP) and 4 levels of advanced IR (iDose4, Philips) providing incremental rates of IR (level 2, 4, 6, 7). In addition, the effects of different reconstruction kernels (semi-smooth [CB], standard with edge-enhancement [XCB]) and a ?multi-resolution? feature [MR] to preserve the noise power spectrum were evaluated resulting in a total of n?=?480 image sets. Contrast-to-noise ratios (CNR) were computed from regions of interest at 9 coronary locations. The subjective IQ was rated on a 4-point-scale with ?classic? image appearance and noise-related artifacts as main criteria. Results: At an effective dose of 1.7???0.7?mSv, the CNR significantly improved with every increasing level of IR (range: 14.2???27.8; p?

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“…The CT dose index, which is an increasingly used index of radiation exposure but initially not available on individual CT protocols, was not evaluated. The approach of thoracic radiologists to the new iterative reconstruction techniques that allow up to 50% of dose reduction was also not investigated (21,22). Potential conclusions from these scenarios, therefore, cannot indicate more than a general trend.…”

Section: Discussionmentioning

confidence: 99%

Radiation dose management in thoracic ct: an international survey

Molinari

Tack²,

Boiselle³

et al. 2012

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to examine current practice patterns of international thoracic radiologists regarding radiation dose management in adult thoracic computed tomography (CT) examinations. MATERIALS AND METHODSAn electronic questionnaire was sent to 800 members of five thoracic radiology societies in North America, Europe, Asia, and Latin America addressing radiation dose training and education, standard kVp and mAs settings for thoracic CT, dose reduction practices, clinical scenarios, and demographics. RESULTSOf the 800 radiologists, 146 responded to our survey. Nearly half (66/146, 45% [95% confidence interval, 37%-53%]) had no formal training in dose reduction, with "self-study of the literature" being the most common form of training (54/146, 37% [29%-45%]). One hundred and seventeen (80% [74%-87%]) had automatic exposure control, and 76 (65% [56%-74%]) used it in all patients. Notably, most respondents (89% [84%-94%]) used a 120 to 125 kVp standard setting, whereas none used 140 kVp. The most common average dose-length-product (DLP) value was 150 to 249 mGy.cm (75/146, 51% [43%-59%]), and 59% (51%-67%) delivered less than 250 mGy.cm in a 70 kg patient. There was a tendency towards higher DLP values with multidetector-row CT. Age, gender, and pregnancy were associated more with dose reduction than weight and clinical indication. CONCLUSION Efforts for reducing patient radiation dose are highly prevalent among thoracic radiologists. Areas for improvement include reduction of default tube current settings, reduction of anatomical scan coverage, greater use of automatic exposure control, and eventually, reduction of current reference dose values. Our study emphasizes the need for international guidelines to foster greater conformity in dose reduction by thoracic radiologists.

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A Prospective Evaluation of Dose Reduction and Image Quality in Chest CT Using Adaptive Statistical Iterative Reconstruction

Abstract: In clinically indicated chest CT examinations, ASIR images had better image quality and less image noise at a lower radiation dose than images acquired with a conventional FBP reconstruction algorithm.

Cited by 216 publications

References 13 publications

Intraindividual Evaluation of the Influence of Iterative Reconstruction and Filter Kernel on Subjective and Objective Image Quality in Computed Tomography of the Brain

Intraindividual Evaluation of the Influence of Iterative Reconstruction and Filter Kernel on Subjective and Objective Image Quality in Computed Tomography of the Brain

Impact of Increasing Levels of Advanced Iterative Reconstruction on Image Quality in Low-Dose Cardiac CT Angiography

Radiation dose management in thoracic ct: an international survey

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