scholarly journals Impact of dose reduction and iterative model reconstruction on multi-detector CT imaging of the brain in patients with suspected ischemic stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Karolin J. Paprottka ◽  
Karina Kupfer ◽  
Isabelle Riederer ◽  
Claus Zimmer ◽  
Meinrad Beer ◽  
...  

AbstractNon-contrast cerebral computed tomography (CT) is frequently performed as a first-line diagnostic approach in patients with suspected ischemic stroke. The purpose of this study was to evaluate the performance of hybrid and model-based iterative image reconstruction for standard-dose (SD) and low-dose (LD) non-contrast cerebral imaging by multi-detector CT (MDCT). We retrospectively analyzed 131 patients with suspected ischemic stroke (mean age: 74.2 ± 14.3 years, 67 females) who underwent initial MDCT with a SD protocol (300 mAs) as well as follow-up MDCT after a maximum of 10 days with a LD protocol (200 mAs). Ischemic demarcation was detected in 26 patients for initial and in 64 patients for follow-up imaging, with diffusion-weighted magnetic resonance imaging (MRI) confirming ischemia in all of those patients. The non-contrast cerebral MDCT images were reconstructed using hybrid (Philips “iDose4”) and model-based iterative (Philips “IMR3”) reconstruction algorithms. Two readers assessed overall image quality, anatomic detail, differentiation of gray matter (GM)/white matter (WM), and conspicuity of ischemic demarcation, if any. Quantitative assessment included signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) calculations for WM, GM, and demarcated areas. Ischemic demarcation was detected in all MDCT images of affected patients by both readers, irrespective of the reconstruction method used. For LD imaging, anatomic detail and GM/WM differentiation was significantly better when using the model-based iterative compared to the hybrid reconstruction method. Furthermore, CNR of GM/WM as well as the SNR of WM and GM of healthy brain tissue were significantly higher for LD images with model-based iterative reconstruction when compared to SD or LD images reconstructed with the hybrid algorithm. For patients with ischemic demarcation, there was a significant difference between images using hybrid versus model-based iterative reconstruction for CNR of ischemic/contralateral unaffected areas (mean ± standard deviation: SD_IMR: 4.4 ± 3.1, SD_iDose: 3.5 ± 2.3, P < 0.0001; LD_IMR: 4.6 ± 2.9, LD_iDose: 3.2 ± 2.1, P < 0.0001).  In conclusion, model-based iterative reconstruction provides higher CNR and SNR without significant loss of image quality for non-enhanced cerebral MDCT.

2017 ◽  
Vol 59 (6) ◽  
pp. 740-747
Author(s):  
Marie-Louise Aurumskjöld ◽  
Marcus Söderberg ◽  
Fredrik Stålhammar ◽  
Kristina Vult von Steyern ◽  
Anders Tingberg ◽  
...  

Background In pediatric patients, computed tomography (CT) is important in the medical chain of diagnosing and monitoring various diseases. Because children are more radiosensitive than adults, they require minimal radiation exposure. One way to achieve this goal is to implement new technical solutions, like iterative reconstruction. Purpose To evaluate the potential of a new, iterative, model-based method for reconstructing (IMR) pediatric abdominal CT at a low radiation dose and determine whether it maintains or improves image quality, compared to the current reconstruction method. Material and Methods Forty pediatric patients underwent abdominal CT. Twenty patients were examined with the standard dose settings and 20 patients were examined with a 32% lower radiation dose. Images from the standard examination were reconstructed with a hybrid iterative reconstruction method (iDose4), and images from the low-dose examinations were reconstructed with both iDose4 and IMR. Image quality was evaluated subjectively by three observers, according to modified EU image quality criteria, and evaluated objectively based on the noise observed in liver images. Results Visual grading characteristics analyses showed no difference in image quality between the standard dose examination reconstructed with iDose4 and the low dose examination reconstructed with IMR. IMR showed lower image noise in the liver compared to iDose4 images. Inter- and intra-observer variance was low: the intraclass coefficient was 0.66 (95% confidence interval = 0.60–0.71) for the three observers. Conclusion IMR provided image quality equivalent or superior to the standard iDose4 method for evaluating pediatric abdominal CT, even with a 32% dose reduction.


2021 ◽  
pp. 197140092110087
Author(s):  
Andrea De Vito ◽  
Cesare Maino ◽  
Sophie Lombardi ◽  
Maria Ragusi ◽  
Cammillo Talei Franzesi ◽  
...  

