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  • 1.
    Kataria, Bharti
    Östergötlands Läns Landsting, Center for Diagnostics, Department of Radiology in Norrköping/Finspång. Department of Radiology, Vrinnevi Hospital, Norrköping 601 82, Sweden.
    Patients preference for examination of the large intestine with double contrast Barium Enema or computed tomography colonography2011In: Journal of Radiology Nursing, ISSN 1546-0843, E-ISSN 1555-9912, Vol. 30, no 2, p. 70-81Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare Double Contrast Barium Enema (DCBE) and Computed Tomography Colonography (CT Colon) from the patients perspective. The study population composed of 100 patients aged 18 years or older who underwent CT Colon (n = 50) or a DCBE (n = 50). A 10-point questionnaire was distributed after each procedure. Responses were compared using the Mann-Whitney test, Fishers exact test, and Spearmans correlation test. When compared with male patients, female patients showed a preference for female radiographers. This showed a statistically significant difference where p less than .001. A majority indicated that it was not at all embarrassing and that they were more than satisfied with the information and reception during the examination. No statistically significant difference was found regarding perception of pain and discomfort between the two examinations, as different subjects underwent the two examinations. There was a strong preference for female radiographers by female patients, although the examination was not perceived as being embarrassing or intimate. Patients did not find the examination embarrassing possibly because that they are fully clothed. Copyright © 2011 by the Association for Radiologic and Imaging Nursing.

  • 2. Order onlineBuy this publication >>
    Kataria, Bharti
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Visual grading evaluation of reconstruction methods and dose optimisation in abdominal Computed Tomography2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Since its introduction in the 1970’s CT has emerged as a modality of choice because of its high sensitivity in producing accurate diagnostic images. A third of all Computed Tomography (CT) examinations are abdominal CTs which deliver one of the highest doses among common examinations. An increase in the number of CT examinations has raised concerns about the negative effects of ionising radiation as the dose is cumulative over the life span of the individual. Image quality in CT is closely related to the radiation dose, so that a certain dose with an associated small, but not negligible, risk is a prerequisite for high image quality. Typically, dose reduction in CT results in higher noise and a decrease in low contrast resolution which can be detrimental to the image quality produced. New technology presents a wide range of dose reduction strategies, the latest being iterative reconstruction (IR).The aim of this thesis was to evaluate two different classes of iterative reconstruction algorithms: statistical (SAFIRE) and model-based (ADMIRE) as well as to explore the diagnostic value of a low-dose abdominal CT for optimisation purposes.

    This thesis included a total of 140 human subjects in four image quality evaluation studies, three of which were prospective studies (Papers I, II and IV) and one retrospective study (Paper III). Visual grading experiments to determine the potential dose reductions, were performed with pairwise comparison of image quality in the same patient at different tube loads (dose) and reconstructed with Filtered back projection (FBP) and SAFIRE strength 1 in a low-dose abdominal CT (Paper I) and FBP and ADMIRE strengths 3 and 5 in a standard dose abdominal CT (Paper II). Paper IV evaluated the impact of slice thicknesses in CT images reconstructed with ADMIRE strengths 3 and 5 when comparing multiplanar reconstruction (MPR) formatted images in a standard dose abdominal CT. Paper III, on the other hand, was an absolute assessment of image quality and pathology between the three phases of a CT Urography (CTU) protocol to explore the diagnostic value of low-dose abdominal CT. The anonymised images were displayed in random order and image quality was assessed by a group of radiologists using image quality criteria from the “European guidelines of quality criteria for CT”. The responses from the reviewer assessment were analysed statistically with ordinal logistic regression i.e. Visual Grading Regression (VGR).

    Results in Paper I show that a small dose reduction (5-9 %) was possible using SAFIRE strength 1and indicated the need for further research to evaluate the dose reduction potential of higher strengths of the algorithm. In Paper II a 30% dose reduction was possible without change in ADMIRE algorithm strength as no improvement in image quality was observed between tube loads 98- and 140 mAs. When comparing tube loads 42 and 98 mAs, further dose reduction was possible with ADMIRE strength 3 (22-47%). However, for images reconstructed with ADMIRE strength 5, a dose reduction of 34-74% was possible for some, but not all image criteria. Image quality in low-contrast objects such as the liver parenchyma, was affected and a decline in diagnostic confidence was observed. Paper IV showed potential dose reductions are possible with increasing slice thickness from 1 mm to 2 mm (24-35%) and 1 mm to 3mm (25-41%). ADMIRE strength 3 continued to provide diagnostically acceptable images with possible dose reductions for all image criteria assessed. Despite objective evaluations showing a decrease in noise and an increase in contrast to noise ratio, ADMIRE strength 5 had diverse effects on the five image criteria, depending on slice thickness and further dose reductions were limited to certain image criteria. The findings do not support a general recommendation to replace ADMIRE3 with ADMIRE5 in clinical abdominal CT protocols.

