Abstract
ObjectiveTo compare the radiation dose and the objective and subjective image quality of 80 kVp and 80/150 kVp with tin filter (80/Sn150 kVp) computed tomography (CT) in oncology patients.MethodsOne-hundred-and-forty-five consecutive oncology patients who underwent third-generation dual-source dual-energy CT of the abdomen for evaluation of malignant visceral, peritoneal, extraperitoneal, and bone tumor were retrospectively recruited. Two radiologists independently reviewed each observation in 80 kVp CT and 80/Sn150 kVp CT. Modified line-density profile of the tumor and contrast-to-noise ratio (CNR) were measured. Diagnostic confidence, lesion conspicuity, and subjective image quality were calculated and compared between image sets. The effective dose and size-specific dose estimate (SSDE) were calculated in the image sets.ResultsModified line-density profile analysis revealed higher attenuation differences between the tumor and normal tissue in 80 kVp CT than in 80/Sn150 kVp CT (127 vs. 107, P = 0.05). The 80 kVp CT showed increased CNR in the liver (8.0 vs. 7.6) and the aorta (18.9 vs. 16.3) than the 80/Sn150 kVp CT. The 80 kVp CT yielded higher enhancement of organs (4.9 ± 0.2 vs. 4.7 ± 0.4, P<0.001) and lesion conspicuity (4.9 ± 0.3 vs. 4.8 ± 0.5, P = 0.035) than the 80/Sn150 kVp CT; overall image quality and confidence index were comparable. The effective dose was reduced by 45.2% with 80 kVp CT (2.3 mSv ± 0.9) compared to 80/Sn150 kVp CT (4.1 mSv ± 1.5). The SSDE was 7.4 ± 3.8 mGy on 80/Sn150 kVp CT and 4.1 ± 2.2 mGy on 80 kVp CT.ConclusionsThe 80 kVp CT reduced the radiation dose by 45.2% in oncology patients while showing comparable or superior image quality to that of 80/Sn150 kVp CT for abdominal tumor evaluation.
Highlights
Optimization of the radiation dose delivered in abdominopelvic computed tomography (CT) imaging is important, especially in situations where repeated CT examinations are performed in patients
The 80 kVp CT reduced the radiation dose by 45.2% in oncology patients while showing comparable or superior image quality to that of 80/Sn150 kVp CT for abdominal tumor evaluation
We investigated whether the performance of 80 kVp CT was comparable to that of the 80/ Sn150 kVp CT while reducing the radiation dose, to ascertain if it could be used in oncology patients who receive repetitive dual-energy CT (DECT) scans
Summary
Optimization of the radiation dose delivered in abdominopelvic computed tomography (CT) imaging is important, especially in situations where repeated CT examinations are performed in patients. Various strategies have been developed to further reduce the radiation dose, including low kVp, automated exposure control, and iterative reconstruction (IR) [1,2]. Automatic tube current modulation (ATCM) can allow a reduction in the radiation exposure during CT examination, which is affected by the patient’s size [3,4]. IR selectively reduces statistical noise in the images, thereby improving the quality of subtle image details and may facilitate dose reduction. Advanced modelled iterative reconstruction (ADMIRE; Siemens Healthcare, Forchheim, Germany) is a model-based IR that can reduce noise in raw data and may allow further dose reduction while generating images of acceptable quality. ADMIRE is based on the results of the pseudo raw data, in comparison to the measured data, which is subtracted and reinserted into the loop afterward [11]
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