Low-dose and standard-dose unenhanced helical computed tomography for the assessment of acute renal colic: prospective comparative study

2005 ◽  
Vol 46 (7) ◽  
pp. 756-763 ◽  
Author(s):  
Bong Soo Kim ◽  
Im Kyung Hwang ◽  
Yo Won Choi ◽  
Sook Namkung ◽  
Heung Cheol Kim ◽  
...  

Purpose: To compare the efficacy of low-dose and standard-dose computed tomography (CT) for the diagnosis of ureteral stones. Material and Methods: Unenhanced helical CT was performed with both a standard dose (260 mAs, pitch 1.5) and a low dose (50 mAs, pitch 1.5) in 121 patients suspected of having acute renal colic. The two studies were prospectively and independently interpreted for the presence and location of ureteral stones, abnormalities unrelated to stone disease, identification of secondary signs, i.e. hydronephrosis and perinephric stranding, and tissue rim sign. The standard-dose CT images were interpreted by one reviewer and the low-dose CT images independently by two reviewers unaware of the standard-dose CT findings. The findings of the standard and low-dose CT scans were compared with the exact McNemar test. Interobserver agreements were assessed with kappa analysis. The effective radiation doses resulting from two different protocols were calculated by means of commercially available software to which the Monte-Carlo phantom model was given. Results: The sensitivity, specificity, and accuracy of standard-dose CT for detecting ureteral stones were 99%, 93%, and 98%, respectively, whereas for the two reviewers the sensitivity of low-dose CT was 93% and 95%, specificity 86%, and accuracy 92% and 94%. We found no significant differences between standard-dose and low-dose CT in the sensitivity and specificity for diagnosing ureter stones ( P>0.05 for both). However, the sensitivity of low-dose CT for detection of 19 stones less than or equal to 2 mm in diameter was 79% and 68%, respectively, for the two reviewers. Low-dose CT was comparable to standard-dose CT in visualizing hydronephrosis and the tissue rim sign. Perinephric stranding was far less clear on low-dose CT. Low-dose CT had the same diagnostic performance as standard-dose CT in diagnosing alternative diseases. Interobserver agreement between the two low-dose CT reviewers in the diagnosis of ureter stones and alternative diseases, the identification of secondary signs, and tissue rim sign were high, with kappa values ranging from 0.769 to 0.968. On standard-dose CT scans, the calculated mean effective radiation dose was 7.30 mSv for males and 10.00 mSv for females. On low-dose CT scans, the calculated mean effective radiation dose was 1.40 mSv for males and 1.97 mSv for females. Conclusion: Compared with standard scans using 260 mAs, low-dose unenhanced helical CT using a reduced tube current of 50 mAs results in a concomitant decrease in the radiation dose of 81%. Although low-dose CT was limited in its ability to depict small-sized calculi less than or equal to 2 mm, it is still comparable to standard-dose CT for the diagnosis of ureter stones and alternative disease.

2021 ◽  
pp. 028418512198995
Author(s):  
Erdal Tekin ◽  
Kutsi Tuncer ◽  
Ibrahim Ozlu ◽  
Recep Sade ◽  
Rustem Berhan Pirimoglu ◽  
...  

Background The use and frequency of computed tomography (CT) are increasing day by day in emergency departments (ED). This increases the amount of radiation exposed. Purpose To evaluate the image quality obtained by ultra-low-dose CT (ULDCT) in patients with suspected wrist fractures in the ED and to investigate whether it is an alternative to standard-dose CT (SDCT). Material and Methods This is a study prospectively examining 336 patients who consulted the ED for wrist trauma. After exclusion criteria were applied, the patients were divided into the study and control groups. Then, SDCT (120 kVp and 100 mAs) and ULDCT (80 kVp and 5 mAs) wrist protocols were applied simultaneously. The images obtained were evaluated for image quality and fracture independently by a radiologist and an emergency medical specialist using a 5-point scale. Results The effective radiation dose calculated for the control group scans was 41.1 ± 2.1 µSv, whereas the effective radiation dose calculated for the study group scans was 0.5 ± 0.0 µSv. The effective radiation dose of the study group was significantly lower than that of the control group ( P < 0.01). The CT images in the study group showed no significant differences in the mean image quality score between observer 1 and observer 2 (3.4 and 4.3, respectively; P = 0.58). Both observers could detect all fractures using the ULDCT images. Conclusion ULDCT provides high-quality images in wrist traumas while reducing the radiation dose by approximately 98% compared to SDCT without any changes in diagnostic accuracy.


