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Lee YJ, Hwang JY, Ryu H, Kim TU, Kim YW, Park JH, Choo KS, Nam KJ, Roh J. Image quality and diagnostic accuracy of reduced-dose computed tomography enterography with model-based iterative reconstruction in pediatric Crohn's disease patients. Sci Rep 2022; 12:2147. [PMID: 35140296 PMCID: PMC8828853 DOI: 10.1038/s41598-022-06246-z] [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: 07/22/2021] [Accepted: 01/18/2022] [Indexed: 11/09/2022] Open
Abstract
This study assessed the image quality and diagnostic accuracy in determining disease activity of the terminal ileum of the reduced-dose computed tomography enterography using model-based iterative reconstruction in pediatric patients with Crohn's disease (CD). Eighteen patients were prospectively enrolled and allocated to the standard-dose (SD) and reduced-dose (RD) computed tomography enterography (CTE) groups (n = 9 per group). Image quality, reader confidence in interpreting bowel findings, accuracy in determining active CD in the terminal ileum, and radiation dose were evaluated. Objective image quality did not show intergroup differences, except for image sharpness. Although reader confidence in detecting mural stratification, ulcer, and perienteric fat stranding of the RD-CTE were inferior to SD-CTE, RD-CTE correctly diagnosed active disease in all patients. The mean values of radiation dose metrics (SD-CTE vs. RD-CTE) were 4.3 versus 0.74 mGy, 6.1 versus 1.1 mGy, 211.9 versus 34.5 mGy∙cm, and 4.4 versus 0.7 mSv mGy∙cm for CTDIvol, size-specific dose estimation, dose-length product, and effective dose, respectively. RD-CTE showed comparable diagnostic accuracy to SD-CTE in determining active disease of the terminal ileum in pediatric CD patients. However, image quality and reader confidence in detecting ulcer and perienteric fat stranding was compromised.
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Affiliation(s)
- Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea.
| | - Hwaseong Ryu
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Tae Un Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Yong-Woo Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University Children's Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Ki Seok Choo
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Kyung Jin Nam
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Jieun Roh
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
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Leon S, Olguin E, Schaeffer C, Olguin C, Verma N, Mohammed TL, Grajo J, Arreola M. Comparison of CT image quality between the AIDR 3D and FIRST iterative reconstruction algorithms: an assessment based on phantom measurements and clinical images. Phys Med Biol 2021; 66. [PMID: 34015770 DOI: 10.1088/1361-6560/ac0391] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/20/2021] [Indexed: 11/11/2022]
Abstract
Modern CT iterative reconstruction algorithms are transitioning from a statistical-based to model-based approach. However, increasing complexity does not ensure improved image quality for all indications, and thorough characterization of new algorithms is important to understand their potential clinical impacts. This study performs both quantitative and qualitative analyses of image quality to compare Canon's statistical-based Adaptive Iterative Dose Reduction 3D (AIDR 3D) algorithm to its model-based algorithm, Forward-projected model-based Iterative Reconstruction SoluTion(FIRST). A phantom was used to measure the task-specific modulation transfer function (MTFTask), the noise power spectrum (NPS), and the low-contrast object-specific CNR (CNRLO) for each algorithm using three dose levels and the convolution algorithm (kernel) appropriate for abdomen, lung, and brain imaging. Additionally, MTFTaskwas measured at four contrast levels, and CNRLOwas measured for two object sizes. Lastly, three radiologists participated in a preference study to compare clinical image quality for three study types: non-contrast abdomen, pulmonary embolism (PE), and lung screening. Nine questions related to the appearance of anatomical features or image quality characteristics were scored for twenty exams of each type. The behavior of both algorithms depended strongly on the kernel selected. Phantom measurements suggest that FIRST should be beneficial over AIDR 3D for abdomen imaging, but do not suggest a clear overall benefit to FIRST for lung or brain imaging; metrics suggest performance may be equivalent to or slightly favor AIDR 3D, depending on the size of the object being imaged and whether spatial resolution or low-contrast resolution is more important for the task at hand. Overall, radiologists strongly preferred AIDR 3D for lung screening, slightly preferred AIDR 3D for non-contrast abdomen, and had no preference for PE. FIRST was superior for the reduction of metal artifacts. Radiologist preference may be influenced by changes to noise texture.
