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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The scientific guarantor of this publication is Prof. Carl Roobottom.
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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.
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The authors state that this work has not received any funding.
Statistics and biometry
One of the authors has significant statistical expertise.
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Written informed consent was obtained from all subjects (patients) in this study.
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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