2020 ◽  
Vol 9 (1) ◽  
pp. 27-31
Author(s):  
Mahesh Gautam ◽  
Aziz Ullah ◽  
Manish Raj Pathak

Background: Standard dose computed tomography is standard imaging modality in diagnosis of urolithiasis. The introduction of low dose techniques results in decrease radiation dose without significant change in image quality. However, the image quality of low dose computed tomography is affected by skin fold thickness and subcutaneous abdominal adipose tissue. The aim of this study to evaluate stone location, size, and density using low dose computed tomography compared with standard dose computed tomography in obese population. Material and Methods: This non-randomized non-inferiority trial includes 120 patient having BMI≥25kg/m2 with acute ureteric colic. The low dose and standard dose computed tomography were performed accordingly. Effective radiation doses were calculated from dose-length product obtained from scan report using conversion factor of 0.015. The images were reconstructed using iterative reconstruction algorithm. Effective dose, number and size of stone, Hounsfield Unit value of stone and image quality was assessed. Results: Stones were located in 69 (57.5%) in right and 51 (42.5%) in left ureter. There was no statistical difference in mean diameter, number and density of stones in low dose as compared with standard dose. The radiation dose was significantly lower with low dose. (3.68 mSv) The delineation of the ureter, outline of the stones and image quality in low dose was overall sufficient for diagnosis. No images of low dose scan were subjectively rated as non-diagnostics. Conclusion: Low dose computed tomography with iterative reconstruction technique is as effective as standard dose in diagnosis of ureteric stones in obese patients with lower effective radiation dose.


Author(s):  
Hooman Bahrami-Motlagh ◽  
Yashar Moharamzad ◽  
Golnaz Izadi Amoli ◽  
Sahar Abbasi ◽  
Alireza Abrishami ◽  
...  

Abstract Background Chest CT scan has an important role in the diagnosis and management of COVID-19 infection. A major concern in radiologic assessment of the patients is the radiation dose. Research has been done to evaluate low-dose chest CT in the diagnosis of pulmonary lesions with promising findings. We decided to determine diagnostic performance of ultra-low-dose chest CT in comparison to low-dose CT for viral pneumonia during the COVID-19 pandemic. Results 167 patients underwent both low-dose and ultra-low-dose chest CT scans. Two radiologists blinded to the diagnosis independently examined ultra-low-dose chest CT scans for findings consistent with COVID-19 pneumonia. In case of any disagreement, a third senior radiologist made the final diagnosis. Agreement between two CT protocols regarding ground-glass opacity, consolidation, reticulation, and nodular infiltration were recorded. On low-dose chest CT, 44 patients had findings consistent with COVID-19 infection. Ultra-low-dose chest CT had sensitivity and specificity values of 100% and 98.4%, respectively for diagnosis of viral pneumonia. Two patients were falsely categorized to have pneumonia on ultra-low-dose CT scan. Positive predictive value and negative predictive value of ultra-low-dose CT scan were respectively 95.7% and 100%. There was good agreement between low-dose and ultra-low-dose methods (kappa = 0.97; P < 0.001). Perfect agreement between low-dose and ultra-low-dose scans was found regarding diagnosis of ground-glass opacity (kappa = 0.83, P < 0.001), consolidation (kappa = 0.88, P < 0.001), reticulation (kappa = 0.82, P < 0.001), and nodular infiltration (kappa = 0.87, P < 0.001). Conclusion Ultra-low-dose chest CT scan is comparable to low-dose chest CT for detection of lung infiltration during the COVID-19 outbreak while maintaining less radiation dose. It can also be used instead of low-dose chest CT scan for patient triage in circumstances where rapid-abundant PCR tests are not available.