    Paper III studied another aspect of optimisation and results show that visualisation of renal anatomy was as expected in favour of the post-contrast phases when compared to the native phase. Assessment of pathology showed no significant differences between the three phases. Significantly higher diagnostic certainty for renal anatomy was observed for the post-contrast phases when compared to the native phase. Significantly high certainty scores were also seen for the nephrographic phase for incidental findings. The conclusion is that a low-dose series seems to be sufficient as a first-line modality in certain patient groups.

    This thesis clinically evaluated the effect of IR in abdominal CT imaging and estimated potential dose reductions. The important conclusion from papers I, II and IV is that IR improves image quality in abdominal CT allowing for some dose reductions. However, the clinical utility of the highest strength of the algorithm is limited to certain criteria. The results can be used to optimise the clinical abdominal CT protocol. The conclusion from paper III may increase clinical awareness of the value of the low-dose abdominal protocol when choosing an imaging method for certain patient groups who are more sensitive to radiation.

    List of papers
    1. Patient dose and image quality in low-dose abdominal CT: a comparison between iterative reconstruction and filtered back projection
    Open this publication in new window or tab >>Patient dose and image quality in low-dose abdominal CT: a comparison between iterative reconstruction and filtered back projection
    2013 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 54, no 5, p. 540-548Article in journal (Refereed) Published
    Abstract [en]

    Background In computed tomography (CT), there is increasing concern for potential CT radiation hazards. Several raw-data-based iterative reconstruction techniques attempt to facilitate low-dose imaging without compromising image quality, which raises the question whether these techniques may allow further dose reduction.

    Purpose To compare image quality of iterative reconstruction and filtered back projection in low-dose abdominal CT and study the potential for further dose reduction.

    Material and Methods Forty-five patients underwent CT of the abdomen twice: with standard low-dose technique and with 30% reduced dose, using both iterative reconstruction and filtered back projection. Four radiologists made pair-wise image quality assessment using five visual criteria. Visual grading regression (VGR) and weighted kappa (κ w) were used to analyze the data.

    Results There were significant effects of log(mAs) (P <0.001) and reconstruction algorithm (P <0.01) on all image quality criteria with an estimated potential dose reduction of 5–9%. Inter-observer agreement ranged from 70% to 91% and κ w from −0.01 to 0.57.

    Conclusion An iterative reconstruction algorithm improved image quality in abdominal CT, but the estimated dose reduction was rather small. The full potential of the algorithm remains unclear.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-90019 (URN)10.1177/0284185113476019 (DOI)000322323400014 ()23474768 (PubMedID)
    Available from: 2013-03-15 Created: 2013-03-15 Last updated: 2019-10-15Bibliographically approved
    2. Assessment of image quality in abdominal CT: potential dose reduction with model-based iterative reconstruction
    Open this publication in new window or tab >>Assessment of image quality in abdominal CT: potential dose reduction with model-based iterative reconstruction
    Show others...
    2018 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084Article in journal (Refereed) Published
    Abstract [en]

    Purpose To estimate potential dose reduction in abdominal CT by visually comparing images reconstructed with filtered back projection (FBP) and strengths of 3 and 5 of a specific MBIR.

    Material and methods A dual-source scanner was used to obtain three data sets each for 50 recruited patients with 30, 70 and 100% tube loads (mean CTDIvol 1.9, 3.4 and 6.2 mGy). Six image criteria were assessed independently by five radiologists. Potential dose reduction was estimated with Visual Grading Regression (VGR).

    Results Comparing 30 and 70% tube load, improved image quality was observed as a significant strong effect of log tube load and reconstruction method with potential dose reduction relative to FBP of 22–47% for MBIR strength 3 (p < 0.001). For MBIR strength 5 no dose reduction was possible for image criteria 1 (liver parenchyma), but dose reduction between 34 and 74% was achieved for other criteria. Interobserver reliability showed agreement of 71–76% (κw 0.201–0.286) and intra-observer reliability of 82–96% (κw 0.525–0.783).

