Management of patient dose and image noise in routine pediatric CT abdominal examinations

Verdun, Francis R.; Lepori, D.; Monnin, Pascal; Valley, J.-F.; Schnyder, P.; Gudinchet, F.

doi:10.1007/s00330-003-2206-z

Cited by 48 publications

(46 citation statements)

References 25 publications

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“…The latter figure is comparable with that given by UNSCEAR for the period 1991-1996 [1]. Only general guidelines are available for the use of CT in the paediatric population [9][10][11][12][13] and the need for size-based CT protocols has only recently been emphasised [6,[14][15][16][17][18]. Given the recent attention to radiation risks and CT in children [19][20][21][22][23][24] there is an urgent need for optimisation of the present practice by means of the introduction of the Diagnostic Reference Level (DRL) by the International Commission on Radiological Protection (ICRP) in 1997 [25].…”

Section: Introductionmentioning

confidence: 69%

CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland

et al. 2008

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This work aimed at assessing the doses delivered in Switzerland to paediatric patients during computed tomography (CT) examinations of the brain, chest and abdomen, and at establishing diagnostic reference levels (DRLs) for various age groups. Forms were sent to the ten centres performing CT on children, addressing the demographics, the indication and the scanning parameters: number of series, kilovoltage, tube current, rotation time, reconstruction slice thickness and pitch, volume CT dose index (CTDI(vol)) and dose length product (DLP). Per age group, the proposed DRLs for brain, chest and abdomen are, respectively, in terms of CTDI(vol): 20, 30, 40, 60 mGy; 5, 8, 10, 12 mGy; 7, 9, 13, 16 mGy; and in terms of DLP: 270, 420, 560, 1,000 mGy cm; 110, 200, 220, 460 mGy cm; 130, 300, 380, 500 mGy cm. An optimisation process should be initiated to reduce the spread in dose recorded in this study. A major element of this process should be the use of DRLs.

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Section: Introductionmentioning

confidence: 69%

CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland

et al. 2008

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“…Choices of those parameters that are controlled by the operator may influence the radiation dose given to the patient. Recently, interest is growing in decreasing the radiation dose in various CT applications [4][5][6][7]. However, studies evaluating the feasibility of reducing the radiation dose in head CT applications are limited [3,8,9].…”

Section: Discussionmentioning

confidence: 99%

Assessment of image quality of a standard and three dose-reducing protocols in adult cranial CT

et al. 2004

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The purpose of this study was to analyze the effect of various tube current settings (mAs) and optimize the image quality and dose for adult cranial CT protocol. Sixty adult patients who underwent a cranial CT scanning for different indications were subdivided into three subgroups. Subjective image and noise quality scores and quantitative noise measurements were selectively studied on three reference levels (cerebellar, basal ganglia and centrum semiovale levels). For each subgroup, only one level was studied. Head circumference (HC) and the maximum anteroposterior diameter (MAPD) of each patient were measured. At 50% decreased dose protocol, there was no poor quality score at any level. At nearly 60% decreased dose protocol, the incidence of poor quality scores was much higher at the cerebellar level than at the other two levels. For the same protocol number, quantitative noise measurements were higher at the cerebellar level than the other two supratentorial levels. The correlation was found to be significant between HC, MAPD and quantitative noise measurements, and there was a non-significant correlation between HC and subjective noise scores. In adult cranial CT, depending on the level, a dose reduction of up to 60% may be possible while maintaining image quality.

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“…As such, substantial emphasis has been placed on strategies to reduce CT radiation doses while maintaining image quality (7). Most CT dose reduction strategies rely on reducing radiation output from the scanner, with the inherent trade-off being greater image noise and diminished image quality (8,9). Because of this, new iterative CT image reconstruction techniques have been developed in an attempt to decrease image noise when scanning at lower CT radiation doses (10)(11)(12)(13).…”

Section: Methodsmentioning

confidence: 99%

Model-based Iterative Reconstruction: Effect on Patient Radiation Dose and Image Quality in Pediatric Body CT

Smith¹,

Dillman²,

Goodsitt³

et al. 2014

Radiology

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Purpose:To retrospectively compare image quality and radiation dose between a reduced-dose computed tomographic (CT) protocol that uses model-based iterative reconstruction (MBIR) and a standard-dose CT protocol that uses 30% adaptive statistical iterative reconstruction (ASIR) with filtered back projection. Materials and Methods:Institutional review board approval was obtained. Clinical CT images of the chest, abdomen, and pelvis obtained with a reduced-dose protocol were identified. Images were reconstructed with two algorithms: MBIR and 100% ASIR. All subjects had undergone standard-dose CT within the prior year, and the images were reconstructed with 30% ASIR. Reduced-and standard-dose images were evaluated objectively and subjectively. Reduced-dose images were evaluated for lesion detectability. Spatial resolution was assessed in a phantom. Radiation dose was estimated by using volumetric CT dose index (CTDI vol ) and calculated size-specific dose estimates (SSDE). A combination of descriptive statistics, analysis of variance, and t tests was used for statistical analysis. Results:In the 25 patients who underwent the reduced-dose protocol, mean decrease in CTDI vol was 46% (range, 19%-65%) and mean decrease in SSDE was 44% (range, 19%-64%). Reduced-dose MBIR images had less noise (P . .004). Spatial resolution was superior for reduced-dose MBIR images. Reduced-dose MBIR images were equivalent to standard-dose images for lungs and soft tissues (P . .05) but were inferior for bones (P = .004). Reduceddose 100% ASIR images were inferior for soft tissues (P , .002), lungs (P , .001), and bones (P , .001). By using the same reduced-dose acquisition, lesion detectability was better (38% [32 of 84 rated lesions]) or the same (62% [52 of 84 rated lesions]) with MBIR as compared with 100% ASIR. Conclusion:CT performed with a reduced-dose protocol and MBIR is feasible in the pediatric population, and it maintains diagnostic quality.q RSNA, 2013

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Management of patient dose and image noise in routine pediatric CT abdominal examinations

Cited by 48 publications

References 25 publications

CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland

CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland

Assessment of image quality of a standard and three dose-reducing protocols in adult cranial CT

Model-based Iterative Reconstruction: Effect on Patient Radiation Dose and Image Quality in Pediatric Body CT

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