Reduced-Dose CT: Effect on Reader Evaluation in Detection of Pulmonary Embolism

MacKenzie, J. D.; Nazario-Larrieu, Javier; Cai, Tianxi; Ledbetter, M. Stephen; Duran-Mendicuti, Maria Alejandra; Judy, Philip F.; Rybicki, Frank J.

doi:10.2214/ajr.07.2686

Cited by 35 publications

(14 citation statements)

References 26 publications

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“…Previous reports investigated the image quality of CTPA after dose reduction due to decrease kVp or mA or both [5,29,30] or due to lowering of the z coverage [31,32]. All these reports showed that PE could be diagnosed with a DLP varying from 40 to 110 mGy cm.…”

Section: Discussionmentioning

confidence: 99%

Image quality of low mA CT pulmonary angiography reconstructed with model based iterative reconstruction versus standard CT pulmonary angiography reconstructed with filtered back projection: an equivalency trial

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Image quality of low mA CT pulmonary angiography reconstructed with model based iterative reconstruction versus standard CT pulmonary angiography reconstructed with filtered back projection: an equivalency trial

et al. 2014

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“…The mathematical addition of CT noise provides the opportunity to directly compare quality among images that depict the same anatomy through simulation of a lower tube current [26]. Noise addition tools have been effectively used to evaluate the effects of dose reduction, primarily outside the heart [27–29]. Both the phantom and the clinical data demonstrate the expected changes in noise based on photon statistics when a 50 % dose reduction is simulated with the noise addition tool (calculated as the product of the noise from FBP and√ 2).…”

Section: Discussionmentioning

confidence: 99%

Simulated 50 % radiation dose reduction in coronary CT angiography using adaptive iterative dose reduction in three-dimensions (AIDR3D)

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Steigner

Leung

et al. 2013

Int J Cardiovasc Imaging

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To compare the image quality of coronary CT angiography (CTA) studies between standard filtered back projection (FBP) and adaptive iterative dose reduction in three-dimensions (AIDR3D) reconstruction using CT noise additional software to simulate reduced radiation exposure. Images from 93 consecutive clinical coronary CTA studies were processed utilizing standard FBP, FBP with 50 % simulated dose reduction (FBP50 %), and AIDR3D with simulated 50 % dose reduction (AIDR50 %). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured within 5 regions-of-interest, and image quality for each reconstruction strategy was assessed by two independent readers using a 4-point scale. Compared to FBP, the SNR measured from the AIDR50 % images was similar or higher (airway: 38.3 ± 12.7 vs. 38.5 ± 14.5, p = 0.81, fat: 5.5 ± 1.9 vs. 5.4 ± 2.0, p = 0.20, muscle: 3.2 ± 1.2 vs. 3.1 ± 1.3, p = 0.38, aorta: 22.6 ± 9.4 vs. 20.2 ± 9.7, p < 0.0001, liver: 2.7 ± 1.0 vs. 2.3 ± 1.1, p < 0.0001), while the SNR of the FBP50 % images were all lower (p values < 0.0001). The CNR measured from AIDR50 % images was also higher than that from the FBP images for the aorta relative to muscle (20.5 ± 9.0 vs. 18.3 ± 9.2, p < 0.0001). The interobserver agreement in the image quality score was excellent (κ = 0.82). The quality score was significantly higher for the AIDR50 % images compared to the FBP images (3.6 ± 0.6 vs. 3.3 ± 0.7, p = 0.004). Simulated radiation dose reduction applied to clinical coronary CTA images suggests that a 50 % reduction in radiation dose can be achieved with adaptive iterative dose reduction software with image quality that is at least comparable to images acquired at standard radiation exposure and reconstructed with filtered back projection.

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“…However, using a tube potential of 80 kV will emit an x-ray spectrum that is considered to be "soft" and hence less penetrable in body tissue. A standard use of 80 kV without tube current correction in unselected patients may be discussed controversially, as a clear dependency of image quality parameters on patient size is regularly seen [31,33,34], even with negative effect on diagnostic confidence [35]. Diagnostic confidence is essential for maintaining the accuracy and especially the high negative predictive value of CTPA and giving the strength of this test [6,8,36,37].…”

Section: Discussionmentioning

confidence: 99%

Dose and image quality at CT pulmonary angiography—comparison of first and second generation dual-energy CT and 64-slice CT

et al. 2011

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Reduced-Dose CT: Effect on Reader Evaluation in Detection of Pulmonary Embolism

Abstract: Reduction in dose for CT angiography in the detection of pulmonary embolism has a significant adverse effect on readers' subjective assessment of diagnostic confidence and image quality. Detection of pulmonary embolism also decreases as the tube current dose is reduced.

Cited by 35 publications

References 26 publications

Image quality of low mA CT pulmonary angiography reconstructed with model based iterative reconstruction versus standard CT pulmonary angiography reconstructed with filtered back projection: an equivalency trial

Image quality of low mA CT pulmonary angiography reconstructed with model based iterative reconstruction versus standard CT pulmonary angiography reconstructed with filtered back projection: an equivalency trial

Simulated 50 % radiation dose reduction in coronary CT angiography using adaptive iterative dose reduction in three-dimensions (AIDR3D)

Dose and image quality at CT pulmonary angiography—comparison of first and second generation dual-energy CT and 64-slice CT

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