    Conclusion MBIR showed improved image quality compared to FBP with positive correlation between MBIR strength and increasing potential dose reduction for all but one image criterion.

    Place, publisher, year, edition, pages
    Heidelberg: Springer, 2018
    Keywords
    Dose Computed tomography Iterative reconstruction Abdomen FBP
    National Category
    Radiology, Nuclear Medicine and Medical Imaging
    Identifiers
    urn:nbn:se:liu:diva-145274 (URN)10.1007/s00330-017-5113-4 (DOI)000431653200023 ()29368163 (PubMedID)2-s2.0-85040915759 (Scopus ID)
    Note

    Funding agencies: ALF-grant from Region Ostergotland; LFoU-grant from Region Ostergotland; Medical Faculty at Linkoping University

    Available from: 2018-02-20 Created: 2018-02-20 Last updated: 2019-10-15Bibliographically approved
    3. Image quality and pathology assessment in CT Urography: when is the low-dose series sufficient?
    Open this publication in new window or tab >>Image quality and pathology assessment in CT Urography: when is the low-dose series sufficient?
    Show others...
    2019 (English)In: BMC Medical Imaging, ISSN 1471-2342, E-ISSN 1471-2342, Vol. 19, no 1, article id 64Article in journal (Refereed) Published
    Abstract [en]

    Background

    Our aim was to compare CT images from native, nephrographic and excretory phases using image quality criteria as well as the detection of positive pathological findings in CT Urography, to explore if the radiation burden to the younger group of patients or patients with negative outcomes can be reduced.

    Methods

    This is a retrospective study of 40 patients who underwent a CT Urography examination on a 192-slice dual source scanner. Image quality was assessed for four specific renal image criteria from the European guidelines, together with pathological assessment in three categories: renal, other abdominal, and incidental findings without clinical significance. Each phase was assessed individually by three radiologists with varying experience using a graded scale. Certainty scores were derived based on the graded assessments. Statistical analysis was performed using visual grading regression (VGR). The limit for significance was set at p = 0.05.

    Results

    For visual reproduction of the renal parenchyma and renal arteries, the image quality was judged better for the nephrogram phase (p < 0.001), whereas renal pelvis/calyces and proximal ureters were better reproduced in the excretory phase compared to the native phase (p < 0.001). Similarly, significantly higher certainty scores were obtained in the nephrogram phase for renal parenchyma and renal arteries, but in the excretory phase for renal pelvis/calyxes and proximal ureters. Assessment of pathology in the three categories showed no statistically significant differences between the three phases. Certainty scores for assessment of pathology, however, showed a significantly higher certainty for renal pathology when comparing the native phase to nephrogram and excretory phase and a significantly higher score for nephrographic phase but only for incidental findings.

    Conclusion

    Visualisation of renal anatomy was as expected with each post-contrast phase showing favourable scores compared to the native phase. No statistically significant differences in the assessment of pathology were found between the three phases. The low-dose CT (LDCT) seems to be sufficient in differentiating between normal and pathological examinations. To reduce the radiation burden in certain patient groups, the LDCT could be considered a suitable alternative as a first line imaging method. However, radiologists should be aware of its limitations.

    Place, publisher, year, edition, pages
    BioMed Central, 2019
    Keywords
    Computed tomography; Urography; Low-dose; Optimization; Image quality; Dose
    National Category
    Radiology, Nuclear Medicine and Medical Imaging
    Identifiers
    urn:nbn:se:liu:diva-160048 (URN)10.1186/s12880-019-0363-z (DOI)000480486200001 ()31399078 (PubMedID)2-s2.0-85070460822 (Scopus ID)
    Note

    Funding Agencies|ALF-and LFoU-grants from Region Ostergotland; Medical Faculty at Linkoping University

    Available from: 2019-09-06 Created: 2019-09-06 Last updated: 2019-11-25Bibliographically approved
  • 3.
    Kataria, Bharti
    et al.
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Nilsson Althen, Jonas
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics.
    Smedby, Örjan
    School of Technology and Health (STH), KTH Royal Institute, Stockholm, Sweden.
    Persson, Anders
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Sökjer, Hannibal
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Sandborg, Michael
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics.
    Assessment of image quality in abdominal CT: potential dose reduction with model-based iterative reconstruction2018In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084Article in journal (Refereed)
    Abstract [en]

    Purpose To estimate potential dose reduction in abdominal CT by visually comparing images reconstructed with filtered back projection (FBP) and strengths of 3 and 5 of a specific MBIR.

