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Hee Kim K, Choo KS, Jin Nam K, Lee K, Hwang JY, Park C, Jung Yang W. Cardiac CTA image quality of adaptive statistical iterative reconstruction-V versus deep learning reconstruction "TrueFidelity" in children with congenital heart disease. Medicine (Baltimore) 2022; 101:e31169. [PMID: 36281124 PMCID: PMC9592454 DOI: 10.1097/md.0000000000031169] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several recent studies have reported that deep learning reconstruction "TrueFidelity" (TF) improves computed tomography (CT) image quality. However, no study has compared adaptive statistical repeated reconstruction (ASIR-V) using TF in pediatric cardiac CT angiography (CTA) with a low peak kilovoltage. OBJECTIVE This study aimed to determine whether ASIR-V or TF CTA image quality is superior in children with congenital heart disease (CHD). MATERIALS AND METHODS Fifty children (median age, 2 months; interquartile range, 0-5 months; 28 men) with CHD who underwent CTA were enrolled between June and September 2020. Images were reconstructed using 2 ASIR-V blending factors (80% and 100% [AV-100]) and 3 TF settings (low, medium, and high [TF-H] strength levels). For the quantitative analyses, 3 objective image qualities (attenuation, noise, and signal-to-noise ratio [SNR]) were measured of the great vessels and heart chambers. The contrast-to-noise ratio (CNR) was also evaluated between the left ventricle and the dial wall. For the qualitative analyses, the degree of quantum mottle and blurring at the upper level to the first branch of the main pulmonary artery was assessed independently by 2 radiologists. RESULTS When the ASIR-V blending factor level and TF strength were higher, the noise was lower, and the SNR was higher. The image noise and SNR of TF-H were significantly lower and higher than those of AV-100 (P < .01), except for noise in the right atrium and left pulmonary artery and SNR of the right ventricle. Regarding CNR, TF-H was significantly better than AV-100 (P < .01). In addition, in the objective assessment of the degree of quantum mottle and blurring, TF-H had the best score among all examined image sets (P < .01). CONCLUSION TF-H is superior to AV-100 in terms of objective and subjective image quality. Consequently, TF-H was the best image set for cardiac CTA in children with CHD.
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Affiliation(s)
- Kun Hee Kim
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - Ki Seok Choo
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
- *Correspondence: Ki Seok Choo, Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-RI, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 626-770, Korea (e-mail: )
| | - Kyoung Jin Nam
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - Kyeyoung Lee
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - ChanKue Park
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - Woo Jung Yang
- Barunmom Rehabilitation Medicine, Busanjin-gu, Busan, Korea
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Coronary Artery Magnetic Resonance Angiography Combined with Computed Tomography Angiography in Diagnosis of Coronary Heart Disease by Reconstruction Algorithm. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:8628668. [PMID: 35685658 PMCID: PMC9165524 DOI: 10.1155/2022/8628668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022]
Abstract
This research aimed at discussing the diagnosis effect of coronary artery magnetic resonance angiography (MRA) combined with computed tomography (CT) angiography (CTA) based on the back-projection filter reconstruction (BPFR) algorithm in coronary heart disease (CHD), and its role in the diagnosis of coronary artery disease (CAD). Sixty patients with CHD were selected and randomly rolled into group A (undergone MRA examination), group B (undergone CTA examination), and group C (undergone MRA + CTA), with 20 cases in each group. Taking the diagnostic results of coronary angiography as the gold standard, the MRA and CTA images were reconstructed using a BPFR algorithm, and a filter function was added to solve the problem of image sharpness. In addition, the iterative reconstruction algorithm and the Fourier transform analysis method were introduced. As a result, the image clarity and resolution obtained by the BPFR algorithm were better than those obtained by the Fourier transform analytical method and the iterative reconstruction algorithm. The accuracy of group C for the diagnosis of mild coronary stenosis, moderate stenosis, and severe stenosis was 94.02%, 96.13%, and 98.01%, respectively, which was significantly higher than that of group B (87.5%, 90.2%, and 88.4%) and group C (83.4%, 89.1%, and 91.5%) (P < 0.05). The sensitivity and specificity for the diagnosis of noncalcified plaque in group C were 87.9% and 89.2%, respectively, and the sensitivity and specificity for the diagnosis of calcified plaque were 84.5% and 78.4%, respectively, which were significantly higher than those in groups B and C (P < 0.05). In summary, the BPFR algorithm had good denoising and artifact removal effects on coronary MRA and CTA images. The combined detection of reconstructed MRA and CTA images had a high diagnostic value for CHD.