2019 ◽  
Vol 61 (5) ◽  
pp. 662-667 ◽  
Author(s):  
Yousuf Zakko ◽  
Daniel Thor ◽  
Irina Savitcheva ◽  
Albert Sundvall ◽  
Cecilia Wassberg ◽  
...  

Background Hybrid SPECT/CT systems allow the shortening of lead time for investigation of cancer patients, since a complementary CT for radiological characterization of focally increased isotope uptake of unclear origin in bone scintigraphy can be performed simultaneously. The use of low-dose CT (sub-mSv CT) reduces radiation dose compared to standard-dose CT and facilitates the application of complementary CT. Purpose To test the feasibility of sub-mSv CT for the characterization of non-specific findings in the bone scintigraphy of oncological patients. Material and Methods Nineteen oncological patients with a total of 50 findings of unclear origin on bone scintigraphy which required further correlation with morphologic data were included in the study. Each patient underwent two CT scan series consecutively: one low-dose CT and one standard-dose CT. The CT studies were randomized and each finding was rated by four blinded experienced radiologists. A shift in ratings between standard-dose and low-dose images were assessed using the Stuart–Maxwell chi-squared test. Inter-observer agreement and intra-observer agreement was assessed using Light’s kappa and Cohen’s kappa, respectively. Results The mean effective dose of low-dose CT scans was 0.8 mSv compared to 4.2 mSv for the standard-dose CT scans. No statistically significant shift in ratings was observed ( P = 0.62). There was no statistically significant difference in the inter-observer agreements: the values for the standard-dose and low-dose groups were 0.68 (95% confidence interval [CI] 0.57–0.79) and 0.60 (95% CI 0.47–0.72), respectively. Conclusion These results indicate that sub-mSv CT for characterization of non-specific findings in bone scintigraphy of oncological patients is feasible.


2021 ◽  
Vol 12 (4) ◽  
pp. 529-534
Author(s):  
Li Xiong ◽  
Mehul D. Patel ◽  
Gurur Biliciler-Denktas ◽  
Ali Dodge-Khatami ◽  
Jorge Salazar ◽  
...  

Background: Low-dose multidetector computed tomographic angiography (MDCTA) is playing an increasingly larger role in the diagnosis of anomalous pulmonary venous return (APVR). Despite advances in new computed tomographic (CT) techniques with radiation dose reduction, there are limited studies describing radiation dose parameters to allow routine use of cardiac CT in infants and children with APVR. This study compares cardiac CT findings with intraoperative findings and describes comprehensive radiation exposure parameters. Methods: A retrospective analysis of 27 patients compared MDCTA and intraoperative or cardiac catheterization findings of the pulmonary venous anatomy. Results: A total of 32 MDCTA studies were performed on these 27 patients. Of the 28 studies with subsequent intervention, MDCTA accurately diagnosed the anomalous pulmonary venous anatomy in 27 (96.4%) patients. Narrowing of the pulmonary venous confluence entrance to the coronary sinus was missed on cardiac CT in one patient due to motion artifact, but it was noted intraoperatively. Median estimated effective radiation dose was 0.98 mSv (range: 0.39-3.2 mSv), and mean estimated effective radiation dose was 1.1 ± 0.68 mSv. Median total dose length product (DLP) was 25 mGy cm (range: 10-83 mGy cm), and mean total DLP was 28 ± 18 mGy cm. Median CTDI volume was 3.8 mGy (range: 2.5-14.6 mGy), and mean CTDI volume was 5.0 ± 3.2 mGy. Conclusions: We conclude that modern cardiac MDCTA is the best imaging modality to guide management in both preintervention and postintervention APVR patients. In this study, we describe comprehensive radiation exposure parameters in infants and children with APVR.