    Material and methods A dual-source scanner was used to obtain three data sets each for 50 recruited patients with 30, 70 and 100% tube loads (mean CTDIvol 1.9, 3.4 and 6.2 mGy). Six image criteria were assessed independently by five radiologists. Potential dose reduction was estimated with Visual Grading Regression (VGR).

    Results Comparing 30 and 70% tube load, improved image quality was observed as a significant strong effect of log tube load and reconstruction method with potential dose reduction relative to FBP of 22–47% for MBIR strength 3 (p < 0.001). For MBIR strength 5 no dose reduction was possible for image criteria 1 (liver parenchyma), but dose reduction between 34 and 74% was achieved for other criteria. Interobserver reliability showed agreement of 71–76% (κw 0.201–0.286) and intra-observer reliability of 82–96% (κw 0.525–0.783).

    Conclusion MBIR showed improved image quality compared to FBP with positive correlation between MBIR strength and increasing potential dose reduction for all but one image criterion.

  • 4.
    Kataria, Bharti
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Nilsson Althén, Jonas
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics.
    Smedby, Orjan
    KTH Royal Inst Technol, Sweden.
    Persson, Anders
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Sökjer-Petersen, Hannibal
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Sandborg, Michael
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Assessment of image quality in abdominal computed tomography: Effect of model-based iterative reconstruction, multi-planar reconstruction and slice thickness on potential dose reduction2020In: European Journal of Radiology, ISSN 0720-048X, E-ISSN 1872-7727, Vol. 122, article id 108703Article in journal (Refereed)
    Abstract [en]

    Purpose: To determine the effect of tube load, model-based iterative reconstruction (MBIR) strength and slice thickness in abdominal CT using visual comparison of multi-planar reconstruction images. Method: Five image criteria were assessed independently by four radiologists on two data sets at 42- and 98-mAs tube loads for 25 patients examined on a 192-slice dual-source CT scanner. Effect of tube load, MBIR strength, slice thickness and potential dose reduction was estimated with Visual Grading Regression (VGR). Objective image quality was determined by measuring noise (SD), contrast-to-noise (CNR) ratio and noise-power spectra (NPS). Results: Comparing 42- and 98-mAs tube loads, improved image quality was observed as a strong effect of log tube load regardless of MBIR strength (p amp;lt; 0.001). Comparing strength 5 to 3, better image quality was obtained for two criteria (p amp;lt; 0.01), but inferior for liver parenchyma and overall image quality. Image quality was significantly better for slice thicknesses of 2mm and 3mm compared to 1mm, with potential dose reductions between 24%-41%. As expected, with decrease in slice thickness and algorithm strength, the noise power and SD (HU-values) increased, while the CNR decreased. Conclusion: Increasing slice thickness from 1 mm to 2 mm or 3 mm allows for a possible dose reduction. MBIR strength 5 shows improved image quality for three out of five criteria for 1 mm slice thickness. Increasing MBIR strength from 3 to 5 has diverse effects on image quality. Our findings do not support a general recommendation to replace strength 3 by strength 5 in clinical abdominal CT protocols. However, strength 5 may be used in task-based protocols.

  • 5.
    Kataria, Bharti
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Nilsson Althén, Jonas
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics.
    Smedby, Örjan
    KTH Royal Inst Technol, Sweden.
    Persson, Anders
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Sökjer-Petersen, Hannibal
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Sandborg, Michael
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Image quality and pathology assessment in CT Urography: when is the low-dose series sufficient?2019In: BMC Medical Imaging, ISSN 1471-2342, E-ISSN 1471-2342, Vol. 19, no 1, article id 64Article in journal (Refereed)
    Abstract [en]

    Background

    Our aim was to compare CT images from native, nephrographic and excretory phases using image quality criteria as well as the detection of positive pathological findings in CT Urography, to explore if the radiation burden to the younger group of patients or patients with negative outcomes can be reduced.

