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Chun M, Choi JH, Kim S, Ahn C, Kim JH. Fully automated image quality evaluation on patient CT: Multi-vendor and multi-reconstruction study. PLoS One 2022; 17:e0271724. [PMID: 35857804 PMCID: PMC9299323 DOI: 10.1371/journal.pone.0271724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/06/2022] [Indexed: 12/21/2022] Open
Abstract
While the recent advancements of computed tomography (CT) technology have contributed in reducing radiation dose and image noise, an objective evaluation of image quality in patient scans has not yet been established. In this study, we present a patient-specific CT image quality evaluation method that includes fully automated measurements of noise level, structure sharpness, and alteration of structure. This study used the CT images of 120 patients from four different CT scanners reconstructed with three types of algorithm: filtered back projection (FBP), vendor-specific iterative reconstruction (IR), and a vendor-agnostic deep learning model (DLM, ClariCT.AI, ClariPi Inc.). The structure coherence feature (SCF) was used to divide an image into the homogeneous (RH) and structure edge (RS) regions, which in turn were used to localize the regions of interests (ROIs) for subsequent analysis of image quality indices. The noise level was calculated by averaging the standard deviations from five randomly selected ROIs on RH, and the mean SCFs on RS was used to estimate the structure sharpness. The structure alteration was defined by the standard deviation ratio between RS and RH on the subtraction image between FBP and IR or DLM, in which lower structure alterations indicate successful noise reduction without degradation of structure details. The estimated structure sharpness showed a high correlation of 0.793 with manually measured edge slopes. Compared to FBP, IR and DLM showed 34.38% and 51.30% noise reduction, 2.87% and 0.59% lower structure sharpness, and 2.20% and -12.03% structure alteration, respectively, on an average. DLM showed statistically superior performance to IR in all three image quality metrics. This study is expected to contribute to enhance the CT protocol optimization process by allowing a high throughput and quantitative image quality evaluation during the introduction or adjustment of lower-dose CT protocol into routine practice.
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Affiliation(s)
- Minsoo Chun
- Department of Radiation Oncology, Chung-Ang University Gwang Myeong Hospital, Gyeonggi-do, Republic of Korea
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jin Hwa Choi
- Department of Radiation Oncology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Sihwan Kim
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Chulkyun Ahn
- Department of Transdisciplinary Studies, Program in Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- ClariPi Research, Seoul, Republic of Korea
| | - Jong Hyo Kim
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- Department of Transdisciplinary Studies, Program in Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- ClariPi Research, Seoul, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Center for Medical-IT Convergence Technology Research, Advanced Institutes of Convergence Technology, Suwon, Republic of Korea
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Cantarinha A, Dillenseger JP, Bellin MF. Development and Evaluation of a CT Pulmonary Angiography Protocol Dedicated to Pregnant and Postpartum Women. J Med Imaging Radiat Sci 2020; 51:480-488. [PMID: 32741741 DOI: 10.1016/j.jmir.2020.05.007] [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: 01/16/2020] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION This study presents and evaluates a CT pulmonary angiography protocol dedicated to pregnant women. The specific feature of this protocol is to place the region of interest (ROI) (bolus detection) in the superior vena cava. The objective is to evaluate the performances of this method. MATERIALS AND METHODS The protocol uses a iodine-based contrast agent at 300mgI/mL and an injection rate of 5 to 6 mL/sec for an injection volume of 50 mL of iodine contrast agent followed by 40 mL of NaCl. The ROI is positioned on the superior vena cava, with a 100 Hounsfield units (HU) threshold, and the acquisition is performed at 100 kVp. This protocol was evaluated retrospectively on a large population (n = 105: group 1) and compared with a control group that did not benefit from this protocol (n = 55: group 2). Both groups were studied on the same device in the same center. Each examination was evaluated and classified into 3 groups: optimal, suboptimal, and noncontributory. Dose length products (DLP) values were also recorded. Statistical tests were applied to the data collected. RESULTS The rate of noncontributory examinations increased from 43.1% for the control group to 4.8% for the new protocol group. The reference enhancement level in the pulmonary trunk is 250 UH. The mean enhancement in the pulmonary trunk of the new protocol group (332 HU (±71 HU (±71 HU)) is significantly greater than the reference value of 250 HU (P < .0001), which is not the case for control group (P = .3485 > .05), which has a mean enhancement of 239 HU (±87 HU). The control group had a mean DLP of 225 mGy.cm (±81 mGy.cm), and the new-protocol group had a mean DLP of 189 mGy.cm (±75 mGy.cm). DISCUSSION Our noncontributory examination rate is the lowest rate described in the literature. Our protocol contradicts standard practices of placing an ROI in the pulmonary trunk for bolus detection of iodinated contrast media. CONCLUSION The results of this study showed that this protocol reduces the number of noncontributory examinations while reducing the dose delivered to patients. This robust protocol is applicable to other devices and meets perfectly radiation-safety requirements and injected contrast media volume limitation.
