Abstract
Objectives
The objective of this study was to assess the influence of an iterative CT reconstruction algorithm (IA), newly available for CT-fluoroscopy (CTF), on image noise, readers’ confidence and effective dose compared to filtered back projection (FBP).
Methods
Data from 165 patients (FBP/IA = 82/74) with CTF in the thorax, abdomen and pelvis were included. Noise was analysed in a large-diameter vessel. The impact of reconstruction and variables (e.g. X-ray tube current I) influencing noise and effective dose were analysed by ANOVA and a pairwise t-test with Bonferroni–Holm correction. Noise and readers’ confidence were evaluated by three readers.
Results
Noise was significantly influenced by reconstruction, I, body region and circumference (all p ≤ 0.0002). IA reduced the noise significantly compared to FBP (p = 0.02). The effect varied for body regions and circumferences (p ≤ 0.001). The effective dose was influenced by the reconstruction, body region, interventional procedure and I (all p ≤ 0.02). The inter-rater reliability for noise and readers’ confidence was good (W ≥ 0.75, p < 0.0001). Noise and readers’ confidence were significantly better in AIDR-3D compared to FBP (p ≤ 0.03). Generally, IA yielded a significant reduction of the median effective dose.
Conclusion
The CTF reconstruction by IA showed a significant reduction in noise and effective dose while readers’ confidence increased.
Key Points
• CTF is performed for image guidance in interventional radiology.
• Patient exposure was estimated from DLP documented by the CT.
• Iterative CT reconstruction is appropriate to reduce image noise in CTF.
• Using iterative CT reconstruction, the effective dose was significantly reduced in abdominal interventions.
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Abbreviations
- AIDR 3D:
-
Adaptive Iterative Dose Reduction 3D
- ANOVA:
-
Analysis of variance
- BMI:
-
Body mass index
- CTF:
-
CT fluoroscopy
- DLP:
-
Dose length product
- FBP:
-
Filtered back projection
- HU:
-
Hounsfield units
- I:
-
X-ray tube current
- IQR:
-
Interquartile range
- IR:
-
Interventional radiologist
- MWA:
-
Microwave ablation
- PMMA:
-
Polymethylmethacrylate
- RFA:
-
Radiofrequency ablation
- ROI:
-
Region of interest
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Acknowledgements
We thank Toshiba Medical Systems Corporation for funding the clinical trial.
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The scientific guarantor of this publication is Jens Ricke.
Conflict of interest
The authors of this manuscript declare relationships with Toshiba Medical Systems Corporation.
Funding
This study has received funding by Toshiba Medical Systems Corporation.
Statistics and biometry
One of the authors has significant statistical expertise.
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Institutional Review Board approval was obtained.
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Written informed consent was obtained from all subjects (patients) in this study.
Methodology
• retrospective
• observational
• performed at one institution
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Grosser, O.S., Wybranski, C., Kupitz, D. et al. Improvement of image quality and dose management in CT fluoroscopy by iterative 3D image reconstruction. Eur Radiol 27, 3625–3634 (2017). https://doi.org/10.1007/s00330-017-4754-7
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DOI: https://doi.org/10.1007/s00330-017-4754-7