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Affiliation(s)
- Stephanie Leon
- University of Florida, Gainesville, FL, United States of America
| | - Edmond Olguin
- University of Florida, Gainesville, FL, United States of America
| | - Colin Schaeffer
- University of Florida, Gainesville, FL, United States of America
| | - Catherine Olguin
- University of Florida, Gainesville, FL, United States of America
| | - Nupur Verma
- University of Florida, Gainesville, FL, United States of America
| | | | - Joseph Grajo
- University of Florida, Gainesville, FL, United States of America
| | - Manuel Arreola
- University of Florida, Gainesville, FL, United States of America
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Nachand D, Gandhi NS. Imaging of bowel in patients requiring surgery for Crohn's disease. SEMINARS IN COLON AND RECTAL SURGERY 2020. [DOI: 10.1016/j.scrs.2020.100741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Schaafs LA, Pfeil J, Köhlitz T, Hamm B, Niehues SM. LOW-DOSE COMPUTED TOMOGRAPHY OF THE PARANASAL SINUSES: PERFORMANCE OF TWO DIFFERENT ITERATIVE RECONSTRUCTION ALGORITHMS. RADIATION PROTECTION DOSIMETRY 2019; 183:386-392. [PMID: 30165539 DOI: 10.1093/rpd/ncy153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/29/2018] [Accepted: 08/02/2018] [Indexed: 06/08/2023]
Abstract
To evaluate the performance of two iterative reconstruction algorithms in low-dose paranasal sinus computed tomography (CT). Sinus CT scans were reconstructed using Adaptive Iterative Dose Reduction 3D (AIDR 3D, n = 36 patients) or Sinogram Affirmed Iterative Reconstruction (SAFIRE, n = 32 patients). Reconstructed images were evaluated regarding subjective image quality, depiction of anatomic landmarks and noise (HU). Dose-length product (DLP), calculated effective dose (ED) and CT dose index (CTDIvol) were documented for each scan. Images were not significantly different in subjective image quality (p = 0.09) and conspicuity of anatomic landmarks (p = 0.28). Noise was significantly lower in images reconstructed with AIDR 3D (p = 0.012). DLP, ED and CTDIvol were significantly lower in the SAFIRE datasets (each p < 0.001). The results indicate that iterative reconstruction, independent of the manufacturer, enables for imaging the paranasal sinuses with an ED below 0.1 mSv while ensuring diagnostic image quality.
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Affiliation(s)
- Lars-Arne Schaafs
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany
| | - Julian Pfeil
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany
| | - Torsten Köhlitz
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany
| | - Stefan Markus Niehues
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany
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Goto M, Tominaga C, Taura M, Azumi H, Sato K, Homma N, Mori I. A method to measure slice sensitivity profiles of CT images under low-contrast and high-noise conditions. Phys Med 2019; 60:100-110. [PMID: 31000069 DOI: 10.1016/j.ejmp.2019.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 03/03/2019] [Accepted: 03/11/2019] [Indexed: 11/17/2022] Open
Abstract
Noise reduction features of iterative reconstruction (IR) methods in computed tomography might accompany the sacrifice of the longitudinal resolution, or slice sensitivity profile (SSP), at low contrast-to-noise ratio (CNR) conditions. To assess the benefit of IR methods correctly, the difference of SSP between IR methods and filtered-backprojection (FBP) must be taken into account. Therefore, SSP measurement under low-CNR conditions is necessary. Although edge methods are predominantly used, their performance under low-CNR conditions appears to be not fully established. We developed a method that is compatible with extremely low-CNR conditions. Thin plastic disk-shaped sheets embedded in acrylic resin were used as low-contrast test objects. The lowest peak contrast used was approximately 17 [HU]. We assessed the performance of our method by using FBP images. We identified a source of measurement instability aside from noise: the measured thin-slice SSP is dependent on the orbital phase of helical scan, presumably because of cone-beam artifacts. This impediment to high accuracy is manageable using phase-controlled scans. We confirmed that table position repeatability is much better than the value of the specifications, and therefore the ensemble-averaged images of multiple scans can be used for SSP measurement. Accurate measurement of SSP under extremely low-CNR conditions is possible, even when the test object is visually indiscernible from the noisy background. Low-contrast SSP behavior is elucidated for IR methods (AIDR-3D, FIRST, and AiSR-V) by using this measurement method.
