Low-dose CT of postoperative pelvic fractures: a comparison with radiography

Background Computed tomography (CT) is superior to conventional radiography (CR) for assessing internal fixation of pelvic fractures, but with a higher radiation exposure. Low-dose CT (LDCT) could possibly have a sufficient diagnostic accuracy but with a lower radiation dose. Purpose To compare postoperative diagnostic accuracy of LDCT and CR after open reduction and internal fixation of pelvic fracture. Material and Methods Twenty-one patients were examined with LDCT and CR 0–9 days after surgery. The examinations were reviewed by two musculoskeletal radiologists. Hardware, degree of fracture reduction, image quality, and reviewing time were assessed, and effective radiation dose was calculated. Inter-reader agreement was calculated. Results LDCT was significantly better than CR in determining whether hardware positioning was assessable ( P < 0.001). Acetabular congruence was assessable in all fractured patients with LDCT. In 12 of the 32 assessments with CR of patients with an acetabular fracture, joint congruence was not assessable due to overlapping hardware ( P = 0.001). Image quality was significantly higher for LDCT. Median time to review was 240 s for LDCT compared to 180 s for CR. Effective dose was 0.79 mSv for LDCT compared to 0.32 mSv for CR ( P < 0.001). Conclusion LDCT is more reliable than CR in assessing hardware position and fracture reduction. Joint congruency is sometimes not possible to assess with CR, due to overlapping hardware. The image quality is higher, but also the effective dose, with LDCT than with CR.

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SAT0550 SPINAL AND PELVIC MDCT USING “iDose5” ITERATIVE RECONSTRUCTION ALGORITHM IN PATIENTS WITH PSORIATIC SPONDYLOARTHRITIS: DIAGNOSTIC CAPABILITIES AND IMAGE QUALITY IN RELATION TO RADIATION EXPOSURE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6631 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1232-1233

Author(s):

V. Bizimi ◽

P. Katsimbri ◽

A. Plousi ◽

D. Tseronis ◽

N. Sideri ◽

...

Keyword(s):

Ankylosing Spondylitis ◽

Image Quality ◽

Radiation Dose ◽

Effective Dose ◽

Iterative Reconstruction ◽

Low Dose ◽

Reconstruction Algorithm ◽

Low Dose Ct ◽

Iterative Reconstruction Algorithm ◽

Diagnostic Capabilities

Background:Psoriatic spondyloarthritis (PsSpA) is an inflammatory arthritis related to psoriasis, whereas a large number of patients may have persistent inflammation developing gradual and in some cases extensive joint involvement of the axial skeleton.Conventional radiographs (CRs) have been used for the detection of structural damage (syndesmophyte formation, paravertebral ossification, sacroiliitis, ankyloses and erosions), facilitating as an important measure of efficacy of various therapies. However overlapping of anatomic structures of pelvis and spine as well as limited capabilities to visualize soft tissue have led to the development of newer imaging technologies (1). Multidetector CT technology (MDCT), it is now possible to perform low dose CT (ldCT) of the entire vertebral column, viewed in multiple planes and without overprojection with a low radiation dose. (2) Still, the capabilities of ldCT algorithms in the diagnosis and progression of PsSpA has not been fully explored.Objectives:The aim of this study is to examine the effect of “iDose5” iterative reconstruction algorithm on radiation dose, diagnostic capabilities and image quality in spine-pelvis (S-P) CT scanning compared with CRs, in detection of findings suggestive of PsSpA.Methods:Thirty-nine patients with PsSpA (26 females and 13 males, age range: 23 to 70 years old) were prospectively studied with “iDose5” CT of spine and pelvis on a 64-row MDCT scanner. Multiplannar reformats followed. All patients satisfied the Psoriatic Arthritis (CASPAR) classification criteria and had undergone standard AP and lateral CRs of the cervical, thoracic and lumbar spine and AP radiographs of the pelvis within one months of the iDose CT. Twenty-five patients underwent, additional MR imaging (MRI) of the same anatomic areas. Written consent was obtained from all patients. Two musculoskeletal radiologists read and scored CT scans and CRs in consensus, according to the PASRI criteria and the CTSS score. CT image quality and effective dose for CT and radiographs were assessed.All data were analyzed using SPSS 24.0 statistical software.Results:CT revealed erosions and ankyloses of the sacroiliac joints, fusion of the posterior elements of vertebra especially in the thoracic spine, enthesophytes, not seen with CRs, in 26 patients (p<0,05).Level of diagnostic confidence was higher when interpreting CT compared to CRs, in cases of erosions and ankyloses, in 35 patients (p<0,05).CT was slightly superior in the detection and characterization of syndesmophytes, enthesopathy and calcifications.Effective dose for “i-Dose 5” CT was 1.20 ± 0.26 mSv and for CR =1.07 ± 0.21 mSv. The difference was not statistically significant (p=0.588).Conclusion:iDose CT of spine and pelvis at an effective dose, lower than previously published, seems to perform better than radiographs in the detection of structural changes of PsSpA. Further studies are needed to document the capabilities of iDose CT for the imaging assessment of PsSpA in daily clinical practice.References:[1]Baraliakos Χ, et al (2009)The Natural Course of Radiographic Progression in Ankylosing Spondylitis — Evidence for Major Individual Variations in a Large Proportion of Patients The Journal of Rheumatology May, 36 (5) 997-1002[2]de Koning A et, al (2018) Low-dose CT detects more progression of bone formation in comparison to conventional radiography in patients with ankylosing spondylitis: results from the SIAS cohort. Ann Rheum Dis.;77(2):293-299.Disclosure of Interests:None declared