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Affiliation(s)
- Alfredo Cantarinha
- Pôle d'imagerie médicale, CHU du Kremlin Bicêtre, Paris, France; Collège scientifique de l'Association française du personnel paramédical d'électroradiologie médicale (AFPPE), Paris, France.
| | - Jean-Philippe Dillenseger
- Collège scientifique de l'Association française du personnel paramédical d'électroradiologie médicale (AFPPE), Paris, France; Section Imagerie Médicale et Radiologie Thérapeutique, Académie de Strasbourg, Strasbourg, France; ICube - UMR 7357, CNRS, Université de Strasbourg, Strasbourg, France
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Wu D, Wang G, Bian B, Liu Z, Li D. Benefits of Low-Dose CT Scan of Head for Patients With Intracranial Hemorrhage. Dose Response 2020; 19:1559325820909778. [PMID: 32214915 PMCID: PMC7065437 DOI: 10.1177/1559325820909778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/23/2019] [Accepted: 01/16/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives: For patients with intracranial hemorrhage (ICH), routine follow-up computed tomography (CT) scans are typically required to monitor the progression of intracranial pathology. Remarkable levels of radiation exposure are accumulated during repeated CT scan. However, the effects and associated risks have still remained elusive. This study presented an effective approach to quantify organ-specific radiation dose of repeated CT scans of head for patients with ICH. We also indicated whether a low-dose CT scan may reduce radiation exposure and keep the image quality highly acceptable for diagnosis. Methods: Herein, 72 patients with a history of ICH were recruited. The patients were divided into 4 groups and underwent CT scan of head with different tube current–time products (250, 200, 150, and 100 mAs). Two experienced radiologists visually rated scores of quality of images according to objective image noise, sharpness, diagnostic acceptability, and artifacts due to physiological noise on the same workstation. Organ-/tissue-specific radiation doses were analyzed using Radimetrics. Results: In conventional CT scan group, signal to noise ratio (SNR) and contrast to noise ratio (CNR) of ICH images were significantly higher than those in normal brain structures. Reducing the tube current–time product may decrease the image quality. However, the predilection sites for ICH could be clearly identified. The SNR and CNR in the predilection sites for ICH were notably higher than other areas. The brain, eye lenses, and salivary glands received the highest radiation dose. Reducing tube current–time product from 250 to 100 mA can significantly reduce the radiation dose. Discussion: We demonstrated that low-dose CT scan of head can still provide reasonable images for diagnosing ICH. The radiation dose can be reduced to ∼45% of the conventional CT scan group.
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Affiliation(s)
- Dan Wu
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Gang Wang
- Department of Orthopedics, The Third Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Bingyang Bian
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Zhuohang Liu
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Dan Li
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
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Achuka JA, Usikalu MR, Aweda MA, Onumejor CA, Babarimisa IO. Background Radiation Dose in Selected X-Ray Facilities in Southwest Nigeria. ACTA ACUST UNITED AC 2019. [DOI: 10.1088/1742-6596/1299/1/012103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Tang H, Liu Z, Hu Z, He T, Li D, Yu N, Jia Y, Shi H. Clinical value of a new generation adaptive statistical iterative reconstruction (ASIR-V) in the diagnosis of pulmonary nodule in low-dose chest CT. Br J Radiol 2019; 92:20180909. [PMID: 31469289 DOI: 10.1259/bjr.20180909] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the clinical value of low-dose chest CT combined with the new generation adaptive statistical iterative reconstruction (ASIR-V) algorithm in the diagnosis of pulmonary nodule. METHODS 30 patients with pulmonary nodules underwent chest CT using Revolution CT. The patients were first scanned with standard-dose at a noise index (NI) of 14, and the images were reconstructed with filtered back projection (FBP) algorithm. If pulmonary nodules were found, a low-dose targeted scan, with NI of 24, was performed localized on the nodules, and the images were reconstructed with 60% ASIR-V. The detection rate of pulmonary nodules in the two scanning modes was recorded. The size of nodules, CT value and standard deviation of nodules were measured. The signal-to-noise ratio and contrast-to-noise ratio were also calculated. Two experienced radiologists used a 5-point method to score the image quality. The volumetric CT dose index, and dose-length product were recorded and the effective dose (ED) was calculated of the two scanning modes. RESULTS Volumetric CT dose index (ED) of the standard-dose scan covering the entire lungs was 7.29 ± 2.38 mGy (3.52 ± 1.09 mSv), and that of low-dose targeted scan was 2.56 ± 1.87 mGy (0.51 ± 0.32 mSv). However, the ED of the virtual low-dose scan for the entire lungs was 1.44 ± 0.15 mSv, which would mean a dose reduction of 59.1% compared with the standard-dose scan. 85 of the 87 pulmonary nodules were detected in the low-dose targeted scan, with 2 of the ground-glass density nodules with size less than 1 cm missed, resulting in 97.7% overall detection rate. There was no difference between the low-dose ASIR-V images and standard-dose FBP images for the size (1.49 ± 0.74 cm vs 1.48 ± 0.75 cm), CT value [33.02 ± 1.95 Hounsfield unit (HU) vs 34.6 ± 3.07 HU], standard deviation (27.64 ± 14.42 HU vs 30.38 ± 20.04 HU), signal-to-noise ratio (1.44 ± 0.88 vs 1.43 ± 1.31) and contrast-to-noise ratio (38.95 ± 18.43 vs 38.23 ± 14.99) of nodules (all p > 0.05). There was no difference in the subjective scores between the two scanning modes. CONCLUSION The low-dose CT scan combined with ASIR-V algorithm is of comparable value in the detection and the display of pulmonary nodules when compared with the FBP images obtained by standard-dose scan. ADVANCES IN KNOWLEDGE This is a clinical study to evaluate the clinical value of pulmonary nodules using ASIR-V algorithm in the same patients in the low-dose chest CT scans. It suggests that ASIR-V provides similar image quality and detection rate for pulmonary nodules at much reduced radiation dose.