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Affiliation(s)
- Mitsunori Goto
- Graduate School of Medicine, Tohoku University, Sendai 980-8575, Japan; Miyagi Cancer Center Natori, 981-1293, Japan.
| | - Chiaki Tominaga
- Graduate School of Medicine, Tohoku University, Sendai 980-8575, Japan; Chiba University Hospital, Chiba 260-8677, Japan
| | - Masaaki Taura
- Tohoku Medical and Pharmaceutical University Hospital, Sendai 983-8512, Japan
| | | | - Kazuhiro Sato
- Graduate School of Medicine, Tohoku University, Sendai 980-8575, Japan
| | - Noriyasu Homma
- Graduate School of Medicine, Tohoku University, Sendai 980-8575, Japan
| | - Issei Mori
- Graduate School of Medicine, Tohoku University, Sendai 980-8575, Japan
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Rees MA, Dillman JR, Anton CG, Rattan MS, Smith EA, Towbin AJ, Zhang B, Trout AT. Inter-radiologist agreement using Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus nomenclature for reporting CT and MR enterography in children and young adults with small bowel Crohn disease. Abdom Radiol (NY) 2019; 44:391-397. [PMID: 30120514 DOI: 10.1007/s00261-018-1743-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To assess inter-radiologist agreement using the Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus recommendations for reporting CT/MR enterography exams in pediatric and young adult small bowel Crohn disease (CD). METHODS Institutional review board approval was obtained for this HIPAA-compliant retrospective investigation; the requirement for informed consent was waived. 25 CT and 25 MR enterography exams performed in children and young adults (age range: 6-23 years) between January 2015 and April 2017 with a distribution of ileal CD severity (phenotype) were identified: normal or chronic CD without active inflammation (40%), active inflammatory CD (20%), stricturing CD (20%), and penetrating CD (20%). Five fellowship-trained pediatric radiologists, blinded to one another, documented key imaging findings and standardized impressions based on SAR-AGA consensus recommendations. Inter-radiologist agreement was evaluated using Fleiss' multi-rater kappa statistic (κ) with 95% confidence intervals (CI). RESULTS Inter-radiologist agreement was moderate for all key imaging findings except presence of ulcerations (κ 0.37 [95% CI 0.28-0.46]) and sacculations (κ 0.31 [95% CI 0.23-0.40]). Agreement for standardized impressions was substantial for stricturing disease (κ 0.79 [95% CI 0.70-0.87]) and moderate for presence of inflammation (κ 0.49 [95% CI 0.44-0.56]) and penetrating disease (κ 0.58 [95% CI 0.49-0.67]). No significant difference in agreement was found between CT and MRI. CONCLUSIONS Agreement among five pediatric radiologists was moderate to substantial for SAR-AGA standardized impressions and fair to moderate for key imaging findings of pediatric and young adult CD.
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Affiliation(s)
- Mitchell A Rees
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
| | - Jonathan R Dillman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Christopher G Anton
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Mantosh S Rattan
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Ethan A Smith
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Bin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Andrew T Trout
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
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Yu S, Zheng J, Zhang L. Craniocervical computed tomography angiography with adaptive iterative dose reduction 3D algorithm and automatic tube current modulation in patients with different body mass indexes. Medicine (Baltimore) 2018; 97:e11841. [PMID: 30200068 PMCID: PMC6133620 DOI: 10.1097/md.0000000000011841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The aim of this study was to investigate the feasibility of head and neck computed tomography angiography (CTA) using the 80-kV tube voltage and the adaptive iterative dose reduction (AIDR) 3D algorithm in patients with different body mass indexes (BMIs).From November 2016 to January 2017, 128 consecutive patients scheduled for head and neck CTA examinations were randomized into the 100-kV group (n = 60) and the 80-kV group (n = 68). Both groups used the automatic tube current modulation technique and the AIDR 3D algorithm. The patients were further grouped as slender (BMI < 22 kg/m), normal weight (22 kg/m≤BMI < 25 kg/m), and overweight (BMI ≥25 kg/m). The image quality and the radiation dose of each subgroup were analyzed.The images of the head and neck vessels and the brain tissue obtained with 100 kV were all of diagnostic quality. Slender and normal weight patients imaged with 80 kV also produced images of diagnostic quality. However, 80 kV in the overweight patients failed to produce images of diagnostic quality. The radiation dose in the patients imaged with 80 kV was significantly decreased in comparison with those imaged with 100 kV. The effective dose was 0.36 ± 0.06 and 0.41 ± 0.05 mSv in the slender and normal weight patients imaged with 80 kV.Head and neck CTA scanning with 80 kV, automatic tube current modulation, and AIDR 3D algorithm can produce high quality images with reduced radiation dose in slender or normal weight patients.
