PMID- 33710371
OWN - NLM
STAT- MEDLINE
DCOM- 20210824
LR  - 20230707
IS  - 1432-1084 (Electronic)
IS  - 0938-7994 (Print)
IS  - 0938-7994 (Linking)
VI  - 31
IP  - 9
DP  - 2021 Sep
TI  - Pelvic bone CT: can tin-filtered ultra-low-dose CT and virtual radiographs be 
      used as alternative for standard CT and digital radiographs?
PG  - 6793-6801
LID - 10.1007/s00330-021-07824-x [doi]
AB  - OBJECTIVES: To compare ultra-low-dose CT (ULD-CT) of the osseous pelvis with tin 
      filtration to standard clinical CT (CT), and to assess the quality of computed 
      virtual pelvic radiographs (VRs). METHODS: CT protocols were optimized in a 
      phantom and three pelvic cadavers. Thirty prospectively included patients 
      received both standard CT (automated tube voltage selection and current 
      modulation) and tin-filtered ULD-CT of the pelvis (Sn140kV/50mAs). VRs of ULD-CT 
      data were computed using an adapted cone beam-based projection algorithm and were 
      compared to digital radiographs (DRs) of the pelvis. CT and DR dose parameters 
      and quantitative and qualitative measures (1 = worst, 4 = best) were compared. CT 
      and ULD-CT were assessed for osseous pathologies. RESULTS: Dose reduction of 
      ULD-CT was 84% compared to CT, with a median effective dose of 0.38 mSv (quartile 
      1-3: 0.37-0.4 mSv) versus 2.31 mSv (1.82-3.58 mSv; p < .001), respectively. Mean 
      dose of DR was 0.37 mSv (+/- 0.14 mSv). The median signal-to-noise ratio (SNR) and 
      contrast-to-noise ratio (CNR) of bone were significantly higher for CT (64.3 and 
      21.5, respectively) compared to ULD-CT (50.4 and 18.8; p </= .01), while ULD-CT was 
      significantly more dose efficient (figure of merit (FOM) 927.6) than CT (FOM 
      167.6; p < .001). Both CT and ULD-CT were of good image quality with excellent 
      depiction of anatomy, with a median score of 4 (4-4) for both methods (p = .1). 
      Agreement was perfect between both methods regarding the prevalence of assessed 
      osseous pathologies (p > .99). VRs were successfully calculated and were 
      equivalent to DRs. CONCLUSION: Tin-filtered ULD-CT of the pelvis at a dose 
      equivalent to standard radiographs is adequate for assessing bone anatomy and 
      osseous pathologies and had a markedly superior dose efficiency than standard CT. 
      KEY POINTS: * Ultra-low-dose pelvic CT with tin filtration (0.38 mSv) can be 
      performed at a dose of digital radiographs (0.37 mSv), with a dose reduction of 
      84% compared to standard CT (2.31 mSv). * Tin-filtered ultra-low-dose CT had 
      lower SNR and CNR and higher image noise than standard CT, but showed clear 
      depiction of anatomy and accurate detection of osseous pathologies. * Virtual 
      pelvic radiographs were successfully calculated from ultra-low-dose CT data and 
      were equivalent to digital radiographs.
CI  - (c) 2021. The Author(s).
FAU - Stern, Christoph
AU  - Stern C
AUID- ORCID: 0000-0003-2833-5753
AD  - Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, 
      Switzerland. christoph.stern@balgrist.ch.
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland. 
      christoph.stern@balgrist.ch.
FAU - Sommer, Stefan
AU  - Sommer S
AD  - Siemens Healthcare AG, Zurich, Switzerland.
AD  - SCMI, Swiss Center for Musculoskeletal Imaging, Balgrist Campus, Zurich, 
      Switzerland.
FAU - Germann, Christoph
AU  - Germann C
AD  - Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, 
      Switzerland.
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland.
FAU - Galley, Julien
AU  - Galley J
AD  - Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, 
      Switzerland.
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland.
FAU - Pfirrmann, Christian W A
AU  - Pfirrmann CWA
AD  - Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, 
      Switzerland.
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland.
FAU - Fritz, Benjamin
AU  - Fritz B
AD  - Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, 
      Switzerland.
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland.
FAU - Sutter, Reto
AU  - Sutter R
AD  - Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, 
      Switzerland.
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20210312
PL  - Germany
TA  - Eur Radiol
JT  - European radiology
JID - 9114774
RN  - 7440-31-5 (Tin)
SB  - IM
MH  - Humans
MH  - *Pelvic Bones/diagnostic imaging
MH  - Radiation Dosage
MH  - Radiographic Image Interpretation, Computer-Assisted
MH  - Radiography
MH  - *Tin
MH  - Tomography, X-Ray Computed
PMC - PMC8379132
OTO - NOTNLM
OT  - Computed tomography, X-ray
OT  - Pelvic bones
OT  - Radiation dosage
OT  - Tin
COIS- Stefan Sommer is an employee of Siemens Healthcare AG. All other authors have 
      nothing to disclose.
EDAT- 2021/03/13 06:00
MHDA- 2021/08/25 06:00
PMCR- 2021/03/12
CRDT- 2021/03/12 12:42
PHST- 2020/09/14 00:00 [received]
PHST- 2021/02/22 00:00 [accepted]
PHST- 2021/02/04 00:00 [revised]
PHST- 2021/03/13 06:00 [pubmed]
PHST- 2021/08/25 06:00 [medline]
PHST- 2021/03/12 12:42 [entrez]
PHST- 2021/03/12 00:00 [pmc-release]
AID - 10.1007/s00330-021-07824-x [pii]
AID - 7824 [pii]
AID - 10.1007/s00330-021-07824-x [doi]
PST - ppublish
SO  - Eur Radiol. 2021 Sep;31(9):6793-6801. doi: 10.1007/s00330-021-07824-x. Epub 2021 
      Mar 12.