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Goo HW. Contrast-Enhanced CT Protocol for the Fontan Pathway: Comparison Between 1- and 3-Minute Scan Delays. Pediatr Cardiol 2022; 43:1104-1113. [PMID: 35107628 DOI: 10.1007/s00246-022-02830-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
Abstract
Optimal enhancement of the Fontan pathway is crucial for the accurate CT evaluation. Current guidelines for contrast-enhanced CT protocols are rather inconsistent in scan delays and injection methods. This single-center, retrospective study was performed to compare objective measures of contrast enhancement between 1- and 3-min scan delays (41 and 36 patients, respectively) to determine a better contrast-enhanced CT protocols for evaluating the Fontan pathway. In both groups, a biphasic injection protocol, in which 50% diluted contrast agent (the amount of iodinated contrast agent: 2.0 mL/kg; the amount of saline: 2.0 mL/kg) was injected at the injection rate of 0.5‒2.5 mL/s for 50 s followed by a saline flush at the same injection rate (0.5‒2.5 mL/s), was used. The degree and heterogeneity of cardiovascular enhancement, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were quantitatively evaluated. The mean densities of all cardiovascular structures were significantly higher in the 1-min delay protocol than in the 3-min delay protocols (p < 0.001). Heterogeneous enhancement (normalized standard deviation > 0.70) in the Fontan pathway was significantly more frequent in the 1-min delay protocol (p < 0.001). No significant differences were found in image noise (p > 0.141) and the frequency showing suboptimal noise (p = 1.000) between the two protocols. SNR and CNR were significantly lower in the 3-min delay protocol (p < 0.001). Compared with the 1-min delay protocol, the 3-min delay protocol achieved more homogeneous enhancement in the Fontan pathway on CT but showed lower contrast enhancement, SNR, and, CNR, indicating the need for further improvement.
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Affiliation(s)
- Hyun Woo Goo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Lenga L, Lange M, Martin SS, Albrecht MH, Booz C, Yel I, Arendt CT, Vogl TJ, Leithner D. Head and neck single- and dual-energy CT: differences in radiation dose and image quality of 2nd and 3rd generation dual-source CT. Br J Radiol 2021; 94:20210069. [PMID: 33914613 PMCID: PMC8173672 DOI: 10.1259/bjr.20210069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To compare radiation dose and image quality of single-energy (SECT) and dual-energy (DECT) head and neck CT examinations performed with second- and third-generation dual-source CT (DSCT) in matched patient cohorts. METHODS 200 patients (mean age 55.1 ± 16.9 years) who underwent venous phase head and neck CT with a vendor-preset protocol were retrospectively divided into four equal groups (n = 50) matched by gender and BMI: second (Group A, SECT, 100-kV; Group B, DECT, 80/Sn140-kV), and third-generation DSCT (Group C, SECT, 100-kV; Group D, DECT, 90/Sn150-kV). Assessment of radiation dose was performed for an average scan length of 27 cm. Contrast-to-noise ratio measurements and dose-independent figure-of-merit calculations of the submandibular gland, thyroid, internal jugular vein, and common carotid artery were analyzed quantitatively. Qualitative image parameters were evaluated regarding overall image quality, artifacts and reader confidence using 5-point Likert scales. RESULTS Effective radiation dose (ED) was not significantly different between SECT and DECT acquisition for each scanner generation (p = 0.10). Significantly lower effective radiation dose (p < 0.01) values were observed for third-generation DSCT groups C (1.1 ± 0.2 mSv) and D (1.0 ± 0.3 mSv) compared to second-generation DSCT groups A (1.8 ± 0.1 mSv) and B (1.6 ± 0.2 mSv). Figure-of-merit/contrast-to-noise ratio analysis revealed superior results for third-generation DECT Group D compared to all other groups. Qualitative image parameters showed non-significant differences between all groups (p > 0.06). CONCLUSION Contrast-enhanced head and neck DECT can be performed with second- and third-generation DSCT systems without radiation penalty or impaired image quality compared with SECT, while third-generation DSCT is the most dose efficient acquisition method. ADVANCES IN KNOWLEDGE Differences in radiation dose between SECT and DECT of the dose-vulnerable head and neck region using DSCT systems have not been evaluated so far. Therefore, this study directly compares radiation dose and image quality of standard SECT and DECT protocols of second- and third-generation DSCT platforms.
