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Updated: Apr 20, 2026
In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
MDCT arthrography of the hip: value of the adaptive statistical iterative reconstruction technique and potential for
Frank Tobalem1, Eric Dugert, Francis R Verdun
11 Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, Lausanne 1011, Switzerland.
Objective:
The purpose of this article is to assess the effect of the adaptive statistical iterative reconstruction (ASIR) technique on image quality in hip MDCT arthrography and to evaluate its potential for reducing radiation dose.
Subjects And Methods:
Thirty-seven patients examined with hip MDCT arthrography were prospectively randomized into three different protocols: one with a regular dose (volume CT dose index [CTDIvol], 38.4 mGy) and two with a reduced dose (CTDIvol, 24.6 or 15.4 mGy). Images were reconstructed using filtered back projection (FBP) and four increasing percentages of ASIR (30%, 50%, 70%, and 90%). Image noise and contrast-to-noise ratio (CNR) were measured. Two musculoskeletal radiologists independently evaluated several anatomic structures and image quality parameters using a 4-point scale. They also jointly assessed acetabular labrum tears and articular cartilage lesions.
Results:
With decreasing radiation dose level, image noise statistically significantly increased (p=0.0009) and CNR statistically significantly decreased (p=0.001). We also found a statistically significant reduction in noise (p=0.0001) and increase in CNR (p≤0.003) with increasing percentage of ASIR; in addition, we noted statistically significant increases in image quality scores for the labrum and cartilage, subchondral bone, overall diagnostic quality (up to 50% ASIR), and subjective noise (p≤0.04), and statistically significant reductions for the trabecular bone and muscles (p≤0.03). Regardless of the radiation dose level, there were no statistically significant differences in the detection and characterization of labral tears (n=24; p=1) and cartilage lesions (n=40; p≥0.89) depending on the ASIR percentage.
Conclusion:
The use of up to 50% ASIR in hip MDCT arthrography helps to reduce radiation dose by approximately 35-60%, while maintaining diagnostic image quality comparable to that of a regular-dose protocol using FBP.
Insights
Adaptive Statistical Iterative Reconstruction (ASIR) up to 50% in hip MDCT arthrography significantly reduces radiation dose by 35-60%. This technique maintains diagnostic image quality comparable to standard protocols, aiding in dose reduction without compromising diagnostic accuracy.
Area of Science:
- Radiology
- Medical Imaging
- Computed Tomography
Background:
- Multi-detector computed tomography (MDCT) arthrography is crucial for evaluating hip joint pathologies.
- Radiation dose reduction is a significant concern in medical imaging procedures.
- Adaptive Statistical Iterative Reconstruction (ASIR) is an advanced image processing technique.
Purpose of the Study:
- To evaluate the impact of ASIR on image quality in hip MDCT arthrography.
- To determine the potential of ASIR for reducing radiation exposure.
- To compare ASIR with filtered back projection (FBP) at various dose levels.
Main Methods:
- Prospective randomization of 37 patients into three dose protocols (regular and two reduced doses).
- Image reconstruction using FBP and increasing percentages of ASIR (30%, 50%, 70%, 90%).
- Quantitative (noise, CNR) and qualitative (radiologist assessment) image quality evaluation, including labral tear and cartilage lesion detection.
Main Results:
- Decreased radiation dose increased image noise and decreased contrast-to-noise ratio (CNR).
- Increased ASIR percentage significantly reduced noise and improved CNR, enhancing image quality scores for specific structures.
- No significant difference in detecting labral tears or cartilage lesions was observed across different ASIR percentages.
Conclusions:
- Utilizing up to 50% ASIR in hip MDCT arthrography allows for substantial radiation dose reduction (35-60%).
- Diagnostic image quality is maintained at levels comparable to regular-dose FBP protocols.
- ASIR is a valuable tool for optimizing radiation dose in hip MDCT arthrography without compromising diagnostic efficacy.
