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Li J, Wei WF, Song LN, Mei XY, Yuan XS, He JB, Jiang LZ, Li HY, Wu HL, Chen JP. Double low-dose computed tomography (CT) angiography of craniocervical arteries using a test bolus of diluted contrast medium and a personalized contrast protocol. Clin Radiol 2024; 79:e1330-e1338. [PMID: 39198109 DOI: 10.1016/j.crad.2024.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/24/2024] [Accepted: 07/29/2024] [Indexed: 09/01/2024]
Abstract
AIM To prospectively assess the value of a test bolus of diluted contrast medium (CM) combined with a personalized contrast protocol in craniocervical computed tomography angiography (cc-CTA) with low radiation and CM doses. MATERIALS AND METHODS Eighty-six consecutive subjects were divided into two groups at random (43 in each one): group A: 100/Sn140 kVp, filtered back-projection reconstruction, iopromide (370 mgI/ml) 50 ml; group B: 80/Sn140 kVp, iterative reconstruction, iodixanol (270 mgI/ml). In group B, the test bolus contained 27 ml of diluted CM, a personalized protocol with low-concentration CM was used for angiography, and the test bolus injection duration in angiography remained the same. Artery values over 200 Hounsfield units were considered significant. RESULTS Image quality for all cases was found to be diagnostic. No significant differences were found in the arterial densities of the ascending aorta or basilar artery between the groups. The values of the common carotid artery, internal carotid artery, and middle cerebral artery in group B were significantly lower. The effective dose and average iodine uptake were significantly lower in group B. CONCLUSION With double-low-dose cc-CTA, test bolus scanning based on diluted CM combined with a personalized contrast protocol can yield diagnostic-quality images and significantly reduce the radiation and CM doses.
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Affiliation(s)
- J Li
- Department of Radiology, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China
| | - W-F Wei
- Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China
| | - L-N Song
- Medical Record Department, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China
| | - X-Y Mei
- Department of Radiology, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China
| | - X-S Yuan
- Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China
| | - J-B He
- Department of Radiology, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China
| | - L-Z Jiang
- Department of Radiology, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China
| | - H-Y Li
- Department of Radiology, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China.
| | - H-L Wu
- Department of Radiology, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China.
| | - J-P Chen
- Department of Radiology, Wujin Hospital Affiliated to Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu, China.
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Alsaihati N, Solomon J, McCrum E, Samei E. Development, validation, and application of a generic image-based noise addition method for simulating reduced dose computed tomography images. Med Phys 2024. [PMID: 39387993 DOI: 10.1002/mp.17444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 09/09/2024] [Accepted: 09/17/2024] [Indexed: 10/15/2024] Open
Abstract
BACKGROUND Major efforts in computed tomography (CT) have been focused on reducing radiation dose to patients while maintaining adequate diagnostic quality. To that end, research tools have been developed to simulate reduced-dose images via either image-based or projection-based methods. The former is limited to fully capturing realistic texture, streak, and non-stationary characteristics of reduced dose, while the latter is impractical clinically. PURPOSE To develop and validate an image-based noise addition method that accounts for such attributes while being practical in clinical settings. METHODS A noise addition method was developed to add realistic noise in the image domain. The method first estimates the noise power spectrum (NPS) of CT images, which are also forward-projected to form synthetic projections. The projection data are supplemented with random white noise proportional to their attenuation values. The noise sinogram is then back-projected onto the image, filtered by the NPS, and scaled according to the desired dose reduction level. The tool was evaluated using both phantom images and patient data. The phantom images were acquired using a multi-sized image quality phantom (Mercury Phantom 3.0, Duke University), and a thorax anthropomorphic phantom (Lungman Phantom, Kyoto Kagaku) at different dose levels and reconstruction settings. The patient images consisted of two dose levels of various CT examinations and reconstruction settings. The simulated and real reduced-dose images were compared in terms of the noise magnitude and texture (i.e., NPS average frequency, NPS-fav). The utility of this methodology was also assessed for routine clinical use for CT protocol review. RESULTS For the phantom images, the percent errors in the noise magnitude between the simulated images and the actual images of the Mercury Phantom and anthropomorphic phantom images were 3.34% and 3.50%, respectively. The difference in fav was 0.07 mm-1 for the Mercury Phantom and 0.06 mm-1 for the anthropomorphic phantom between the simulated and actual images. The average noise magnitude percent error between the simulated and actual patient images was 4.61% with noise texture judged to be visually comparable with some kernel dependencies. When implemented clinically, the tool proved practical to simplify the process of estimating radiation dose reduction for CT protocols, resulting in a 50% dose reduction of our multiple myeloma protocol. CONCLUSIONS The method generated simulated CT images with realistic noise properties similar to images acquired at the same radiation exposure without needing access to raw projection data.
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Affiliation(s)
- Njood Alsaihati
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
- Center for Virtual Imaging Trials (CVIT), Duke University, Durham, North Carolina, USA
| | - Justin Solomon
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
- Center for Virtual Imaging Trials (CVIT), Duke University, Durham, North Carolina, USA
- Clinical Imaging Physics Group, Department of Radiology, Duke University Health System, Durham, North Carolina, USA
| | - Erin McCrum
- Charlotte Radiology, Charlotte, North Carolina, USA
| | - Ehsan Samei
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
- Center for Virtual Imaging Trials (CVIT), Duke University, Durham, North Carolina, USA
- Clinical Imaging Physics Group, Department of Radiology, Duke University Health System, Durham, North Carolina, USA
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Caruso D, De Santis D, Tremamunno G, Santangeli C, Polidori T, Bona GG, Zerunian M, Del Gaudio A, Pugliese L, Laghi A. Deep learning reconstruction algorithm and high-concentration contrast medium: feasibility of a double-low protocol in coronary computed tomography angiography. Eur Radiol 2024:10.1007/s00330-024-11059-x. [PMID: 39299952 DOI: 10.1007/s00330-024-11059-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/28/2024] [Accepted: 08/16/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVE To evaluate radiation dose and image quality of a double-low CCTA protocol reconstructed utilizing high-strength deep learning image reconstructions (DLIR-H) compared to standard adaptive statistical iterative reconstruction (ASiR-V) protocol in non-obese patients. MATERIALS AND METHODS From June to October 2022, consecutive patients, undergoing clinically indicated CCTA, with BMI < 30 kg/m2 were prospectively included and randomly assigned into three groups: group A (100 kVp, ASiR-V 50%, iodine delivery rate [IDR] = 1.8 g/s), group B (80 kVp, DLIR-H, IDR = 1.4 g/s), and group C (80 kVp, DLIR-H, IDR = 1.2 g/s). High-concentration contrast medium was administered. Image quality analysis was evaluated by two radiologists. Radiation and contrast dose, and objective and subjective image quality were compared across the three groups. RESULTS The final population consisted of 255 patients (64 ± 10 years, 161 men), 85 per group. Group B yielded 42% radiation dose reduction (2.36 ± 0.9 mSv) compared to group A (4.07 ± 1.2 mSv; p < 0.001) and achieved a higher signal-to-noise ratio (30.5 ± 11.5), contrast-to-noise-ratio (27.8 ± 11), and subjective image quality (Likert scale score: 4, interquartile range: 3-4) compared to group A and group C (all p ≤ 0.001). Contrast medium dose in group C (44.8 ± 4.4 mL) was lower than group A (57.7 ± 6.2 mL) and B (50.4 ± 4.3 mL), all the comparisons were statistically different (all p < 0.001). CONCLUSION DLIR-H combined with 80-kVp CCTA with an IDR 1.4 significantly reduces radiation and contrast medium exposure while improving image quality compared to conventional 100-kVp with 1.8 IDR protocol in non-obese patients. CLINICAL RELEVANCE STATEMENT Low radiation and low contrast medium dose coronary CT angiography protocol is feasible with high-strength deep learning reconstruction and high-concentration contrast medium without compromising image quality. KEY POINTS Minimizing the radiation and contrast medium dose while maintaining CT image quality is highly desirable. High-strength deep learning iterative reconstruction protocol yielded 42% radiation dose reduction compared to conventional protocol. "Double-low" coronary CTA is feasible with high-strength deep learning reconstruction without compromising image quality in non-obese patients.
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Affiliation(s)
- Damiano Caruso
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Domenico De Santis
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Tremamunno
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Curzio Santangeli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Tiziano Polidori
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Giovanna G Bona
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Marta Zerunian
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonella Del Gaudio
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Luca Pugliese
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Andrea Laghi
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy.
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Manninen AL, Järvinen J, Sierpowska J, Mäkelä TJ, Rissanen TT. Implantation of CRT pacemaker during pregnancy: estimated fetal radiation dose. RADIATION PROTECTION DOSIMETRY 2024; 200:1477-1485. [PMID: 39216989 DOI: 10.1093/rpd/ncae182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 07/31/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
The benefits of a cardiac resynchronization therapy (CRT) implantation are known in severe heart failure and its implantation may also be considered during pregnancy to ensure safe pregnancy and delivery for both the mother and the fetus. This study on a patient case aimed to estimate the absorbed dose (AD) to the fetus during the CRT implantation of 21st week of the pregnant woman. AD measurement was done using anthropomorphic phantom, radiophotoluminescence dosemeters and Monte Carlo simulation utilizing kerma area product (KAP) of the procedures. The measured AD for a phantom's uterus and heart was 0.116 and 14.7 mGy with total KAP of 27.9 Gycm2. The estimated actual AD to the fetus and the mother's heart was 0.004 and 1.2 mGy, with total KAP of 1.5 Gycm2. The dose to the fetus can be minimized with the optimized procedure.
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Affiliation(s)
- Anna-Leena Manninen
- Department of Diagnostic Radiology, Oulu University Hospital, PO Box 10, FI-90029 Oulu, Finland
| | - Jukka Järvinen
- Turku Heart Center, Department of Cardiology, Turku University Hospital, PO Box 52, 20521 Turku, Finland
- Medical Imaging Centre of Southwest Finland, Department of Radiology, Turku University Hospital, PO Box 52, 20521 Turku, Finland
- Department of Medical Physics, Turku University Hospital, PO Box 52, 20521 Turku, Finland
| | - Joanna Sierpowska
- Department of Radiology, Central Hospital of North Karelia, FI-80210 Joensuu, Finland
| | - Timo J Mäkelä
- OYS Heart Center, Oulu University Hospital, Pohde, PO Box 10, FI-90029 Oulu, Finland
| | - Tuomas T Rissanen
- Heart Center, Central Hospital of North Karelia, Siunsote, FI-80210 Joensuu, Finland
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Žatkuliaková V, Števík M, Vorčák M, Sýkora J, Trabalková Z, Broocks G, Meyer L, Fiehler J, Zeleňák K. Comparison of doses received from non-contrast enhanced brain CT examinations between two CT scanners. Heliyon 2024; 10:e37043. [PMID: 39295996 PMCID: PMC11408143 DOI: 10.1016/j.heliyon.2024.e37043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 08/26/2024] [Accepted: 08/27/2024] [Indexed: 09/21/2024] Open
Abstract
Objectives Medical devices based on X-ray imaging, such as computed tomography, are considered notable sources of artificial radiation. The aim of this study was to compare the computed tomography dose volume index, the dose length product, and the effective dose of the brain non-contrast enhanced examination on two CT scanners to determine the current state in terms of radiation doses, compare doses to the reference values, and possibly optimize the examination. Materials and methods Data from January 2020 to the second half of 2021 were retrospectively obtained by accessing dose reports from the Picture Archiving and Communication System (PACS). Data were collected and analyzed in Microsoft Excel. The effective dose was estimated using the dose-length product parameter and the normalized conversion factor for a given anatomical region. For statistical analysis, a two-sample t-test was used. Results The first data set consists of 200 patients (100 and 100 for older and newer CT scanners) regardless of the scan technique; the average CTDIvol and DLP for the older CT scanner were 57.61 ± 2.89 mGy and 993.28 ± 146.18 mGy cm, and for the newer CT scanner, 43.66 ± 11.15 mGy and 828.14 ± 130.06 mGy cm. The second data set consists of 100 patients (50 for the older CT scanner and 50 for the newer CT scanner) for a sequential scan; the average CTDIvol and DLP for the older CT scanner were 58.63 ± 3.33 mGy and 949.42 ± 80.87 mGy.cm, and for the newer CT, 57.25 ± 3.4 mGy and 942.13 ± 73.05 mGy cm. The third data set consists of 40 patients (20 and 20 for older and newer CT scanners) for the helical scan - the average CTDIvol and DLP for the older CT scanner were 54.6 ± 0 mGy and 1252.2 ± 52.11 mGy.cm, and for the newer CT, 37.18 ± 2.52 mGy and 859.66 ± 72.04 mGy cm. The difference between the older and newer CT scanners in terms of dose reduction was approximately 30 % in favor of the newer scanner for noncontrast enhanced brain examinations performed using the helical scan technique. Conclusion A non-contrast enhanced brain examination scanned with newer CT equipment was associated with a lower radiation burden on the patient.
