Prospective evaluation of ultra-low-dose contrast-enhanced 100-kV abdominal computed tomography with tin filter: effect on radiation dose reduction and image quality with a third-generation dual-source CT system
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To investigate the radiation dose exposure, image quality, and diagnostic performance of enhanced 100-kVp abdominopelvic single-energy CT protocol with tin filter (TF).
Ninety-three consecutive patients referred for a single-phase enhanced abdominopelvic CT were prospectively included after informed consent. They underwent in addition to a standard protocol (SP) an acquisition with TF. Both examinations were performed on a third-generation dual-source CT system (DSCT), in single energy, using automatic tube current modulation, identical pitch, and identical level of iterative reconstruction. Radiation metrics were compared. Size-specific dose estimates (SSDE), contrast to noise ratio (CNR), and figure of merit (FOM) were calculated. Diagnostic confidence for the assessment of a predetermined list of abdominal lesions was rated by two independent readers.
The mean dose of the TF protocol was significantly lower (CDTI 1.56 ± 0.43 mGy vs. 8.13 ± 3.32, p < 0.001; SSDE 9.94 ± 3.08 vs. 1.93 ± 0.39, p < 0.001), with an effective dose close to 1 mSv (1.14 mSv ± 0.34; p < 0.001). TF group exhibited non-significant lower liver CNR (2.76 vs. 3.03, p = 0.56) and was more dose efficient (FOM 10.6 vs. 2.49/mSv, p < 0.001) in comparison to SP. The mean diagnostic confidence for visceral, bone, and peritoneal tumors was equivalent between both groups.
Enhanced 100-kVp abdominopelvic CT acquired after spectral shaping with tin filtration can achieve similar diagnostic performance and CNR compared to a standard CT protocol, while reducing the radiation dose by 81%.
• 100-kVp spectral filtration enables enhanced abdominal CT with high-dose efficiency.
• The radiation dose reaches the 1-mSv range.
• Predetermined abdominopelvic lesions can be assessed without impairing on diagnostic confidence.
KeywordsRadiation dose Multidetector computed tomography Abdomen
Advanced Modeled Iterative Reconstruction
Automated tube voltage selection
Contrast to noise ratio
Volumetric CT dose index
Dose length product
Dual-source computed tomography
Figure of merit
Region of interest
Signal to noise ratio
Size-specific dose estimates
Compliance with ethical standards
The scientific guarantor of this publication is Catherine Roy, MD, PhD.
Conflict of interest
The authors declare that they have no conflict of interest.
Statistics and biometry
François Lefebvre, MD, kindly provided statistical advice for this manuscript.
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all patients in this study.
Institutional Review Board approval was obtained.
• Case-control study
• Performed at one institution
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