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European Radiology

, Volume 29, Issue 4, pp 2107–2116 | Cite as

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

  • Pierre LeyendeckerEmail author
  • Vanina Faucher
  • Aissam Labani
  • Vincent Noblet
  • François Lefebvre
  • Paul Magotteaux
  • Mickaël Ohana
  • Catherine Roy
Computed Tomography
  • 123 Downloads

Abstract

Objectives

To investigate the radiation dose exposure, image quality, and diagnostic performance of enhanced 100-kVp abdominopelvic single-energy CT protocol with tin filter (TF).

Methods

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.

Results

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.

Conclusions

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%.

Key Points

• 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.

Keywords

Radiation dose Multidetector computed tomography Abdomen 

Abbreviations

ADMIRE

Advanced Modeled Iterative Reconstruction

ATVS

Automated tube voltage selection

CNR

Contrast to noise ratio

CT

Computed tomography

CTDIvol

Volumetric CT dose index

DLP

Dose length product

DSCT

Dual-source computed tomography

ED

Effective dose

FOM

Figure of merit

HU

Hounsfield unit

IR

Iterative reconstruction

ROI

Region of interest

SD

Standard deviation

SNR

Signal to noise ratio

SSDE

Size-specific dose estimates

TF

Tin filters

Notes

Compliance with ethical standards

Guarantor

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.

Informed consent

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

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Prospective

• Case-control study

• Performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Service de Radiologie B, Nouvel Hôpital CivilHôpitaux Universitaires de StrasbourgStrasbourg CedexFrance
  2. 2.iCube, Telecom Physique StrasbourgUniversité de Strasbourg, CNRS UMR 7357IllkirchFrance
  3. 3.Département de Biostatistiques, Hôpital CivilHôpitaux Universitaires de StrasbourgStrasbourgFrance
  4. 4.GIE RadiologieInstitut Hospitalo-Universitaire, Institut de chirurgie guidée par l’imageStrasbourgFrance
  5. 5.Faculté de MédecineStrasbourgFrance

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