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Affiliation(s)
- Veronika Žatkuliaková
- Clinic of Radiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, Martin, Slovakia
| | - Martin Števík
- Clinic of Radiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, Martin, Slovakia
| | - Martin Vorčák
- Clinic of Radiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, Martin, Slovakia
| | - Ján Sýkora
- Clinic of Radiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, Martin, Slovakia
| | - Zuzana Trabalková
- Clinic of Radiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, Martin, Slovakia
| | - Gabriel Broocks
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lukas Meyer
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kamil Zeleňák
- Clinic of Radiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, Martin, Slovakia
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Yao Y, Su X, Deng L, Zhang J, Xu Z, Li J, Li X. Effects of tube voltage, radiation dose and adaptive statistical iterative reconstruction strength level on the detection and characterization of pulmonary nodules in ultra-low-dose chest CT. Cancer Imaging 2024; 24:123. [PMID: 39278933 PMCID: PMC11402195 DOI: 10.1186/s40644-024-00770-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 09/03/2024] [Indexed: 09/18/2024] Open
Abstract
OBJECTIVE To explore the effects of tube voltage, radiation dose and adaptive statistical iterative reconstruction (ASiR-V) strength level on the detection and characterization of pulmonary nodules by an artificial intelligence (AI) software in ultra-low-dose chest CT (ULDCT). MATERIALS AND METHODS An anthropomorphic thorax phantom containing 12 spherical simulated nodules (Diameter: 12 mm, 10 mm, 8 mm, 5 mm; CT value: -800HU, -630HU, 100HU) was scanned with three ULDCT protocols: Dose-1 (70kVp:0.11mSv, 100kVp:0.10mSv), Dose-2 (70kVp:0.34mSv, 100kVp:0.32mSv), Dose-3 (70kVp:0.53mSv, 100kVp:0.51mSv). All scanning protocols were repeated five times. CT images were reconstructed using four different strength levels of ASiR-V (0%=FBP, 30%, 50%, 70%ASiR-V) with a slice thickness of 1.25 mm. The characteristics of the physical nodules were used as reference standards. All images were analyzed using a commercially available AI software to identify nodules for calculating nodule detection rate (DR) and to obtain their long diameter and short diameter, which were used to calculate the deformation coefficient (DC) and size measurement deviation percentage (SP) of nodules. DR, DC and SP of different imaging groups were statistically compared. RESULTS Image noise decreased with the increase of ASiR-V strength level, and the 70 kV images had lower noise under the same strength level (mean-value 70 kV: 40.14 ± 7.05 (dose 1), 27.55 ± 7.38 (dose 2), 23.88 ± 6.98 (dose 3); 100 kV: 42.36 ± 7.62 (dose 1); 30.78 ± 6.87 (dose 2); 26.49 ± 6.61 (dose 3)). Under the same dose level, there were no differences in DR between 70 kV and 100 kV (dose 1: 58.76% vs. 58.33%; dose 2: 73.33% vs. 70.83%; dose 3: 75.42% vs. 75.42%, all p > 0.05). The DR of GGNs increased significantly at dose 2 and higher (70 kV: 38.12% (dose 1), 60.63% (dose 2), 64.38% (dose 3); 100 kV: 37.50% (dose 1), 59.38% (dose 2), 66.25% (dose 3)). In general, the use of ASiR-V at higher strength levels (> 50%) and 100 kV provided better (lower) DC and SP. CONCLUSION Detection rates are similar between 70 kV and 100 kV scans. The 70 kV images have better noise performance under the same ASiR-V level, while images of 100 kV and higher ASiR-V levels are better in preserving the nodule morphology (lower DC and SP); the dose levels above 0.33mSv provide high sensitivity for nodules detection, especially the simulated ground glass nodules.
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Affiliation(s)
- Yue Yao
- Department of Radiology, the second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xuan Su
- Department of Radiology, the second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lei Deng
- Department of Radiology, the second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - JingBin Zhang
- Department of Radiology, the second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Zengmiao Xu
- Department of Radiology, the second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | | | - Xiaohui Li
- Department of Radiology, the second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
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Yu N, Hong Y, Lv X, Liu Q, Yan M. Preoperative diagnostic value of multimodal spectral CT for patients with atrial fibrillation undergoing radiofrequency ablation. Front Med (Lausanne) 2024; 11:1440020. [PMID: 39328316 PMCID: PMC11425045 DOI: 10.3389/fmed.2024.1440020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/23/2024] [Indexed: 09/28/2024] Open
Abstract
Objective Delayed enhancement cardiac computed tomography (CT) empowers the diagnosis of left atrial appendage thrombus while limited to scanning heterogeneity. We optimized the spectral CT scan and post-process protocols, incorporating delayed enhancement and spectral iodine analysis to discriminate left atrial appendage (LAA) thrombus with better morphological relationships between the left atrium, pulmonary vein, and esophagus. Methods A total of 278 consecutive patients were retrieved from January 2019 to June 2023. All patients underwent transesophageal echocardiography (TEE) and spectral CT scan of the left atrial and pulmonary vein, with a complete period including the pulmonary venous phase and three delay phases. TEE diagnosis was used as the standard reference. For patients exhibiting LAA filling defects during the pulmonary venous phase, a delayed scan of 30 s (phase I) was performed. If the filling defects persisted, a further delayed scan of 1 min (phase II) was conducted. In cases where the filling defects persisted, an additional delayed scan of 2 min (phase III) was carried out. Iodine concentration in the filled defect area of LAA and the left atrium was measured in phase III. Moreover, 30 patients were randomly selected for water-swallowing and the other 30 for calm breathing. The image quality and esophageal dilation of the two groups were assessed by two experienced surgeons specializing in radiofrequency ablation. Results In total, 14 patients were diagnosed with thrombi by TEE. The sensitivity, specificity, positive predictive values, negative predictive values, and AUC of phase III delayed combined with iodine quantification for thrombi diagnosis were all 100%. The water-swallowing group exhibited significantly greater esophageal filling and expansion than the calm-breathing group, contributing to a better morphology assessment with no significant difference in image quality. Conclusion Combined with iodine quantification, delayed enhancement of spectral CT imaging presents a promising diagnostic potency for LAA thrombus. Incorporating water swallowing into the CT scan process further enables anatomical visualization of the esophagus, left atrium, and pulmonary vein, thereby providing more objective and authentic imaging evidence to assess the esophageal morphology and positional relationships.
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Affiliation(s)
- Na Yu
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuqin Hong
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xue Lv
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiao Liu
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Min Yan
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Singh S, Singh R, Luthra S, Singla A, Tanvir F, Antaal H, Singh A, Singh H, Singh J, Kaur MS. Evolving Radiological Approaches in the Diagnosis and Monitoring of Arachnoiditis Ossificans. Cureus 2024; 16:e68399. [PMID: 39355477 PMCID: PMC11444744 DOI: 10.7759/cureus.68399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2024] [Indexed: 10/03/2024] Open
Abstract
Arachnoiditis ossificans (AO) is a rare and complex neurological condition characterized by pathological calcification or ossification of the arachnoid membrane. Arachnoiditis ranks as the third most frequent cause of failed back surgery syndrome (FBSS). This narrative review explores the evolving radiological approaches in its diagnosis and monitoring. The historical perspective traces the progression from plain radiographs to advanced imaging techniques. Current radiological modalities, including X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), are discussed, highlighting their respective roles, advantages, and limitations. Emerging and advanced imaging modalities, such as high-resolution CT, 3T and 7T MRI, and PET/CT or PET/MRI, are examined for their potential to enhance diagnostic accuracy and monitoring capabilities. A comparative analysis of these imaging modalities considers their sensitivity, specificity, cost-effectiveness, and radiation exposure implications. The review also explores the crucial role of imaging in disease monitoring and treatment planning, including follow-up protocols, evaluation of disease progression, and guidance for interventional procedures. Future directions in the field are discussed, focusing on promising research areas, the potential of artificial intelligence and machine learning in image analysis, and identified gaps in current knowledge. The review emphasizes the importance of a multimodal imaging approach and the need for standardized protocols. It concludes that while significant advancements have been made, further research is necessary to fully understand the correlation between imaging findings and clinical outcomes. The continued evolution of radiological approaches is expected to significantly improve patient care and outcomes in AO.
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Affiliation(s)
- Sumerjit Singh
- Diagnostic Radiology, Government Medical College Amritsar, Amritsar, IND
| | - Ripudaman Singh
- Internal Medicine, Government Medical College Amritsar, Amritsar, IND
| | - Shivansh Luthra
- Medicine, Government Medical College Amritsar, Amritsar, IND
| | | | - Fnu Tanvir
- Internal Medicine, Government Medical College Amritsar, Amritsar, IND
| | - Harman Antaal
- Internal Medicine, Government Medical College Patiala, Patiala, IND
| | - Agamjit Singh
- Psychiatry, Punjab Institute of Medical Sciences, Jalandhar, IND
| | - Harmanjot Singh
- Internal Medicine, The White Medical College and Hospital, Bungal, IND
| | - Jaskaran Singh
- Internal Medicine, Sri Guru Ram Das University of Health Sciences and Research, Amritsar, IND
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9
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Jaruvongvanich V, Muangsomboon K, Teerasamit W, Suvannarerg V, Komoltri C, Thammakittiphan S, Lornimitdee W, Ritsamrej W, Chaisue P, Pongnapang N, Apisarnthanarak P. Optimizing computed tomography image reconstruction for focal hepatic lesions: Deep learning image reconstruction vs iterative reconstruction. Heliyon 2024; 10:e34847. [PMID: 39170325 PMCID: PMC11336302 DOI: 10.1016/j.heliyon.2024.e34847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/27/2024] [Accepted: 07/17/2024] [Indexed: 08/23/2024] Open
Abstract
Background Deep learning image reconstruction (DLIR) is a novel computed tomography (CT) reconstruction technique that minimizes image noise, enhances image quality, and enables radiation dose reduction. This study aims to compare the diagnostic performance of DLIR and iterative reconstruction (IR) in the evaluation of focal hepatic lesions. Methods We conducted a retrospective study of 216 focal hepatic lesions in 109 adult participants who underwent abdominal CT scanning at our institution. We used DLIR (low, medium, and high strength) and IR (0 %, 10 %, 20 %, and 30 %) techniques for image reconstruction. Four experienced abdominal radiologists independently evaluated focal hepatic lesions based on five qualitative aspects (lesion detectability, lesion border, diagnostic confidence level, image artifact, and overall image quality). Quantitatively, we measured and compared the level of image noise for each technique at the liver and aorta. Results There were significant differences (p < 0.001) among the seven reconstruction techniques in terms of lesion borders, image artifacts, and overall image quality. Low-strength DLIR (DLIR-L) exhibited the best overall image quality. Although high-strength DLIR (DLIR-H) had the least image noise and fewest artifacts, it also had the lowest scores for lesion borders and overall image quality. Image noise showed a weak to moderate positive correlation with participants' body mass index and waist circumference. Conclusions The optimal-strength DLIR significantly improved overall image quality for evaluating focal hepatic lesions compared to the IR technique. DLIR-L achieved the best overall image quality while maintaining acceptable levels of image noise and quality of lesion borders.
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Affiliation(s)
- Varin Jaruvongvanich
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kobkun Muangsomboon
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wanwarang Teerasamit
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Voraparee Suvannarerg
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chulaluk Komoltri
- Division of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sastrawut Thammakittiphan
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wimonrat Lornimitdee
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Witchuda Ritsamrej
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Parinya Chaisue
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Napapong Pongnapang
- Department of Radiological Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Piyaporn Apisarnthanarak
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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10
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Malik MMUD, Alqahtani M, Hadadi I, AlQhtani AGM, Alqarni A. An Analysis of Computed Tomography Diagnostic Reference Levels in India Compared to Other Countries. Diagnostics (Basel) 2024; 14:1585. [PMID: 39125460 PMCID: PMC11311628 DOI: 10.3390/diagnostics14151585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
Computed Tomography (CT) is vital for diagnosing and monitoring medical conditions. However, increased usage raises concerns about patient radiation exposure. Diagnostic Reference Levels (DRLs) aim to minimize radiation doses in CT imaging. This study examines CT DRLs in India compared to other countries to identify optimization opportunities. A literature review was conducted to gather data from published studies, guidelines, and regulatory authorities. Findings show significant international variations in CT DRLs, with differences up to 50%. In India, DRLs also vary significantly across states. For head CT exams, Indian DRLs are generally 20-30% lower than international standards (27-47 mGy vs. 60 mGy). Conversely, for abdominal CT scans, Indian DRLs are 10-15% higher (12-16 mGy vs. 13 mGy). Factors influencing DRL variations include equipment differences, imaging protocols, patient demographics, and regulatory conditions. Dose-optimization techniques like automatic exposure control and iterative reconstruction can reduce radiation exposure by 25-60% while maintaining image quality. Comparative data highlight best practices, such as the United Kingdom's 30% reduction in CT doses from 1984 to 1995 via DRL implementation. This study suggests that adopting similar practices in India could reduce radiation doses by 20-40% for common CT procedures, promoting responsible CT usage and minimizing patient exposure.
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Affiliation(s)
- Maajid Mohi Ud Din Malik
- Dr. D.Y. Patil School of Allied Health Sciences, Dr. D.Y. Patil Vidyapeeth, Sant Tukaram Nagar, Pimpri, Pune 411018, MH, India;
| | - Mansour Alqahtani
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia;
| | - Ibrahim Hadadi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Abdullah G. M. AlQhtani
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (A.G.M.A.); (A.A.)
| | - Abdullah Alqarni
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (A.G.M.A.); (A.A.)
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11
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Ahmed M, Garzanich M, Melaragno LE, Nyirjesy S, Windheim NV, Marquardt M, Luttrull M, Quails N, VanKoevering KK. Exploring CT pixel and voxel size effect on anatomic modeling in mandibular reconstruction. 3D Print Med 2024; 10:21. [PMID: 38922481 PMCID: PMC11202317 DOI: 10.1186/s41205-024-00223-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/10/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Computer-aided modeling and design (CAM/CAD) of patient anatomy from computed tomography (CT) imaging and 3D printing technology enable the creation of tangible, patient-specific anatomic models that can be used for surgical guidance. These models have been associated with better patient outcomes; however, a lack of CT imaging guidelines risks the capture of unsuitable imaging for patient-specific modeling. This study aims to investigate how CT image pixel size (X-Y) and slice thickness (Z) impact the accuracy of mandibular models. METHODS Six cadaver heads were CT scanned at varying slice thicknesses and pixel sizes and turned into CAD models of the mandible for each scan. The cadaveric mandibles were then dissected and surface scanned, producing a CAD model of the true anatomy to be used as the gold standard for digital comparison. The root mean square (RMS) value of these comparisons, and the percentage of points that deviated from the true cadaveric anatomy by over 2.00 mm were used to evaluate accuracy. Two-way ANOVA and Tukey-Kramer post-hoc tests were used to determine significant differences in accuracy. RESULTS Two-way ANOVA demonstrated significant difference in RMS for slice thickness but not pixel size while post-hoc testing showed a significant difference in pixel size only between pixels of 0.32 mm and 1.32 mm. For slice thickness, post-hoc testing revealed significantly smaller RMS values for scans with slice thicknesses of 0.67 mm, 1.25 mm, and 3.00 mm compared to those with a slice thickness of 5.00 mm. No significant differences were found between 0.67 mm, 1.25 mm, and 3.00 mm slice thicknesses. Results for the percentage of points deviating from cadaveric anatomy greater than 2.00 mm agreed with those for RMS except when comparing pixel sizes of 0.75 mm and 0.818 mm against 1.32 mm in post-hoc testing, which showed a significant difference as well. CONCLUSION This study suggests that slice thickness has a more significant impact on 3D model accuracy than pixel size, providing objective validation for guidelines favoring rigorous standards for slice thickness while recommending isotropic voxels. Additionally, our results indicate that CT scans up to 3.00 mm in slice thickness may provide an adequate 3D model for facial bony anatomy, such as the mandible, depending on the clinical indication.