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Ultra-Low-Dose CT of the Thorax Using Iterative Reconstruction: Evaluation of Image Quality and Radiation Dose Reduction

American Journal of Roentgenology ◽

10.2214/ajr.14.13629 ◽

2015 ◽

Vol 204 (6) ◽

pp. 1197-1202 ◽

Cited By ~ 61

Author(s):

Yookyung Kim ◽

Yoon Kyung Kim ◽

Bo Eun Lee ◽

Seok Jeong Lee ◽

Yon Ju Ryu ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Dose Reduction ◽

Iterative Reconstruction ◽

Low Dose ◽

Radiation Dose Reduction ◽

Low Dose Ct

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Low-Dose CT Examinations in Crohn's Disease: Impact on Image Quality, Diagnostic Performance, and Radiation Dose

American Journal of Roentgenology ◽

10.2214/ajr.09.3420 ◽

2010 ◽

Vol 195 (1) ◽

pp. 78-88 ◽

Cited By ~ 68

Author(s):

Avinash R. Kambadakone ◽

Priyanka Prakash ◽

Peter F. Hahn ◽

Dushyant V. Sahani

Keyword(s):

Crohn’S Disease ◽

Image Quality ◽

Crohn's Disease ◽

Radiation Dose ◽

Diagnostic Performance ◽

Low Dose ◽

Low Dose Ct ◽

Disease Impact

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Ultra-low-dose lung screening CT with model-based iterative reconstruction: an assessment of image quality and lesion conspicuity

Acta Radiologica ◽

10.1177/0284185117726099 ◽

2017 ◽

Vol 59 (5) ◽

pp. 553-559 ◽

Cited By ~ 4

Author(s):

Yun Hye Ju ◽

Geewon Lee ◽

Ji Won Lee ◽

Seung Baek Hong ◽

Young Ju Suh ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Iterative Reconstruction ◽

