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06.02.2017 | Computed Tomography

Improvement of image quality and dose management in CT fluoroscopy by iterative 3D image reconstruction

verfasst von: Oliver S. Grosser, Christian Wybranski, Dennis Kupitz, Maciej Powerski, Konrad Mohnike, Maciej Pech, Holger Amthauer, Jens Ricke

Erschienen in: European Radiology | Ausgabe 9/2017

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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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Froelich JJ, Ishaque N, Regn J, Saar B, Walthers EM, Klose KJ (2002) Guidance of percutaneous pulmonary biopsies with real-time CT fluoroscopy. Eur J Radiol 42:74–79CrossRefPubMed

Silverman SG, Tuncali K, Adams DF, Hooton S, Tuncali K, Adams DF (1999) CT fluoroscopy-guided abdominal interventions: techniques, results, and radiation exposure. Radiology 212:673–681CrossRefPubMed

Kim GR, Hur J, Lee SM et al (2011) CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol 21:232–239CrossRefPubMed

Carlson SK, Bender CE, Classic KL et al (2001) Benefits and safety of CT fluoroscopy in interventional radiologic procedures. Radiology 219:515–520CrossRefPubMed

Prosch H, Stadler A, Schilling M et al (2012) CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: accuracy, complications and radiation dose. Eur J Radiol 81:1029–1033CrossRefPubMed

Kloeckner R, dos Santos DP, Schneider J, Kara L, Dueber C, Pitton MB (2013) Radiation exposure in CT-guided interventions. Eur J Radiol 82:2253–2257CrossRefPubMed

Pereira MF, Alves JG, Sarmento S et al (2011) Preliminary assessment of the dose to the interventional radiologist in fluoro-CT-guided procedures. Radiat Prot Dosim 144:448–452CrossRef

Nawfel RD, Judy PF, Silverman SG et al (2000) Patient and personnel exposure during CT fluoroscopy-guided interventional procedures. Radiology 216:180–184CrossRefPubMed

Tsalafoutas IA, Tsapaki V, Triantopoulou C, Gorantonaki A, Papailiou J (2007) CT-guided interventional procedures without CT fluoroscopy assistance: patient effective dose and absorbed dose considerations. Am J Roentgenol 188:1479–1484CrossRef

10.

Joemai RMS, Zweers D, Obermann WR, Geleijns J (2009) Assessment of patient and occupational dose in established and new applications of MDCT fluoroscopy. Am J Roentgenol 192:881–886CrossRef

11.

Wagner LK, Eifel PJ, Geise RA (1994) Potential biological effects following high X-ray dose interventional procedures. J Vasc Interv Radiol 5:71–84CrossRefPubMed

12.

Berrington de González A, Darby S (2004) Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet 363:345–351CrossRefPubMed

13.

National Council on Radiation Protection (2009) Ionizing radiation exposure of the population of the United States. National Council on Radiation Protection and Measurements, Bethesda, MD

14.

Grosser OS, Kupitz D, Ruf J et al (2015) Optimization of SPECT-CT Hybrid Imaging Using Iterative Image Reconstruction for Low-Dose CT: A Phantom Study. PLoS ONE 10, e0138658CrossRefPubMedPubMedCentral

15.

Xia T, Alessio AM, De Man B, Manjeshwar R, Asma E, Kinahan PE (2012) Ultra-low dose CT attenuation correction for PET/CT. Phys Med Biol 57:309–328CrossRefPubMed

16.

Martinsen ACT, Sæther HK, Hol PK, Olsen DR, Skaane P (2012) Iterative reconstruction reduces abdominal CT dose. Eur J Radiol 81:1483–1487CrossRefPubMed

17.

Sagara Y, Hara AK, Pavlicek W, Silva AC, Paden RG, Wu Q (2010) Abdominal CT: comparison of low-dose CT with adaptive statistical iterative reconstruction and routine-dose CT with filtered back projection in 53 patients. Am J Roentgenol 195:713–719CrossRef

18.

Hara AK, Paden RG, Silva AC, Kujak JL, Lawder HJ, Pavlicek W (2009) Iterative reconstruction technique for reducing body radiation dose at CT: feasibility study. Am J Roentgenol 193:764–771CrossRef

19.

Leipsic J, Labounty TM, Heilbron B et al (2010) Estimated radiation dose reduction using adaptive statistical iterative reconstruction in coronary CT angiography: the ERASIR study. Am J Roentgenol 195:655–660CrossRef

20.

Gebhard C, Fuchs TA, Fiechter M et al (2013) Image quality of low-dose CCTA in obese patients: impact of high-definition computed tomography and adaptive statistical iterative reconstruction. Int J Cardiovasc Imaging 29:1565–1574CrossRefPubMed

21.