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Affiliation(s)
- Maariyah Ahmed
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Engineering, The Ohio State University College of Engineering, Columbus, OH, USA
| | - Myra Garzanich
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Engineering, The Ohio State University College of Engineering, Columbus, OH, USA
| | - Luigi E Melaragno
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Engineering, The Ohio State University College of Engineering, Columbus, OH, USA
| | - Sarah Nyirjesy
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, 460 W 10th Ave 5th Floor Clinic, Columbus, OH, 43220, USA
| | - Natalia Von Windheim
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, 460 W 10th Ave 5th Floor Clinic, Columbus, OH, 43220, USA
| | - Matthew Marquardt
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, 460 W 10th Ave 5th Floor Clinic, Columbus, OH, 43220, USA
| | - Michael Luttrull
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Nathan Quails
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Kyle K VanKoevering
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, 460 W 10th Ave 5th Floor Clinic, Columbus, OH, 43220, USA.
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12
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Choi HU, Cho J, Hwang J, Lee S, Chang W, Park JH, Lee KH. Diagnostic performance and image quality of an image-based denoising algorithm applied to radiation dose-reduced CT in diagnosing acute appendicitis. Abdom Radiol (NY) 2024; 49:1839-1849. [PMID: 38411690 PMCID: PMC11213764 DOI: 10.1007/s00261-024-04246-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE To evaluate diagnostic performance and image quality of ultralow-dose CT (ULDCT) in diagnosing acute appendicitis with an image-based deep-learning denoising algorithm (IDLDA). METHODS This retrospective multicenter study included 180 patients (mean ± standard deviation, 29 ± 9 years; 91 female) who underwent contrast-enhanced 2-mSv CT for suspected appendicitis from February 2014 to August 2016. We simulated ULDCT from 2-mSv CT, reducing the dose by at least 50%. Then we applied an IDLDA on ULDCT to produce denoised ULDCT (D-ULDCT). Six radiologists with different experience levels (three board-certified radiologists and three residents) independently reviewed the ULDCT and D-ULDCT. They rated the likelihood of appendicitis and subjective image qualities (subjective image noise, diagnostic acceptability, and artificial sensation). One radiologist measured image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). We used the receiver operating characteristic (ROC) analyses, Wilcoxon's signed-rank tests, and paired t-tests. RESULTS The area under the ROC curves (AUC) for diagnosing appendicitis ranged 0.90-0.97 for ULDCT and 0.94-0.97 for D-ULDCT. The AUCs of two residents were significantly higher on D-ULDCT (AUC difference = 0.06 [95% confidence interval, 0.01-0.11; p = .022] and 0.05 [0.00-0.10; p = .046], respectively). D-ULDCT provided better subjective image noise and diagnostic acceptability to all six readers. However, the response of board-certified radiologists and residents differed in artificial sensation (all p ≤ .003). D-ULDCT showed significantly lower image noise, higher SNR, and higher CNR (all p < .001). CONCLUSION An IDLDA can provide better ULDCT image quality and enhance diagnostic performance for less-experienced radiologists.
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Affiliation(s)
- Hyeon Ui Choi
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
| | - Jungheum Cho
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea.
| | - Jinhee Hwang
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Seungjae Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Won Chang
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
| | - Ji Hoon Park
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
- Department of Medical Device Development, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Ho Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
- Department of Medical Device Development, Seoul National University College of Medicine, Seoul, Korea
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13
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Zhou X, Cui M, Liu Y, Wu Y, Hu D, Zhai D, Qin M, Shen J, Ju S, Fan G, Cai W. Low Dose Iodinated Contrast Material and Radiation for Virtual Monochromatic Imaging in Craniocervical Dual-Layer Spectral Detector Computed Tomography Angiography: A Prospective and Randomized Study. Acad Radiol 2024; 31:2501-2510. [PMID: 38135625 DOI: 10.1016/j.acra.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the feasibility of virtual monochromatic imaging (VMI) of dual-layer spectral detector computed tomography (SDCT) to reduce iodinated contrast material (CM) and radiation dose in craniocervical computed tomography angiography (CTA). MATERIALS AND METHODS A total of 280 consecutively selected patients performed craniocervical CTA with SDCT were prospectively selected and randomly divided into four groups (A, DoseRight index (DRI) 31, iopromide 370mgI/mL, volume 0.8 mL/kg; B, DRI 26, iopromide 370mgI/mL, volume 0.4 mL/kg; C, DRI 26, ioversol 320mgI/mL, volume 0.4 mL/kg; D, DRI 26, iohexol 300mgI/mL, volume 0.4 mL/kg). 50-70 kiloelectron volts (keV) VMIs in group B were reconstructed and compared to group A to select the optimal keV. Then, the optimal keV in groups B, C and D was reconstructed and compared. Objective image quality, including vascular attenuation, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), was evaluated. Subjective image quality was assessed using a 5-point Likert scale. In addition, the effective dose (ED), iodine load and iodine delivery rate (IDR) were compared between groups A and D. RESULTS 55 keV VMI was the optimal VMI in group B. The objective and subjective image quality of 55 keV VMI in group B were equal to or better than those of the CI in group A. The SNR, CNR and subjective image quality in group D were similar to those in group B (P > 0.05). The ED, iodine load and IDR of group D were reduced by 44%, 59% and 19%, respectively, when compared to those of group A. CONCLUSION Low dose iodinated CM and radiation for 55 keV VMI in craniocervical CTA using SDCT could still provide equivalent or better image quality than the conventional scanning protocol.
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Affiliation(s)
- Xiuzhi Zhou
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Manman Cui
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Yan Liu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Yuanyuan Wu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Dongliang Hu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Duchang Zhai
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Mingyu Qin
- Suzhou Medical College of Soochow University, Suzhou, 215026, Jiangsu, China (M.Q.)
| | - Junkang Shen
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Shenghong Ju
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, Jiangsu, China (S.J.)
| | - Guohua Fan
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.)
| | - Wu Cai
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Gusu, Suzhou, 215004, Jiangsu, China (X.Z., M.C., Y.L., Y.W., D.H., D.Z., J.S., G.F., W.C.).
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14
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Rajendran K, Bruesewitz M, Swicklik J, Ferrero A, Thorne J, Yu L, McCollough C, Leng S. Task-based automatic keV selection: leveraging routine virtual monoenergetic imaging for dose reduction on clinical photon-counting detector CT . Phys Med Biol 2024; 69:10.1088/1361-6560/ad41b3. [PMID: 38648795 PMCID: PMC11108732 DOI: 10.1088/1361-6560/ad41b3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/22/2024] [Indexed: 04/25/2024]
Abstract
Objective. Photon-counting detector (PCD) CT enables routine virtual-monoenergetic image (VMI) reconstruction. We evaluated the performance of an automatic VMI energy level (keV) selection tool on a clinical PCD-CT system in comparison to an automatic tube potential (kV) selection tool from an energy-integrating-detector (EID) CT system from the same manufacturer.Approach.Four torso-shaped phantoms (20-50 cm width) containing iodine (2, 5, and 10 mg cc-1) and calcium (100 mg cc-1) were scanned on PCD-CT and EID-CT. Dose optimization techniques, task-based VMI energy level and tube-potential selection on PCD-CT (CARE keV) and task-based tube potential selection on EID-CT (CARE kV), were enabled. CT numbers, image noise, and dose-normalized contrast-to-noise ratio (CNRd) were compared.Main results. PCD-CT produced task-specific VMIs at 70, 65, 60, and 55 keV for non-contrast, bone, soft tissue with contrast, and vascular settings, respectively. A 120 kV tube potential was automatically selected on PCD-CT for all scans. In comparison, EID-CT used x-ray tube potentials from 80 to 150 kV based on imaging task and phantom size. PCD-CT achieved consistent dose reduction at 9%, 21% and 39% for bone, soft tissue with contrast, and vascular tasks relative to the non-contrast task, independent of phantom size. On EID-CT, dose reduction factor for contrast tasks relative to the non-contrast task ranged from a 65% decrease (vascular task, 70 kV, 20 cm phantom) to a 21% increase (soft tissue with contrast task, 150 kV, 50 cm phantom) due to size-specific tube potential adaptation. PCD-CT CNRdwas equivalent to or higher than those of EID-CT for all tasks and phantom sizes, except for the vascular task with 20 cm phantom, where 70 kV EID-CT CNRdoutperformed 55 keV PCD-CT images.Significance. PCD-CT produced more consistent CT numbers compared to EID-CT due to standardized VMI output, which greatly benefits standardization efforts and facilitates radiation dose reduction.
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Affiliation(s)
| | | | | | - Andrea Ferrero
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Jamison Thorne
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Lifeng Yu
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Shuai Leng
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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15
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Kasuga I, Yokoe Y, Gamo S, Sugiyama T, Tokura M, Noguchi M, Okayama M, Nagakura R, Ohmori N, Tsuchiya T, Sofuni A, Itoi T, Ohtsubo O. Which is a real valuable screening tool for lung cancer and measure thoracic diseases, chest radiography or low-dose computed tomography?: A review on the current status of Japan and other countries. Medicine (Baltimore) 2024; 103:e38161. [PMID: 38728453 PMCID: PMC11081589 DOI: 10.1097/md.0000000000038161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
Chest radiography (CR) has been used as a screening tool for lung cancer and the use of low-dose computed tomography (LDCT) is not recommended in Japan. We need to reconsider whether CR really contributes to the early detection of lung cancer. In addition, we have not well discussed about other major thoracic disease detection by CR and LDCT compared with lung cancer despite of its high frequency. We review the usefulness of CR and LDCT as veridical screening tools for lung cancer and other thoracic diseases. In the case of lung cancer, many studies showed that LDCT has capability of early detection and improving outcomes compared with CR. Recent large randomized trial also supports former results. In the case of chronic obstructive pulmonary disease (COPD), LDCT contributes to early detection and leads to the implementation of smoking cessation treatments. In the case of pulmonary infections, LDCT can reveal tiny inflammatory changes that are not observed on CR, though many of these cases improve spontaneously. Therefore, LDCT screening for pulmonary infections may be less useful. CR screening is more suitable for the detection of pulmonary infections. In the case of cardiovascular disease (CVD), CR may be a better screening tool for detecting cardiomegaly, whereas LDCT may be a more useful tool for detecting vascular changes. Therefore, the current status of thoracic disease screening is that LDCT may be a better screening tool for detecting lung cancer, COPD, and vascular changes. CR may be a suitable screening tool for pulmonary infections and cardiomegaly.
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Affiliation(s)
- Ikuma Kasuga
- Department of Medicine, Healthcare Center, Shinjuku Oiwake Clinic and Ladies Branch, Seikokai, Tokyo, Japan
- Department of Internal Medicine, Faculty of Medicine, Tokyo Medical University, Tokyo, Japan
- Department of Nursing, Faculty of Human Care, Tohto University, Saitama, Japan
| | - Yoshimi Yokoe
- Department of Medicine, Healthcare Center, Shinjuku Oiwake Clinic and Ladies Branch, Seikokai, Tokyo, Japan
| | - Sanae Gamo
- Department of Medicine, Healthcare Center, Shinjuku Oiwake Clinic and Ladies Branch, Seikokai, Tokyo, Japan
| | - Tomoko Sugiyama
- Department of Medicine, Healthcare Center, Shinjuku Oiwake Clinic and Ladies Branch, Seikokai, Tokyo, Japan
| | - Michiyo Tokura
- Department of Medicine, Healthcare Center, Shinjuku Oiwake Clinic and Ladies Branch, Seikokai, Tokyo, Japan
| | - Maiko Noguchi
- Department of Medicine, Healthcare Center, Shinjuku Oiwake Clinic and Ladies Branch, Seikokai, Tokyo, Japan
| | - Mayumi Okayama
- Department of Medicine, Healthcare Center, Shinjuku Oiwake Clinic and Ladies Branch, Seikokai, Tokyo, Japan
| | - Rei Nagakura
- Department of Medicine, Healthcare Center, Shinjuku Oiwake Clinic and Ladies Branch, Seikokai, Tokyo, Japan
| | - Nariko Ohmori
- Department of Medicine, Healthcare Center, Shinjuku Oiwake Clinic and Ladies Branch, Seikokai, Tokyo, Japan
| | - Takayoshi Tsuchiya
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Atsushi Sofuni
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
- Department of Clinical Oncology, Tokyo Medical University, Tokyo Japan
| | - Takao Itoi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Osamu Ohtsubo
- Department of Nursing, Faculty of Human Care, Tohto University, Saitama, Japan
- Department of Medicine, Kenkoigaku Association, Tokyo Japan
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16
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Zeng SL, Grier AJ, Langdell HC, Blevins KM, Tian WM, French RJ, Mithani SK, Hammert WC, Klifto CS. Comparison of Low-Dose Computed Tomography Versus Conventional-Dose Computed Tomography in the Evaluation of Distal Radius Fractures. Hand (N Y) 2024:15589447241232016. [PMID: 38450618 DOI: 10.1177/15589447241232016] [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] [Indexed: 03/08/2024]
Abstract
BACKGROUND Distal radius fractures (DRFs) are common upper extremity fractures and often require surgical fixation when they are intraarticular. Preoperative computed tomography (CT) has emerged as a surgical planning tool to evaluate intraarticular DRFs. Although CT affords additional details, patients receive higher radiation doses than standard radiographs. We aim to develop a low-dose CT (LDCT) protocol, relative to the institutional standard-dose CT wrist for intraarticular DRFs although providing adequate detail for surgical decision-making. METHODS A single-institution prospective study was conducted on patients with intraarticular DRFs who underwent closed reduction and below-elbow splinting who otherwise would undergo wrist CT. Observations were defined as total measurements taken, with each view undergoing 44 measurements. Patients underwent 2 scans with a standard dose and a 10× dose reduction. Articular step and gap measurements were recorded in the sagittal and coronal images. RESULTS A total of 11 patients were enrolled (7 women and 4 men). The mean age was 55 years (SD = 20.1). There were a total of 4 reviewers: 1 attending surgeon, 2 resident physicians, and 1 student. When comparing LDCT and conventional-dose CT (CDCT), there were no significant differences in step and gap measurements across all reviewers. CONCLUSION This study demonstrated that LDCT provides comparable imaging quality for surgical planning as a CDCT without significant diagnostic decay in the setting of DRFs. This comes with the added benefit of a 10-fold reduction in radiation exposure. These results suggest that LDCT is an opportunity to reduce effective radiation in patients although providing beneficial preoperative imaging.
