Abstract
Patients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures. Our aim was to assess the acceptability of a dedicated, special-purpose sinogram-affirmed iterative reconstruction-based ultra-low-dose CT protocol for neurosurgical intensive care unit surveillance head CT examinations, comparing image quality with studies performed with our standard-of-care sinogram-affirmed iterative reconstruction low-dose CT and legacy filtered back-projection standard-dose CT protocols. A retrospective analysis was performed of 54 head CT examinations: ultra-low-dose CT (n = 22), low-dose CT (n = 12), and standard-dose CT (n = 20) in 22 patients in the neurosurgical intensive care unit. Standard-dose CT was reconstructed by using filtered back-projection on a Somatom Sensation 64 scanner. Ultra-low-dose CT and ultra-low-dose CT examinations were performed on a Siemens AS+128 scanner with commercially available sinogram-affirmed iterative reconstruction. Qualitative and quantitative parameters, including image quality and dose, were evaluated. Sinogram-affirmed iterative reconstruction ultra-low-dose CT represented a 68% lower dose index volume compared with filtered back-projection standard-dose CT techniques in the same patients while maintaining similar quality and SNR levels. Sinogram-affirmed iterative reconstruction low-dose CT offered higher image quality than filtered back-projection standard-dose CT (P < .05) with no differences in SNR at a 24% lower dose index volume. Compared with low-dose CT, ultra-low-dose CT had significantly lower SNR (P = .001) but demonstrated clinically satisfactory measures of image quality. In this cohort of patients in the neurosurgical intensive care unit, dedicated ultra-low-dose CT for surveillance head CT imaging led to a significant dose reduction while maintaining adequate image quality.
Highlights
BACKGROUND AND PURPOSEPatients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures
In this cohort of patients in the neurosurgical intensive care unit, dedicated ultra-low-dose CT for surveillance head CT imaging led to a significant dose reduction while maintaining adequate image quality
iterative reconstruction (IR) methods loop iteratively through the image reconstruction, reducing noise, with each pass permitting the use of lower levels of ionizing radiation while preserving acceptable image quality.[1,2]
Summary
BACKGROUND AND PURPOSEPatients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures. Our aim was to assess the acceptability of a dedicated, special-purpose sinogram-affirmed iterative reconstruction– based ultra-low-dose CT protocol for neurosurgical intensive care unit surveillance head CT examinations, comparing image quality with studies performed with our standard-of-care sinogram-affirmed iterative reconstruction low-dose CT and legacy filtered back-projection standard-dose CT protocols
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