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Affiliation(s)
- Lukas Lenga
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Marvin Lange
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Simon S Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Moritz H Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Christian Booz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Ibrahim Yel
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Christophe T Arendt
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Doris Leithner
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
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Comparison of quantitative image quality of cardiac computed tomography between raw-data-based and model-based iterative reconstruction algorithms with an emphasis on image sharpness. Pediatr Radiol 2020; 50:1570-1578. [PMID: 32591981 DOI: 10.1007/s00247-020-04741-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/12/2020] [Accepted: 05/22/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Image sharpness is commonly degraded on cardiac CT images reconstructed using iterative reconstruction algorithms. OBJECTIVE To compare the image quality of cardiac CT between raw-data-based and model-based iterative reconstruction algorithms developed by the same CT vendor in children and young adults with congenital heart disease. MATERIALS AND METHODS In 29 patients with congenital heart disease, we reconstructed 39 cardiac CT datasets using raw-data-based and model-based iterative reconstruction algorithms. We performed quantitative analysis of image sharpness using distance25-75% and angle25-75% on a line density profile across an edge of the descending thoracic aorta in addition to CT attenuation, image noise, signal-to-noise ratio and contrast-to-noise ratio. We compared these quantitative image-quality measures between the two algorithms. RESULTS CT attenuation did not show significant differences between the algorithms (P>0.05) except in the aorta. Image noise was small but significantly higher in the model-based algorithm than in the raw-data-based algorithm (4.8±2.3 Hounsfield units [HU] vs. 4.7±2.1 HU, P<0.014). Signal-to-noise ratio (110.2±50.9 vs. 108.4±50.4, P=0.050) and contrast-to-noise ratio (91.0±45.7 vs. 89.6±45.1, P=0.063) showed marginal significance between the two algorithms. The model-based algorithm showed a significantly smaller distance25-75% (1.4±0.4 mm vs. 1.6±0.3 mm, P<0.001) and a significantly higher angle25-75% (77.0±4.3° vs. 74.1±5.7°, P<0.001) than the raw-data-based algorithm. CONCLUSION Compared with the raw-data-based algorithm, the model-based iterative reconstruction algorithm demonstrated better image sharpness and higher image noise on cardiac CT in patients with congenital heart disease.
