Abstract
ObjectiveTo develop and assess the value and limitations of an image quality scoring criteria (IQSC) for pediatric CT exams.MethodsIQSC was developed for subjective assessment of image quality using the scoring scale from 0 to 4, with 0 indicating desired anatomy or features not seen, 3 for adequate image quality, and 4 depicting higher than needed image quality. Pediatric CT examinations from 30 separate patients were selected, five each for routine chest, routine abdomen, kidney stone, appendicitis, craniosynostosis, and ventriculoperitoneal (VP) shunt. Five board-certified pediatric radiologists independently performed image quality evaluation using the proposed IQSC. The kappa statistics were used to assess the interobserver variability.ResultsAll five radiologists gave a score of 3 to two-third (67%) of all CT exams, followed by a score of 4 for 29% of CT exams, and 2 for 4% exams. The median image quality scores for all exams were 3 and the interobserver agreement among five readers (acceptable image quality [scores 3 or 4] vs sub-optimal image quality ([scores 1 and 2]) was moderate to very good (kappa 0.4–1). For all five radiologists, the lesion detection was adequate for all CT exams.ConclusionsThe image quality scoring criteria covering routine and some clinical indication-based imaging scenarios for pediatric CT examinations has potential to offer a simple and practical tool for assessing image quality with a reasonable degree of interobserver agreement. A more extensive and multi-centric study is recommended to establish wider usefulness of these criteria.
Highlights
Computed tomography (CT) plays a vital role in pediatric patients
For any action on making CT safer for children, the principle of optimization stipulated by the International Commission on Radiological Protection (ICRP) requires balancing radiation dose with the image quality so that necessary diagnostic information is not compromised [1, 2]
The results show that a particular image quality parameter is sensitive in detecting a specific aspect of information in the image but inadequate as an overall measure of image quality in terms of clinical usefulness
Summary
Computed tomography (CT) plays a vital role in pediatric patients. For any action on making CT safer for children, the principle of optimization stipulated by the International Commission on Radiological Protection (ICRP) requires balancing radiation dose with the image quality so that necessary diagnostic information is not compromised [1, 2]. Padole et al Insights into Imaging (2019) 10:95 be tailored based on clinical indications to ensure that CT radiation dose to pediatric patients is appropriate [4,5,6,7,8]. Most objective scoring criteria are useful for academic studies rather than for applying in day-to-day practice in clinical situations globally. Subjective scoring systems for image quality and some using image noise, contrast, sharpness, and artifacts have been applied to CT image quality [13,14,15,16]. Such studies focus on the visual aspect of quality. If the criteria developed are such that they have a lower interobserver variability, it may become widely acceptable
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