Abstract
BackgroundRadiation dose reduction is a major concern in patients who undergo computed tomography (CT) to follow liver and renal abscess.ObjectivesThe purpose of this study is to investigate the feasibility of ultralow-dose CT with iterative reconstruction (IR) to follow patients with liver and renal abscess.MethodsThis prospective study included 18 patients who underwent ultralow-dose CT with IR to follow abscesses (liver abscesses in 10 patients and renal abscesses in 8 patients; ULD group). The control group consisted of 14 patients who underwent follow-up standard-dose CT for liver abscesses during the same period. The objective image noise was evaluated by measuring standard deviation (SD) in the liver and subcutaneous fat to select a specific IR for qualitative analysis. Two radiologists independently evaluated subjective image quality, noise, and diagnostic confidence to evaluate abscess using a five-point Likert scale. Qualitative parameters were compared between the ULD and control groups with the Mann-Whitney U test.ResultsThe mean CT dose index volume and dose length product of standard-dose CT were 8.7 ± 1.8 mGy and 555.8 ± 142.8 mGy·cm, respectively. Mean dose reduction of ultralow-dose CT was 71.8% compared to standard-dose CT. After measuring SDs, iDose level 5, which showed similar SD to standard-dose CT in both the subcutaneous fat and liver (P = 0.076, and P = 0.124), was selected for qualitative analysis. Ultralow-dose CT showed slightly worse subjective image quality (P < 0.001 for reader 1, and P = 0.005 for reader 2) and noise (P = 0.004 for reader 1, and P = 0.001 for reader 2) than standard-dose CT. However, the diagnostic confidence of ultralow-dose CT for evaluating abscess was comparably excellent to standard-dose CT (P = 0.808 for reader 1, and P = 0.301 for reader 2).ConclusionsUltralow-dose CT with IR can be used in the follow-up of liver and renal abscess with comparable diagnostic confidence.
Highlights
Intra-abdominal abscesses can be clinically suspected in patients with acute abdominal pain and fever
The purpose of this study is to investigate the feasibility of ultralow-dose computed tomography (CT) with iterative reconstruction (IR) to follow patients with liver and renal abscess
Ultralow-dose CT with IR can be used in the follow-up of liver and renal abscess with comparable diagnostic confidence
Summary
Intra-abdominal abscesses can be clinically suspected in patients with acute abdominal pain and fever. Even after initial percutaneous drainage, abscess recurrence can occur to increase morbidity and mortality rates [4,5,6,7]. In those patients with intra-abdominal abscess, imaging studies for initial diagnosis and follow-up are essential. CT plays an important role when deciding treatment options and guiding the drainage procedure for abscess [10,11,12] After appropriate treatment such as antibiotics or drainage procedures, most patients undergo follow-up CT scans to evaluate treatment response within a short time interval. Radiation dose reduction is a major concern in patients who undergo computed tomography (CT) to follow liver and renal abscess
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