Simulated Radiation Dose Reduction in Whole-Body CT on a 3rd Generation Dual-Source Scanner: An Intraindividual Comparison

Abstract

To evaluate the effect of radiation dose reduction on image quality and diagnostic confidence in contrast-enhanced whole-body computed tomography (WBCT) staging. We randomly selected March 2016 for retrospective inclusion of 18 consecutive patients (14 female, 60 ± 15 years) with clinically indicated WBCT staging on the same 3rd generation dual-source CT. Using low-dose simulations, we created data sets with 100, 80, 60, 40, and 20% of the original radiation dose. Each set was reconstructed using filtered back projection (FBP) and Advanced Modeled Iterative Reconstruction (ADMIRE®, Siemens Healthineers, Forchheim, Germany) strength 1–5, resulting in 540 datasets total. ADMIRE 2 was the reference standard for intraindividual comparison. The effective radiation dose was calculated using commercially available software. For comparison of objective image quality, noise assessments of subcutaneous adipose tissue regions were performed automatically using the software. Three radiologists blinded to the study evaluated image quality and diagnostic confidence independently on an equidistant 5-point Likert scale (1 = poor to 5 = excellent). At 100%, the effective radiation dose in our population was 13.3 ± 9.1 mSv. At 20% radiation dose, it was possible to obtain comparably low noise levels when using ADMIRE 5 (p = 1.000, r = 0.29). We identified ADMIRE 3 at 40% radiation dose (5.3 ± 3.6 mSv) as the lowest achievable radiation dose with image quality and diagnostic confidence equal to our reference standard (p = 1.000, r > 0.4). The inter-rater agreement for this result was almost perfect (ICC ≥ 0.958, 95% CI 0.909–0.983). On a 3rd generation scanner, it is feasible to maintain good subjective image quality, diagnostic confidence, and image noise in single-energy WBCT staging at dose levels as low as 40% of the original dose (5.3 ± 3.6 mSv), when using ADMIRE 3.

Estimation of maternal and foetal risk of radiation‐induced cancer from a survey of computed tomography pulmonary angiography and ventilation/perfusion lung scanning for diagnosing pulmonary embolism during pregnancy

“…More recently, some publications have highlighted the lower doses now achievable for CTPA, through a variety of advancements, notably including iterative reconstruction algorithms. [2][3][4][5] Dosimetry from clinical studies demonstrates a wide range of examination protocols that are applied clinically as well as the variety in the methods of dosimetry employed. [3][4][5][6][7] Advanced dosimetric modelling, utilised for CTPA and V/Q examinations, has also been applied to simulated examination conditions to better understand involved relationships such as patient size and gestational age.…”

“…Since that time the literature has continued to reflect clinical and academic interest in maternal and foetal radiation doses from these examinations. More recently, some publications have highlighted the lower doses now achievable for CTPA, through a variety of advancements, notably including iterative reconstruction algorithms 2–5 …”

AI Denoising Significantly Improves Image Quality in Whole-Body Low-Dose Computed Tomography Staging

“…However, reducing the radiation dose in computed tomography is indivisibly linked to image quality deterioration due to rising image noise [ 10 ]. The limits of conventional reconstruction methods for image quality enhancements in low-dose computed tomography have previously been explored [ 11 ]. More recently, however, the advent of AI-based post-processing denoising solutions show promising results for further image quality enhancement [ 12 , 13 , 14 ].…”

Assessment of Radiation Dose in Medical Imaging and Interventional Radiology Procedures for Patient and Staff Safety

“…Paired inspiratory-expiratory scans were able to be acquired on 3rd generation dual source CT (DSCT) system (Somatom Force; Siemens Healthineers, Erlangen, Germany) at substantially lower dose and risk levels when compared to inspiration-only scans at conventional CT systems, offering promising prospects for improved chronic obstructive pulmonary disease diagnosis [ 4 ]. The 3rd generation DSCT system also maintained good subjective image quality, diagnostic confidence, and image noise in single-energy whole-body staging at dose levels as low as 40% of the original dose, when using ADMIRE (with strength 3) [ 5 ].…”