Low Dose ◽

Image Noise ◽

Low Dose Ct ◽

Group 5 ◽

Lung Screening ◽

Lesion Conspicuity ◽

Group 1

Background Reducing radiation dose inevitably increases image noise, and thus, it is important in low-dose computed tomography (CT) to maintain image quality and lesion detection performance. Purpose To assess image quality and lesion conspicuity of ultra-low-dose CT with model-based iterative reconstruction (MBIR) and to determine a suitable protocol for lung screening CT. Material and Methods A total of 120 heavy smokers underwent lung screening CT and were randomly and equally assigned to one of five groups: group 1 = 120 kVp, 25 mAs, with FBP reconstruction; group 2 = 120 kVp, 10 mAs, with MBIR; group 3 = 100 kVp, 15 mAs, with MBIR; group 4 = 100 kVp, 10 mAs, with MBIR; and group 5 = 100 kVp, 5 mAs, with MBIR. Two radiologists evaluated intergroup differences with respect to radiation dose, image noise, image quality, and lesion conspicuity using the Kruskal–Wallis test and the Chi-square test. Results Effective doses were 61–87% lower in groups 2–5 than in group 1. Image noises in groups 1 and 5 were significantly higher than in the other groups ( P < 0.001). Overall image quality was best in group 1, but diagnostic acceptability of overall image qualities in groups 1–3 was not significantly different (all P values > 0.05). Lesion conspicuities were similar in groups 1–4, but were significantly poorer in group 5. Conclusion Lung screening CT with MBIR obtained at 100 kVp and 15 mAs enables a ∼60% reduction in radiation dose versus low-dose CT, while maintaining image quality and lesion conspicuity.

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Low-dose CT angiography using ASiR-V for potential living renal donors: a prospective analysis of image quality and diagnostic accuracy

European Radiology ◽

10.1007/s00330-019-06423-1 ◽

2019 ◽

Vol 30 (2) ◽

pp. 798-805 ◽

Cited By ~ 1

Author(s):

Woong Kyu Han ◽

Joon Chae Na ◽

Sung Yoon Park

Keyword(s):

Image Quality ◽

Diagnostic Accuracy ◽

Ct Angiography ◽

Low Dose ◽

Prospective Analysis ◽

Low Dose Ct

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Effect of a novel denoising technique on image quality and diagnostic accuracy in low-dose CT in patients with suspected appendicitis

European Journal of Radiology ◽

10.1016/j.ejrad.2019.04.026 ◽

2019 ◽

Vol 116 ◽

pp. 198-204 ◽

Cited By ~ 3

Author(s):

Manuel Kolb ◽

Corinna Storz ◽

Jong Hyo Kim ◽

Jakob Weiss ◽

Saif Afat ◽

...

Keyword(s):

Image Quality ◽

Diagnostic Accuracy ◽

Low Dose ◽

Suspected Appendicitis ◽

Low Dose Ct

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Low-dose Computed Tomography (CT) for the Diagnosis of Congenital Heart Disease in Children: A Meta-analysis

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616666200107110611 ◽

2020 ◽

Vol 16 (9) ◽

pp. 1085-1094

Author(s):

Lu Tian ◽

Longlun Wang ◽

Yong Qin ◽

Jinhua Cai

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Image Quality ◽

Radiation Dose ◽

Likelihood Ratio ◽

Odds Ratio ◽

Congenital Heart ◽

Low Dose ◽

Diagnostic Odds Ratio ◽

Low Dose Ct

Background: Low dose CT has become a promising examination method for the diagnosis of Congenital heart disease (CHD) in children because it has a low radiation dose, but it has not been widely accepted as an alternative to standard-dose CT in clinical applications due to concerns about image quality. Therefore, we suggest that the diagnostic accuracy, image quality, and radiation dose of low-dose CT for CHD in children should be fully explored through a metaanalysis of existing studies. Methods: A comprehensive search was performed to identify relevant English and Chinese articles (from inception to May 2019). All selected studies concerned the diagnosis of CHD in children using low-dose CT. The accuracy of low-dose CT was determined by calculating pooled estimates of sensitivity, specificity, diagnostic odds ratio, and likelihood ratio. Pooling was conducted using a bivariate generalized linear mixed model. Forest plots and summary receiver operating characteristic (SROC) curves were generated. Results: Ten studies, accounting for 577 patients, met the eligibility criteria. The pooled sensitivity and specificity were 0.95 (95% confidence interval (CI) 0.92-0.97) and 1.00 (95% CI 1.00- 1.00), respectively. The pooled diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio of low-dose CT were 12705.53 (95% CI 5065.00-31871.73), 671.29 (95% CI 264.77- 1701.97), and 0.05 (95% CI 0.03-0.08), respectively. Additionally, the area under the SROC curve was 1.00 (95% CI 0.99-1.00), suggesting that low-dose CT is an excellent diagnostic tool for CHD in children. Conclusion: Low-dose CT, especially with a prospective ECG-triggering mode, provides excellent imaging quality and high diagnostic accuracy for CHD in children.

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