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Fu B, Wang G, Wu M, Li W, Zheng Y, Chu Z, Lv F. Influence of CT effective dose and convolution kernel on the detection of pulmonary nodules in different artificial intelligence software systems: A phantom study. Eur J Radiol 2020; 126:108928. [DOI: 10.1016/j.ejrad.2020.108928] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 01/05/2020] [Accepted: 02/28/2020] [Indexed: 12/29/2022]
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Pediatric head computed tomography with advanced modeled iterative reconstruction: focus on image quality and reduction of radiation dose. Pediatr Radiol 2020; 50:242-251. [PMID: 31630218 DOI: 10.1007/s00247-019-04532-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 07/21/2019] [Accepted: 09/10/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Iterative reconstruction has become the standard method for reconstructing computed tomography (CT) scans and needs to be verified for adaptation. OBJECTIVE To assess the image quality after adapting advanced modeled iterative reconstruction (ADMIRE) for pediatric head CT. MATERIALS AND METHODS We included image sets with filtered back projection reconstruction (the cFBP group, n=105) and both filtered back projection and ADMIRE reconstruction (the lower-dose group, n=109) after dose reduction. All five strength levels of ADMIRE and filtered back projection were adapted for the lower-dose group and compared with the cFBP group. Quantitative parameters including noise, signal-to-noise ratio and contrast-to-noise ratio and qualitative parameters including noise, white matter and gray matter differentiation of the supra- and infratentorial levels, sharpness, artifact, and diagnostic accuracy were also evaluated and compared with interobserver agreement. RESULTS There was a mean dose reduction of 30.6% in CT dose index volume, 32.1% in dose length product, and 32.1% in effective dose after tube current reduction. There was gradual reduction of noise in air, cerebrospinal fluid and white matter with strength levels of ADMIRE from 1 to 5 (P<0.001). Signal-to-noise ratio and contrast-to-noise ratio in all age groups increased among strength levels of ADMIRE, in sequence from 1 to 5, with statistical significance (P<0.001). Gradual reduction of qualitative parameters was noted among strength levels of ADMIRE in sequence from 1 to 5 (P<0.001). CONCLUSION Use of ADMIRE for pediatric head CT can reduce radiation dose without degrading image quality.
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Image Quality and Lesion Detection on Deep Learning Reconstruction and Iterative Reconstruction of Submillisievert Chest and Abdominal CT. AJR Am J Roentgenol 2020; 214:566-573. [PMID: 31967501 DOI: 10.2214/ajr.19.21809] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE. The objective of this study was to compare image quality and clinically significant lesion detection on deep learning reconstruction (DLR) and iterative reconstruction (IR) images of submillisievert chest and abdominopelvic CT. MATERIALS AND METHODS. Our prospective multiinstitutional study included 59 adult patients (33 women, 26 men; mean age ± SD, 65 ± 12 years old; mean body mass index [weight in kilograms divided by the square of height in meters] = 27 ± 5) who underwent routine chest (n = 22; 16 women, six men) and abdominopelvic (n = 37; 17 women, 20 men) CT on a 640-MDCT scanner (Aquilion ONE, Canon Medical Systems). All patients gave written informed consent for the acquisition of low-dose (LD) CT (LDCT) after a clinically indicated standard-dose (SD) CT (SDCT). The SDCT series (120 kVp, 164-644 mA) were reconstructed with interactive reconstruction (IR) (adaptive iterative dose reduction [AIDR] 3D, Canon Medical Systems), and the LDCT (100 kVp, 120 kVp; 30-50 mA) were reconstructed with filtered back-projection (FBP), IR (AIDR 3D and forward-projected model-based iterative reconstruction solution [FIRST], Canon Medical Systems), and deep learning reconstruction (DLR) (Advanced Intelligent Clear-IQ Engine [AiCE], Canon Medical Systems). Four subspecialty-trained radiologists first read all LD image sets and then compared them side-by-side with SD AIDR 3D images in an independent, randomized, and blinded fashion. Subspecialty radiologists assessed image quality of LDCT images on a 3-point scale (1 = unacceptable, 2 = suboptimal, 3 = optimal). Descriptive statistics were obtained, and the Wilcoxon sign rank test was performed. RESULTS. Mean volume CT dose index and dose-length product for LDCT (2.1 ± 0.8 mGy, 49 ± 13mGy·cm) were lower than those for SDCT (13 ± 4.4 mGy, 567 ± 249 mGy·cm) (p < 0.0001). All 31 clinically significant abdominal lesions were seen on SD AIDR 3D and LD DLR images. Twenty-five, 18, and seven lesions were detected on LD AIDR 3D, LD FIRST, and LD FBP images, respectively. All 39 pulmonary nodules detected on SD AIDR 3D images were also noted on LD DLR images. LD DLR images were deemed acceptable for interpretation in 97% (35/37) of abdominal and 95-100% (21-22/22) of chest LDCT studies (p = 0.2-0.99). The LD FIRST, LD AIDR 3D, and LD FBP images had inferior image quality compared with SD AIDR 3D images (p < 0.0001). CONCLUSION. At submillisievert chest and abdominopelvic CT doses, DLR enables image quality and lesion detection superior to commercial IR and FBP images.