2018 ◽  
Vol 59 (10) ◽  
pp. 1225-1231 ◽  
Author(s):  
Peter B Noël ◽  
Stephan Engels ◽  
Thomas Köhler ◽  
Daniela Muenzel ◽  
Daniela Franz ◽  
...  

Background The explosive growth of computer tomography (CT) has led to a growing public health concern about patient and population radiation dose. A recently introduced technique for dose reduction, which can be combined with tube-current modulation, over-beam reduction, and organ-specific dose reduction, is iterative reconstruction (IR). Purpose To evaluate the quality, at different radiation dose levels, of three reconstruction algorithms for diagnostics of patients with proven liver metastases under tumor follow-up. Material and Methods A total of 40 thorax–abdomen–pelvis CT examinations acquired from 20 patients in a tumor follow-up were included. All patients were imaged using the standard-dose and a specific low-dose CT protocol. Reconstructed slices were generated by using three different reconstruction algorithms: a classical filtered back projection (FBP); a first-generation iterative noise-reduction algorithm (iDose4); and a next generation model-based IR algorithm (IMR). Results The overall detection of liver lesions tended to be higher with the IMR algorithm than with FBP or iDose4. The IMR dataset at standard dose yielded the highest overall detectability, while the low-dose FBP dataset showed the lowest detectability. For the low-dose protocols, a significantly improved detectability of the liver lesion can be reported compared to FBP or iDose4 ( P = 0.01). The radiation dose decreased by an approximate factor of 5 between the standard-dose and the low-dose protocol. Conclusion The latest generation of IR algorithms significantly improved the diagnostic image quality and provided virtually noise-free images for ultra-low-dose CT imaging.


2021 ◽  
Vol 5 (1) ◽  
pp. 32-41
Author(s):  
Cheong-Il Shin ◽  
Se Hyung Kim ◽  
Mi Hye Yu ◽  
Ijin Joo ◽  
Joon Koo Han

Purpose: To evaluate the feasibility of ultra-low dose 80 kVp CT for the evaluation of inflammatory bowel disease (IBD) in a rabbit model and to investigate the effect of two different iterative reconstruction (IR) algorithms on 80 kVp CT in terms of image quality and diagnostic performance in comparison with same session conventional 120 kVp images.Materials and Methods: This study was approved by the Animal Care and Use Committee of our hospital. Twenty-eight New Zealand white rabbits were randomly divided into two groups: IBD group (n=18) and a control group (n=10). To create an acute IBD model, 3mL of a 5% w/v tri-nitrobenzene sulfonic acid solution was administered to the sigmoid colon of the rabbits. CT was performed at 80 kVp and 120 kVp and was reconstructed using filtered back projection (FBP), hybrid statistic-based IR, and full IR algorithms for 80 kVp and using FBP only for 120 kVp. Effective radiation dose, image noise, image quality, and diagnostic performance by two reviewers were recorded and compared using repeated measure analysis of variance, McNemar test, and receiver operating curve (ROC) analysis.Results: Mean effective radiation dose of 80 kVp CT (0.05 mSv) was significantly lower than that (0.285 mSv) of 120 kVp CT. Mean image noise was highest in the 80 kVp FBP setting (60.36) but significantly decreased with IR algorithms (47.02 with hybrid IR and 12.92 with full IR) (P<0.0001). Mean overall image quality score was lowest in the 80 kVp FBP setting (1.57 and 1.46 for reviewers 1 and 2, respectively) but significantly improved with IR algorithms (2.43 and 2.25 for hybrid IR and 4.79 and 4.93 for full IR) (P<0.0001). Sensitivity and area under the curve (AUC) for differentiating a normal bowel from IBD was lowest with 80 kVp FBP (61.1% and 83.3%; 0.883 and 0.967) but improved with IR algorithms (83.3%~100%; 0.992~1), to similar levels as the 120 kVp FBP setting (100% and 1). Differences in sensitivity and AUC between 80 kVp FBP and 80 kVp IR algorithms were statistically significant in reviewer 1.Conclusions: Ultra-low dose 80 kVp CT in a rabbit IBD model is not feasible using the standard FBP algorithm. However, with the application of IR algorithms, diagnostic performance of 80 kVp CT was acceptable and on par with that at conventional 120 kVp FBP.


