Abstract

To evaluate the feasibility of radiation dose reduction using model‐based iterative reconstruction (MBIR) for evaluating the ureters and vasculature in a phantom, a tissue‐equivalent CT dose phantom was scanned using a 64‐channel CT scanner. Tubes of varying diameters filled with different dilutions of a contrast agent, simulating ureters or vessels, were inserted into the center of the phantom. Each combination was scanned using an existing renal protocol at 140 kVp or 120 kVp, yielding a display volumetric CT dose index (CTDIvol) of 24 mGy. The scans were repeated using reduced scan techniques to achieve lower radiation doses down to 0.8 mGy. The images were reconstructed using filtered back‐projection (FBP) and model‐based iterative reconstruction (MBIR). The noise and contrast‐to‐noise ratio (CNR) was measured for each contrast object. Comparisons between the two reconstruction methods at different dose levels were evaluated using a factorial design. At each CTDIvol the measured image noise was lower using MBIR compared to FBP (p<0.0001). At low doses, the percent change in measured image noise between FBP and MBIR was larger. For the 12 mm object simulating a ureter or large vessel with an HU of 600, the measured CNR using MBIR at a CTDIvol of 1.7 mGy was greater than the CNR of FBP at a CTIDvol of 24 mGy (p<0.0001). For the 5 mm object simulating a medium‐sized vessel with a HU of 250, the measured CNR using MBIR at a CTDIvol of 1.7 mGy was equivalent to that of FBP at a CTDIvol of 24 mGy. For the 2 mm, 100 HU object simulating a small vessel, the measured CNR using MBIR at a CTDIvol of 1.7 mGy was equivalent to that of FBP at a CTDIvol of 24 mGy. Low‐dose (3.6 mGy) CT imaging of vasculature and ureter phantoms using MBIR results in similar noise and CNR compared to FBP at approximately one‐sixth the dose. This suggests that, using MBIR, a one milliSievert exam of the ureters and vasculature may be clinically possible whilst still maintaining adequate image qualityPACS number(s): 87.57.‐s, 87.57.Q‐, 87.57.C‐, 87.57.nf, 87.57.cj, 87.57.cm

Highlights

  • Over the past ten years, there have been many advances in computed tomography (CT) technology

  • The purpose of this study is to evaluate the feasibility of radiation dose reduction using model-based iterative reconstruction (MBIR) for evaluating the ureters and vasculature in a phantom

  • Image noise The measured image noise for all of the dose levels using MBIR was significantly lower than filtered back-projection (FBP) (p < 0.0001, Fig. 2)

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Summary

Introduction

Over the past ten years, there have been many advances in computed tomography (CT) technology. Due to the potential risks associated with these scans, methods to reduce the amount of radiation dose delivered to the patient while still achieving adequate diagnostic image quality need to be explored. This is especially the case for younger patients where there is a need for scanning using low-dose techniques due to a larger lifetime attributable risk of radiation-induced cancers.[7] Many studies use a split-bolus protocol in patients under the age of 40,(8-9) acquiring at least 2 phases. A history of urothelial cancer can require life-time surveillance with multiple CT scans Both the ureters and vessels are commonly imaged when opacified with contrast with HU considerably greater than organ parenchyma

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