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Can fully iterative reconstruction technique enable routine abdominal CT at less than 1 mSv? Eur J Radiol Open 2019; 6:225-230. [PMID: 31304196 PMCID: PMC6603257 DOI: 10.1016/j.ejro.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/15/2019] [Accepted: 05/13/2019] [Indexed: 12/16/2022] Open
Abstract
Objective We assessed the effect of the forward projected model-based reconstruction technique (FIRST) on lesion detection of routine abdomen CT at <1 mSv. Materials and methods Thirty-seven adult patients gave written informed consent for acquisition of low-dose CT (LDCT) immediately after their clinically-indicated, standard of care dose (SDCT), routine abdomen CT on a 640-slice MDCT (Aquillion One, Canon Medical System). The LDCT series were reconstructed with FIRST (at STD (Standard) and STR (Strong) levels), and SDCT series with filtered back projection (FBP). Two radiologists assessed lesions in LD-FBP and FIRST images followed by SDCT images. Then, SDCT and LDCT were compared for presence of artifacts in a randomized and blinded fashion. Patient demographics, size and radiation dose descriptors (CTDIvol, DLP) were recorded. Descriptive statistics and inter-observer variability were calculated for data analysis. Results Mean CTDIvol for SDCT and LDCT were 13 ± 4.7 mGy and 2.2 ± 0.8 mGy, respectively. There were 46 true positive lesions detected on SDCT. Radiologists detected 38/46 lesions on LD-FIRST-STD compared to 26/46 lesions on LD-FIRST-STR. The eight lesions (liver and kidney cysts, pancreatic lesions, sub-cm peritoneal lymph node) missed on LD-FIRST-STD were seen in patients with BMI > 25.8 kg/m2. Diagnostic confidence for lesion assessment was optimal in LD-FIRST-STD setting in most patients regardless of their size. The inter-observer agreement (kappa-value) for overall image quality were 0.98 and 0.84 for LD-FIRST-STD and STR levels, respectively. Conclusion FIRST enabled optimal lesion detection in routine abdomen CT at less than 1 mSv radiation dose in patients with body mass less than ≤25.8 kg/m2.
