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Renal perfusion and hemodynamics: accurate in vivo determination at CT with a 10-fold decrease in radiation dose and
Xin Liu1, Andrew N Primak, James D Krier
1Department of Radiology, Divisions of Nephrology and Hypertension, CT Clinical Innovation Center, Mayo Clinic, Rochester, MN 55905, USA.
Radiology
|October 1, 2009
Summary
This study demonstrates that computed tomographic (CT) perfusion imaging of renal hemodynamics can achieve a 10-fold radiation dose reduction without compromising accuracy. The HYPR-LR algorithm significantly improved image quality for low-dose scans.
Area of Science:
- Radiology
- Medical Imaging
- Renal Physiology
Background:
- Computed tomographic (CT) perfusion imaging is crucial for assessing renal hemodynamics and function.
- Reducing radiation dose in CT scans is a significant clinical goal to minimize patient risk.
- Advanced postprocessing techniques are needed to maintain image quality at lower radiation doses.
Purpose of the Study:
- To evaluate the accuracy of renal perfusion CT measurements at a 10-fold reduced radiation dose.
- To assess the efficacy of the highly constrained back-projection (HYPR)-local reconstruction (LR) algorithm in improving low-dose CT image quality.
- To determine if renal hemodynamics and function can be accurately measured with significantly reduced radiation exposure.
Main Methods:
- Prospective evaluation in 10 anesthetized pigs using routine and one-tenth dose CT perfusion acquisitions.
- Images were reconstructed with identical parameters; low-dose images were processed with HYPR-LR.
- Renal perfusion, glomerular filtration rate, and blood flow were calculated using time-attenuation curves and curve-fitting.
- Image quality and agreement between routine and low-dose HYPR-LR images were statistically analyzed.
Main Results:
- Time-attenuation curves were similar between routine and one-tenth dose acquisitions.
- No significant differences were found in renal perfusion and hemodynamic values between routine and low-dose acquisitions.
- Slight, statistically significant differences were noted in some values with one-tenth dose HYPR-LR processing.
- HYPR-LR processing improved the image quality of the one-tenth dose scans, showing good agreement with routine dose images.
Conclusions:
- A 10-fold dose reduction is feasible for in vivo renal perfusion CT without sacrificing accuracy.
- The HYPR-LR noise-reduction algorithm effectively enhances the image quality of low-dose CT scans.
- This approach allows for accurate assessment of renal hemodynamics and function with substantially reduced radiation exposure.