Singh S, Kalra MK, Do S et al (2012) Comparison of hybrid and pure iterative reconstruction techniques with conventional filtered back projection: dose reduction potential in the abdomen. J Comput Assist Tomogr 36:347–353CrossRefPubMed

22.

Hérin E, Gardavaud F, Chiaradia M et al (2015) Use of Model-Based Iterative Reconstruction (MBIR) in reduced-dose CT for routine follow-up of patients with malignant lymphoma: dose savings, image quality and phantom study. Eur Radiol 25:2362–2370CrossRefPubMed

23.

International Commission on Radiation Units and Measurements (2012) ICRU Report No. 87: Radiation dose and image-quality assessment in computed tomography. J ICRU 12:1–149

24.

Hsieh J (2009) Computed Tomography: principles, design, artifacts, and recent advances, 2nd edn. SPIE, Bellingham

25.

Schneider CA, Rasband WS, Eliceiri KW (2012) NIH Image to ImageJ: 25 years of image analysis. Nat Methods 9:671–675CrossRefPubMed

26.

Rosset A, Spadola L, Ratib O (2004) OsiriX: an open-source software for navigating in multidimensional DICOM images. J Digit Imaging 17:205–216CrossRefPubMedPubMedCentral

27.

International Electrotechnical Commission (2009), Medical electrical equipment - Part 2-44: Particular requirements for the basic safety and essential performance of X-ray equipment for computed tomography, IEC publication No. 60601-2-44

28.

ICRP (2007) The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP 37

29.

Bongartz G, Golding SJ, Jurik AG, et al. (2004) European Guidelines for Multislice Computed Tomography. European Commission, EUR 16262 EN

30.

Shrimpton PC, Hillier MC, Lewis MA, Dunn M (2006) National survey of doses from CT in the UK: 2003. Br J Radiol 79:968–980CrossRefPubMed

31.

Menke J (2005) Comparison of different body size parameters for individual dose adaptation in body CT of adults. Radiology 236:565–571CrossRefPubMed

32.

Mitsumori LM, Shuman WP, Busey JM, Kolokythas O, Koprowicz KM (2012) Adaptive statistical iterative reconstruction versus filtered back projection in the same patient: 64 channel liver CT image quality and patient radiation dose. Eur Radiol 22:138–143CrossRefPubMed

33.

Fleischmann D, Boas FE (2011) Computed tomography - old ideas and new technology. Eur Radiol 21:510–517CrossRefPubMed

34.

Neeman Z, Dromi SA, Sarin S, Wood BJ (2006) CT fluoroscopy shielding: decreases in scattered radiation for the patient and operator. J Vasc Interv Radiol 17:1999–2004CrossRefPubMedPubMedCentral

35.

Kato R, Katada K, Anno H, Suzuki S, Ida Y, Koga S (1996) Radiation dosimetry at CT fluoroscopy: physician's hand dose and development of needle holders. Radiology 201:576–578CrossRefPubMed

36.

Irie T, Kajitani M, Itai Y (2001) CT fluoroscopy-guided intervention: marked reduction of scattered radiation dose to the physician's hand by use of a lead plate and an improved I-I device. J Vasc Interv Radiol 12:1417–1421CrossRefPubMed

37.

Katada K, Kato R, Anno H et al (1996) Guidance with real-time CT fluoroscopy: early clinical experience. Radiology 200:851–856CrossRefPubMed

38.

Stoeckelhuber BM, Leibecke T, Schulz E et al (2005) Radiation dose to the radiologist's hand during continuous CT fluoroscopy-guided interventions. Cardiovasc Intervent Radiol 28:589–594CrossRefPubMed

39.

Mahnken AH, Sedlmair M, Ritter C, Banckwitz R, Flohr T (2012) Efficacy of lower-body shielding in computed tomography fluoroscopy-guided interventions. Cardiovasc Intervent Radiol 35:1475–1479CrossRefPubMed

40.

Hohl C, Suess C, Wildberger JE et al (2008) Dose reduction during CT fluoroscopy: phantom study of angular beam modulation. Radiology 246:519–525CrossRefPubMed

Titel: Improvement of image quality and dose management in CT fluoroscopy by iterative 3D image reconstruction
verfasst von: Oliver S. Grosser
Christian Wybranski
Dennis Kupitz
Maciej Powerski
Konrad Mohnike
Maciej Pech
Holger Amthauer
Jens Ricke
Publikationsdatum: 06.02.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4754-7

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Improvement of image quality and dose management in CT fluoroscopy by iterative 3D image reconstruction