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Improvement of image quality and dose management in CT fluoroscopy by iterative 3D image reconstruction

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

The objective of this study was to assess the influence of an iterative CT reconstruction algorithm (IA), newly available for CT-fluoroscopy (CTF), on image noise, readers’ confidence and effective dose compared to filtered back projection (FBP).

Methods

Data from 165 patients (FBP/IA = 82/74) with CTF in the thorax, abdomen and pelvis were included. Noise was analysed in a large-diameter vessel. The impact of reconstruction and variables (e.g. X-ray tube current I) influencing noise and effective dose were analysed by ANOVA and a pairwise t-test with Bonferroni–Holm correction. Noise and readers’ confidence were evaluated by three readers.

Results

Noise was significantly influenced by reconstruction, I, body region and circumference (all p ≤ 0.0002). IA reduced the noise significantly compared to FBP (p = 0.02). The effect varied for body regions and circumferences (p ≤ 0.001). The effective dose was influenced by the reconstruction, body region, interventional procedure and I (all p ≤ 0.02). The inter-rater reliability for noise and readers’ confidence was good (W ≥ 0.75, p < 0.0001). Noise and readers’ confidence were significantly better in AIDR-3D compared to FBP (p ≤ 0.03). Generally, IA yielded a significant reduction of the median effective dose.

Conclusion

The CTF reconstruction by IA showed a significant reduction in noise and effective dose while readers’ confidence increased.

Key Points

• CTF is performed for image guidance in interventional radiology.

• Patient exposure was estimated from DLP documented by the CT.

• Iterative CT reconstruction is appropriate to reduce image noise in CTF.

• Using iterative CT reconstruction, the effective dose was significantly reduced in abdominal interventions.

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Abbreviations

AIDR 3D:

Adaptive Iterative Dose Reduction 3D

ANOVA:

Analysis of variance

BMI:

Body mass index

CTF:

CT fluoroscopy

DLP:

Dose length product

FBP:

Filtered back projection

HU:

Hounsfield units

I:

X-ray tube current

IQR:

Interquartile range

IR:

Interventional radiologist

MWA:

Microwave ablation

PMMA:

Polymethylmethacrylate

RFA:

Radiofrequency ablation

ROI:

Region of interest

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Acknowledgements

We thank Toshiba Medical Systems Corporation for funding the clinical trial.

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany

    Oliver S. Grosser, Christian Wybranski, Dennis Kupitz, Maciej Powerski, Konrad Mohnike, Maciej Pech, Holger Amthauer & Jens Ricke

  2. Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland

    Maciej Pech

  3. Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany

    Christian Wybranski

  4. Department of Nuclear Medicine, Charité, Berlin, Germany

    Holger Amthauer

Authors
  1. Oliver S. Grosser
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  2. Christian Wybranski
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  3. Dennis Kupitz
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  4. Maciej Powerski
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  5. Konrad Mohnike
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  6. Maciej Pech
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  7. Holger Amthauer
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  8. Jens Ricke
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Corresponding author

Correspondence to Oliver S. Grosser.

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Guarantor

The scientific guarantor of this publication is Jens Ricke.

Conflict of interest

The authors of this manuscript declare relationships with Toshiba Medical Systems Corporation.

Funding

This study has received funding by Toshiba Medical Systems Corporation.

Statistics and biometry

One of the authors has significant statistical expertise.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Methodology

• retrospective

• observational

• performed at one institution

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Grosser, O.S., Wybranski, C., Kupitz, D. et al. Improvement of image quality and dose management in CT fluoroscopy by iterative 3D image reconstruction. Eur Radiol 27, 3625–3634 (2017). https://doi.org/10.1007/s00330-017-4754-7

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  • DOI: https://doi.org/10.1007/s00330-017-4754-7

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