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Diagnostic value of fourth-generation iterative reconstruction algorithm with low-dose CT protocol in assessment of mesorectal fascia invasion in rectal cancer: comparison with magnetic resonance

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Abstract

Purpose

The purpose of the article is to compare the diagnostic performance about radiation dose and image quality of low-dose CT with iterative reconstruction algorithm (iDose4) and standard-dose CT in the assessment of mesorectal fascia (MRF) invasion in rectal cancer patients.

Materials and methods

Ninety-one patients with biopsy-proven primary rectal adenocarcinoma underwent CT staging: 42 underwent low-dose CT, 49 underwent standard CT protocol. Low-dose contrast-enhanced MDCT scans were performed on a 256 (ICT, Philips) scanner using 120 kV, automated mAs modulation, iDose4 iterative reconstruction algorithm. Standard-dose MDCT scans were performed on the same scanner with 120 kV, 200–300 mAs. All patients underwent a standard lower abdomen MR study (on 1.5T magnet), including multiplanar sequences, considered as reference standard. Diagnostic accuracy of MRF assessment was determined on CT images for both CT protocols and compared with MRI images. Dose-length product (DLP) and CT dose index (CTDI) calculated for both groups were compared and statistically analyzed.

Results

Low-dose protocol with iDose4 showed high diagnostic quality in assessment of MRF with significant reduction (23%; p = 0.0081) of radiation dose (DLP 2453.47) compared to standard-dose examination (DLP 3194.32).

Conclusions

Low-dose protocol combined with iDose4 reconstruction algorithm offers high-quality images, obtaining significant radiation dose reduction, useful in the evaluation of MRF involvement in rectal cancer patients.

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Authors and Affiliations

  1. School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900, Monza, MB, Italy

    Davide Ippolito, Silvia Girolama Drago, C. R. Talei Franzesi, Alessandra Casiraghi & Sandro Sironi

  2. Department of Diagnostic Radiology, H. S. Gerardo Monza, Via Pergolesi 33, 20900, Monza, MB, Italy

    Davide Ippolito, Silvia Girolama Drago, C. R. Talei Franzesi & Alessandra Casiraghi

  3. Department of Diagnostic Radiology, H. Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, BG, Italy

    Sandro Sironi

Authors
  1. Davide Ippolito
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  2. Silvia Girolama Drago
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  3. C. R. Talei Franzesi
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  4. Alessandra Casiraghi
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  5. Sandro Sironi
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Correspondence to Davide Ippolito.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ippolito, D., Drago, S.G., Talei Franzesi, C.R. et al. Diagnostic value of fourth-generation iterative reconstruction algorithm with low-dose CT protocol in assessment of mesorectal fascia invasion in rectal cancer: comparison with magnetic resonance. Abdom Radiol 42, 2251–2260 (2017). https://doi.org/10.1007/s00261-017-1138-z

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  • DOI: https://doi.org/10.1007/s00261-017-1138-z

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