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Affiliation(s)
| | - A Jordan Grier
- Department of Orthopedic Surgery, Duke University, Durham, NC, USA
| | - Hannah C Langdell
- Division of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA
| | - Kier M Blevins
- Department of Orthopedic Surgery, Duke University, Durham, NC, USA
| | | | | | - Suhail K Mithani
- Division of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA
| | - Warren C Hammert
- Department of Orthopedic Surgery, Duke University, Durham, NC, USA
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Chen H, Li Q, Zhou L, Li F. Deep learning-based algorithms for low-dose CT imaging: A review. Eur J Radiol 2024; 172:111355. [PMID: 38325188 DOI: 10.1016/j.ejrad.2024.111355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/05/2024] [Accepted: 01/31/2024] [Indexed: 02/09/2024]
Abstract
The computed tomography (CT) technique is extensively employed as an imaging modality in clinical settings. The radiation dose of CT, however, is significantly high, thereby raising concerns regarding the potential radiation damage it may cause. The reduction of X-ray exposure dose in CT scanning may result in a significant decline in imaging quality, thereby elevating the risk of missed diagnosis and misdiagnosis. The reduction of CT radiation dose and acquisition of high-quality images to meet clinical diagnostic requirements have always been a critical research focus and challenge in the field of CT. Over the years, scholars have conducted extensive research on enhancing low-dose CT (LDCT) imaging algorithms, among which deep learning-based algorithms have demonstrated superior performance. In this review, we initially introduced the conventional algorithms for CT image reconstruction along with their respective advantages and disadvantages. Subsequently, we provided a detailed description of four aspects concerning the application of deep neural networks in LDCT imaging process: preprocessing in the projection domain, post-processing in the image domain, dual-domain processing imaging, and direct deep learning-based reconstruction (DLR). Furthermore, an analysis was conducted to evaluate the merits and demerits of each method. The commercial and clinical applications of the LDCT-DLR algorithm were also presented in an overview. Finally, we summarized the existing issues pertaining to LDCT-DLR and concluded the paper while outlining prospective trends for algorithmic advancement.
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Affiliation(s)
- Hongchi Chen
- School of Medical Information Engineering, Gannan Medical University, Ganzhou 341000, China
| | - Qiuxia Li
- School of Medical Information Engineering, Gannan Medical University, Ganzhou 341000, China
| | - Lazhen Zhou
- School of Medical Information Engineering, Gannan Medical University, Ganzhou 341000, China
| | - Fangzuo Li
- School of Medical Information Engineering, Gannan Medical University, Ganzhou 341000, China; Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou 341000, China.
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Usui K, Kamiyama S, Arita A, Ogawa K, Sakamoto H, Sakano Y, Kyogoku S, Daida H. Reducing image artifacts in sparse projection CT using conditional generative adversarial networks. Sci Rep 2024; 14:3917. [PMID: 38365934 PMCID: PMC10873335 DOI: 10.1038/s41598-024-54649-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/14/2024] [Indexed: 02/18/2024] Open
Abstract
Reducing the amount of projection data in computed tomography (CT), specifically sparse-view CT, can reduce exposure dose; however, image artifacts can occur. We quantitatively evaluated the effects of conditional generative adversarial networks (CGAN) on image quality restoration for sparse-view CT using simulated sparse projection images and compared them with autoencoder (AE) and U-Net models. The AE, U-Net, and CGAN models were trained using pairs of artifacts and original images; 90% of patient cases were used for training and the remaining for evaluation. Restoration of CT values was evaluated using mean error (ME) and mean absolute error (MAE). The image quality was evaluated using structural image similarity (SSIM) and peak signal-to-noise ratio (PSNR). Image quality improved in all sparse projection data; however, slight deformation in tumor and spine regions was observed, with a dispersed projection of over 5°. Some hallucination regions were observed in the CGAN results. Image resolution decreased, and blurring occurred in AE and U-Net; therefore, large deviations in ME and MAE were observed in lung and air regions, and the SSIM and PSNR results were degraded. The CGAN model achieved accurate CT value restoration and improved SSIM and PSNR compared to AE and U-Net models.
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Affiliation(s)
- Keisuke Usui
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Department of Radiation Oncology, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Sae Kamiyama
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Akihiro Arita
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Koichi Ogawa
- Faculty of Science and Engineering, Hosei University, 3-7-3, Kajino, Koganei, Tokyo, 184-8584, Japan
| | - Hajime Sakamoto
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yasuaki Sakano
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shinsuke Kyogoku
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroyuki Daida
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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Alahmadi A, Abdelsamad Y, Thabet EM, Hafez A, Alghamdi F, Badr KM, Alghamdi S, Hagr A. Advancing Cochlear Implant Programming: X-ray Guided Anatomy-Based Fitting. Otol Neurotol 2024; 45:107-113. [PMID: 38206059 DOI: 10.1097/mao.0000000000004069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND Anatomy-based fitting (ABF) is a new research area in the field of cochlear implants (CIs). Despite the reported benefits and acceptable levels of ABF among CI recipients, some limitations remain, like the postoperative computed tomography (CT) scan, which is preferred for confirming electrode array insertion. OBJECTIVE This study aimed to investigate the feasibility of using plain film radiography (X-ray) for postoperative electrode detection and for building ABF as an alternative to CT. METHODS A total of 53 ears with CI were studied. All cases had routine post-insertion X-rays in the cochlear view and additionally underwent postoperative CT. The insertion angles and center frequencies measured by two independent observers were compared for each imaging modality. The angular insertion depth and center frequencies resulting from the X-ray and CT scans were then compared. RESULTS No significant differences were observed between the X-ray- and CT-measured angles for the electrode contacts. Radiographic measurements between the two readers showed an almost perfect (≥0.8) or substantial (0.71) intraclass correlation coefficient along the electrode contacts. X-ray images showed a mean difference of 4.7 degrees from CT. The mean semitone deviation of the central frequency between the CT and X-ray images was 0.6. CONCLUSIONS X-ray imaging provides a valid and easy-to-perform alternative to CT imaging, with less radiation exposure and lower costs. The radiographs showed excellent concordance with the CT-measured angular insertion depth and consequently with the central frequency for most electrode contacts. Therefore, plain X-ray could be a viable alternative in building ABF for the CI recipients.
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Affiliation(s)
- Asma Alahmadi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia
| | | | | | - Ahmed Hafez
- Electrophysiology Department, MED-EL GmbH, Riyadh, Saudi Arabia
| | | | | | | | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia
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Wang TJ, Wang Y, Zhang ZH, Wang M, Wang M, Su T, Xu YH, Ma ZF, Wang J, Chen Y, Jin ZY. Deep learning reconstruction improves the image quality of low-dose temporal bone CT with otitis media and mastoiditis patients. Heliyon 2024; 10:e22810. [PMID: 38148801 PMCID: PMC10750061 DOI: 10.1016/j.heliyon.2023.e22810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 12/28/2023] Open
Abstract
Objective To evaluate the image quality of low-dose temporal bone computed tomography (CT) in otitis media and mastoiditis patients by using deep learning reconstruction (DLR). Materials and methods A total of ninety-seven temporal bones from 53 consecutive adult patients who had suspected otitis media and mastoiditis and underwent temporal bone CT were prospectively enrolled. All patients underwent high resolution CT protocol (group A) and an additional low-dose protocol (group B). In group A, high resolution data were reconstructed by filter back projection (FBP). In group B, low-dose data were reconstructed by DLR mild (B1), DLR standard (B2) and DLR strong (B3). The objective image quality was analyzed by measuring the CT value and image noise on the transverse image and calculating the signal-to-noise ratio (SNR) on incudomallear joint, retroauricular muscle, vestibule and subcutaneous fat. Subjective image quality was analyzed by using a five-point scale to evaluate nine anatomical structures of middle and inner ear. The number of temporal bone lesions which involved in five structures of middle ear were assessed in group A, B1, B2 and B3 images. Results There were no significant differences in the CT values of the four reconstruction methods at four structures (all p > 0.05). The DLR group B1, B2 and B3 had significantly less image noise and a significantly higher SNR than group A at four structures (all p < 0.001). The group B1 had comparable subjective image quality as group A in nine structures (all p > 0.05), however, the group B3 had lower subjective image quality than group A in modiolus, spiral osseous lamina and stapes (all p < 0.001), the group B2 had lower subjective image quality than group A in modiolus and spiral osseous lamina (both p < 0.05). The number of temporal bone lesions which involved in five structures for group A, B1 and B2 images were no significant difference (all p > 0.05), however, the number of temporal bone lesions which involved in mastoid for group B3 images were significantly more than group A (p < 0.05). The radiation dose of high resolution CT protocol and low-dose protocol were 0.55 mSv and 0.11 mSv, respectively. Conclusion Compared with high resolution CT protocol, in the low-dose protocol of temporal bone CT, DLR mild and standard could improve the objective image quality, maintain good subjective image quality and satisfy clinical diagnosis of otitis media and mastoiditis patients.
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Affiliation(s)
- Tian-Jiao Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Yun Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Zhu-Hua Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Ming Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Man Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Tong Su
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Ying-Hao Xu
- Canon Medical Systems (China) CO., LTD., Building 205, Yard NO. A10, JiuXianQiao North Road, Beijing, 100015, China
| | - Zhuang-Fei Ma
- Canon Medical Systems (China) CO., LTD., Building 205, Yard NO. A10, JiuXianQiao North Road, Beijing, 100015, China
| | - Jian Wang
- Canon Medical Systems (China) CO., LTD., Building 205, Yard NO. A10, JiuXianQiao North Road, Beijing, 100015, China
| | - Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Zheng-Yu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
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Haddad L, Saleme H, Howarth N, Tack D. Reject Analysis in Digital Radiography and Computed Tomography: A Belgian Imaging Department Case Study. J Belg Soc Radiol 2023; 107:100. [PMID: 38144871 PMCID: PMC10742225 DOI: 10.5334/jbsr.3259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/25/2023] [Indexed: 12/26/2023] Open
Abstract
Objective Reject analysis is usually performed in digital radiography (DR) for quality assurance. Data for computed tomography (CT) rejects remains sparse. The aim of this study is to help provide a straightforward benchmark for reject analysis of both DR and CT. Materials and methods This retrospective observational study included 107,277 DR and 20,659 CT during 18 months in a tertiary care center. Rejected acquisitions were retrieved by Dose Archiving and Communication System (DACS). The DR and CT reject analysis included reject rates, reasons for rejection and supplementary radiation dose associated with these rejects. Results 8,904 rejected DR and 514 rejected CT were retrieved. The DR reject rate was 8.3% whereas the CT reject rate was 2.5%. The cumulative effective dose (ED) of DR rejects was 377.3 mSv while the cumulative ED of CT rejects was 1267.4 mSv. The major reason for rejects was positioning for both DR (61%) and CT (44%). Conclusion This study helps constitute a simple reproducible method to analyze both DR and CT rejects simultaneously. Although CT rejects are less often monitored than DR rejects, the radiation dose associated with CT rejects is much higher, which emphasizes the need to systematically monitor both DR and CT rejects. Investigating the reasons and the most frequently rejected examinations gives an opportunity for improvement of imaging techniques in cooperation with technologists.
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Affiliation(s)
| | - Hanna Saleme
- Department of Radiology, Epicura La Madeleine, Rue Maria Thomée, 1, 7800 Ath, Belgium
| | - Nigel Howarth
- Department of Radiology, Hislanden –Clinique des Grangettes, 7 Chemin des Grangettes, 1224 Chênes-Bougeries, Switzerland
| | - Denis Tack
- Department of Radiology, Epicura La Madeleine, Rue Maria Thomée, 1, 7800 Ath, Belgium
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22
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Donuru A, Araki T, Dako F, Dave JK, Perez RP, Xu D, Nachiappan A, Barbosa EM, Noel P, Litt H, Knollman F. Photon-counting detector CT allows significant reduction in radiation dose while maintaining image quality and noise on non-contrast chest CT. Eur J Radiol Open 2023; 11:100538. [PMID: 38028186 PMCID: PMC10665661 DOI: 10.1016/j.ejro.2023.100538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose To investigate if clinical non-contrast chest CT studies obtained with PCD CT using much lower radiation exposure can achieve the same image quality as with the currently established EID protocol. Materials/methods A total of seventy-one patients were identified who had a non-contrast chest computed tomography (CT) done on PCD CT and EID CT scanners within a 4-month interval. Five fellowship trained chest radiologists, blinded to the scanner details were asked to review the cases side-by-side and record their preference for images from either the photon-counting-detector (PCD) CT or the energy-integrating detector (EID) CT scanner. Results The median CTDIvol for PCD-CT system was 4.710 mGy and EID system was 7.80 mGy (p < 0.001). The median DLP with the PCD-CT was 182.0 mGy.cm and EID system was 262.60 mGy.cm (p < 0.001). The contrast to noise ratio (CNR) was superior on the PCD-CT system 59.2 compared to the EID-CT 53.3; (p < 0.001). Kappa-statistic showed that there was poor agreement between the readers over the image quality from the PCD and EID scanners (κ = 0.19; 95 % CI: 0.12 - 0.27; p < 0.001). Chi-square analysis revealed that 3 out of 5 readers showed a significant preference for images from the PCDCT (p ≤ 0.012). There was no significant difference in the preferences of two readers between EID-CT and PCD-CT images. Conclusion The first clinical PCD-CT system allows a significant reduction in radiation exposure while maintaining image quality and image noise using a standardized non-contrast chest CT protocol.
