Dedicated sub 0.1 mSv 3DCT using MBIR in children with suspected craniosynostosis: quality assessment
Caroline W Ernst1, Tine L Hulstaert2, Dries Belsack2
1Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium. caroline.ernst@uzbrussel.be.
Insights
A new low-dose 3D CT protocol significantly reduces radiation exposure in children with suspected craniosynostosis without compromising diagnostic image quality. This optimized protocol allows for effective diagnosis with minimal radiation.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Radiological Physics
Background:
- Craniosynostosis diagnosis in children requires cranial 3D CT.
- Minimizing radiation exposure in pediatric patients is crucial.
- Optimizing CT protocols can reduce radiation dose while maintaining diagnostic quality.
Purpose of the Study:
- To compare the image quality of a low-dose CT protocol with a standard CT protocol in pediatric patients with suspected craniosynostosis.
- To evaluate the diagnostic acceptability and image characteristics of reduced radiation dose protocols.
Main Methods:
- Retrospective analysis of 48 pediatric patients (0-35 months) undergoing cranial 3D CT.
- Comparison between a standard protocol (32.18 mGy CTDIvol) and a low-dose protocol (0.94 mGy CTDIvol) with iterative reconstruction.
- Image quality assessed via expert review and objective analysis; statistical comparison using t-test and Mann-Whitney U test.
Main Results:
- The low-dose protocol achieved an effective dose of 0.08 mSv, a 97% reduction.
- Overall diagnostic acceptability, noise levels, bone edge sharpness, and artifact presence were similar between protocols.
- The low-dose protocol demonstrated superior objective sharpness of the bone-brain interface and subjective noise perception.
Conclusions:
- A cranial 3D CT protocol under 0.1 mSv is effective for diagnosing craniosynostosis in children.
- Combining 80 kVp with iterative reconstruction enables significant dose reduction.
- This low-dose protocol can be implemented without sacrificing diagnostic quality in pediatric patients.
Objective:
To retrospectively compare image quality of a lowered dose CT protocol to a standard CT protocol in children with suspicion of craniosynostosis.
Methods:
Forty-eight patients (age 0- 35 months), who presented with a cranial deformity underwent cranial 3D CT to assess sutural patency: between 2009 - 2010, 24 patients were imaged with a standard protocol (CTDIvol 32.18 mGy), from 2011-2012, 24 underwent a low dose protocol (0.94 mGy) combined with iterative reconstruction. Image quality was evaluated by both expert reading and objective analysis. Differences were assessed by independent t-test and Mann-Whitney U test, interreader agreement by Cohen's Kappa test.
Results:
Effective dose of the low dose protocol was 0.08 mSv, corresponding to a reduction of 97 %. Image quality was similar in both groups in terms of overall diagnostic acceptability, objective noise measurements, subjective cranial bone edge sharpness and presence of artefacts. For objective sharpness of cranial bone-brain interface and subjective perception of noise, the images of the low dose protocol were superior. For all evaluated structures, interreader agreement was moderate to almost perfect.
Conclusion:
In the diagnosis of craniosynostosis in children with cranial deformities, a dedicated sub 0.1 mSv cranial 3DCT protocol can be used without loss in image quality.
Key Points:
3DCT is used for the diagnosis of craniosynostosis. Imaging protocols should be optimized to minimize radiation exposure to children. Combining 80 kVp with iterative reconstruction can help to reduce dose. A sub 0.1 mSv cranial 3DCT protocol can be used without loss of diagnostic quality.
