Pierre Leyendecker1, Vanina Faucher2, Aissam Labani2, Vincent Noblet3, François Lefebvre4, Paul Magotteaux5, Mickaël Ohana2,3, Catherine Roy2,6. 1. Service de Radiologie B, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1, place de l'hôpital, BP 426, 67091, Strasbourg Cedex, France. pierre.leyendecker@chru-strasbourg.fr. 2. Service de Radiologie B, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1, place de l'hôpital, BP 426, 67091, Strasbourg Cedex, France. 3. iCube, Telecom Physique Strasbourg, Université de Strasbourg, CNRS UMR 7357, Illkirch, France. 4. Département de Biostatistiques, Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. 5. GIE Radiologie, Institut Hospitalo-Universitaire, Institut de chirurgie guidée par l'image, Strasbourg, France. 6. Faculté de Médecine, Strasbourg, France.
Abstract
OBJECTIVES: To investigate the radiation dose exposure, image quality, and diagnostic performance of enhanced 100-kVp abdominopelvic single-energy CT protocol with tin filter (TF). METHODS: Ninety-three consecutive patients referred for a single-phase enhanced abdominopelvic CT were prospectively included after informed consent. They underwent in addition to a standard protocol (SP) an acquisition with TF. Both examinations were performed on a third-generation dual-source CT system (DSCT), in single energy, using automatic tube current modulation, identical pitch, and identical level of iterative reconstruction. Radiation metrics were compared. Size-specific dose estimates (SSDE), contrast to noise ratio (CNR), and figure of merit (FOM) were calculated. Diagnostic confidence for the assessment of a predetermined list of abdominal lesions was rated by two independent readers. RESULTS: The mean dose of the TF protocol was significantly lower (CDTI 1.56 ± 0.43 mGy vs. 8.13 ± 3.32, p < 0.001; SSDE 9.94 ± 3.08 vs. 1.93 ± 0.39, p < 0.001), with an effective dose close to 1 mSv (1.14 mSv ± 0.34; p < 0.001). TF group exhibited non-significant lower liver CNR (2.76 vs. 3.03, p = 0.56) and was more dose efficient (FOM 10.6 vs. 2.49/mSv, p < 0.001) in comparison to SP. The mean diagnostic confidence for visceral, bone, and peritoneal tumors was equivalent between both groups. CONCLUSIONS: Enhanced 100-kVp abdominopelvic CT acquired after spectral shaping with tin filtration can achieve similar diagnostic performance and CNR compared to a standard CT protocol, while reducing the radiation dose by 81%. KEY POINTS: • 100-kVp spectral filtration enables enhanced abdominal CT with high-dose efficiency. • The radiation dose reaches the 1-mSv range. • Predetermined abdominopelvic lesions can be assessed without impairing on diagnostic confidence.
OBJECTIVES: To investigate the radiation dose exposure, image quality, and diagnostic performance of enhanced 100-kVp abdominopelvic single-energy CT protocol with tin filter (TF). METHODS: Ninety-three consecutive patients referred for a single-phase enhanced abdominopelvic CT were prospectively included after informed consent. They underwent in addition to a standard protocol (SP) an acquisition with TF. Both examinations were performed on a third-generation dual-source CT system (DSCT), in single energy, using automatic tube current modulation, identical pitch, and identical level of iterative reconstruction. Radiation metrics were compared. Size-specific dose estimates (SSDE), contrast to noise ratio (CNR), and figure of merit (FOM) were calculated. Diagnostic confidence for the assessment of a predetermined list of abdominal lesions was rated by two independent readers. RESULTS: The mean dose of the TF protocol was significantly lower (CDTI 1.56 ± 0.43 mGy vs. 8.13 ± 3.32, p < 0.001; SSDE 9.94 ± 3.08 vs. 1.93 ± 0.39, p < 0.001), with an effective dose close to 1 mSv (1.14 mSv ± 0.34; p < 0.001). TF group exhibited non-significant lower liver CNR (2.76 vs. 3.03, p = 0.56) and was more dose efficient (FOM 10.6 vs. 2.49/mSv, p < 0.001) in comparison to SP. The mean diagnostic confidence for visceral, bone, and peritoneal tumors was equivalent between both groups. CONCLUSIONS: Enhanced 100-kVp abdominopelvic CT acquired after spectral shaping with tin filtration can achieve similar diagnostic performance and CNR compared to a standard CT protocol, while reducing the radiation dose by 81%. KEY POINTS: • 100-kVp spectral filtration enables enhanced abdominal CT with high-dose efficiency. • The radiation dose reaches the 1-mSv range. • Predetermined abdominopelvic lesions can be assessed without impairing on diagnostic confidence.
Authors: Matthias Wetzl; Matthias S May; Daniel Weinmann; Matthias Hammon; Christoph Treutlein; Martin Zeilinger; Alexander Kiefer; Regina Trollmann; Joachim Woelfle; Michael Uder; Oliver Rompel Journal: Pediatr Radiol Date: 2020-06-17
Authors: Christoph Stern; Stefan Sommer; Christoph Germann; Julien Galley; Christian W A Pfirrmann; Benjamin Fritz; Reto Sutter Journal: Eur Radiol Date: 2021-03-12 Impact factor: 5.315