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Comparison of Radiation Dose and Image Quality of Contrast-Enhanced Dual-Source CT of the Chest: Single-Versus Dual-Energy and Second-Versus Third-Generation Technology. AJR Am J Roentgenol 2019; 212:741-747. [PMID: 30699006 DOI: 10.2214/ajr.18.20065] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Lenga L, Trapp F, Albrecht MH, Wichmann JL, Johnson AA, Yel I, D'Angelo T, Booz C, Vogl TJ, Martin SS. Single- and dual-energy CT pulmonary angiography using second- and third-generation dual-source CT systems: comparison of radiation dose and image quality. Eur Radiol 2019; 29:4603-4612. [PMID: 30666446 DOI: 10.1007/s00330-018-5982-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/23/2018] [Accepted: 12/17/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To evaluate radiation exposure and image quality in matched patient cohorts for CT pulmonary angiography (CTPA) acquired in single- and dual-energy mode using second- and third-generation dual-source CT (DSCT) systems. METHODS We retrospectively included 200 patients (mean age, 65.5 years ± 15.7 years) with suspected pulmonary embolism-equally divided into four study groups (n = 50) and matched by gender and body mass index. CTPA was performed with vendor-predefined second-generation (group A, 100-kV single-energy computed tomography (SECT); group B, 80/Sn140-kV dual-energy computed tomography (DECT)) or third-generation DSCT (group C, 100-kV SECT; group D, 90/Sn150-kV DECT) devices. Radiation metrics were assessed using a normalized scan range of 27.5 cm. For objective image quality evaluation, dose-independent figure-of-merit (FOM) contrast-to-noise ratios (CNRs) were calculated. Subjective image analysis included ratings for overall image quality, reader confidence, and image artifacts using five-point Likert scales. RESULTS Calculations of the effective dose (ED) of radiation for a normalized scan range of 27.5 cm showed nonsignificant differences between SECT and DECT acquisitions for each scanner generation (p ≥ 0.253). The mean effective radiation dose was lower for third-generation groups C (1.5 mSv ± 0.8 mSv) and D (1.4 mSv ± 0.7 mSv) compared to second-generation groups A (2.5 mSv ± 0.9 mSv) and B (2.3 mSv ± 0.6 mSv) (both p ≤ 0.013). FOM-CNR measurements were highest for group D. Qualitative image parameters of overall image quality, reader confidence, and image artifacts showed nonsignificant differences among the four groups (p ≥ 0.162). CONCLUSIONS Third-generation DSCT systems show lower radiation dose parameters for CTPA compared to second-generation DSCT. DECT can be performed with both scanner generations without radiation dose penalty or detrimental effects on image quality compared to SECT. KEY POINTS • Radiation exposure showed nonsignificant differences between SECT and DECT for both DSCT scanner devices. • Dual-energy CTPA provides equivalent image quality compared to standard image acquisition. • Subjective image quality assessment was similar among the four study groups.
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Affiliation(s)
- Lukas Lenga
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Franziska Trapp
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Moritz H Albrecht
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Julian L Wichmann
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Addison A Johnson
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Ibrahim Yel
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Tommaso D'Angelo
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Simon S Martin
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
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Örgel A, Bier G, Hennersdorf F, Richter H, Ernemann U, Hauser TK. Image Quality of CT Angiography of Supra-Aortic Arteries : Comparison Between Advanced Modelled Iterative Reconstruction (ADMIRE), Sinogram Affirmed Iterative Reconstruction (SAFIRE) and Filtered Back Projection (FBP) in One Patients' Group. Clin Neuroradiol 2018; 30:101-107. [PMID: 30397728 DOI: 10.1007/s00062-018-0740-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/19/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To evaluate the potential benefit in image quality of the iterative reconstruction (IR) technique advanced modelled iterative reconstruction (ADMIRE) in CT angiography (CTA) of supra-aortic arteries compared to sinogram affirmed iterative reconstruction (SAFIRE) and standard filtered back projection (FBP) in one patients' group. METHODS In this study 29 patients underwent standard CTA of supra-aortic arteries. Images were reconstructed using three different reconstruction algorithms, FBP, and IR techniques ADMIRE and SAFIRE. General image quality was assessed by two radiologists in different arterial segments using a 5-point Likert scale. Mean attenuation and noise were measured at different levels of each vessel and signal-to-noise ratio (SNR) was calculated. Interrater variability was determined. RESULTS Regarding total image quality IR showed only excellent, very good and good results and was more often graded excellent and very good than FBP reconstruction. Image noise levels and SNR were significantly (p < 0.01) improved in IR at the bilateral subclavian arteries (only in SAFIRE), vertebral V1 and V3 segments, common carotid arteries and proximal and distal internal carotid arteries. No significant differences in image quality were found when comparing SAFIRE and ADMIRE reconstructions except for V1 and V3. In these regions ADMIRE showed significantly better image quality than SAFIRE (p < 0.001 and p < 0.01). Interrater agreement was almost perfect (κ = 0.88) for different image quality parameters. CONCLUSION The CTA of supra-aortic arteries using the IR techniques SAFIRE and ADMIRE was superior to FBP when comparing the objective and subjective image quality and ADMIRE has the potential to overcome SAFIRE.