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Nakamoto A, Yamamoto K, Sakane M, Nakai G, Higashiyama A, Juri H, Yoshikawa S, Narumi Y. Reduction of the radiation dose and the amount of contrast material in hepatic dynamic CT using low tube voltage and adaptive iterative dose reduction 3-dimensional. Medicine (Baltimore) 2018; 97:e11857. [PMID: 30142778 PMCID: PMC6113013 DOI: 10.1097/md.0000000000011857] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The purpose of this study was to prospectively evaluate the image quality and the diagnostic ability of low tube voltage and reduced contrast material dose hepatic dynamic computed tomography (CT) reconstructed with adaptive iterative dose reduction 3-dimensional (AIDR 3D).Eighty-nine patients underwent hepatic dynamic CT using one of the 2 protocols: tube voltage of 120 kVp, contrast dose of 600 mgI/kg, and filtered back projection in Protocol A (n = 46), and tube voltage of 100 kVp, contrast dose of 500 mgI/kg, and AIDR 3D in Protocol B (n = 43). The volume CT dose index (CTDIvol) and size-specific dose estimates (SSDEs) were compared between the 2 groups. Objective image noise and tumor to liver contrast-to-noise ratio (CNR) were also compared. Three radiologists independently reviewed image quality. The jackknife alternative free-response receiver-operating characteristic (JAFROC) analysis was performed to compare diagnostic performance.The mean CTDIvol and SSDE of Protocol B (14.3 and 20.2, respectively) were significantly lower than those of Protocol A (22.1 and 31.4, P < .001). There were no significant differences in either objective image noise or CNR. In the qualitative analysis, 2 readers assigned significant lower scores to images of Protocol B for at least one of the 3 phases regarding overall image quality (P < .05). There was no significant difference in the JAFROC1 figure of merit between protocols.Low tube voltage CT with AIDR 3D yielded a reduction in radiation dose and in the amount of contrast material while maintaining diagnostic performance.
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Affiliation(s)
- Atsushi Nakamoto
- Department of Radiology, Osaka Medical College, Takatsuki
- Department of Radiology, Osaka University Graduate School of Medicine, Suita
| | | | - Makoto Sakane
- Department of Radiology, Osaka Medical College, Takatsuki
| | - Go Nakai
- Department of Radiology, Osaka Medical College, Takatsuki
| | | | - Hiroshi Juri
- Department of Radiology, Osaka Medical College, Takatsuki
| | - Shushi Yoshikawa
- Central Radiology Department, Osaka Medical College Hospital, Takatsuki, Osaka, Japan
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Elsholtz FHJ, Schaafs LA, Erxleben C, Hamm B, Niehues SM. Periradicular infiltration of the lumbar spine: is iterative reconstruction software necessary to establish ultra-low-dose protocols? A quantitative and qualitative approach. Radiol Med 2018; 123:827-832. [PMID: 29923084 DOI: 10.1007/s11547-018-0913-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 06/12/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Computed tomography (CT)-guided periradicular infiltration therapy has emerged as an effective treatment option for patients with low back pain. Concern about radiation exposure requires approaches allowing significant dose reduction. The purpose of this study is to evaluate the need for iterative reconstruction software in CT-guided periradicular infiltration therapy with an ultra-low-dose protocol. MATERIALS AND METHODS One hundred patients underwent CT-guided periradicular infiltration therapy of the lumbar spine using an ultra-low-dose protocol with adaptive iterative dose reduction 3D (AIDR 3D) for image reconstruction. In addition, images were reconstructed with filtered back-projection (FBP). Four experienced raters evaluated both reconstruction types for conspicuity of anatomical and instrumental features important for ensuring safe patient treatment. Image noise was measured as a quantitative marker of image quality. RESULTS Interrater agreement was good for both AIDR 3D (Kendall's W = 0.83) and FBP (0.78) reconstructions. Readers assigned the same scores for all features and both reconstruction algorithms in 81.3% of cases. Image noise was significantly lower (average SD of 60.07 vs. 99.54, p < 0.05) for AIDR 3D-reconstructed images. CONCLUSION Although it significantly lowers image noise, iterative reconstruction software is not mandatory to achieve adequate image quality with an ultra-low-dose CT protocol for guiding periradicular infiltration therapy of the lumbar spine.
