Assessment of iterative image reconstruction on kidney and liver donors: Potential role of adaptive iterative dose reduction 3D (AIDR 3D) technology

Abstract

Objective: The aim of this study was to evaluate the radiation exposure levels in two different types of subjects including liver and kidney donors in diagnostic assessment of transplant operation and also the significance of dose reduction on total effective dose.

Materials and methods: A number of Sixty subjects (40 males and 20 females, average age of 35 ± 10 years) were randomly prospectively recruited and equally divided into two distinct groups namely kidney donors (KD, 24 M and 6 F) and liver donors (LD, 21 M and 9 female). Kidney donors were divided into full dose (KFD, n = 20) group and low dose (KLD, n = 10) group. They had undergone dynamic renal scan using Tc99 m-DTPA, CT renal angiography and x-ray plain radiograph. Liver donors were divided into full dose (LFD, n = 20) and low dose (LLD, n = 10) groups and performed CT liver volumetry. The CT dose index (CTDIvol), dose length product (DLP), total milli-ampere product time mAs, effective dose and image noise index were measured in all subjects of kidney and liver donors comparing full dose and low dose protocols.

Results: In comparison of all subjects of kidney donor groups (KFD vs KLD), the parameters (mAs = 16386.8 ± 3140.7 vs 2830.286 ± 831.676), (CTDIvol = 183.19 ± 32.58 mGy vs. 45.5 ± 13.3 mGy), DLP = 2884 ± 859.0 mGy.cm vs. 1437.5 ± 399 mGy.cm) and (effective dose = 49.0 ± 9.0 mSv vs. 18.9 mSv±5.7 mSv) were significant, p < 0.0005. Statistical evaluation of liver donors groups (LFD vs LLD) showed that (mAs = 14348.8 ± 4571.8 vs 3123.357 ± 794.5), (CTDIvol = 333.6 ± 59.5 mGy vs. 51.4 ± 13 mGy), (DLP = 3268.3 ± 604.3 mGy.cm vs 1260.5 ± 404.6 mGy.cm) and (effective dose = 43.3 mSv±12.9 mSv vs. 21.6 ± 5.9 mSv) are statistically significant, p < 0.0005. Nevertheless, the comparative evaluation of the image quality noise index of KFD vs KLD groups and LFD vs LLD showed a no statistical significance p > 0.05.

Conclusion: Renal and liver donors bear a relatively significant radiation dose due to diagnostic evaluation and patient management. The CT iterative reconstruction using AIDR3D proved very valuable tool in dose reduction such that it can reduce 37% in kidney donors and 48% in liver donors while able to maintain an acceptable image quality. Monitoring of those subjects on the clinical and radiobiological levels are recommended.

Keywords: AIDR3D; Effective dose; Iterative reconstruction; Kidney donors; Liver donors; Radiation exposure.