J C Montoya1, L J Eckel1, D R DeLone1, A L Kotsenas1, F E Diehn1, L Yu1, A C Bartley2, R E Carter2, C H McCollough1, J G Fletcher3. 1. From the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.). 2. Health Sciences Research (A.C.B., R.E.C.), Mayo Clinic, Rochester, Minnesota. 3. From the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.) fletcher.joel@mayo.edu.
Abstract
BACKGROUND AND PURPOSE: Given the positive impact of early intervention for craniosynostosis, CT is often performed for evaluation but radiation dosage remains a concern. We evaluated the potential for substantial radiation dose reduction in pediatric patients with suspected craniosynostosis. MATERIALS AND METHODS: CT projection data from pediatric patients undergoing head CT for suspected craniosynostosis were archived. Simulated lower-dose CT images corresponding to 25%, 10%, and 2% of the applied dose were created using a validated method. Three neuroradiologists independently interpreted images in a blinded, randomized fashion. All sutures were evaluated by using 3D volume-rendered images alone, and subsequently with 2D and 3D images together. Reference standards were defined by reader agreement by using routine dose and 2D and 3D images. Performance figures of merit were calculated based on reader response and confidence. RESULTS: Of 33 pediatric patients, 21 had craniosynostosis (39 positive sutures and 225 negative sutures). The mean volume CT dose index was 15.5 ± 2.3 mGy (range, 9.69-19.38 mGy) for the routine dose examination. Average figures of merit for multireader analysis ranged from 0.92 (95% CI, 0.90-0.95) at routine pediatric dose to 0.86 (95% CI, 0.79-0.94) at 2% dose using 3D images alone. Similarly, pooled reader figures of merit ranged from 0.91 (95% CI, 0.89-0.95) at routine pediatric dose to 0.85 (95% CI, 0.76-0.95) at 2% dose using 2D and 3D images together. At 25% and 10% dose, 95% CI of the difference in figures of merit from routine dose included 0, suggesting similar or noninferior performance. CONCLUSIONS: For pediatric head CT for evaluation of craniosynostosis, dose reductions of 75%-90% were possible without compromising observer performance.
BACKGROUND AND PURPOSE: Given the positive impact of early intervention for craniosynostosis, CT is often performed for evaluation but radiation dosage remains a concern. We evaluated the potential for substantial radiation dose reduction in pediatric patients with suspected craniosynostosis. MATERIALS AND METHODS: CT projection data from pediatric patients undergoing head CT for suspected craniosynostosis were archived. Simulated lower-dose CT images corresponding to 25%, 10%, and 2% of the applied dose were created using a validated method. Three neuroradiologists independently interpreted images in a blinded, randomized fashion. All sutures were evaluated by using 3D volume-rendered images alone, and subsequently with 2D and 3D images together. Reference standards were defined by reader agreement by using routine dose and 2D and 3D images. Performance figures of merit were calculated based on reader response and confidence. RESULTS: Of 33 pediatric patients, 21 had craniosynostosis (39 positive sutures and 225 negative sutures). The mean volume CT dose index was 15.5 ± 2.3 mGy (range, 9.69-19.38 mGy) for the routine dose examination. Average figures of merit for multireader analysis ranged from 0.92 (95% CI, 0.90-0.95) at routine pediatric dose to 0.86 (95% CI, 0.79-0.94) at 2% dose using 3D images alone. Similarly, pooled reader figures of merit ranged from 0.91 (95% CI, 0.89-0.95) at routine pediatric dose to 0.85 (95% CI, 0.76-0.95) at 2% dose using 2D and 3D images together. At 25% and 10% dose, 95% CI of the difference in figures of merit from routine dose included 0, suggesting similar or noninferior performance. CONCLUSIONS: For pediatric head CT for evaluation of craniosynostosis, dose reductions of 75%-90% were possible without compromising observer performance.
Authors: Eric C Ehman; Lifeng Yu; Armando Manduca; Amy K Hara; Maria M Shiung; Dayna Jondal; David S Lake; Robert G Paden; Daniel J Blezek; Michael R Bruesewitz; Cynthia H McCollough; David M Hough; Joel G Fletcher Journal: Radiographics Date: 2014 Jul-Aug Impact factor: 5.333
Authors: S Gabriel; L J Eckel; D R DeLone; K N Krecke; P H Luetmer; C H McCollough; J G Fletcher; L Yu Journal: AJNR Am J Neuroradiol Date: 2014-07-31 Impact factor: 3.825
Authors: Ryan P Morton; Renee M Reynolds; Rohan Ramakrishna; Michael R Levitt; Richard A Hopper; Amy Lee; Samuel R Browd Journal: J Neurosurg Pediatr Date: 2013-08-23 Impact factor: 2.375
Authors: Caroline W Ernst; Tine L Hulstaert; Dries Belsack; Nico Buls; Gert Van Gompel; Koenraad H Nieboer; Ronald Buyl; Filip Verhelle; Michel De Maeseneer; Johan de Mey Journal: Eur Radiol Date: 2015-06-30 Impact factor: 5.315
Authors: J G Fletcher; D R DeLone; A L Kotsenas; N G Campeau; V T Lehman; L Yu; S Leng; D R Holmes; P K Edwards; M P Johnson; G J Michalak; R E Carter; C H McCollough Journal: AJNR Am J Neuroradiol Date: 2019-10-24 Impact factor: 3.825
Authors: Andrea Rossi; Maria Argyropoulou; Dora Zlatareva; Gregoire Boulouis; Francesca B Pizzini; Luc van den Hauwe; Maria Raissaki; Jean-Pierre Pruvo; Karen Rosendahl; Chen Hoffmann; Pia C Sundgren Journal: Pediatr Radiol Date: 2022-09-05
Authors: Joel G Fletcher; Jeff L Fidler; Sudhakar K Venkatesh; David M Hough; Naoki Takahashi; Lifeng Yu; Matthew Johnson; Shuai Leng; David R Holmes; Rickey Carter; Cynthia H McCollough Journal: Radiology Date: 2018-09-11 Impact factor: 11.105
Authors: Joel G Fletcher; David L Levin; Anne-Marie G Sykes; Rebecca M Lindell; Darin B White; Ronald S Kuzo; Vighnesh Suresh; Lifeng Yu; Shuai Leng; David R Holmes; Akitoshi Inoue; Matthew P Johnson; Rickey E Carter; Cynthia H McCollough Journal: Radiology Date: 2020-09-29 Impact factor: 11.105
Authors: Carrie E Zimmerman; Pulkit Khandelwal; Long Xie; Hyunyeol Lee; Hee Kwon Song; Paul A Yushkevich; Arastoo Vossough; Scott P Bartlett; Felix W Wehrli Journal: Acad Radiol Date: 2021-04-24 Impact factor: 3.173