Abstract
PurposeTo prospectively investigate the effect of using Gemstone Spectral Imaging (GSI) and adaptive statistical iterative reconstruction (ASIR) for reducing radiation and iodine contrast dose in abdominal CT patients with high BMI values.Materials and Methods26 patients (weight > 65kg and BMI ≥ 22) underwent abdominal CT using GSI mode with 300mgI/kg contrast material as study group (group A). Another 21 patients (weight ≤ 65kg and BMI ≥ 22) were scanned with a conventional 120 kVp tube voltage for noise index (NI) of 11 with 450mgI/kg contrast material as control group (group B). GSI images were reconstructed at 60keV with 50%ASIR and the conventional 120kVp images were reconstructed with FBP reconstruction. The CT values, standard deviation (SD), signal-noise-ratio (SNR), contrast-noise-ratio (CNR) of 26 landmarks were quantitatively measured and image quality qualitatively assessed using statistical analysis.ResultsAs for the quantitative analysis, the difference of CNR between groups A and B was all significant except for the mesenteric vein. The SNR in group A was higher than B except the mesenteric artery and splenic artery. As for the qualitative analysis, all images had diagnostic quality and the agreement for image quality assessment between the reviewers was substantial (kappa = 0.684). CT dose index (CTDI) values for non-enhanced, arterial phase and portal phase in group A were decreased by 49.04%, 40.51% and 40.54% compared with group B (P = 0.000), respectively. The total dose and the injection rate for the contrast material were reduced by 14.40% and 14.95% in A compared with B.ConclusionThe use of GSI and ASIR provides similar enhancement in vessels and image quality with reduced radiation dose and contrast dose, compared with the use of conventional scan protocol.
Highlights
The concerns for the increasing potential radiation-induced malignancies [1,2,3,4,5] from CT continue to escalate since the dramatic increase of CT usage
The SNR in group A was higher than B except the mesenteric artery and splenic artery
CT dose index (CTDI) values for non-enhanced, arterial phase and portal phase in group A were decreased by 49.04%, 40.51% and 40.54% compared with group B (P = 0.000), respectively
Summary
The concerns for the increasing potential radiation-induced malignancies [1,2,3,4,5] from CT continue to escalate since the dramatic increase of CT usage. Radiologists should adhere to both the principle of ALARA (as low as reasonably achievable— referring to radiation dose) and the principle of AHARA (as high as reasonably achievable— referring to benefit)[8]. Iterative reconstruction algorithms such as the adaptive statistical iterative reconstruction (ASIR) have been proposed and studied to substantially reduce radiation dose without decreasing image quality in the whole body [9,10,11,12,13]. To the best of our knowledge, the combination of GSI and ASIR in reducing radiation and contrast agent dose in abdominal pelvic CT has not been reported to date. The purpose of the present study was to prospectively investigate the effect of using GSI and ASIR for reducing radiation dose and iodine contrast dose in abdominal CT patients with high BMI values
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