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Affiliation(s)
- Achala Donuru
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tetsuro Araki
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Farouk Dako
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jaydev K. Dave
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Raul Porto Perez
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Dongming Xu
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Arun Nachiappan
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Eduardo Mortani Barbosa
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Peter Noel
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Harold Litt
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Friedrich Knollman
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
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Gao Y, Tan J, Shi Y, Zhang H, Lu S, Gupta A, Li H, Reiter M, Liang Z. Machine Learned Texture Prior From Full-Dose CT Database via Multi-Modality Feature Selection for Bayesian Reconstruction of Low-Dose CT. IEEE TRANSACTIONS ON MEDICAL IMAGING 2023; 42:3129-3139. [PMID: 34968178 PMCID: PMC9243192 DOI: 10.1109/tmi.2021.3139533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In our earlier study, we proposed a regional Markov random field type tissue-specific texture prior from previous full-dose computed tomography (FdCT) scan for current low-dose CT (LdCT) imaging, which showed clinical benefits through task-based evaluation. Nevertheless, two assumptions were made for early study. One assumption is that the center pixel has a linear relationship with its nearby neighbors and the other is previous FdCT scans of the same subject are available. To eliminate the two assumptions, we proposed a database assisted end-to-end LdCT reconstruction framework which includes a deep learning texture prior model and a multi-modality feature based candidate selection model. A convolutional neural network-based texture prior is proposed to eliminate the linear relationship assumption. And for scenarios in which the concerned subject has no previous FdCT scans, we propose to select one proper prior candidate from the FdCT database using multi-modality features. Features from three modalities are used including the subjects' physiological factors, the CT scan protocol, and a novel feature named Lung Mark which is deliberately proposed to reflect the z-axial property of human anatomy. Moreover, a majority vote strategy is designed to overcome the noise effect from LdCT scans. Experimental results showed the effectiveness of Lung Mark. The selection model has accuracy of 84% testing on 1,470 images from 49 subjects. The learned texture prior from FdCT database provided reconstruction comparable to the subjects having corresponding FdCT. This study demonstrated the feasibility of bringing clinically relevant textures from available FdCT database to perform Bayesian reconstruction of any current LdCT scan.
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Ramesh A, Di Laura A, Henckel J, Hart A. The variability of CT scan protocols for total hip arthroplasty: a call for harmonisation. EFORT Open Rev 2023; 8:809-817. [PMID: 37909704 PMCID: PMC10646515 DOI: 10.1530/eor-22-0141] [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] [Indexed: 11/03/2023] Open
Abstract
CT is the principal imaging modality used for the pre-operative 3D planning and assessment of total hip arthroplasty (THA). The image quality offered by CT has a radiation penalty to the patient. Higher than necessary radiation exposure is of particular concern when imaging young patients and women of childbearing age, due to the greater risk of radiation-induced cancer in this group. A harmonised low-dose CT protocol is needed, evidenced by the huge variability in the 17 protocols reviewed. The majority of the protocols were incomplete, leading to uncertainty among radiographers when performing the scans. Only three protocols (20%) were optimised for both 'field of view' and image acquisition parameters. 10 protocols (60%) were optimised for 'field of view' only. These protocols included imaging of the relevant landmarks in the bony pelvis in addition to the knees - the reference for femoral anteversion. CT parameters, including the scanner kilovoltage (kV), milliamperage-time product (mAs) and slice thickness, must be optimised with a 'field of view' that includes the relevant bony landmarks. The recommended kV and mAs values were very wide ranging from 100 to 150 and from 100 to 250, respectively. The large variability that exists amongst the CT protocols illustrates the need for a more consistent low-dose CT protocol for the planning of THA. This must provide an optimal balance between image quality and radiation dose to the patient. Current CT scanners do not allow for measurements of functional pelvic orientation and additional upright imaging modalities are needed to augment them.
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Affiliation(s)
- Angelika Ramesh
- Department of Mechanical Engineering, University College London, United Kingdom
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, United Kingdom
| | - Anna Di Laura
- Department of Mechanical Engineering, University College London, United Kingdom
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, United Kingdom
| | - Johann Henckel
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, United Kingdom
| | - Alister Hart
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, United Kingdom
- Institute of Orthopaedics and Musculoskeletal Science, University College London, United Kingdom
- Cleveland Clinic London, United Kingdom
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Brady SL. Implementation of AI image reconstruction in CT-how is it validated and what dose reductions can be achieved. Br J Radiol 2023; 96:20220915. [PMID: 37102695 PMCID: PMC10546449 DOI: 10.1259/bjr.20220915] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 04/28/2023] Open
Abstract
CT reconstruction has undergone a substantial change over the last decade with the introduction of iterative reconstruction (IR) and now with deep learning reconstruction (DLR). In this review, DLR will be compared to IR and filtered back-projection (FBP) reconstructions. Comparisons will be made using image quality metrics such as noise power spectrum, contrast-dependent task-based transfer function, and non-prewhitening filter detectability index (dNPW'). Discussion on how DLR has impacted CT image quality, low-contrast detectability, and diagnostic confidence will be provided. DLR has shown the ability to improve in areas that IR is lacking, namely: noise magnitude reduction does not alter noise texture to the degree that IR did, and the noise texture found in DLR is more aligned with noise texture of an FBP reconstruction. Additionally, the dose reduction potential for DLR is shown to be greater than IR. For IR, the consensus was dose reduction should be limited to no more than 15-30% to preserve low-contrast detectability. For DLR, initial phantom and patient observer studies have shown acceptable dose reduction between 44 and 83% for both low- and high-contrast object detectability tasks. Ultimately, DLR is able to be used for CT reconstruction in place of IR, making it an easy "turnkey" upgrade for CT reconstruction. DLR for CT is actively being improved as more vendor options are being developed and current DLR options are being enhanced with second generation algorithms being released. DLR is still in its developmental early stages, but is shown to be a promising future for CT reconstruction.
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Efthymiou FO, Metaxas VI, Dimitroukas CP, Delis HB, Zikou KD, Ntzanis ES, Zampakis PE, Panayiotakis GS, Kalogeropoulou CP. A retrospective survey to establish institutional diagnostic reference levels for CT urography examinations based on clinical indications: preliminary results. Biomed Phys Eng Express 2023; 9:065005. [PMID: 37651989 DOI: 10.1088/2057-1976/acf582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/31/2023] [Indexed: 09/02/2023]
Abstract
Objective. To establish institutional diagnostic reference levels (IDRLs) based on clinical indications (CIs) for three- and four-phase computed tomography urography (CTU).Methods. Volumetric computed tomography dose index (CTDIvol), dose-length product (DLP), patients' demographics, selected CIs like lithiasis, cancer, and other diseases, and protocols' parameters were retrospectively recorded for 198 CTUs conducted on a Toshiba Aquilion Prime 80 scanner. Patients were categorised based on CIs and number of phases. These groups' 75th percentiles of CTDIvoland DLP were proposed as IDRLs. The mean, median and IDRLs were compared with previously published values.Results. For the three-phase protocol, the CTDIvol(mGy) and DLP (mGy.cm) were 22.7/992 for the whole group, 23.4/992 for lithiasis, 22.8/1037 for cancer, and 21.2/981 for other diseases. The corresponding CTDIvol(mGy) and DLP (mGy.cm) values for the four-phase protocol were 28.6/1172, 30.6/1203, 27.3/1077, and 28.7/1252, respectively. A significant difference was found in CTDIvoland DLP between the two protocols, among the phases of three-phase (except cancer) and four-phase protocols (except DLP for other diseases), and in DLP between the second and third phases (except for cancer group). The results are comparable or lower than most studies published in the last decade.Conclusions. The CT technologist must be aware of the critical dose dependence on the scan length and the applied exposure parameters for each phase, according to the patient's clinical background and the corresponding imaging anatomy, which must have been properly targeted by the competent radiologist. When clinically feasible, restricting the number of phases to three instead of four could remarkably reduce the patient's radiation dose. CI-based IDRLs will serve as a baseline for comparison with CTU practice in other hospitals and could contribute to national DRL establishment. The awareness and knowledge of dose levels during CTU will prompt optimisation strategies in CT facilities.
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Affiliation(s)
- Fotios O Efthymiou
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Vasileios I Metaxas
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Christos P Dimitroukas
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
- Department of Medical Physics, University Hospital of Patras, 26504 Patras, Greece
| | - Harry B Delis
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Kiriaki D Zikou
- Department of Radiology, University Hospital of Patras, 26504 Patras, Greece
| | | | - Petros E Zampakis
- Department of Radiology, University Hospital of Patras, 26504 Patras, Greece
- Department of Radiology, School of Medicine, University of Patras, 26504 Patras, Greece
| | - George S Panayiotakis
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
- Department of Medical Physics, University Hospital of Patras, 26504 Patras, Greece
| | - Christina P Kalogeropoulou
- Department of Radiology, University Hospital of Patras, 26504 Patras, Greece
- Department of Radiology, School of Medicine, University of Patras, 26504 Patras, Greece
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Karami V, Albosof M, Gholami M, Adeli M, Hekmatnia A, Sheidaei MFB, Behbahani AT, Sharif HS, Jafrasteh S. Tradeoffs between Radiation Exposure to the Lens of the Eyes and Diagnostic Image Quality in Pediatric Brain Computed Tomography. JOURNAL OF MEDICAL SIGNALS & SENSORS 2023; 13:208-216. [PMID: 37622039 PMCID: PMC10445673 DOI: 10.4103/jmss.jmss_19_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/04/2022] [Accepted: 03/16/2023] [Indexed: 08/26/2023]
Abstract
Background Computed tomography (CT) of the brain is associated with radiation exposure to the lens of the eyes. Therefore, it is necessary to optimize scan settings to keep radiation exposure as low as reasonably achievable without compromising diagnostic image information. The aim of this study was to compare the effectiveness of the five practical techniques for lowering eye radiation exposure and their effects on diagnostic image quality in pediatric brain CT. Methods The following scan protocols were performed: reference scan, 0.06-mm Pbeq bismuth shield, 30% globally lowering tube current (GLTC), reducing tube voltage (RTV) from 120 to 90 kVp, gantry tilting, and combination of gantry tilting with bismuth shielding. Radiation measurements were performed using thermoluminescence dosimeters. Objective and subjective image quality was evaluated. Results All strategies significantly reduced eye dose, and increased the posterior fossa artifact index and the temporal lobe artifact index, relative to the reference scan. GLTC and RTV increased image noise, leading to a decrease signal-to-noise ratio and contrast-to-noise ratio. Except for bismuth shielding, subjective image quality was relatively the same as the reference scan. Conclusions Gantry tilting may be the most effective method for reducing eye radiation exposure in pediatric brain CT. When the scanner does not support gantry tilting, GLTC might be an alternative.
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Affiliation(s)
- Vahid Karami
- Clinical Research Development Unit, Ganjavian Hospital, Dezful University of Medical Sciences, Dezful, Iran
| | - Mohsen Albosof
- Department of Biomedical Engineering, Dezful Branch, Islamic Azad University, Dezful, Iran
| | - Mehrdad Gholami
- Department of Medical Physics, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Adeli
- Department of Biomedical Engineering, Dezful Branch, Islamic Azad University, Dezful, Iran
| | - Ali Hekmatnia
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Hoda Sadat Sharif
- Clinical Research Development Unit, Ganjavian Hospital, Dezful University of Medical Sciences, Dezful, Iran
| | - Somayeh Jafrasteh
- Clinical Research Development Unit, Ganjavian Hospital, Dezful University of Medical Sciences, Dezful, Iran
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Bohang SAM, Sohaimi N. An Overview on the Alignment of Radiation Protection in Computed Tomography with Maqasid al-Shari'ah in the Context of al-Dharuriyat. Malays J Med Sci 2023; 30:60-72. [PMID: 37425388 PMCID: PMC10325131 DOI: 10.21315/mjms2023.30.3.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/08/2022] [Indexed: 07/11/2023] Open
Abstract
The increasing utilisation of computed tomography (CT) in the medical field has raised a greater concern regarding the radiation-induced health effects as CT imposes high radiation risks on the exposed individual. Adherence to radiation protection measures in CT as endorsed by regulatory bodies; justification, optimisation and dose limit, is essential to minimise radiation risks. Islam values every human being and Maqasid al-Shari'ah helps to protect human beings through its sacred principles which aim to fulfil human beings' benefits (maslahah) and prevent mischief (mafsadah). Alignment of the concept of radiation protection in CT within the framework of al-Dharuriyat; protection of faith or religion (din), protection of life (nafs), protection of lineage (nasl), protection of intellect ('aql) and protection of property (mal) is essential. This strengthens the concept and practices of radiation protection in CT among radiology personnel, particularly Muslim radiographers. The alignment provides supplementary knowledge towards the integration of knowledge fields between Islamic worldview and radiation protection in medical imaging, particularly in CT. This paper is hoped to set a benchmark for future studies on the integration of knowledge between the Islamic worldview and radiation protection in medical imaging in terms of other classifications of Maqasid al-Shari'ah; al-Hajiyat and al-Tahsiniyat.
