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Intra-patient comparison of reduced-dose model-based iterative reconstruction with standard-dose adaptive statistical iterative reconstruction in the CT diagnosis and follow-up of urolithiasis

  • Computed Tomography
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Abstract

Objectives

To evaluate the accuracy of reduced-dose CT scans reconstructed using a new generation of model-based iterative reconstruction (MBIR) in the imaging of urinary tract stone disease, compared with a standard-dose CT using 30% adaptive statistical iterative reconstruction.

Methods

This single-institution prospective study recruited 125 patients presenting either with acute renal colic or for follow-up of known urinary tract stones. They underwent two immediately consecutive scans, one at standard dose settings and one at the lowest dose (highest noise index) the scanner would allow. The reduced-dose scans were reconstructed using both ASIR 30% and MBIR algorithms and reviewed independently by two radiologists. Objective and subjective image quality measures as well as diagnostic data were obtained.

Results

The reduced-dose MBIR scan was 100% concordant with the reference standard for the assessment of ureteric stones. It was extremely accurate at identifying calculi of 3 mm and above. The algorithm allowed a dose reduction of 58% without any loss of scan quality.

Conclusions

A reduced-dose CT scan using MBIR is accurate in acute imaging for renal colic symptoms and for urolithiasis follow-up and allows a significant reduction in dose.

Key points

MBIR allows reduced CT dose with similar diagnostic accuracy

MBIR outperforms ASIR when used for the reconstruction of reduced-dose scans

MBIR can be used to accurately assess stones 3 mm and above

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Abbreviations

ASIR:

Adaptive statistical iterative reconstruction

MBIR:

Model-based iterative reconstruction

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Acknowledgements

Initial sample size calculation was performed by Alan Wright, Research Fellow in Statistics, Plymouth University. Ethical approval was given by the National Research Ethics Service (NRES) Committee South West - Cornwall & Plymouth.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Sean Tenant.

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Guarantor

The scientific guarantor of this publication is Prof. Carl Roobottom.

Conflict of interest

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.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

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

Ethical approval

Local and regional ethics approval was obtained.

Methodology

Prospective diagnostic study performed at a single institution.

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Tenant, S., Pang, C.L., Dissanayake, P. et al. Intra-patient comparison of reduced-dose model-based iterative reconstruction with standard-dose adaptive statistical iterative reconstruction in the CT diagnosis and follow-up of urolithiasis. Eur Radiol 27, 4163–4172 (2017). https://doi.org/10.1007/s00330-017-4783-2

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  • DOI: https://doi.org/10.1007/s00330-017-4783-2

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