Comparative analysis of radiation dose and image quality between organ dose modulation and 3D smart mA modulation during head-neck CT angiography

Abstract

OBJECTIVE:

To assess the difference in absorbed organ dose and image quality for head-neck CT angiography using organ dose modulation compared with 3D smart mA modulation in different body mass indices (BMIs) using an adaptive statistical iterative reconstruction (ASiR-V) algorithm.

METHODS:

Three hundred patients underwent head-neck CTA were equally divided into three groups: A (18.5 kg/m²≦BMI < 24.9 kg/m²), B (24.9 kg/m²≦BMI < 29.9 kg/m²) and C (29.9 kg/m²≦BMI≦34.9 kg/m²). The groups were randomly subdivided into two subgroups (n = 50): A1-A2, B1-B2 and C1-C2. The patients in subgroups A1, B1 and C1 underwent organ dose modulation with the ASiR-V algorithm, while other patients underwent 3D smart mA modulation. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of all head-neck CT angiography images were calculated. Images were then subjectively evaluated. Mean values of several indices including dose-length product (DLP) were computed. The DLP was converted to the effective dose (ED). SNR, CNR and ED in groups A, B, and C were compared in statistical data analysis.

RESULTS:

SNR, CNR, and subjective image scores show no statistical differences in three groups (P > 0.05). However, there is significant difference of ED values (P < 0.05) . For example, in subgroup A1 mean ED values are 15.30% and 23.66% lower than those in subgroup A2 at thyroid gland and eye lens, respectively. Similar patterns also exist in groups B (B1 vs. B2) and C (C1 vs. C2).

CONCLUSIONS:

Using organ dose modulation and applying the ASiR-V algorithm can more effectively reduce the radiation dose in head-neck CT angiography than using 3D smart mA modulation, while maintaining image quality. Thus, using organ-based dose modulation has the additional benefit of reducing dose to the thyroid gland and eye lens.

Keywords

Organ dose modulation 3D smart mA modulation radiation dose image quality head-neck CT angiography

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References

Hirai ,

Korogi ,

Takahashi , et al., CT angiography in the assessment of intracranial vessels. In: Multidetector-Row CT Angiography. Berlin, Germany: Springer-Verlag; 2005.

W.L.

Zhang ,

Li ,

Zhang , et al., CT angiography of the head-and-neck vessels acquired with low tube voltage, low iodine, and iterative image reconstruction: Clinical evaluation of radiation dose and image quality, PLoS One 8 (2013), e81486.

T.H.

Wu ,

S.C.

Hung ,

J.Y.

Sun , et al., How far can the radiation dose be lowered in head CT with iterative reconstruction? Analysis of imaging quality and diagnostic accuracy, Eur Radiol 23 (2013), 2612–2621.

E.S.

Cho ,

T.S.

Chung ,

D.K.

Oh , et al., Cerebral computed tomography angiography using a low tube voltage (80kVp) and a moderate concentration of iodine contrast material a quantitative and qualitative comparison with conventional computed tomography angiography, Investig Radiol 47 (2012), 142–147.

Zhao ,

Wu ,

Zuo , et al., CT pulmonary angiography using different noise index with iterative reconstruction algorithm and dual energy CT imaging using different body mass indices: Image quality and radiation dose, J Xray Sci Technol 25 (2017), 79–91.

Zhao ,

Zuo ,

Suo , et al., A comparison of the image quality and radiation dose using 100-kVp combination of different noise index and 120-kVp in CT pulmonary angiography, Journal of Computer Assisted Tomography 40 (2016), 784–790.

Zhao ,

Zuo ,

Suo , et al., CT pulmonary angiography using automatic tube current modulation combination with different noise index with iterative reconstruction algorithm in different body mass index: Image quality and radiation dose, Academic Radiology 23 (2016), 1513–1520.

Chen ,

Zhang ,

Schoepf , et al., Radiation dose and image quality of 70 kVp cerebral CT angiography with optimized sinogram-affirmed iterative reconstruction: Comparison with 120 kVp cerebral CT angiography, Eur Radiol 25 (2015), 1453–1463.

M.P.

Lungren ,

T.T.

Yoshizumi ,

S.M.