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Affiliation(s)
- Siti Aisyah Munirah Bohang
- Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - Norhanna Sohaimi
- Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
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Mainprize JG, Yaffe MJ, Chawla T, Glanc P. Effects of ionizing radiation exposure during pregnancy. Abdom Radiol (NY) 2023; 48:1564-1578. [PMID: 36933026 PMCID: PMC10024285 DOI: 10.1007/s00261-023-03861-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE To review the effects of ionizing radiation to the conceptus and the relationship to the timing of the exposure during pregnancy. To consider strategies that would mitigate potential harms associated with exposure to ionizing radiation during pregnancy. METHODS Data reported in the peer-reviewed literature on entrance KERMA received from specific radiological examinations were combined with published results from experiment or Monte Carlo modeling of tissue and organ doses per entrance KERMA to estimate total doses that could be received from specific procedures. Data reported in the peer-reviewed literature on dose mitigation strategies, best practices for shielding, consent, counseling and emerging technologies were reviewed. RESULTS For procedures utilizing ionizing radiation for which the conceptus is not included in the primary radiation beam, typical doses are well below the threshold for causing tissue reactions and the risk of induction of childhood cancer is low. For procedures that include the conceptus in the primary radiation field, longer fluoroscopic interventional procedures or multiphase/multiple exposures potentially could approach or exceed thresholds for tissue reactions and the risk of cancer induction must be weighed against the expected risk/benefit of performing (or not) the imaging examination. Gonadal shielding is no longer considered best practice. Emerging technologies such as whole-body DWI/MRI, dual-energy CT and ultralow dose studies are gaining importance for overall dose reduction strategies. CONCLUSION The ALARA principle, considering potential benefits and risks should be followed with respect to the use of ionizing radiation. Nevertheless, as Wieseler et al. (2010) state, "no examination should be withheld when an important clinical diagnosis is under consideration." Best practices require updates on current available technologies and guidelines.
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Affiliation(s)
- James G. Mainprize
- Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Ave., Rm S632/S657, Toronto, ON M4N 3M5 Canada
| | - Martin J. Yaffe
- Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Ave., Rm S632/S657, Toronto, ON M4N 3M5 Canada
- Departments of Medical Biophysics and Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave., Rm S657, Toronto, ON M4N 3M5 Canada
| | - Tanya Chawla
- Joint Department of Medical Imaging, Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, ON M5G 1X5 Canada
| | - Phyllis Glanc
- Departments Medical Imaging, Obstetrics & Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Rm MG 160, Toronto, ON M4N 3M5 Canada
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Alsaihati N, Ria F, Solomon J, Ding A, Frush D, Samei E. Making CT Dose Monitoring Meaningful: Augmenting Dose with Imaging Quality. Tomography 2023; 9:798-809. [PMID: 37104136 PMCID: PMC10145563 DOI: 10.3390/tomography9020065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
Due to the concerns about radiation dose associated with medical imaging, radiation dose monitoring systems (RDMSs) are now utilized by many radiology providers to collect, process, analyze, and manage radiation dose-related information. Currently, most commercially available RDMSs focus only on radiation dose information and do not track any metrics related to image quality. However, to enable comprehensive patient-based imaging optimization, it is equally important to monitor image quality as well. This article describes how RDMS design can be extended beyond radiation dose to simultaneously monitor image quality. A newly designed interface was evaluated by different groups of radiology professionals (radiologists, technologists, and physicists) on a Likert scale. The results show that the new design is effective in assessing both image quality and safety in clinical practices, with an overall average score of 7.8 out of 10.0 and scores ranging from 5.5 to 10.0. Radiologists rated the interface highest at 8.4 out of 10.0, followed by technologists at 7.6 out of 10.0, and medical physicists at 7.5 out of 10.0. This work demonstrates how the assessment of the radiation dose can be performed in conjunction with the image quality using customizable user interfaces based on the clinical needs associated with different radiology professions.
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Affiliation(s)
- Njood Alsaihati
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Francesco Ria
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
- Center for Virtual Imaging Trials, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Justin Solomon
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
- Center for Virtual Imaging Trials, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Aiping Ding
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Donald Frush
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Center for Virtual Imaging Trials, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Ehsan Samei
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
- Center for Virtual Imaging Trials, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
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Im DJ, Kim YH, Choo KS, Kang JW, Jung JI, Won Y, Kim HR, Chung MH, Han K, Choi BW. Comparison of Coronary Computed Tomography Angiography Image Quality With High-concentration and Low-concentration Contrast Agents: The Randomized CONCENTRATE Trial. J Thorac Imaging 2023; 38:120-127. [PMID: 36821380 DOI: 10.1097/rti.0000000000000633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To confirm that the image quality of coronary computed tomography (CT) angiography with a low tube voltage (80 to 100 kVp), iterative reconstruction, and low-concentration contrast agents (iodixanol 270 to 320 mgI/mL) was not inferior to that with conventional high tube voltage (120 kVp) and high-concentration contrast agent (iopamidol 370 mgI/mL). MATERIALS AND METHODS This prospective, multicenter, noninferiority, randomized trial enrolled a total of 318 patients from 8 clinical sites. All patients were randomly assigned 1: 1: 1 for each contrast medium of 270, 320, and 370 mgI/mL. CT scans were taken with a standard protocol in the high-concentration group (370 mgI/mL) and with 20 kVp lower protocol in the low-concentration group (270 or 320 mgI/mL). Image quality and radiation dose were compared between the groups. Image quality was evaluated with a score of 1 to 4 as subject image quality. RESULTS The mean HU, signal-to-noise ratio, and contrast-to-noise ratio of the 3 groups were significantly different (all P<0.0001). The signal-to-noise ratio and contrast-to-noise ratio of the low-concentration groups were significantly lower than those of the high-concentration group (P<0.05). However, the image quality scores were not significantly different among the 3 groups (P=0.745). The dose length product and effective dose of the high-concentration group were significantly higher than those of the low-concentration group (P<0.0001 and 0.003, respectively). CONCLUSIONS The CT protocol with iterative reconstruction and lower tube voltage for low-concentration contrast agents significantly reduced the effective radiation dose (mean: 3.7±2.7 to 4.1±3.1 mSv) while keeping the subjective image quality as good as the standard protocol (mean: 5.7±3.4 mSv).
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Affiliation(s)
- Dong Jin Im
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine
| | - Yun-Hyeon Kim
- Department of Radiology, Chonnam National University Hospital, Chonnam University Medical School, Gwangju
| | - Ki Seok Choo
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Pusan
| | - Joon-Won Kang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine
| | - Jung Im Jung
- Department of Radiology, Seoul St. Mary's Hospital
| | - Yoodong Won
- Department of Radiology, Uijeongbu St. Mary's Hospital, Catholic University of Korea, Uijeongbu
| | - Hyo Rim Kim
- Department of Radiology, Yeouido St. Mary's Hospital, Catholic University of Korea, Seoul
| | - Myung Hee Chung
- Department of Radiology, Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, Republic of Korea
| | - Kyunghwa Han
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine
| | - Byoung Wook Choi
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine
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Mortazavi SMJ, Taleinejad F, Haghani M, Sihver L. How Worrying Is the Impact of COVID-19 Pandemic on the Population Radiation Risk from Increased Number of CT-Scans? J Biomed Phys Eng 2023; 13:1-2. [PMID: 36818012 PMCID: PMC9923242 DOI: 10.31661/jbpe.v0i0.2212-1575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/20/2023] [Indexed: 02/01/2023]
Affiliation(s)
| | - Fatemeh Taleinejad
- Department of Medical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Haghani
- Department of Radiology, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Lembit Sihver
- Nuclear Physics Institute of the CAS, Prague, Czech Republic
- Vienna University of Technology, Atominstitut, Vienna, Austria
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Huber NR, Missert AD, Gong H, Leng S, Yu L, McCollough CH. Technical note: Phantom-based training framework for convolutional neural network CT noise reduction. Med Phys 2023; 50:821-830. [PMID: 36385704 PMCID: PMC9931634 DOI: 10.1002/mp.16093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Deep artificial neural networks such as convolutional neural networks (CNNs) have been shown to be effective models for reducing noise in CT images while preserving anatomic details. A practical bottleneck for developing CNN-based denoising models is the procurement of training data consisting of paired examples of high-noise and low-noise CT images. Obtaining these paired data are not practical in a clinical setting where the raw projection data is not available. This work outlines a technique to optimize CNN denoising models using methods that are available in a routine clinical setting. PURPOSE To demonstrate a phantom-based training framework for CNN noise reduction that can be efficiently implemented on any CT scanner. METHODS The phantom-based training framework uses supervised learning in which training data are synthesized using an image-based noise insertion technique. Ten patient image series were used for training and validation (9:1) and noise-only images obtained from anthropomorphic phantom scans. Phantom noise-only images were superimposed on patient images to imitate low-dose CT images for use in training. A modified U-Net architecture was used with mean-squared-error and feature reconstruction loss. The training framework was tested for clinically indicated whole-body-low-dose CT images, as well as routine abdomen-pelvis exams for which projection data was unavailable. Performance was assessed based on root-mean-square error, structural similarity, line profiles, and visual assessment. RESULTS When the CNN was tested on five reserved quarter-dose whole-body-low-dose CT images, noise was reduced by 75%, root-mean-square-error reduced by 34%, and structural similarity increased by 60%. Visual analysis and line profiles indicated that the method significantly reduced noise while maintaining spatial resolution of anatomic features. CONCLUSION The proposed phantom-based training framework demonstrated strong noise reduction while preserving spatial detail. Because this method is based within the image domain, it can be easily implemented without access to projection data.
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Affiliation(s)
| | | | - Hao Gong
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, USA
| | - Shuai Leng
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, USA
| | - Lifeng Yu
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, USA
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Shapira N, Bharthulwar S, Noël PB. Convolutional Encoder-Decoder Networks for Volumetric Computed Tomography Surviews from Single- and Dual-View Topograms. RESEARCH SQUARE 2023:rs.3.rs-2449089. [PMID: 36711997 PMCID: PMC9882676 DOI: 10.21203/rs.3.rs-2449089/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Computed tomography (CT) is an extensively used imaging modality capable of generating detailed images of a patient's internal anatomy for diagnostic and interventional procedures. High-resolution volumes are created by measuring and combining information along many radiographic projection angles. In current medical practice, single and dual-view two-dimensional (2D) topograms are utilized for planning the proceeding diagnostic scans and for selecting favorable acquisition parameters, either manually or automatically, as well as for dose modulation calculations. In this study, we develop modified 2D to three-dimensional (3D) encoder-decoder neural network architectures to generate CT-like volumes from single and dual-view topograms. We validate the developed neural networks on synthesized topograms from publicly available thoracic CT datasets. Finally, we assess the viability of the proposed transformational encoder-decoder architecture on both common image similarity metrics and quantitative clinical use case metrics, a first for 2D-to-3D CT reconstruction research. According to our findings, both single-input and dual-input neural networks are able to provide accurate volumetric anatomical estimates. The proposed technology will allow for improved (i) planning of diagnostic CT acquisitions, (ii) input for various dose modulation techniques, and (iii) recommendations for acquisition parameters and/or automatic parameter selection. It may also provide for an accurate attenuation correction map for positron emission tomography (PET) with only a small fraction of the radiation dose utilized.
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Affiliation(s)
- Nadav Shapira
- Perelman School of Medicine of the University of Pennsylvania
| | | | - Peter B Noël
- Perelman School of Medicine of the University of Pennsylvania
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Gopireddy DR, Kee-Sampson JW, Vulasala SSR, Stein R, Kumar S, Virarkar M. Imaging of penetrating vascular trauma of the body and extremities secondary to ballistic and stab wounds. J Clin Imaging Sci 2023; 13:1. [PMID: 36751564 PMCID: PMC9899476 DOI: 10.25259/jcis_99_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023] Open
Abstract
In the United States, gunshot wounds (GSWs) have become a critical public health concern with substantial annual morbidity, disability, and mortality. Vascular injuries associated with GSW may pose a clinical challenge to the physicians in the emergency department. Patients demonstrating hard signs require immediate intervention, whereas patients with soft signs can undergo further diagnostic testing for better injury delineation. Although digital subtraction angiography is the gold standard modality to assess vascular injuries, non-invasive techniques such as Doppler ultrasound, computed tomography angiography, and magnetic resonance angiography have evolved as appropriate alternatives. This article discusses penetrating bodily vascular injuries, specifically ballistic and stab wounds, and the corresponding radiological presentations.
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Affiliation(s)
- Dheeraj Reddy Gopireddy
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
| | - Joanna W. Kee-Sampson
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
| | - Sai Swarupa Reddy Vulasala
- Department of Internal Medicine, East Carolina University Health Medical Center, Greenville, North Carolina, United States
| | - Rachel Stein
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
| | - Sindhu Kumar
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
| | - Mayur Virarkar
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
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Evaluating the Outcome of an Unnecessary Request for CT Scan in Be'sat Hospital of Hamadan. Radiol Res Pract 2023; 2023:3709015. [PMID: 36874208 PMCID: PMC9977522 DOI: 10.1155/2023/3709015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/24/2023] Open
Abstract
Aim This study aimed to investigate the frequency of unnecessary tests requested in Be'sat Hospital in Hamadan. Materials and Methods This descriptive research was conducted in order to investigate the frequency of unnecessary requests for CT scan and radiography of patients referring to the imaging department of Be'sat Hospital in Hamadan in a 4- to 6-month period. Patient information, including gender, age, type of CT scan test, the reason for requesting the test, the expertise of the requesting physician, and the result of the radiologist's report on each test, was extracted and collected. Results A total of 1000 CT scans were evaluated. The mean age of these patients was about 36 years and most of them were men. The highest and lowest percentages of unnecessary cases were related to CT scans of the brain (42.3%) and facial bones (2.3%), respectively. The most and the least unnecessary CT scans based on the reason given for the request were related to multiple physical trauma (30.7%) and chronic kidney disease (1.5%), respectively. Conclusion In all tests, over 74% of the reports were unnecessary and less than 26% were necessary. Therefore, it is necessary to reduce unnecessary requests to reduce the radiation dose of patients. Also, the knowledge of doctors should be increased in the field of appropriate evaluation of CT scan tests based on clinical guidelines.
