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Evaluation of dose reduction and image quality in CT colonography: Comparison of low-dose CT with iterative reconstruction and routine-dose CT with filtered back projection

  • Gastrointestinal
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Abstract

Objective

To prospectively evaluate the radiation dose and image quality comparing low-dose CT colonography (CTC) reconstructed using different levels of iterative reconstruction techniques with routine-dose CTC reconstructed with filtered back projection.

Methods

Following institutional ethics clearance and informed consent procedures, 210 patients underwent screening CTC using automatic tube current modulation for dual positions. Examinations were performed in the supine position with a routine-dose protocol and in the prone position, randomly applying four different low-dose protocols. Supine images were reconstructed with filtered back projection and prone images with iterative reconstruction. Two blinded observers assessed the image quality of endoluminal images. Image noise was quantitatively assessed by region-of-interest measurements.

Results

The mean effective dose in the supine series was 1.88 mSv using routine-dose CTC, compared to 0.92, 0.69, 0.57, and 0.46 mSv at four different low doses in the prone series (p < 0.01). Overall image quality and noise of low-dose CTC with iterative reconstruction were significantly improved compared to routine-dose CTC using filtered back projection. The lowest dose group had image quality comparable to routine-dose images.

Conclusions

Low-dose CTC with iterative reconstruction reduces the radiation dose by 48.5 to 75.1 % without image quality degradation compared to routine-dose CTC with filtered back projection.

Key Points

• Low-dose CTC reduces radiation dose ≥48.5 % compared to routine-dose CTC.

• Iterative reconstruction improves overall CTC image quality compared with FBP.

• Iterative reconstruction reduces overall CTC image noise compared with FBP.

• Automated exposure control with iterative reconstruction is useful for low-dose CTC.

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Abbreviations

CTC:

Computed tomographic colonography

AIDR 3D:

Adaptive iterative dose reduction system using a three-dimensional processing algorithm

FBP:

Filtered back projection

CTDIvol :

Weighted volume computed tomography dose index

DLP:

Dose-length product

mSv:

Millisieverts

SD:

Standard deviation

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Acknowledgements

The scientific guarantor of this publication is Toru Mitsushima. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, randomised controlled trial, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan

    Koichi Nagata

  2. Department of Radiology, Jichi Medical University, Tochigi, Japan

    Koichi Nagata, Hidenori Kanazawa & Hideharu Sugimoto

  3. Cancer Screening Technology Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan

    Koichi Nagata

  4. Department of Radiology, Kameda Medical Center Makuhari, Chiba, Japan

    Masanori Fujiwara, Tomohiro Mogi & Nao Iida

  5. Department of Gastroenterology, Kameda Medical Center Makuhari, Chiba, Japan

    Toru Mitsushima

  6. Department of Surgery, Jichi Medical University, Tochigi, Japan

    Alan T. Lefor

Authors
  1. Koichi Nagata
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  2. Masanori Fujiwara
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  3. Hidenori Kanazawa
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  4. Tomohiro Mogi
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  5. Nao Iida
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  6. Toru Mitsushima
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  7. Alan T. Lefor
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  8. Hideharu Sugimoto
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Corresponding author

Correspondence to Koichi Nagata.

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Nagata, K., Fujiwara, M., Kanazawa, H. et al. Evaluation of dose reduction and image quality in CT colonography: Comparison of low-dose CT with iterative reconstruction and routine-dose CT with filtered back projection. Eur Radiol 25, 221–229 (2015). https://doi.org/10.1007/s00330-014-3350-3

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  • DOI: https://doi.org/10.1007/s00330-014-3350-3

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