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Affiliation(s)
- Fabian Henry Jürgen Elsholtz
- Klinik und Hochschulambulanz für Radiologie, Charité- Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Lars-Arne Schaafs
- Klinik und Hochschulambulanz für Radiologie, Charité- Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Christoph Erxleben
- Klinik und Hochschulambulanz für Radiologie, Charité- Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Bernd Hamm
- Klinik und Hochschulambulanz für Radiologie, Charité- Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Stefan Markus Niehues
- Klinik und Hochschulambulanz für Radiologie, Charité- Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
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Comparison of Radiation Dose and Image Quality of Abdominopelvic CT Using Iterative (AIDR 3D) and Conventional Reconstructions. AJR Am J Roentgenol 2018; 210:127-133. [DOI: 10.2214/ajr.17.18025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Specialized Imaging and Procedures in Pediatric Pancreatology: A North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Clinical Report. J Pediatr Gastroenterol Nutr 2017; 64:472-484. [PMID: 28230608 DOI: 10.1097/mpg.0000000000001371] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES An increasing number of children are being diagnosed with pancreatitis and other pancreatic abnormalities. Dissemination of the information regarding existing imaging techniques and endoscopic modalities to diagnose and manage pancreatic disorders in children is sorely needed. METHODS We conducted a review of the medical literature on the use of the following imaging and procedural modalities in pediatric pancreatology: transabdominal ultrasonography (TUS), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP). Recommendations for current use and future research were identified. RESULTS TUS offers noninvasive images of the pancreas but has limitations to details of parenchyma and ductal structures. CT offers improved detail of pancreatic parenchyma, solid masses, and traumatic injuries, but requires relatively high levels of ionizing radiation and does not adequately assess ductal anatomy. MRI/MRCP offers detailed intrinsic tissue assessment and pancreatic ductal characterization, but requires longer image acquisition time and is relatively poor at imaging calcifications. EUS provides excellent evaluation of pancreatic parenchyma and ductal anatomy, but can be subjective and operator dependent and requires sedation or anesthesia. EUS offers the capacity to obtain tissue samples and drain fluid collections and ERCP offers the ability to improve drainage by performing sphincterotomy or placing pancreatic stents across duct injuries and strictures. CONCLUSIONS Various imaging modalities may be used in pediatric pancreatology, but TUS and MRI/MRCP are favored. Interventional therapeutic maneuvers primarily involve use of ERCP and EUS. Future research is necessary to optimize equipment, expertise, and appropriate indications.
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Diagnostic performance of reduced-dose CT with a hybrid iterative reconstruction algorithm for the detection of hypervascular liver lesions: a phantom study. Eur Radiol 2016; 27:2995-3003. [DOI: 10.1007/s00330-016-4687-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/15/2016] [Accepted: 11/29/2016] [Indexed: 12/26/2022]
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Wang R, Luo Y, Yang S, Lin J, Gao D, Zhao Y, Liu J, Shi X, Wang X. Hyaluronic acid-modified manganese-chelated dendrimer-entrapped gold nanoparticles for the targeted CT/MR dual-mode imaging of hepatocellular carcinoma. Sci Rep 2016; 6:33844. [PMID: 27653258 PMCID: PMC5032118 DOI: 10.1038/srep33844] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 09/02/2016] [Indexed: 12/18/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. The early and effective diagnosis has always been desired. Herein, we present the preparation and characterization of hyaluronic acid (HA)-modified, multifunctional nanoparticles (NPs) targeting CD44 receptor-expressing cancer cells for computed tomography (CT)/magnetic resonance (MR) dual-mode imaging. We first modified amine-terminated generation 5 poly(amidoamine) dendrimers (G5.NH2) with an Mn chelator, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA), fluorescein isothiocyanate (FI), and HA. Then, gold nanoparticles (AuNPs) were entrapped within the above raw product, denoted as G5.NH2-FI-DOTA-HA. The designed multifunctional NPs were formed after further Mn chelation and purification and were denoted as {(Au0)100G5.NH2-FI-DOTA(Mn)-HA}. These NPs were characterized via several different techniques. We found that the {(Au0)100G5.NH2-FI-DOTA(Mn)-HA} NPs exhibited good water dispersibility, stability under different conditions, and cytocompatibility within a given concentration range. Because both AuNPs and Mn were present in the product, {(Au0)100G5.NH2-FI-DOTA(Mn)-HA} displayed a high X-ray attenuation intensity and favorable r1 relaxivity, which are advantageous properties for targeted CT/MR dual-mode imaging. This approach was used to image HCC cells in vitro and orthotopically transplanted HCC tumors in a unique in vivo model through the CD44 receptor-mediated endocytosis pathway. This work introduces a novel strategy for preparing multifunctional NPs via dendrimer nanotechnology.
