Abstract
This study aimed to evaluate the imaging quality of head and neck computed tomographic angiography (CTA) in pediatric patients at a lowered radiation dose by combining an iterative model reconstruction (IMR) with low voltage scanning. Eighty-three pediatric patients were randomized into two groups as follows: Group A (n = 42), 100 kV/50 ml contrast media (CM), using filtered back projection (FBP); and Group B (n = 41), 80 kV/30 ml CM, using IMR. The enhanced CT value of the arteries, the image noise, the signal-to-noise ratio (SNR)/contrast-to-noise ratio (CNR), the image quality, the effective radiation dose (ED) and the iodine intake were compared between the two groups. The mean ED and iodine intake of group B were reduced by 69.8% and 40.0%, respectively, compared to those of group A. The mean CT values of the arteries in group B were higher than those in group A (p < 0.01), whereas the image noise of group B was lower than that of group A (p < 0.01). Group B exhibited a better image quality and a higher mean CNR/SNR than that of group A (p < 0.01). Compared to FBP, IMR in head and neck CTA enables a significant reduction in the radiation dose while preserving the diagnostic image quality. Thus, IMR, combined with low tube voltage scanning, provided an excellent solution for improving the image quality of craniocervical vessels in children.
Highlights
With advances in multislice computed tomography (MSCT) and CT angiography (CTA) techniques, computed tomographic angiography (CTA) of the brain-supplying arteries is frequently used in clinical practice as a noninvasive examination, especially in patients with head and neck vascular disease[1,2]
adaptive statistical iterative reconstruction (ASiR) induces artifacts in the conjunction texture[17,18], while model-based iterative reconstruction (MBIR) induces a seriously time delay in the reconstruction process compared to filtered back projection (FBP) and ASiR, where approximately 3–4 datasets are reconstructed per hour[19]
Our current results demonstrated that CT imaging with the iterative model reconstruction (IMR) algorithm in head and neck CTA enabled a significant reduction in patient radiation dose
Summary
With advances in multislice computed tomography (MSCT) and CT angiography (CTA) techniques, CTA of the brain-supplying arteries is frequently used in clinical practice as a noninvasive examination, especially in patients with head and neck vascular disease[1,2]. A substantial emphasis is placed on strategies to reduce CT radiation doses while maintaining the image quality[7] Some techniques, such as an automatic adjustment of the tube current[8], a reduced tube voltage[9], a noise reduction filter[10] and a higher pitch[11], have been applied in the clinical practice. These strategies cause increased image noise or/and decreased image quality[12,13]. We aimed to evaluate the image quality and diagnostic performance improvement using the knowledge-based IMR method combined with a low tube voltage and a low iodine load in head and neck CTA for pediatric patients
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