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Affiliation(s)
- Anja Örgel
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.
| | - Georg Bier
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany
| | - Florian Hennersdorf
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany
| | - Hardy Richter
- Department of Neurology with Focus on Neurovascular Diseases and Neurooncology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany
| | - Ulrike Ernemann
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany
| | - Till-Karsten Hauser
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany
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CT-angiography of the aorta in patients with Marfan disease - High-pitch MDCT at different levels of tube voltage combined with Sinogram Affirmed Iterative Reconstruction. Clin Imaging 2018; 51:123-132. [DOI: 10.1016/j.clinimag.2018.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/20/2018] [Accepted: 02/06/2018] [Indexed: 01/16/2023]
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Leithner D, Gruber-Rouh T, Beeres M, Wichmann JL, Mahmoudi S, Martin SS, Lenga L, Albrecht MH, Booz C, Vogl TJ, Scholtz JE. 90-kVp low-tube-voltage CT pulmonary angiography in combination with advanced modeled iterative reconstruction algorithm: effects on radiation dose, image quality and diagnostic accuracy for the detection of pulmonary embolism. Br J Radiol 2018; 91:20180269. [PMID: 29792729 DOI: 10.1259/bjr.20180269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To evaluate low-tube-voltage 90-kVp CT pulmonary angiography (CTPA) with advanced modeled iterative reconstruction algorithm (Admire) compared to 120-kVp equivalent dual-energy (DE) acquisition with regards to radiation exposure, image quality and diagnostic accuracy for pulmonary embolism (PE) assessment. METHODS CTPA studies of 40 patients with suspected PE (56.7 ± 16.3 years) performed on a third-generation 192-slice dual-source CT scanner were retrospectively included. 120-kVp equivalent linearly-blended (60% 90-kVp, 40% 150-kVp) and 90-kVp images were reconstructed. Attenuation and noise of the pulmonary trunk were measured to calculate contrast-to-noise ratios (CNR). Three radiologists assessed the presence of central and segmental PE and diagnostic confidence. Interobserver agreement was calculated using intraclass correlation coefficient (ICC). Radiation exposure was assessed as effective dose (ED). RESULTS Pulmonary trunk CNR values were significantly increased in 90-kVp compared to linearly-blended series (15.4 ± 6.3 vs 11.3 ± 4.6, p < 0.001). Diagnostic accuracy for PE assessment was similar in both series with excellent interobserver agreement (p = 0.48; ICC, 0.83; p = 0.48). Overall confidence for PE assessment was rated excellent for both series with a significant advantage for linearly-blended series (p < 0.001; 4.1 vs 3.8). ED was reduced by 37.2% with 90-kVp compared to 120-kVp equivalent image series (1.1 ± 0.6 vs 1.7 ± 0.7 mSv, p < 0.001). CONCLUSION 90-kVp CTPA with Admire provided increased quantitative image quality with similar diagnostic accuracy and confidence for PE assessment compared to 120-kVp equivalent acquisition, while radiation dose was reduced by 37.2%. Advances in knowledge: 90-kVp CTPA with an advanced iterative reconstruction algorithm results in excellent image quality and reduction of radiation exposure without limiting diagnostic performance.
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Affiliation(s)
- Doris Leithner
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.,2 Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center , New York, NY , USA
| | - Tatjana Gruber-Rouh
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Martin Beeres
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Julian L Wichmann
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Scherwin Mahmoudi
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Simon S Martin
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Lukas Lenga
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Moritz H Albrecht
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Christian Booz
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Thomas J Vogl
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany
| | - Jan-Erik Scholtz
- 1 Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt , Frankfurt , Germany.,3 Department of Radiology, Massachusetts General Hospital, Cardiac MR PET CT Program, Harvard Medical School , Boston, MA , USA
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