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Affiliation(s)
- Ruizhi Wang
- Shanghai Institute of Medical Imaging, Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China
| | - Yu Luo
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, P. R. China
| | - Shuohui Yang
- Shanghai Institute of Medical Imaging, Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China
| | - Jiang Lin
- Shanghai Institute of Medical Imaging, Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China
| | - Dongmei Gao
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China
| | - Yan Zhao
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China
| | - Jinguo Liu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China
| | - Xiangyang Shi
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, P. R. China
| | - Xiaolin Wang
- Shanghai Institute of Medical Imaging, Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China
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Yu S, Zhang L, Zheng J, Xu Y, Chen Y, Song Z. A comparison of adaptive iterative dose reduction 3D and filtered back projection in craniocervical CT angiography. Clin Radiol 2016; 72:96.e1-96.e6. [PMID: 27647546 DOI: 10.1016/j.crad.2016.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 02/03/2023]
Abstract
AIM To compare the effects of exposure parameters on image quality and radiation dose for craniocervical computed tomography angiography (CTA) using adaptive iterative dose reduction in three dimensions (AIDR 3D) and filtered back projection (FBP) algorithms. MATERIALS AND METHODS One hundred and eighty patients were divided into three groups; group A (120 kV, 300 mA, FBP), group B (100 kV, automatic mA, AIDR 3D) and group C (80kV, automatic mA, AIDR 3D). Image quality and radiation dose were evaluated for each group. RESULTS For both cervical and intracranial vessels, CT attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were higher in the AIDR 3D groups. The difference in mean vascular noise was also statistically significant (p<0.001), with group B having the lowest value at 16.5±3.2 HU and group C having the highest at 19.1±2.9 HU. FBP reconstruction resulted in lower image-quality scores for the common carotid artery. Parenchymal image-quality scores also varied significantly different between groups with group C partially failing to meet the minimum standards for diagnostic use. For the middle cerebral artery, image-quality scores were significantly better in group A, although images from groups B and C also satisfied clinical diagnostic requirements. The image quality of the internal carotid artery was the best in group B. Image-quality scores between groups were not significantly different for the carotid sinus. Radiation doses in the groups using AIDR 3D were >70% lower than in the FBP group. CONCLUSION AIDR 3D (100 kV, automatic modulation) provides optimal image quality of vascular and parenchymal tissues at significantly lower radiation doses (mSV) than FBP in craniocervical CTA. For cases in which highly accurate parenchymal assessment is not required, the tube voltage can be lowered to 80 kV to further decrease radiation dose.
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Affiliation(s)
- S Yu
- Department of CT Diagnosis, Cangzhou Central Hospital, Cangzhou, Hebei, 061001, China.
