Periradicular infiltration of the lumbar spine: is iterative reconstruction software necessary to establish ultra-low-dose protocols? A quantitative and qualitative approach
- 91 Downloads
Computed tomography (CT)-guided periradicular infiltration therapy has emerged as an effective treatment option for patients with low back pain. Concern about radiation exposure requires approaches allowing significant dose reduction. The purpose of this study is to evaluate the need for iterative reconstruction software in CT-guided periradicular infiltration therapy with an ultra-low-dose protocol.
Materials and methods
One hundred patients underwent CT-guided periradicular infiltration therapy of the lumbar spine using an ultra-low-dose protocol with adaptive iterative dose reduction 3D (AIDR 3D) for image reconstruction. In addition, images were reconstructed with filtered back-projection (FBP). Four experienced raters evaluated both reconstruction types for conspicuity of anatomical and instrumental features important for ensuring safe patient treatment. Image noise was measured as a quantitative marker of image quality.
Interrater agreement was good for both AIDR 3D (Kendall’s W = 0.83) and FBP (0.78) reconstructions. Readers assigned the same scores for all features and both reconstruction algorithms in 81.3% of cases. Image noise was significantly lower (average SD of 60.07 vs. 99.54, p < 0.05) for AIDR 3D-reconstructed images.
Although it significantly lowers image noise, iterative reconstruction software is not mandatory to achieve adequate image quality with an ultra-low-dose CT protocol for guiding periradicular infiltration therapy of the lumbar spine.
KeywordsComputed tomography (CT) Interventional Spine Dosimetry
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
- 6.Irwan B NS, Blum A (2012) AIDR 3D—reduces dose and simultaneously improves image quality. Toshiba Medical Systems WhitepaperGoogle Scholar
- 8.Blobel J, Mews J, Schuijf JD, Overlaet W (2013) Determining the radiation dose reduction potential for coronary calcium scanning with computed tomography: an anthropomorphic phantom study comparing filtered backprojection and the adaptive iterative dose reduction algorithm for image reconstruction. Invest Radiol 48(12):857–862. https://doi.org/10.1097/RLI.0b013e31829e3932 CrossRefPubMedGoogle Scholar
- 9.Tatsugami F, Matsuki M, Nakai G, Inada Y, Kanazawa S, Takeda Y, Morita H, Takada H, Yoshikawa S, Fukumura K, Narumi Y (2012) The effect of adaptive iterative dose reduction on image quality in 320-detector row CT coronary angiography. Br J Radiol 85(1016):e378–382. https://doi.org/10.1259/bjr/10084599 CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Juri H, Tsuboyama T, Kumano S, Inada Y, Koyama M, Azuma H, Narumi Y (2016) Detection of bladder cancer: comparison of low-dose scans with AIDR 3D and routine-dose scans with FBP on the excretory phase in CT urography. Br J Radiol 89(1058):20150495. https://doi.org/10.1259/bjr.20150495 CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Wallihan DB, Podberesky DJ, Sullivan J, Denson LA, Zhang B, Salisbury SR, Towbin AJ (2015) Diagnostic performance and dose comparison of filtered back projection and adaptive iterative dose reduction three-dimensional CT enterography in children and young adults. Radiology 276(1):233–242. https://doi.org/10.1148/radiol.14140468 CrossRefPubMedGoogle Scholar
- 13.Gervaise A, Osemont B, Louis M, Lecocq S, Teixeira P, Blum A (2014) Standard dose versus low-dose abdominal and pelvic CT: comparison between filtered back projection versus adaptive iterative dose reduction 3D. Diagn Interven Imaging 95(1):47–53. https://doi.org/10.1016/j.diii.2013.05.005 CrossRefGoogle Scholar
- 15.Matsuki M, Murakami T, Juri H, Yoshikawa S, Narumi Y (2013) Impact of adaptive iterative dose reduction (AIDR) 3D on low-dose abdominal CT: comparison with routine-dose CT using filtered back projection. Acta Radiol (Stockholm, Sweden: 1987) 54(8):869–875. https://doi.org/10.1177/0284185113488576 CrossRefGoogle Scholar
- 16.Christner JA, Kofler JM, McCollough CH (2010) Estimating effective dose for CT using dose-length product compared with using organ doses: consequences of adopting international commission on radiological protection publication 103 or dual-energy scanning. AJR Am J Roentgenol 194(4):881–889. https://doi.org/10.2214/ajr.09.3462 CrossRefPubMedGoogle Scholar
- 18.Wu TH, Hung SC, Sun JY, Lin CJ, Lin CH, Chiu CF, Liu MJ, Teng MM, Guo WY, Chang CY (2013) How far can the radiation dose be lowered in head CT with iterative reconstruction? Analysis of imaging quality and diagnostic accuracy. Eur Radiol 23(9):2612–2621. https://doi.org/10.1007/s00330-013-2846-6 CrossRefPubMedGoogle Scholar
- 19.Geyer LL, Glenn GR, De Cecco CN, Van Horn M, Canstein C, Silverman JR, Krazinski AW, Kemper JM, Bucher A, Ebersberger U, Costello P, Bamberg F, Schoepf UJ (2015) CT evaluation of small-diameter coronary artery stents: effect of an integrated circuit detector with iterative reconstruction. Radiology 276(3):706–714. https://doi.org/10.1148/radiol.15140427 CrossRefPubMedGoogle Scholar