Korean J Radiol.  2015 Oct;16(5):1047-1055. 10.3348/kjr.2015.16.5.1047.

Feasibility Study of Radiation Dose Reduction in Adult Female Pelvic CT Scan with Low Tube-Voltage and Adaptive Statistical Iterative Reconstruction

Affiliations
  • 1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. hw_doctor@sina.com

Abstract


OBJECTIVE
To evaluate image quality of female pelvic computed tomography (CT) scans reconstructed with the adaptive statistical iterative reconstruction (ASIR) technique combined with low tube-voltage and to explore the feasibility of its clinical application.
MATERIALS AND METHODS
Ninety-four patients were divided into two groups. The study group used 100 kVp, and images were reconstructed with 30%, 50%, 70%, and 90% ASIR. The control group used 120 kVp, and images were reconstructed with 30% ASIR. The noise index was 15 for the study group and 11 for the control group. The CT values and noise levels of different tissues were measured. The contrast to noise ratio (CNR) was calculated. A subjective evaluation was carried out by two experienced radiologists. The CT dose index volume (CTDIvol) was recorded.
RESULTS
A 44.7% reduction in CTDIvol was observed in the study group (8.18 +/- 3.58 mGy) compared with that in the control group (14.78 +/- 6.15 mGy). No significant differences were observed in the tissue noise levels and CNR values between the 70% ASIR group and the control group (p = 0.068-1.000). The subjective scores indicated that visibility of small structures, diagnostic confidence, and the overall image quality score in the 70% ASIR group was the best, and were similar to those in the control group (1.87 vs. 1.79, 1.26 vs. 1.28, and 4.53 vs. 4.57; p = 0.122-0.585). No significant difference in diagnostic accuracy was detected between the study group and the control group (42/47 vs. 43/47, p = 1.000).
CONCLUSION
Low tube-voltage combined with automatic tube current modulation and 70% ASIR allowed the low CT radiation dose to be reduced by 44.7% without losing image quality on female pelvic scan.

Keyword

Adaptive statistical iterative reconstruction; Tube-voltage; CT; Radiation dose

MeSH Terms

Adult
Aged
Body Mass Index
Feasibility Studies
Female
Genital Diseases, Female/diagnosis/*radiography
Humans
Middle Aged
Pelvis/*radiography
Radiation Dosage
Radiographic Image Interpretation, Computer-Assisted
Signal-To-Noise Ratio
*Tomography, X-Ray Computed

Figure

  • Fig. 1 Images reconstructed with different proportions of ASIR and kVp. A-E are reconstructed images using 30% ASIR (100 kVp), 50% ASIR (100 kVp), 70% ASIR (100 kVp), 90% ASIR (100 kVp), and 30% ASIR (120 kVp), respectively. Image scores for these five sets of images were > 3 points. Noise level in D was lower than that in A. Noise level in E was similar to those in C and D. A-D were from same patient with BMI of 23.2 kg/m2 and CTDIvol of 6.35 mGy. E was from another patient with BMI of 22.8 kg/m2 and CTDIvol of 13.3 mGy. ASIR = adaptive statistical iterative reconstruction, BMI = body mass index, CTDIvol = computed tomography dose index volume

  • Fig. 2 Locations of ROIs in different tissues. A. Image shows locations of ROI in bladder. B. Image shows locations of ROIs in iliac and fat. C. Image shows locations of ROI in uterine. D. Image shows locations of ROI in obturator muscles. ROI = region of interest

  • Fig. 3 Noise level at different ASIR proportions and over smooth appearance on 70% and 90% ASIR images. A-D are 30-90% ASIR images from same patient. Noise level decreased in proportion to increases in ASIR. C and D show over smooth appearance. ASIR = adaptive statistical iterative reconstruction

  • Fig. 4 Noise level at different ASIR proportions; over smooth appearance on 90% ASIR image. A-D are 30-90% ASIR images from same patient. Noise level decreased in proportion to increases in ASIR. D shows over smooth appearance. ASIR = adaptive statistical iterative reconstruction


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