| | - L Zhang
- Department of CT Diagnosis, Cangzhou Central Hospital, Cangzhou, Hebei, 061001, China
| | - J Zheng
- Department of CT Diagnosis, Cangzhou Central Hospital, Cangzhou, Hebei, 061001, China
| | - Y Xu
- Department of CT Diagnosis, Cangzhou Central Hospital, Cangzhou, Hebei, 061001, China
| | - Y Chen
- Department of CT Diagnosis, Cangzhou Central Hospital, Cangzhou, Hebei, 061001, China
| | - Z Song
- Department of CT Diagnosis, Cangzhou Central Hospital, Cangzhou, Hebei, 061001, China
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15
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Gandhi NS, Baker ME, Goenka AH, Bullen JA, Obuchowski NA, Remer EM, Coppa CP, Einstein D, Feldman MK, Kanmaniraja D, Purysko AS, Vahdat N, Primak AN, Karim W, Herts BR. Diagnostic Accuracy of CT Enterography for Active Inflammatory Terminal Ileal Crohn Disease: Comparison of Full-Dose and Half-Dose Images Reconstructed with FBP and Half-Dose Images with SAFIRE. Radiology 2016; 280:436-45. [DOI: 10.1148/radiol.2016151281] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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16
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Kalra MK, Sodickson AD, Mayo-Smith WW. CT Radiation: Key Concepts for Gentle and Wise Use. Radiographics 2016; 35:1706-21. [PMID: 26466180 DOI: 10.1148/rg.2015150118] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Use of computed tomography (CT) in medicine comes with the responsibility of its appropriate (wise) and safe (gentle) application to obtain required diagnostic information with the lowest possible dose of radiation. CT provides useful information that may not be available with other imaging modalities in many clinical situations in children and adults. Inappropriate or excessive use of CT should be avoided, especially if required information can be obtained in an accurate and time-efficient manner with other modalities that require a lower radiation dose, or non-radiation-based imaging modalities such as ultrasonography and magnetic resonance imaging. In addition to appropriate use of CT, the radiology community also must monitor scanning practices and protocols. When appropriate, high-contrast regions and lesions should be scanned with reduced dose, but overly zealous dose reduction should be avoided for assessment of low-contrast lesions. Patients' cross-sectional body size should be taken into account to deliver lower radiation dose to smaller patients and children. Wise use of CT scanning with gentle application of radiation dose can help maximize the diagnostic value of CT, as well as address concerns about potential risks of radiation. In this article, key concepts in CT radiation dose are reviewed, including CT dose descriptors; radiation doses from CT procedures; and factors and technologies that affect radiation dose and image quality, including their use in creating dose-saving protocols. Also discussed are the contributions of radiation awareness campaigns such as the Image Gently and Image Wisely campaigns and the American College of Radiology Dose Index Registry initiatives.
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Affiliation(s)
- Mannudeep K Kalra
- From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (M.K.K.); and Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 and Harvard Medical School, Boston, Mass (A.D.S., W.W.M.S.)
| | - Aaron D Sodickson
- From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (M.K.K.); and Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 and Harvard Medical School, Boston, Mass (A.D.S., W.W.M.S.)
| | - William W Mayo-Smith
- From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (M.K.K.); and Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 and Harvard Medical School, Boston, Mass (A.D.S., W.W.M.S.)
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17
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Haas K, Rubesova E, Bass D. Role of imaging in the evaluation of inflammatory bowel disease: How much is too much? World J Radiol 2016; 8:124-131. [PMID: 26981221 PMCID: PMC4770174 DOI: 10.4329/wjr.v8.i2.124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 11/24/2015] [Accepted: 01/07/2016] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a lifelong condition with waxing and waning disease course that requires reassessment of disease status as well as screening for complications throughout a patient’s lifetime. Laboratory testing, endoscopic assessment, and fecal biomarkers are often used in the initial diagnosis and ongoing monitoring of a patient with IBD. Imaging plays an integral role in the diagnosis and evaluation of IBD. Different imaging modalities can be used over the course of a patient’s lifetime, from the initial screening and diagnosis of IBD, to determining the extent of intestinal involvement, monitoring for disease activity, and evaluating for complications of uncontrolled IBD. The various imaging modalities available to the provider each have a unique set of risks and benefits when considering cost, radiation exposure, need for anesthesia, and image quality. In this article we review the imaging techniques available for the evaluation of IBD including fluoroscopic small bowel follow-through, computed tomography enterography, magnetic resonance enterography, and transabdominal ultrasound with particular focus on the judicious use of imaging and the risks and benefits of each option. We also review the risks of ionizing radiation, strategies to reduce exposure to ionizing radiation, and current imaging guidelines among pediatric and adult patient with IBD.
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Blum A, Gervaise A, Teixeira P. Iterative reconstruction: Why, how and when? Diagn Interv Imaging 2015; 96:421-2. [DOI: 10.1016/j.diii.2015.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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