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Koch V, Conrades LM, Gruenewald LD, Eichler K, Martin SS, Booz C, D'Angelo T, Yel I, Bernatz S, Mahmoudi S, Albrecht MH, Scholtz J, Thalhammer A, Zangos S, Vogl TJ, Gruber‐Rouh T. Reduction of radiation dose using real-time visual feedback dosimetry during angiographic interventions. J Appl Clin Med Phys 2022; 24:e13860. [PMID: 36565180 PMCID: PMC9924107 DOI: 10.1002/acm2.13860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/31/2022] [Accepted: 11/15/2022] [Indexed: 12/25/2022] Open
Abstract
This prospective study sought to evaluate potential savings of radiation dose to medical staff using real-time dosimetry coupled with visual radiation dose feedback during angiographic interventions. For this purpose, we analyzed a total of 214 angiographic examinations that consisted of chemoembolizations and several other types of therapeutic interventions. The Unfors RaySafe i2 dosimeter was worn by the interventionalist at chest height over the lead protection. A total of 110 interventions were performed with real-time radiation dosimetry allowing the interventionalist to react upon higher x-ray exposure and 104 examinations served as the comparative group without real-time radiation monitoring. By using the real-time display during interventions, the overall mean operator radiation dose decreased from 3.67 (IQR, 0.95-23.01) to 2.36 μSv (IQR, 0.52-12.66) (-36%; p = 0.032) at simultaneously reduced operator exposure time by 4.5 min (p = 0.071). Dividing interventions into chemoembolizations and other types of therapeutic interventions, radiation dose decreased from 1.31 (IQR, 0.46-3.62) to 0.95 μSv (IQR, 0.53-3.11) and from 24.39 (IQR, 12.14-63.0) to 10.37 μSv (IQR, 0.85-36.84), respectively, using live-screen dosimetry (p ≤ 0.005). Radiation dose reductions were also observed for the participating assistants, indicating that they could also benefit from real-time visual feedback dosimetry during interventions (-30%; p = 0.039). Integration of real-time dosimetry into clinical processes might be useful in reducing occupational radiation exposure time during angiographic interventions. The real-time visual feedback raised the awareness of interventionalists and their assistants to the potential danger of prolonged radiation exposure leading to the adoption of radiation-sparing practices. Therefore, it might create a safer environment for the medical staff by keeping the applied radiation exposure as low as possible.
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Affiliation(s)
- Vitali Koch
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Lena Marie Conrades
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Leon D. Gruenewald
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Katrin Eichler
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Simon S. Martin
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Christian Booz
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Tommaso D'Angelo
- Department of Biomedical Sciences and Morphological and Functional ImagingUniversity Hospital MessinaMessinaItaly
| | - Ibrahim Yel
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Simon Bernatz
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Scherwin Mahmoudi
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Moritz H. Albrecht
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Jan‐Erik Scholtz
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Axel Thalhammer
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Stephan Zangos
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Thomas J. Vogl
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
| | - Tatjana Gruber‐Rouh
- Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
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Radiation Exposure and Lifetime Attributable Risk of Cancer Incidence and Mortality from Low- and Standard-Dose CT Chest: Implications for COVID-19 Pneumonia Subjects. Diagnostics (Basel) 2022; 12:diagnostics12123043. [PMID: 36553050 PMCID: PMC9777015 DOI: 10.3390/diagnostics12123043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/07/2022] Open
Abstract
Since the novel coronavirus disease 2019 (COVID-19) outbreak, there has been an unprecedented increase in the acquisition of chest computed tomography (CT) scans. Nearly 616 million people have been infected by COVID-19 worldwide to date, of whom many were subjected to CT scanning. CT exposes the patients to hazardous ionizing radiation, which can damage the genetic material in the cells, leading to stochastic health effects in the form of heritable genetic mutations and increased cancer risk. These probabilistic, long-term carcinogenic effects of radiation can be seen over a lifetime and may sometimes take several decades to manifest. This review briefly describes what is known about the health effects of radiation, the lowest dose for which there exists compelling evidence about increased radiation-induced cancer risk and the evidence regarding this risk at typical CT doses. The lifetime attributable risk (LAR) of cancer from low- and standard-dose chest CT scans performed in COVID-19 subjects is also discussed along with the projected number of future cancers that could be related to chest CT scans performed during the COVID-19 pandemic. The LAR of cancer Incidence from chest CT has also been compared with those from other radiation sources, daily life risks and lifetime baseline risk.
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Zhou B, Chen X, Xie H, Zhou SK, Duncan JS, Liu C. DuDoUFNet: Dual-Domain Under-to-Fully-Complete Progressive Restoration Network for Simultaneous Metal Artifact Reduction and Low-Dose CT Reconstruction. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:3587-3599. [PMID: 35816532 PMCID: PMC9812027 DOI: 10.1109/tmi.2022.3189759] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
To reduce the potential risk of radiation to the patient, low-dose computed tomography (LDCT) has been widely adopted in clinical practice for reconstructing cross-sectional images using sinograms with reduced x-ray flux. The LDCT image quality is often degraded by different levels of noise depending on the low-dose protocols. The image quality will be further degraded when the patient has metallic implants, where the image suffers from additional streak artifacts along with further amplified noise levels, thus affecting the medical diagnosis and other CT-related applications. Previous studies mainly focused either on denoising LDCT without considering metallic implants or full-dose CT metal artifact reduction (MAR). Directly applying previous LDCT or MAR approaches to the issue of simultaneous metal artifact reduction and low-dose CT (MARLD) may yield sub-optimal reconstruction results. In this work, we develop a dual-domain under-to-fully-complete progressive restoration network, called DuDoUFNet, for MARLD. Our DuDoUFNet aims to reconstruct images with substantially reduced noise and artifact by progressive sinogram to image domain restoration with a two-stage progressive restoration network design. Our experimental results demonstrate that our method can provide high-quality reconstruction, superior to previous LDCT and MAR methods under various low-dose and metal settings.
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Gupta RV, Kalra MK, Ebrahimian S, Kaviani P, Primak A, Bizzo B, Dreyer KJ. Complex Relationship Between Artificial Intelligence and CT Radiation Dose. Acad Radiol 2022; 29:1709-1719. [PMID: 34836775 DOI: 10.1016/j.acra.2021.10.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 12/22/2022]
Abstract
Concerns over need for CT radiation dose optimization and reduction led to improved scanner efficiency and introduction of several reconstruction techniques and image processing-based software. The latest technologies use artificial intelligence (AI) for CT dose optimization and image quality improvement. While CT dose optimization has and can benefit from AI, variations in scanner technologies, reconstruction methods, and scan protocols can lead to substantial variations in radiation doses and image quality across and within different scanners. These variations in turn can influence performance of AI algorithms being deployed for tasks such as detection, segmentation, characterization, and quantification. We review the complex relationship between AI and CT radiation dose.
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Affiliation(s)
- Reya V Gupta
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Court, Suite 248, Boston, Massachusetts
| | - Mannudeep K Kalra
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Court, Suite 248, Boston, Massachusetts.
| | - Shadi Ebrahimian
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Court, Suite 248, Boston, Massachusetts
| | - Parisa Kaviani
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Court, Suite 248, Boston, Massachusetts
| | - Andrew Primak
- Siemens Medical Solutions USA Inc, Malvern, Pennsylvania
| | - Bernardo Bizzo
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Court, Suite 248, Boston, Massachusetts; MGH & BWH Center for Clinical Data Science, Boston, Massachusetts
| | - Keith J Dreyer
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Court, Suite 248, Boston, Massachusetts; MGH & BWH Center for Clinical Data Science, Boston, Massachusetts
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Cao J, Xie N, Qian P, Hu M, Tu J. Feasibility analysis of high pitch cervical spine CT in uncooperative patients with acute cervical spine trauma: An initial experience. Medicine (Baltimore) 2022; 101:e30785. [PMID: 36181071 PMCID: PMC9524935 DOI: 10.1097/md.0000000000030785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Cervical computed tomography (CT) often suffers from examination failure in uncooperative patients with acute cervical spinal trauma. Therefore, this study aimed to evaluate the feasibility of using high-pitch cervical CT (HP-CT) in such populations. A total of 95 patients with acute neck/head-neck trauma who underwent HP-CT (n = 29) or standard cervical CT (SD-CT, n = 66) from October 2020 to June 2021 were included in this study. Differences in patient characteristics between the HP-CT group and the SD-CT group were firstly compared. Then, the objective image quality based on the mean score of the signal-to-noise ratio (SNR)/contrast noise ratio (CNR) was evaluated, while double-blind five-point scoring was adopted for the subjective evaluation. Finally, radiation doses in HP-CT and SD-CT were compared. Furthermore, the Student t test and/or Mann-Whitney U test were performed to analyze differences in patient characteristics, image quality, and radiation dose between the two regimes. A total of 17 cases of cervical spine fractures were found in 95 patients, including 6 cases in the HP-CT group and 11 cases in the SD-CT group. The average age of patients who received HP-CT was higher than that of those who received SD-CT, and the scan time using HP-CT was shorter than that SD-CT. The differences were statistically significant (both, P < .05). In addition, there was no significant difference between HP-CT and SD-CT in terms of sex, body mass index, field of view (FOV), and scan length (all P > .05). The SNR/CNR at the middle and upper neck was not significantly different between HP-CT and SD-CT (all P > .05). However, the SNR/CNR at the lower neck in HP-CT was lower than that in SD-CT (all P < .05). There was no significant difference in the subjective scores between HP-CT and SD-CT images in both the soft tissue and bone window (P = .129 and 0.649, respectively). The radiation dose in HP-CT was lower than that in SD-CT (all P < .05). With a scan time reduction of 73%, radiation dose reduction of 10%, and similar image quality, high-pitch cervical CT was of feasibility to evaluate cervical spine injury in uncooperative patients with acute cervical spine trauma.
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Affiliation(s)
- Juntao Cao
- Department of Radiology, Kunshan Hospital of Traditional Chinese Medicine, Jiangsu Province, China
| | - Na Xie
- Department of Medical Imaging, Kunshan Maternal and Child Health Hospital, China
| | - Pingkang Qian
- Trauma Center, Kunshan Hospital of Traditional Chinese Medicine, China
| | - Ming Hu
- Department of Radiology, Kunshan Hospital of Traditional Chinese Medicine, Jiangsu Province, China
| | - Jianchun Tu
- Department of Radiology, Kunshan Hospital of Traditional Chinese Medicine, Jiangsu Province, China
- *Correspondence: Jianchun TU, Department of Radiology, Kunshan Hospital of Traditional Chinese Medicine. No. 189, Chaoyangxi Road, Kunshan City 215300, Jiangsu Province, China (e-mail: )
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Cai X, Chen X, Wang J, Wei X, Liu W, Li Y, Wang S, Zhu J, Haacke EM, Wang G. Susceptibility-weighted imaging to evaluate normal and abnormal vertebrae in fetuses:a preliminary study. Prenat Diagn 2022; 42:1398-1408. [PMID: 36097375 DOI: 10.1002/pd.6235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the performance of Susceptibility-weighted imaging (SWI) in visualizing normal and abnormal fetal vertebrae in vivo and in utero. METHODS Ninety-seven women with normal fetal vertebrae and 127 women suspected fetal vertebral anomalies on ultrasound were included in our study. SWI, TrueFISP and HASTE of the fetal spine were performed on 1.5-T MRI. The image quality and diagnostic performance between HASTE/TrueFISP and SWI were compared. Pearson correlations to correlate the L1 centrum ossification center (COC) measurements with gestational age (GA) were performed. RESULTS The visibility of the fetal vertebral structures on the SWI images (3.58 ± 0.69) was significantly greater than those on the HASTE (1.98 ± 0.51, P < 0.001) and TrueFISP (2.63 ± 0.52, P < 0.001). The diagnostic accuracy of SWI (89.0%) was superior to HASTE/TrueFISP (48.0%) (P < 0.001) and the area under the curve (AUC) for SWI was 0.909 (P < 0.001). The height, transverse, sagittal diameter and area of L1 COC were linearly correlated with GA (all P < 0.001). CONCLUSION SWI proved to be a reliable method for depicting fetal vertebral structure and growth, which can significantly improve the diagnostic performance of vertebral anomalies in fetuses. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xianyun Cai
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xin Chen
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xinhong Wei
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Wen Liu
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuchao Li
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shanshan Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd, Beijing, China
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Guangbin Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Akhilesh P, Pathan M, Sharma SD. Evaluation of computed tomography dose profiler probe for computed tomography dose index and geometric efficiency measurements. Biomed Phys Eng Express 2022; 8. [PMID: 36049400 DOI: 10.1088/2057-1976/ac8e71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/01/2022] [Indexed: 11/12/2022]
Abstract
The purpose of this study was to evaluate the performance of solid state sensor based computed tomography dose profiler (CTDP) probe for measurement of standard computed tomography dose metric CTDI100 and free in air geometric efficiency for various beam widths available in a 128 slice CT scanner and also to estimate the efficiency of CTDI100 metric. The response accuracy of CTDP probe was verified using a standard 100 mm long ionization chamber. The geometric efficiency measurements performed by CTDP probe were validated using XR-QA2 radiochromic film measurements. The efficiency of CTDI100 metric was assessed by calculating the ratio of CTDI100 measured in the center hole position to CTDI∞ measured in the same position of both head and body phantoms. The weighted CTDI values derived from CTDI100 measured by CTDP probe showed an average variation of 8% from ionization chamber measured values. The efficiency of CTDI100 metric estimated using CTDP probe and 150 mm long phantoms was in the range of 82% to 86% and 76% to 80% for head and body phantom measurements respectively. The variation in the geometric efficiency values for various beam settings and tube voltages measured by the CTDP probe and films were within 7%. Taken together, the results of this study proved that unlike the 100 mm long ionization chamber, the CTDP probe can be efficiently used to determine CTDI for any length over which dose integration is desired and also measure geometric efficiency of MDCT scanners for various beam widths in helical mode of operation.
