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Computed tomography of the cervical spine: comparison of image quality between a standard-dose and a low-dose protocol using filtered back-projection and iterative reconstruction

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Abstract

Objective

To compare image quality of a standard-dose (SD) and a low-dose (LD) cervical spine CT protocol using filtered back-projection (FBP) and iterative reconstruction (IR).

Materials and methods

Forty patients investigated by cervical spine CT were prospectively randomised into two groups: SD (120 kVp, 275 mAs) and LD (120 kVp, 150 mAs), both applying automatic tube current modulation. Data were reconstructed using both FBP and sinogram-affirmed IR. Image noise, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were measured. Two radiologists independently and blindly assessed the following anatomical structures at C3–C4 and C6–C7 levels, using a four-point scale: intervertebral disc, content of neural foramina and dural sac, ligaments, soft tissues and vertebrae. They subsequently rated overall image quality using a ten-point scale.

Results

For both protocols and at each disc level, IR significantly decreased image noise and increased SNR and CNR, compared with FBP. SNR and CNR were statistically equivalent in LD-IR and SD-FBP protocols. Regardless of the dose and disc level, the qualitative scores with IR compared with FBP, and with LD-IR compared with SD-FBP, were significantly higher or not statistically different for intervertebral discs, neural foramina and ligaments, while significantly lower or not statistically different for soft tissues and vertebrae. The overall image quality scores were significantly higher with IR compared with FBP, and with LD-IR compared with SD-FBP.

Conclusion

LD-IR cervical spine CT provides better image quality for intervertebral discs, neural foramina and ligaments, and worse image quality for soft tissues and vertebrae, compared with SD-FBP, while reducing radiation dose by approximately 40 %.

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Acknowledgements

The authors thank Julien G. Ott for his help with the noise power spectrum analysis.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Fabio Becce & Reto Meuli

  2. Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium

    Fabio Becce, Yosr Ben Salah, Bruno C. Vande Berg, Frederic E. Lecouvet & Patrick Omoumi

  3. Institute of Radiation Physics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Rue du Grand-Pré 1, 1007, Lausanne, Switzerland

    Francis R. Verdun

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  1. Fabio Becce
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  2. Yosr Ben Salah
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  3. Francis R. Verdun
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Correspondence to Fabio Becce.

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Becce, F., Ben Salah, Y., Verdun, F.R. et al. Computed tomography of the cervical spine: comparison of image quality between a standard-dose and a low-dose protocol using filtered back-projection and iterative reconstruction. Skeletal Radiol 42, 937–945 (2013). https://doi.org/10.1007/s00256-013-1576-9

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  • DOI: https://doi.org/10.1007/s00256-013-1576-9

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