Brady , et al., Radiation dose estimations to the thorax using organ-based dose modulation, Am J Roentgenol 199 (2012), W65–W73.

10.

L.M.

Hurwitz ,

T.T.

Yoshizumi ,

P.C.

Goodman , et al., Radiation dose savings for adult pulmonary embolus 64-MDCT using bismuth breast shields, lower peak kilovoltage, and automatic tube current modulation, Am J Roentgenol 192 (2009), 244–253.

11.

Apfaltrer ,

Sudarski ,

Schneider , et al., Value of monoenergetic low-kV dual energy CT datasets for improved image quality of CT pulmonary angiography, European Journal of Radiology 83 (2014), 322–328.

12.

R.D.

MacDougall ,

P.L.

Kleinman and

M.J.

Callahan , Size-based protocol optimization using automatic tube current modulation and automatic kV selection in computed tomography, J Appl Clin MedPhys 17 (2016), 328–341.

13.

Ghetti ,

Ortenzia and

Serreli , CT iterative reconstruction in image space: A phantom study. Phys Med 28 (2012), 161–165.

14.

A.K.

Hara ,

R.G.

Paden ,

A.C.

Silva , et al., Iterative reconstruction technique for reducing body radiation dose at CT: Feasibility study, Am J Roentgenol 193 (2009), 764–771.

15.

Wang ,

Zhang ,

Xue , et al., Combined use of iterative reconstruction and monochromatic imaging in spinal fusion CT images, Acta Radiol 58 (2017), 62–69.

16.

Kwon ,

Cho ,

Oh ,

Kim , et al., The adaptive statistical iterative reconstruction-V technique for radiation dose reduction in abdominal CT: Comparison with the adaptive statistical iterative reconstruction technique, Br J Radiol 88 (2015), doi:10.1259/bjr.20150463

17.

Cai ,

C.H.

Hu ,

X.M.

Wang , et al., Applied research of "quadri-low" combined with automatic tube current modulation and iterative model reconstruction technology in head and neck CT angiography, Zhonghua Yi Xue Za Zhi 98 (2018), 30–35.

18.

International Commission on Radiological Protection. 2007 recommendations of the International Commission on Radiological Protection (publication no. 103), Ann ICRP 37 (2007), 2–4.

19.

J.A.

Christner ,

J.M.

Kofler and

C.H.

McCollough , Estimating Effective Dose for CT Using Dose-Length Product Compared With Using Organ Doses: Consequences of Adopting International Commission on Radiological Protection Publication 103 or Dual-Energy Scanning, Am J Roentgenol 194 (2010), 881–889.

20.

Ma ,

Yu ,

Duan , et al., Subtraction CT angiography in head and neck with low radiation and contrast dose dual-energy spectral CT using rapid kV-switching technique, Br J Radiol 91 (2017), 1–7.

21.

Cai ,

Hu ,

Hu , et al., Feasibility study of iterative model reconstruction combined with low tube voltage, low iodine load, and low iodine delivery rate in craniocervical CT angiography, Clinical Radiology 73 (2018), 217.e1–217.e6.

22.

F.F.

Behrendt ,

Schmidt ,

Plumhans , et al., Image fusion in dual energy computed tomography: Effect on contrast enhancement, signal-to-noise ratio and image quality in computed tomography angiography, Invest Radiol 44 (2009), 1–6.

23.

Fanous ,

Kashani ,

Jimenez , et al., Image quality and radiation dose of pulmonary CT angiography performed using 100 and 120 kVp, Am J Roentgenol 199 (2012), 990–996.

24.

Y.X.

Zhao ,

H.N.

Suo ,

Z.W.

Zuo , et al., A comparison of the image quality and radiation dose with routine CT and the latest Gemstone Spectral Imaging combination of different scanning protocols in CT angiography of the kidney, Journal of Computer Assisted Tomography 40(6) (2016), 632–640.

25.

J.K.

Hoang ,

T.T.

Yoshizumi ,

K.R.

Choudhury , et al., Organ-based dose current modulation and thyroid shields: Techniques of radiation dose reduction for neck CT, Am J Roentgenol 198 (2012), 1132–1138.