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Published on: September 11, 2011
Dose reduction in paediatric cranial CT via iterative reconstruction: a clinical study in 78 patients
1Department of Radiology, Charité School of Medicine and University Hospital, Charitéplatz 1, 10117 Berlin, Germany; Department of Radiation Oncology, Charité School of Medicine and University Hospital, Augustenburger Platz 1, 13353 Berlin, Germany.
Insights
Adaptive statistical iterative reconstruction (ASIR) significantly reduces radiation dose in pediatric head CT scans. This technique maintains adequate image quality for clinical diagnosis and follow-up imaging.
Area of Science:
- Radiology
- Medical Imaging
- Pediatric Imaging
Background:
- Pediatric non-contrast cranial computed tomography (cCT) requires careful radiation dose management.
- Adaptive statistical iterative reconstruction (ASIR) is a post-processing technique that may allow for dose reduction.
Purpose of the Study:
- To evaluate the impact of ASIR on radiation dose and image quality in pediatric cCT.
- To determine optimal ASIR parameters for dose reduction while preserving diagnostic image quality.
Main Methods:
- 78 pediatric patients underwent non-contrast cranial CT using various protocols with filtered back projection (FBP) and different levels of ASIR (20%, 30%, 40%/60% blend).
- Effective dose was calculated, and image quality was assessed quantitatively and qualitatively.
Main Results:
- ASIR protocols (20% and 30%) significantly reduced the dose-length product (DLP) by 34.4% and 64.4% compared to the control group.
- While all ASIR groups showed reduced noise and improved diagnosability, Group C (100 kV, 20% ASIR) was adequate for routine clinical practice.
- Group D2 (100 kV, 40% ASIR/60% FBP blend) was suitable for follow-up imaging of severe acute events.
Conclusions:
- Combining ASIR with low tube voltage offers significant radiation dose reduction in pediatric cCT.
- Adequate image quality for clinical diagnosis and specific follow-up scenarios can be maintained with ASIR.
Aim:
To assess how adaptive statistical iterative reconstruction (ASIR) contributes to dose reduction and affects image quality of non-contrast cranial computed tomography (cCT) in children.
Materials And Methods:
Non-contrast cranial CT acquired in 78 paediatric patients (age 0-12 years) were evaluated. The images were acquired and processed using four different protocols: Group A (control): 120 kV, filtered back projection (FBP), n=18; Group B: 100 kV, FBP, n=22; Group C: 100 kV, scan and reconstruction performed with 20% ASIR, n=20; Group D1: 100 kV, scan and reconstruction performed with 30% ASIR, n=18; Group D2: raw data from Group D1 reconstructed using a blending of 40% ASIR and 60% FBP, n=18. The effective dose was calculated and the image quality was assessed quantitatively and qualitatively.
Results:
Compared to Group A, Groups C and D1/D2 showed a significant reduction of the dose-length product (DLP) by 34.4% and 64.4%, respectively. All experimental groups also showed significantly reduced qualitative levels of noise, contrast, and overall diagnosability. Diagnosis-related confidence grading showed Group C to be adequate for everyday clinical practice. Quantitative measures of Groups B and C were comparable to Group A with only few parameters compromised. Quantitative scores in Groups D1 and D2 were mainly lower compared to Group A, with Group D2 performing better than Group D1. Group D2 was considered adequate for follow-up imaging of severe acute events such as bleeding or hydrocephalus.
Discussion:
The use of ASIR combined with low tube voltage may reduce radiation significantly while maintaining adequate image quality in non-contrast paediatric cCT.
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