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Affiliation(s)
- Philomina Akhilesh
- Bhabha Atomic Research Centre, Radiological Physics and Advisory Division, Anushaktinagar, Mumbai, Mumbai, 400085, INDIA
| | - Munir Pathan
- Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, BARC, MUMBAI, Mumbai, 400085, INDIA
| | - Sunil Dutt Sharma
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400 085, Mumbai, Maharashtra, 400085, INDIA
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Yoon S, Yoo KH, Park SH, Kim H, Lee JH, Park J, Park SH, Kim HJ. Low-dose abdominopelvic computed tomography in patients with lymphoma: An image quality and radiation dose reduction study. PLoS One 2022; 17:e0272356. [PMID: 35951525 PMCID: PMC9371255 DOI: 10.1371/journal.pone.0272356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 07/18/2022] [Indexed: 12/04/2022] Open
Abstract
This study aimed to evaluate image quality, the detection rate of enlarged lymph nodes, and radiation dose exposure of ultralow-dose and low-dose abdominopelvic computed tomography (CT) in patients with lymphoma. Patients with lymphoma who underwent abdominopelvic CT using dual-source scanner were retrospectively recruited from a single center. CT images were obtained at 90 kVp dual-source mode reformatted in three data sets using the advanced modelled iterative reconstruction algorithm: 100% (standard-dose CT), 66.7% (low-dose CT), and 33.3% (ultralow-dose CT). Two radiologists analyzed subjective image quality and detection of abdominal enlarged lymph nodes on ultralow-dose, low-dose, and standard-dose CT blindly and independently. The results were compared with reference standards. Three readers (two radiologists and one hematologist) reviewed overall image quality and spleen size. In total, 128 consecutive CT scans (77 complete response, 44 partial response, 6 progressive disease, and 1 initial evaluation) from 86 patients (64 B-cell lymphoma, 14 T/NK-cell lymphoma, and 8 Hodgkin’s lymphoma cases) were assessed. The enlarged lymph node-based detection rates for two readers were 97.0% (96/99) and 94.0% (93/99) on standard-dose CT, 97.0% (96/99) and 94.0% (93/99) on low-dose CT, and 94.0% (93/99) and 89.9% (89/99) on ultralow-dose CT. Overall image quality was 3.8 ± 0.5, 3.9 ± 0.5, and 4.1 ± 0.5 on ultralow-dose CT; 4.7 ± 0.4, 4.6 ± 0.5, and 4.8 ± 0.3 on low-dose CT; and 4.8 ± 0.4, 4.7 ± 0.4, and 4.9 ± 0.2 on standard-dose CT, according to two radiologists and one hematologist, respectively. Intraclass correlation coefficients of spleen size were 0.90 (95% confidence interval [CI], 0.87–0.93), 0.91 (95% CI, 0.88–0.93), and 0.91 (95% CI, 0.88–0.93) on ultralow-dose, low-dose, and standard-dose CT, respectively. Mean effective radiation doses of standard-dose, low-dose, and ultralow-dose CT were 5.7 ±1.8 mSv, 3.8 ± 1.2 mSv, and 1.9 ± 0.6 mSv, respectively. Our findings suggest that ultralow-dose and low-dose CT, even with radiation doses reduced by 66.7% and 33.3%, respectively, maintained adequate image quality. These imaging modalities may be employed for follow-up lymphoma evaluation in consideration of the long surveillance periods.
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Affiliation(s)
- Sungjin Yoon
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Kwai Han Yoo
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - So Hyun Park
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
- * E-mail:
| | - Hawk Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jae Hoon Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jinny Park
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seong Ho Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
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Manohar A, Colvert GM, Yang J, Chen Z, Ledesma-Carbayo MJ, Kronborg MB, Sommer A, Nørgaard BL, Nielsen JC, McVeigh ER. Prediction of Cardiac Resynchronization Therapy Response Using a Lead Placement Score Derived From 4-Dimensional Computed Tomography. Circ Cardiovasc Imaging 2022; 15:e014165. [PMID: 35973012 PMCID: PMC9558060 DOI: 10.1161/circimaging.122.014165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/19/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cardiac resynchronization therapy (CRT) is an effective treatment for patients with heart failure; however, 30% of patients do not respond to the treatment. We sought to derive patient-specific left ventricle maps of lead placement scores (LPS) that highlight target pacing lead sites for achieving a higher probability of CRT response. METHODS Eighty-two subjects recruited for the ImagingCRT trial (Empiric Versus Imaging Guided Left Ventricular Lead Placement in Cardiac Resynchronization Therapy) were retrospectively analyzed. All 82 subjects had 2 contrast-enhanced full cardiac cycle 4-dimensional computed tomography scans: a baseline and a 6-month follow-up scan. CRT response was defined as a reduction in computed tomography-derived end-systolic volume ≥15%. Eight left ventricle features derived from the baseline scans were used to train a support vector machine via a bagging approach. An LPS map over the left ventricle was created for each subject as a linear combination of the support vector machine feature weights and the subject's own feature vector. Performance for distinguishing responders was performed on the original 82 subjects. RESULTS Fifty-two (63%) subjects were responders. Subjects with an LPS≤Q1 (lower-quartile) had a posttest probability of responding of 14% (3/21), while subjects with an LPS≥ Q3 (upper-quartile) had a posttest probability of responding of 90% (19/21). Subjects with Q1 CONCLUSIONS An LPS map was defined using 4-dimensional computed tomography-derived features of left ventricular mechanics. The LPS correlated with CRT response, reclassifying 25% of the subjects into low probability of response, 25% into high probability of response, and 50% unchanged. These encouraging results highlight the potential utility of 4-dimensional computed tomography in guiding patient selection for CRT. The present findings need verification in larger independent data sets and prospective trials.
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Affiliation(s)
- Ashish Manohar
- Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, California, USA
| | - Gabrielle M. Colvert
- Department of Bioengineering, University of California San Diego, La Jolla, California, USA
| | - James Yang
- Department of Bioengineering, University of California San Diego, La Jolla, California, USA
| | - Zhennong Chen
- Department of Bioengineering, University of California San Diego, La Jolla, California, USA
| | - Maria J. Ledesma-Carbayo
- Biomedical Image Technologies Laboratory, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain
| | | | - Anders Sommer
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Jens Cosedis Nielsen
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Elliot R. McVeigh
- Department of Bioengineering, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
- Department of Medicine, Cardiovascular Division, University of California San Diego, La Jolla, California, USA
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Radiologist-Trained and -Tested (R2.2.4) Deep Learning Models for Identifying Anatomical Landmarks in Chest CT. Diagnostics (Basel) 2022; 12:diagnostics12081844. [PMID: 36010194 PMCID: PMC9407000 DOI: 10.3390/diagnostics12081844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/20/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Optimal anatomic coverage is important for radiation-dose optimization. We trained and tested (R2.2.4) two (R3-2) deep learning (DL) algorithms on a machine vision tool library platform (Cognex Vision Pro Deep Learning software) to recognize anatomic landmarks and classify chest CT as those with optimum, under-scanned, or over-scanned scan length. (2) Methods: To test our hypothesis, we performed a study with 428 consecutive chest CT examinations (mean age 70 ± 14 years; male:female 190:238) performed at one of the four hospitals. CT examinations from two hospitals were used to train the DL classification algorithms to identify lung apices and bases. The developed algorithms were then tested on the data from the remaining two hospitals. For each CT, we recorded the scan lengths above and below the lung apices and bases. Model performance was assessed with receiver operating characteristics (ROC) analysis. (3) Results: The two DL models for lung apex and bases had high sensitivity, specificity, accuracy, and areas under the curve (AUC) for identifying under-scanning (100%, 99%, 99%, and 0.999 (95% CI 0.996–1.000)) and over-scanning (99%, 99%, 99%, and 0.998 (95%CI 0.992–1.000)). (4) Conclusions: Our DL models can accurately identify markers for missing anatomic coverage and over-scanning in chest CTs.
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Kasuga I, Maezawa H, Gamo S, Yokoe Y, Yanagihara Y, Sugiyama T, Tokura M, Okayama M, Ohtsubo O. Evaluation of chest radiography and low-dose computed tomography as valuable screening tools for thoracic diseases. Medicine (Baltimore) 2022; 101:e29261. [PMID: 35866756 PMCID: PMC9302368 DOI: 10.1097/md.0000000000029261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Recent studies have shown that low-dose computed tomography (LDCT) is effective for the early detection of lung cancer. However, the utility of chest radiography (CR) and LDCT for other thoracic diseases has not been as well investigated as it has been for lung cancer. This study aimed to clarify the usefulness of the veridical method in the screening of various thoracic diseases. METHODS Among individuals who had received general health checkups over a 10-year period, those who had undergone both CR and LDCT were selected for analysis. The present study included 4317 individuals (3146 men and 1171 women). We investigated cases in which abnormal opacity was detected on CR and/or LDCT. RESULTS A total of 47 and 124 cases had abnormal opacity on CR and LDCT, respectively. Among these, 41 cases in which the abnormal opacity was identified by both methods contained 20 treated cases. Six cases had abnormalities only on CR, and none of the cases required further treatment. Eighty-three cases were identified using LDCT alone. Of these, many cases, especially those over the age of 50 years, were diagnosed with thoracic tumors and chronic obstructive pulmonary disease, which required early treatment. In contrast, many cases of pulmonary infections have improved spontaneously, without any treatment. CONCLUSION These results revealed that LDCT allowed early detection of thoracic tumors and chronic obstructive pulmonary disease, especially in individuals over the age of 50 years. CR is still a useful imaging modality for other thoracic diseases, especially in individuals under the age of 49 years.
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Affiliation(s)
- Ikuma Kasuga
- Health Care Center, Shinjuku Oiwake Clinic and Ladies Branch, Tokyo, Japan
- Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan
- *Correspondence: Ikuma Kasuga, Health Care Center, Shinjuku Oiwake Clinic, 7th floor 3-1-13, Shinjuku, Shinjuku-ku, Tokyo 160-0022, Japan (e-mail: )
| | - Hiromi Maezawa
- Health Care Center, Shinjuku Oiwake Clinic and Ladies Branch, Tokyo, Japan
| | - Sanae Gamo
- Health Care Center, Shinjuku Oiwake Clinic and Ladies Branch, Tokyo, Japan
| | - Yoshimi Yokoe
- Health Care Center, Shinjuku Oiwake Clinic and Ladies Branch, Tokyo, Japan
| | - Yuri Yanagihara
- Health Care Center, Shinjuku Oiwake Clinic and Ladies Branch, Tokyo, Japan
| | - Tomoko Sugiyama
- Health Care Center, Shinjuku Oiwake Clinic and Ladies Branch, Tokyo, Japan
| | - Michiyo Tokura
- Health Care Center, Shinjuku Oiwake Clinic and Ladies Branch, Tokyo, Japan
| | - Mayumi Okayama
- Health Care Center, Shinjuku Oiwake Clinic and Ladies Branch, Tokyo, Japan
| | - Osamu Ohtsubo
- Health Care Center, Shinjuku Oiwake Clinic and Ladies Branch, Tokyo, Japan
- Department of Nursing, Faculty of Human Care, Tohto University, Saitama, Japan
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Sulieman A, Tamam N, Elnour A, Alkhorayef M, Babikir E, Al-Mohammed H, Abuhadi N, Khandaker MU, A.Bradley D. Effective radiation dose and radiogenic cancer risk during contrast enhanced abdominal computed tomography examinations. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Garba I, Fatima AM, Mansur Y, Ismail A, Abubakar A. FIRST CARDIAC COMPUTED TOMOGRAPHY TYPICAL RADIATION DOSE VALUES FROM A SINGLE CENTRE IN NIGERIA: A PILOT STUDY. RADIATION PROTECTION DOSIMETRY 2022; 198:434-439. [PMID: 35640252 DOI: 10.1093/rpd/ncac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/30/2022] [Accepted: 04/23/2022] [Indexed: 06/15/2023]
Abstract
Concern regarding radiation dose associated with cardiac computed tomography (CT) still exists and requires the use of diagnostic reference levels for dose optimisation. Typical median doses were established for 58 consented adult patients from a single centre for coronary artery calcium score (CACS) as volume computed tomography dose index (CTDIvol): 5.9 mGy; dose length product (DLP): 86.6 mGy*cm and cardiac CT angiography (CCTA) as CTDIvol: 11.1 mGy; DLP: 190.8 mGy*cm. Wide radiation dose variability in terms of CTDIvol was noted for CACS: 2.7-15.9 mGy, a 6-fold, whereas for CCTA it ranges from 3.8 to 52.8 mGy, a 14-fold. The DLP values for CACS range from 33.2 to 344.2 mGy*cm, which is 10-fold, whereas for CCTA it ranges from 32.8 to 834.9 mGy*cm, a 25-fold. The typical values compared lower than the radiation dose from other countries; however, the wide variability in dose remains a call for concern.
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Affiliation(s)
- I Garba
- Department of Radiography, College of Health Sciences, Bayero University Kano, Kano, Kano State, Nigeria
| | - A M Fatima
- Department of Radiography, College of Health Sciences, Bayero University Kano, Kano, Kano State, Nigeria
| | - Y Mansur
- Department of Radiology, College of Health Sciences, Bayero University Kano, Nigeria
| | - A Ismail
- Department of Radiology, College of Health Sciences, Bayero University Kano, Nigeria
| | - A Abubakar
- Department of Radiography, College of Medical Sciences, University of Maiduguri, Nigeria
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Patient dose in CT angiography examinations: An institutional survey. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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