Ultra-low dose CT colonography with automatic tube current modulation and sinogram-affirmed iterative reconstruction: Effects on radiation exposure and image quality

J Appl Clin Med Phys. 2019 Jan;20(1):321-330. doi: 10.1002/acm2.12510. Epub 2018 Dec 26.

Abstract

Objective: To assess the radiation dose and image quality of ultra-low dose (ULD)-CT colonography (CTC) obtained with the combined use of automatic tube current (mAs) modulation with a quality reference mAs of 25 and sinogram-affirmed iterative reconstruction (SAFIRE), compared to low-dose (LD) CTC acquired with a quality reference mAs of 55 and reconstructed with filtered back projection (FBP).

Methods: Eighty-two patients underwent ULD-CTC acquisition in prone position and LD-CTC acquisition in supine position. Both ULD-CTC and LD-CTC protocols were compared in terms of radiation dose [weighted volume computed tomography dose index (CTDIvol ) and effective dose], image noise, image quality, and polyp detection.

Results: The mean effective dose of ULD-CTC was significantly lower than that of LD-CTC (0.98 and 2.69 mSv respectively, P < 0.0001) with an overall dose reduction of 63.2%. Image noise was comparable between ULD-CTC and LD-CTC (28.6 and 29.8 respectively, P = 0.09). There was no relevant difference when comparing image quality scores and polyp detection for both 2D and 3D images.

Conclusion: ULD-CTC allows to significantly reduce the radiation dose without meaningful image quality degradation compared to LD-CTC.

Keywords: automated tube current modulation; computed tomographic colonography; computed tomographic colonography, technique; dose reduction; iterative reconstruction techniques; radiation dose.

MeSH terms

  • Algorithms*
  • Colonic Diseases / diagnostic imaging*
  • Colonic Diseases / pathology
  • Colonic Diseases / radiotherapy
  • Colonography, Computed Tomographic / methods*
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Patient Positioning
  • Prone Position
  • Radiation Exposure*
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Radiotherapy Dosage
  • Retrospective Studies