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Affiliation(s)
- Hui Tang
- Department of Radiology, Xi'an No.1 Hospital, Xi'an, Shaanxi, China
| | - Zhentang Liu
- Department of Radiology, Chang'an Hospital, Xi'an, Shaanxi, China
| | - Zhijun Hu
- Department of Radiology, Chang'an Hospital, Xi'an, Shaanxi, China
| | - Taiping He
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Dou Li
- Department of Radiology, Chang'an Hospital, Xi'an, Shaanxi, China
| | - Nan Yu
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yongjun Jia
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Hong Shi
- Department of Radiology, Xi'an No.1 Hospital, Xi'an, Shaanxi, China
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Ippolito D, Casiraghi AS, Franzesi CT, Fior D, Meloni F, Sironi S. Low-dose computed tomography with 4 th-generation iterative reconstruction algorithm in assessment of oncologic patients. World J Gastrointest Oncol 2017; 9:423-430. [PMID: 29085569 PMCID: PMC5648986 DOI: 10.4251/wjgo.v9.i10.423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 07/25/2017] [Accepted: 08/17/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To compare radiation dose and image quality of low-dose computed tomography (CT) protocol combined with hybrid-iterative reconstruction algorithm with standard-dose CT examinations for follow-up of oncologic patients.
METHODS Fifty-one patients with known malignant diseases which underwent, during clinical follow-up, both standard-dose and low-dose whole-body CT scans were enrolled. Low-dose CT was performed on 256-row scanner, with 120 kV and automated mA modulation, and iterative reconstruction algorithm. Standard-dose CT was performed on 16-rows scanner, with 120 kV, 200-400 mAs (depending on patient weight). We evaluated density values and signal-to-noise ratio, along with image noise (SD), sharpness and diagnostic quality with 4-point scale.
RESULTS Density values in liver, spleen and aorta were higher in low-dose images (liver 112.55 HU vs 103.90 HU, P < 0.001), as SD values in liver and spleen (liver 16.81 vs 14.41). Volumetric-Computed-Tomographic-Dose-Index (CTDIvol) and Dose-Length-Product (DLP) were significantly lower in low-dose CT as compared to standard-dose (DLP 1025.6 mGy*cm vs 1429.2 mGy*cm, P < 0.001) with overall dose reduction of 28.9%. Qualitative analysis did not reveal significant differences in image noise and diagnostic quality.
CONCLUSION Automatic tube-current modulation combined with hybrid-iterative algorithm allows radiation dose reduction of 28.9% without loss of diagnostic quality, being useful in reducing dose exposure in oncologic patients.
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Affiliation(s)
- Davide Ippolito
- Department of Diagnostic Radiology, “San Gerardo” Hospital, 20900 Monza, Italy
- School of Medicine, University of Milano-Bicocca, 20900 Monza, Italy
| | - Alessandra Silvia Casiraghi
- Department of Diagnostic Radiology, “San Gerardo” Hospital, 20900 Monza, Italy
- School of Medicine, University of Milano-Bicocca, 20900 Monza, Italy
| | - Cammillo Talei Franzesi
- Department of Diagnostic Radiology, “San Gerardo” Hospital, 20900 Monza, Italy
- School of Medicine, University of Milano-Bicocca, 20900 Monza, Italy
| | - Davide Fior
- Department of Diagnostic Radiology, “San Gerardo” Hospital, 20900 Monza, Italy
- School of Medicine, University of Milano-Bicocca, 20900 Monza, Italy
| | - Franca Meloni
- School of Medicine, University of Milano-Bicocca, 20900 Monza, Italy
| | - Sandro Sironi
- School of Medicine, University of Milano-Bicocca, 20900 Monza, Italy
- Department of Diagnostic Radiology, “Papa Giovanni XXIII” Hospital, 24127 Bergamo, Italy
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