    Methods

    This is a retrospective study of 40 patients who underwent a CT Urography examination on a 192-slice dual source scanner. Image quality was assessed for four specific renal image criteria from the European guidelines, together with pathological assessment in three categories: renal, other abdominal, and incidental findings without clinical significance. Each phase was assessed individually by three radiologists with varying experience using a graded scale. Certainty scores were derived based on the graded assessments. Statistical analysis was performed using visual grading regression (VGR). The limit for significance was set at p = 0.05.

    Results

    For visual reproduction of the renal parenchyma and renal arteries, the image quality was judged better for the nephrogram phase (p < 0.001), whereas renal pelvis/calyces and proximal ureters were better reproduced in the excretory phase compared to the native phase (p < 0.001). Similarly, significantly higher certainty scores were obtained in the nephrogram phase for renal parenchyma and renal arteries, but in the excretory phase for renal pelvis/calyxes and proximal ureters. Assessment of pathology in the three categories showed no statistically significant differences between the three phases. Certainty scores for assessment of pathology, however, showed a significantly higher certainty for renal pathology when comparing the native phase to nephrogram and excretory phase and a significantly higher score for nephrographic phase but only for incidental findings.

    Conclusion

    Visualisation of renal anatomy was as expected with each post-contrast phase showing favourable scores compared to the native phase. No statistically significant differences in the assessment of pathology were found between the three phases. The low-dose CT (LDCT) seems to be sufficient in differentiating between normal and pathological examinations. To reduce the radiation burden in certain patient groups, the LDCT could be considered a suitable alternative as a first line imaging method. However, radiologists should be aware of its limitations.

  • 6.
    Kataria, Bharti
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Sandborg, Michael
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Nilsson Althen, Jonas
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics. Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences.
    IMPLICATIONS OF PATIENT CENTRING ON ORGAN DOSE IN COMPUTED TOMOGRAPHY2016In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 169, no 1-4, p. 130-135Article in journal (Refereed)
    Abstract [en]

    Automatic exposure control (AEC) in computed tomography (CT) facilitates optimisation of dose absorbed by the patient. The use of AEC requires appropriate ‘patient centring’ within the gantry, since positioning the patient off-centre may affect both image quality and absorbed dose. The aim of this experimental study was to measure the variation in organ and abdominal surface dose during CTexaminations of the head, neck/thorax and abdomen. The dose was compared at the isocenter with two off-centre positions—ventral and dorsal to the isocenter. Measurements were made with an anthropomorphic adult phantom and thermoluminescent dosemeters. Organs and surfaces for ventral regions received lesser dose (5.6–39.0 %) than the isocenter when the phantom was positioned 13 cm off-centre. Similarly, organ and surface doses for dorsal regions were reduced by 5.0–21.0 % at 25 cm off-centre. Therefore, correct vertical positioning of the patient at the gantry isocenter is important to maintain optimal imaging conditions.

  • 7.
    Kataria, Bharti
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland.
    Smedby, Örjan
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Radiology in Linköping.
    Patient dose and image quality in low-dose abdominal CT: a comparison between iterative reconstruction and filtered back projection2013In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 54, no 5, p. 540-548Article in journal (Refereed)
    Abstract [en]

    Background In computed tomography (CT), there is increasing concern for potential CT radiation hazards. Several raw-data-based iterative reconstruction techniques attempt to facilitate low-dose imaging without compromising image quality, which raises the question whether these techniques may allow further dose reduction.

    Purpose To compare image quality of iterative reconstruction and filtered back projection in low-dose abdominal CT and study the potential for further dose reduction.

    Material and Methods Forty-five patients underwent CT of the abdomen twice: with standard low-dose technique and with 30% reduced dose, using both iterative reconstruction and filtered back projection. Four radiologists made pair-wise image quality assessment using five visual criteria. Visual grading regression (VGR) and weighted kappa (κ w) were used to analyze the data.

    Results There were significant effects of log(mAs) (P <0.001) and reconstruction algorithm (P <0.01) on all image quality criteria with an estimated potential dose reduction of 5–9%. Inter-observer agreement ranged from 70% to 91% and κ w from −0.01 to 0.57.

    Conclusion An iterative reconstruction algorithm improved image quality in abdominal CT, but the estimated dose reduction was rather small. The full potential of the algorithm remains unclear.

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