Background and purpose To evaluate the added value of a model-based reconstruction algorithm in the assessment of acute traumatic brain lesions in emergency non-enhanced computed tomography, in comparison with a standard hybrid iterative reconstruction approach. Materials and methods We retrospectively evaluated a total of 350 patients who underwent a 256-row non-enhanced computed tomography scan at the emergency department for brain trauma. Images were reconstructed both with hybrid and model-based iterative algorithm. Two radiologists, blinded to clinical data, recorded the presence, nature, number, and location of acute findings. Subjective image quality was performed using a 4-point scale. Objective image quality was determined by computing the signal-to-noise ratio and contrast-to-noise ratio. The agreement between the two readers was evaluated using k-statistics. Results A subjective image quality analysis using model-based iterative reconstruction gave a higher detection rate of acute trauma-related lesions in comparison to hybrid iterative reconstruction (extradural haematomas 116 vs. 68, subdural haemorrhages 162 vs. 98, subarachnoid haemorrhages 118 vs. 78, parenchymal haemorrhages 94 vs. 64, contusive lesions 36 vs. 28, diffuse axonal injuries 75 vs. 31; all P<0.001). Inter-observer agreement was moderate to excellent in evaluating all injuries (extradural haematomas k=0.79, subdural haemorrhages k=0.82, subarachnoid haemorrhages k=0.91, parenchymal haemorrhages k=0.98, contusive lesions k=0.88, diffuse axonal injuries k=0.70). Quantitatively, the mean standard deviation of the thalamus on model-based iterative reconstruction images was lower in comparison to hybrid iterative one (2.12 ± 0.92 vsa 3.52 ± 1.10; P=0.030) while the contrast-to-noise ratio and signal-to-noise ratio were significantly higher (contrast-to-noise ratio 3.06 ± 0.55 vs. 1.55 ± 0.68, signal-to-noise ratio 14.51 ± 1.78 vs. 8.62 ± 1.88; P<0.0001). Median subjective image quality values for model-based iterative reconstruction were significantly higher ( P=0.003). Conclusion Model-based iterative reconstruction, offering a higher image quality at a thinner slice, allowed the identification of a higher number of acute traumatic lesions than hybrid iterative reconstruction, with a significant reduction of noise.


2015 ◽  
Vol 25 (8) ◽  
pp. 2362-2370 ◽  
Author(s):  
Edouard Hérin ◽  
François Gardavaud ◽  
Mélanie Chiaradia ◽  
Pauline Beaussart ◽  
Philippe Richard ◽  
...  

2018 ◽  
Vol 59 (11) ◽  
pp. 1316-1325 ◽  
Author(s):  
Georg Böning ◽  
Roman A Rotzinger ◽  
Johannes F Kahn ◽  
Patrick Freyhardt ◽  
Diane M Renz ◽  
...  

Background Endovascular aneurysm repair (EVAR) requires lifelong surveillance by computed tomography angiography (CTA). This is attended by a substantial accumulation of radiation exposure. Iterative reconstruction (IR) has been introduced to approach dose reduction. Purpose To evaluate adaptive statistical iterative reconstruction (ASIR) at different levels of tube voltage concerning image quality and dose reduction potential in follow-up post EVAR. Material and Methods One hundred CTAs in 67 patients with EVAR were examined using five protocols: protocol A (n = 40) as biphasic standard using filtered back projection (FBP) at 120 kV; protocols B (n = 40), C (n = 10), and D1 (n = 5) biphasic using ASIR at 120, 100, and 80 kV, respectively; and protocol D2 (n = 5) with a monophasic splitbolus ASIR protocol at 80 kV. Image quality was assessed quantitatively and qualitatively. Applied doses were determined. Results Applied doses in ASIR protocols were significantly lower than FBP standard (up to 75%). Compared to protocol A, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) (e.g. arterial CNR intra-/extra-stent lumen: A = 35.4 ± 13.5, B = 34.2 ± 10.0, C = 29.6 ± 6.8, D1 = 32.1 ± 6.3, D2 = 40.8 ± 23.1) in protocol B were equal and in protocols C and D equal to partially inferior, however not decisive for diagnostic quality. Subjective image quality ratings in all protocols were good to excellent without impairments of diagnostic confidence (A–D2: 5), with high inter-rater agreement (60–100%). Conclusion ASIR contributes to significant dose reduction without decisive impairments of image quality and diagnostic confidence. We recommend an adapted follow-up introducing ASIR and combined low-kV in the long-term surveillance after EVAR.


2016 ◽  
Vol 58 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Marie-Louise Aurumskjöld ◽  
Kristina Ydström ◽  
Anders Tingberg ◽  
Marcus Söderberg

Background The number of computed tomography (CT) examinations is increasing and leading to an increase in total patient exposure. It is therefore important to optimize CT scan imaging conditions in order to reduce the radiation dose. The introduction of iterative reconstruction methods has enabled an improvement in image quality and a reduction in radiation dose. Purpose To investigate how image quality depends on reconstruction method and to discuss patient dose reduction resulting from the use of hybrid and model-based iterative reconstruction. Material and Methods An image quality phantom (Catphan® 600) and an anthropomorphic torso phantom were examined on a Philips Brilliance iCT. The image quality was evaluated in terms of CT numbers, noise, noise power spectra (NPS), contrast-to-noise ratio (CNR), low-contrast resolution, and spatial resolution for different scan parameters and dose levels. The images were reconstructed using filtered back projection (FBP) and different settings of hybrid (iDose4) and model-based (IMR) iterative reconstruction methods. Results iDose4 decreased the noise by 15–45% compared with FBP depending on the level of iDose4. The IMR reduced the noise even further, by 60–75% compared to FBP. The results are independent of dose. The NPS showed changes in the noise distribution for different reconstruction methods. The low-contrast resolution and CNR were improved with iDose4, and the improvement was even greater with IMR. Conclusion There is great potential to reduce noise and thereby improve image quality by using hybrid or, in particular, model-based iterative reconstruction methods, or to lower radiation dose and maintain image quality.


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