Dose-Response ◽  
2020 ◽  
Vol 19 (1) ◽  
pp. 155932582090977
Author(s):  
Dan Wu ◽  
Gang Wang ◽  
Bingyang Bian ◽  
Zhuohang Liu ◽  
Dan Li

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.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Edwin A. Takahashi ◽  
Hyo-Chun Yoon

Purpose.The objective of this study was to determine the estimated effective radiation dose of pulmonary CT angiography (CTA) for suspected pulmonary embolism (PE) contributing to total medical radiation exposure over a 4-year period.Materials and Methods.This investigation retrospectively reviewed 300 patients who presented to the emergency department and received a pulmonary CTA scan for suspected PE. We evaluated these patients' electronic medical record to determine their estimated radiation exposure to CT scans during the following four years. Using DLP toEconversion coefficients, we calculated the cumulative effective radiation dose each subject received.Results.A total of 900 CT scans were reviewed in this study. Pulmonary CTA delivered an average effective radiation dose of 10.7 ± 2.5 mSv and accounted for approximately 65% of subjects' 4-year cumulative medical radiation dose. Only 6.3% of subjects had a positive acute PE according to their radiology report.Conclusion.Pulmonary CTA accounted for the majority of subjects’ medically related effective radiation dose over a 4-year period. With only a minority of subjects having positive findings for acute PE, increased efforts should be made to clinically assess pretest probability before the consideration of imaging.


2020 ◽  
Vol 21 (2) ◽  
pp. 28-43
Author(s):  
Piyaporn Apisarnthanarak ◽  
Chosita Buranont ◽  
Chulaluck Boonma ◽  
Sureerat Janpanich ◽  
Tarntip Suwatananonthakij ◽  
...  

OBJECTIVE: To compare radiation dose and image quality between standard dose abdominal CT currently performed at our hospital and new low dose abdominal CT using various percentages (0%, 10%, 20%, and 30%) of Adaptive Statistical Iterative Reconstruction (ASiR). MATERIALS AND METHODS: We prospectively performed low dose abdominal CT (30% reduction of standard tube current) in 119 participants. The low dose CT images were post processed with four parameters (0%, 10%, 20% and 30%) of ASiR. The volume CT dose index (CTDIvol) of standard and low dose CT were compared. Four experienced abdominal radiologists independently assessed the quality of low dose CT with aforementioned ASiR parameters using a 5-point-scale satisfaction score (1 = unacceptable, 2 = poor, 3 = average, 4 = good, and 5 = excellent image quality) by using prior standard dose CT as a reference of excellent image quality (5). Each reader selected the preference ASiR parameter for each participant. The image noise of the liver and the aorta in all 5 (1 prior standard dose and 4 current low dose) image sets was measured.     RESULTS: The mean CTDIvol of low dose CT was significantly lower than of standard dose CT (7.17 ± 0.08 vs 12.02 ±1.61 mGy, p<0.001). The mean satisfaction scores for low dose CT with 0%, 10%, 20% and 30% ASiR were 3.95, 3.99, 3.91 and 3.87, respectively with the ranges of 3 to 5 in all techniques. The preferred ASiR parameters of each participant randomly selected by each reader were varied, depending on the readers’ opinions. The mean image noise of the aorta on standard dose CT and low dose CT with 0%, 10%, 20%, and 30% ASiR was 29.07, 36.97, 33.92, 31.49, and 29.11, respectively, while the mean image noise of the liver was 24.60, 30.21, 28.33, 26.25, and 24.32, respectively. CONCLUSION: Low dose CT with 30% reduction of standard mA had acceptable image quality with significantly reduced radiation dose. The increment of ASiR was helpful in reducing image noise.  


Sign in / Sign up

Export Citation Format

Share Document