PMID- 26204293
OWN - NLM
STAT- MEDLINE
DCOM- 20151007
LR  - 20220331
IS  - 1546-3141 (Electronic)
IS  - 0361-803X (Linking)
VI  - 205
IP  - 2
DP  - 2015 Aug
TI  - Successful Dose Reduction Using Reduced Tube Voltage With Hybrid Iterative 
      Reconstruction in Pediatric Abdominal CT.
PG  - 392-9
LID - 10.2214/AJR.14.12698 [doi]
AB  - OBJECTIVE: The purpose of this article is to assess radiation dose reduction, 
      image quality, and diagnostic confidence using low tube voltage in combination 
      with hybrid iterative reconstruction in contrast-enhanced pediatric abdominal CT. 
      MATERIALS AND METHODS: CT examinations of 133 patients (median age, 10 years) 
      were performed at sequentially reduced doses. The first group (group 1) was 
      scanned using dimension-based protocols at 120 kV for all patient sizes. The 
      optimized group (group 5) was scanned at 80 kV for less than 18 cm in the lateral 
      dimension and 100 kV in the 19-30 cm lateral dimension. CT examinations 
      reconstructed with filtered back projection (FBP) and four levels of hybrid 
      iterative reconstruction were reviewed by four blinded readers for subjective 
      image quality and diagnostic confidence. Objective noise, volume CT dose index 
      (CTDIvol), and size-specific dose estimate (SSDE) were recorded. Data were 
      analyzed using t tests, one and two-way ANOVA, and the intraclass correlation 
      coefficient. RESULTS: Compared with group 1, the radiation dose was reduced for 
      group 5 by 63% measured by SSDE (4.69 vs 10.00 mGy; p < 0.001). Subjective image 
      noise was increased for FBP images (p < 0.001) but not was statistically 
      significantly different for all levels of hybrid iterative reconstruction; 
      artifacts were reduced and visibility of small structures was improved (both p < 
      0.001). Diagnostic confidence was improved for solid organ injury and metastatic 
      disease (both p < 0.001) and was not statistically significantly different for 
      appendicitis (p = 0.306). CONCLUSION: Use of hybrid iterative reconstruction with 
      low-tube-voltage protocols enables substantial radiation dose reduction for 
      pediatric abdominal CT with equivalent to improved subjective image quality and 
      diagnostic confidence.
FAU - Berlin, Sheila C
AU  - Berlin SC
AD  - 1 Department of Radiology, University Hospitals Case Medical Center, Case Western 
      Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106.
FAU - Weinert, Dayna M
AU  - Weinert DM
AD  - 1 Department of Radiology, University Hospitals Case Medical Center, Case Western 
      Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106.
FAU - Vasavada, Pauravi S
AU  - Vasavada PS
AD  - 1 Department of Radiology, University Hospitals Case Medical Center, Case Western 
      Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106.
FAU - Martinez-Rios, Claudia
AU  - Martinez-Rios C
AD  - 1 Department of Radiology, University Hospitals Case Medical Center, Case Western 
      Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106.
AD  - 2 Present address: Department of Radiology, The Hospital for Sick Children, 
      Toronto, ON, Canada.
FAU - Parikh, Roshni A
AU  - Parikh RA
AD  - 1 Department of Radiology, University Hospitals Case Medical Center, Case Western 
      Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106.
FAU - Wien, Michael A
AU  - Wien MA
AD  - 1 Department of Radiology, University Hospitals Case Medical Center, Case Western 
      Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106.
AD  - 3 Present address: Children's National Medical Center, Washington, DC.
FAU - Jordan, David W
AU  - Jordan DW
AD  - 1 Department of Radiology, University Hospitals Case Medical Center, Case Western 
      Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106.
FAU - Novak, Ronald D
AU  - Novak RD
AD  - 1 Department of Radiology, University Hospitals Case Medical Center, Case Western 
      Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - AJR Am J Roentgenol
JT  - AJR. American journal of roentgenology
JID - 7708173
RN  - 0 (Contrast Media)
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Contrast Media
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - *Radiation Dosage
MH  - Radiation Protection/*methods
MH  - Radiographic Image Interpretation, Computer-Assisted/*methods
MH  - Radiography, Abdominal/*methods
MH  - Retrospective Studies
MH  - Tomography, X-Ray Computed/instrumentation/*methods
MH  - Young Adult
OTO - NOTNLM
OT  - ALARA
OT  - dose reduction
OT  - iterative reconstruction
OT  - low tube voltage
OT  - pediatric body CT
EDAT- 2015/07/24 06:00
MHDA- 2015/10/08 06:00
CRDT- 2015/07/24 06:00
PHST- 2015/07/24 06:00 [entrez]
PHST- 2015/07/24 06:00 [pubmed]
PHST- 2015/10/08 06:00 [medline]
AID - 10.2214/AJR.14.12698 [doi]
PST - ppublish
SO  - AJR Am J Roentgenol. 2015 Aug;205(2):392-9. doi: 10.2214/AJR.14.12698.