A prospective feasibility study of sub-millisievert abdominopelvic CT using iterative reconstruction in Crohn's disease.
Eur Radiol
; 23(9): 2503-12, 2013 Sep.
Article
em En
| MEDLINE
| ID: mdl-23740025
ABSTRACT
OBJECTIVE:
Iterative reconstruction (IR) allows diagnostic CT imaging with less radiation exposure than filtered back projection (FBP). We studied an IR low-dose CT abdomen/pelvis (LDCTAP) protocol, designed to image at an effective dose (ED) approximating 1 mSv in patients with Crohn's disease (CD).METHODS:
Forty patients, mean age 37 ± 13.4 years (range 17-69), with CD underwent two synchronous CT protocols (conventional-dose (CDCTAP) and LDCTAP). CDCTAP and LDCTAP images were compared for diagnostic acceptability, yield, image quality and ED (in millisieverts). The optimal level of IR for LDCTAP was also studied.RESULTS:
LDCTAP yielded a mean ED of 1.3 ± 0.8 mSv compared with 4.7 ± 2.9 mSv for CDCTAP, reducing ED by 73.7 ± 3.3 % (mean dose reduction, 3.5 ± 2.1 mSv; P < 0.001) and dose length product by 73.6 ± 2.6 % (P < 0.001). Sub-millisievert (0.84 mSv) imaging was performed for patients with a body mass index (BMI) less than 25 (i.e. 63 % of our cohort). LDCTAP resulted in increased image noise and reduced diagnostic acceptability compared with CDCTAP despite use of IR, but detection of extra-luminal complications was comparable.CONCLUSION:
Patients with suspected active CD can be adequately imaged using LDCTAP, yielding comparable information regarding extent, activity and complications of CD compared with CDCTAP, but with 74 % less dose. LDCTAP at doses equivalent to that of two abdominal radiographs represents a feasible alternative to CDCTAP. KEY POINTS ⢠Radiation dose is a concern when imaging patients with Crohn's disease. ⢠New techniques allow low-dose abdominopelvic CT with acceptable image quality. ⢠Using hybrid iterative reconstruction, its diagnostic yield compares well with that of conventional CT. ⢠Sub-millisievert CT of patients with Crohn's disease appears technically and clinically feasible.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Radiografia Abdominal
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Interpretação de Imagem Radiográfica Assistida por Computador
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Doença de Crohn
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Tomografia Computadorizada por Raios X
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Adolescent
/
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article