PMID- 27077382
OWN - NLM
STAT- MEDLINE
DCOM- 20170517
LR  - 20170517
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Linking)
VI  - 280
IP  - 2
DP  - 2016 Aug
TI  - Diagnostic Accuracy of CT Enterography for Active Inflammatory Terminal Ileal 
      Crohn Disease: Comparison of Full-Dose and Half-Dose Images Reconstructed with 
      FBP and Half-Dose Images with SAFIRE.
PG  - 436-45
LID - 10.1148/radiol.2016151281 [doi]
AB  - Purpose To compare the diagnostic accuracy and image quality of computed 
      tomographic (CT) enterographic images obtained at half dose and reconstructed 
      with filtered back projection (FBP) and sinogram-affirmed iterative 
      reconstruction (SAFIRE) with those of full-dose CT enterographic images 
      reconstructed with FBP for active inflammatory terminal or neoterminal ileal 
      Crohn disease. Materials and Methods This retrospective study was compliant with 
      HIPAA and approved by the institutional review board. The requirement to obtain 
      informed consent was waived. Ninety subjects (45 with active terminal ileal Crohn 
      disease and 45 without Crohn disease) underwent CT enterography with a 
      dual-source CT unit. The reference standard for confirmation of active Crohn 
      disease was active terminal ileal Crohn disease based on ileocolonoscopy or 
      established Crohn disease and imaging features of active terminal ileal Crohn 
      disease. Data from both tubes were reconstructed with FBP (100% exposure); data 
      from the primary tube (50% exposure) were reconstructed with FBP and SAFIRE 
      strengths 3 and 4, yielding four datasets per CT enterographic examination. The 
      mean volume CT dose index (CTDIvol) and size-specific dose estimate (SSDE) at 
      full dose were 13.1 mGy (median, 7.36 mGy) and 15.9 mGy (median, 13.06 mGy), 
      respectively, and those at half dose were 6.55 mGy (median, 3.68 mGy) and 7.95 
      mGy (median, 6.5 mGy). Images were subjectively evaluated by eight radiologists 
      for quality and diagnostic confidence for Crohn disease. Areas under the receiver 
      operating characteristic curves (AUCs) were estimated, and the multireader, 
      multicase analysis of variance method was used to compare reconstruction methods 
      on the basis of a noninferiority margin of 0.05. Results The mean AUCs with 
      half-dose scans (FBP, 0.908; SAFIRE 3, 0.935; SAFIRE 4, 0.924) were noninferior 
      to the mean AUC with full-dose FBP scans (0.908; P < .003). The proportion of 
      images with inferior quality was significantly higher with all half-dose 
      reconstructions than with full-dose FBP (mean proportion: 0.117 for half-dose 
      FBP, 0.054 for half-dose SAFIRE 3, 0.054 for half-dose SAFIRE 4, and 0.017 for 
      full-dose FBP; P < .001). Conclusion The diagnostic accuracy of half-dose CT 
      enterography with FBP and SAFIRE is statistically noninferior to that of 
      full-dose CT enterography for active inflammatory terminal ileal Crohn disease, 
      despite an inferior subjective image quality. ((c)) RSNA, 2016 Online supplemental 
      material is available for this article.
FAU - Gandhi, Namita S
AU  - Gandhi NS
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Baker, Mark E
AU  - Baker ME
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Goenka, Ajit H
AU  - Goenka AH
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Bullen, Jennifer A
AU  - Bullen JA
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Obuchowski, Nancy A
AU  - Obuchowski NA
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Remer, Erick M
AU  - Remer EM
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Coppa, Christopher P
AU  - Coppa CP
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Einstein, David
AU  - Einstein D
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Feldman, Myra K
AU  - Feldman MK
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Kanmaniraja, Devaraju
AU  - Kanmaniraja D
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Purysko, Andrei S
AU  - Purysko AS
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Vahdat, Noushin
AU  - Vahdat N
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Primak, Andrew N
AU  - Primak AN
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Karim, Wadih
AU  - Karim W
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
FAU - Herts, Brian R
AU  - Herts BR
AD  - From the Section of Abdominal Imaging (N.S.G., M.E.B., A.H.G., E.M.R., C.P.C., 
      D.E., M.K.F., D.K., A.S.P., N.V., W.K., B.R.H.) and Imaging Institute and 
      Quantitative Health Sciences (J.A.B., N.A.O.), Cleveland Clinic, 9500 Euclid Ave, 
      Cleveland, OH 44195; and Siemens Medical Solutions, Malvern, Pa (A.N.P.).
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20160414
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
SB  - IM
MH  - Adult
MH  - Crohn Disease/complications/*diagnostic imaging
MH  - Female
MH  - Gastrointestinal Tract/diagnostic imaging
MH  - Humans
MH  - Ileitis/complications/*diagnostic imaging
MH  - Ileum/diagnostic imaging
MH  - Male
MH  - Middle Aged
MH  - *Radiation Dosage
MH  - Radiographic Image Interpretation, Computer-Assisted/*methods
MH  - Reproducibility of Results
MH  - Tomography, X-Ray Computed/*methods
EDAT- 2016/04/15 06:00
MHDA- 2017/05/18 06:00
CRDT- 2016/04/15 06:00
PHST- 2016/04/15 06:00 [entrez]
PHST- 2016/04/15 06:00 [pubmed]
PHST- 2017/05/18 06:00 [medline]
AID - 10.1148/radiol.2016151281 [doi]
PST - ppublish
SO  - Radiology. 2016 Aug;280(2):436-45. doi: 10.1148/radiol.2016151281. Epub 2016 Apr 
      14.