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Low-iodine-dose computed tomography coupled with an artificial intelligence-based contrast-boosting technique in children: a retrospective study on comparison with conventional-iodine-dose computed tomography.
Shin, Dong-Joo; Choi, Young Hun; Lee, Seul Bi; Cho, Yeon Jin; Lee, Seunghyun; Cheon, Jung-Eun.
Affiliation
  • Shin DJ; Department of Radiology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
  • Choi YH; Department of Radiology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea. iater@snu.ac.kr.
  • Lee SB; Department of Radiology, Seoul National University College of Medicine, Jongno-Gu, Seoul, Republic of Korea. iater@snu.ac.kr.
  • Cho YJ; Department of Radiology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
  • Lee S; Department of Radiology, Seoul National University College of Medicine, Jongno-Gu, Seoul, Republic of Korea.
  • Cheon JE; Department of Radiology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
Pediatr Radiol ; 54(8): 1315-1324, 2024 07.
Article in En | MEDLINE | ID: mdl-38839610
ABSTRACT

BACKGROUND:

Low-iodine-dose computed tomography (CT) protocols have emerged to mitigate the risks associated with contrast injection, often resulting in decreased image quality.

OBJECTIVE:

To evaluate the image quality of low-iodine-dose CT combined with an artificial intelligence (AI)-based contrast-boosting technique in abdominal CT, compared to a standard-iodine-dose protocol in children. MATERIALS AND

METHODS:

This single-center retrospective study included 35 pediatric patients (mean age 9.2 years, range 1-17 years) who underwent sequential abdominal CT scans-one with a standard-iodine-dose protocol (standard-dose group, Iobitridol 350 mgI/mL) and another with a low-iodine-dose protocol (low-dose group, Iohexol 240 mgI/mL)-within a 4-month interval from January 2022 to July 2022. The low-iodine CT protocol was reconstructed using an AI-based contrast-boosting technique (contrast-boosted group). Quantitative and qualitative parameters were measured in the three groups. For qualitative parameters, interobserver agreement was assessed using the intraclass correlation coefficient, and mean values were employed for subsequent analyses. For quantitative analysis of the three groups, repeated measures one-way analysis of variance with post hoc pairwise analysis was used. For qualitative analysis, the Friedman test followed by post hoc pairwise analysis was used. Paired t-tests were employed to compare radiation dose and iodine uptake between the standard- and low-dose groups.

RESULTS:

The standard-dose group exhibited higher attenuation, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) of organs and vessels compared to the low-dose group (all P-values < 0.05 except for liver SNR, P = 0.12). However, noise levels did not differ between the standard- and low-dose groups (P = 0.86). The contrast-boosted group had increased attenuation, CNR, and SNR of organs and vessels, and reduced noise compared with the low-dose group (all P < 0.05). The contrast-boosted group showed no differences in attenuation, CNR, and SNR of organs and vessels (all P > 0.05), and lower noise (P = 0.002), than the standard-dose group. In qualitative analysis, the contrast-boosted group did not differ regarding vessel enhancement and lesion conspicuity (P > 0.05) but had lower noise (P < 0.05) and higher organ enhancement and artifacts (all P < 0.05) than the standard-dose group. While iodine uptake was significantly reduced in low-iodine-dose CT (P < 0.001), there was no difference in radiation dose between standard- and low-iodine-dose CT (all P > 0.05).

CONCLUSION:

Low-iodine-dose abdominal CT, combined with an AI-based contrast-boosting technique exhibited comparable organ and vessel enhancement, as well as lesion conspicuity compared to standard-iodine-dose CT in children. Moreover, image noise decreased in the contrast-boosted group, albeit with an increase in artifacts.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Artificial Intelligence / Tomography, X-Ray Computed / Contrast Media Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: En Journal: Pediatr Radiol Year: 2024 Document type: Article Country of publication: Germany

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Artificial Intelligence / Tomography, X-Ray Computed / Contrast Media Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: En Journal: Pediatr Radiol Year: 2024 Document type: Article Country of publication: Germany