Abstract
PurposeTo prospectively determine the diagnostic performance of low-dose CT (LDCT) with adaptive statistical iterative reconstruction (ASIR) technique for the detection of urinary stone disease.ResultsThe average DLP and ED was 408.16 ± 119.04 mGy and 6.12 ± 1.79 mSv in CDCT, and 138.19 ± 76.87 mGy and 2.07 ± 1.15 mSv in LDCT, respectively. The dose reduction rate of LDCT was nearly 66.1% for both DLP and ED (P < 0.05). LDCT–80% ASIR images showed great image quality (mean score = 4.09), which was similar to CDCT-FBP images (mean score = 4.17) (P > 0.05), but higher than LDCT-FBP images (mean score = 2.77) (P < 0.05).Materials and Methods70 consetutive patients with clinically suspected urolithiasis underwent non-enhanced CT. Followed by both conventional-dose CT (CDCT) and low-dose CT (LDCT) scans. Automatic tube current modulation (ATCM) scanning was used, with a noise index setting of 13 in CDCT and 25 in LDCT. Reconstructions were performed with filtered back projection (FBP) and different settings of adaptive statistical iterative reconstruction [ASIR(40%, 60%, 80%)]. Urinary calculi (size, location, number), image quality (scale 1–5), image noise (scale 1–3) and diagnostic confidence levels (scale 1–3) were evaluated and measured by two radiologists independently. Radiation dose was recorded by calculating dose length product (DLP) and effective dose (ED). Statistical analyses included Mann-Whitney U test and Paired t tests.ConclusionsLDCT with ASIR can reduce the radiation dose while maintain relatively high image quality in the diagnosis of urinary stone diseases.
Highlights
Urolithiasis is one of the most common disorders of urinary tract
A total of 70 patients were enrolled in this prospectively study and were scanned using both conventional computed tomography (CT) (CDCT) and low-dose CT (LDCT)
The images noise was lowest on LDCT-80% adaptive statistical iterative reconstruction (ASIR) images, which was similar to conventional-dose CT (CDCT)-filtered back projection (FBP) images (p = 0.015, 0.088, 0.087, respectively), and was highest on LDCT-FBP images
Summary
Urolithiasis is one of the most common disorders of urinary tract. Imaging is important for the diagnosis of acute and chronic urinary stone disease. Conventional abdominal radiology, intravenous urography and renal ultrasound (US) were usually used for the assessment of urinary stones, while about 34% of ureteral calculi, especially the. X-ray negative calculi, can not be found by abdominal radiology [3]. Intravenous urography was used for diagnosing urinary stones, the additional requirement of intravenous contrast media can cause serious complications, such as renal toxicity and acute allergic reaction. In adults, Unenhanced Multidetector computed tomography (CT) has a high sensitivity (95%–96%) and specificity (97%–100%) for the diagnosis of urinary stones, which was higher than intravenous urography or KUB [4, 5]. With respect to radiation dose, Unenhanced CT has a higher risk of radiation hazard than www.oncotarget.com
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