Intravenous pyelogram artefacts unique to digital tomosynthesis reconstruction

Area of Science:

• Medical Imaging
• Radiology
• Diagnostic Technology

Background:

• Digital tomosynthesis (DT) offers retrospective multi-planar reconstruction for investigations like intravenous pyelogram (IVP).
• DT imaging utilizes a limited angular range, resulting in incomplete data sets and potential out-of-focus information in reconstructed images.

Purpose of the Study:

• To describe and identify the causes of two artifacts unique to DT imaging.
• To investigate the potential for misdiagnosis of renal system anatomy due to these artifacts.

Main Methods:

• Analysis of DT imaging data from intravenous pyelogram (IVP) examinations.
• Correlation of imaging artifacts with patient breathing, renal anatomy, acquisition methods, and reconstruction algorithms.

Main Results:

• Two novel artifacts unique to DT imaging were identified, not solely attributable to blurring.
• These artifacts are hypothesized to result from patient breathing during data acquisition, compounded by other factors.
• A potential for misdiagnosis of a duplex collecting system by unaware radiologists was noted.

Conclusions:

• DT IVP artifacts are likely caused by breathing during data acquisition combined with specific imaging parameters.
• Recommendations include using DT IVP only in patients capable of breath-holding.
• Performing DT IVP with a breath-hold after expiration is suggested to mitigate artifacts.