Department of Radiology, University Hospital Erlangen, Erlangen, Germany.
Imaging Science Institute, University Hospital Erlangen, Erlangen, Germany.
Pediatr Radiol. 2020 Aug;50(9):1240-1248. doi: 10.1007/s00247-020-04714-0. Epub 2020 Jun 17.
Radiation dose at CT should be as low as possible without compromising diagnostic quality.
To assess the potential for maximum dose reduction of pediatric lung dual-source CT with spectral shaping and advanced iterative reconstruction (ADMIRE).
We retrospectively analyzed dual-source CT acquisitions in a full-dose group (FD: 100 kV, 64 reference mAs) and in three groups with spectral shaping and differing reference mAs values (Sn: 100 kV, 96/64/32 reference mAs), each group consisting of 16 patients (age mean 11.5 years, standard deviation 4.8 years, median 12.8 years, range 1.3-18 years). Advanced iterative reconstruction of images was performed with different strengths (FD: ADMIRE Level 2; Sn: ADMIRE Levels 2, 3 and 4). We analyzed dose parameters and measured noise. Diagnostic confidence and detectability of lung lesions as well as anatomical structures were assessed using a Likert scale (from 1 [unacceptable] to 4 [fully acceptable]).
Compared to full dose, effective dose was reduced to 16.7% in the Sn 96 group, 11.1% in Sn64, and 5.5% in Sn32 (P<0.001). Noise values of Sn64 did not statistically differ from those in FD (45.7 vs. 38.9 Hounsfield units [HU]; P=0.132), whereas noise was significantly higher in Sn32 compared to Sn64 (61.5 HU; P<0.001). A Likert score >3 was reached in Sn64 regarding diagnostic confidence (3.2) and detectability of lung lesions (3.3). For detectability of most anatomical structures, no significant differences were found between FD and Sn64 (P≥0.05).
In pediatric lung dual-source CT, spectral shaping together with ADMIRE 4 enable radiation dose reduction to about 10% of a full-dose protocol while maintaining an acceptable diagnostic quality.
在不影响诊断质量的情况下，CT 的辐射剂量应尽可能降低。
评估使用光谱成形和高级迭代重建（ADMIRE）技术降低儿童肺部双源 CT 最大剂量的潜力。
我们回顾性分析了全剂量组（FD：100kV，64 参考 mAs）和三组光谱成形且参考 mAs 值不同的双源 CT 采集（Sn：100kV，96/64/32 参考 mAs），每组 16 例患者（年龄平均 11.5 岁，标准差 4.8 岁，中位数 12.8 岁，范围 1.3-18 岁）。使用不同强度的高级迭代重建图像（FD：ADMIRE Level 2；Sn：ADMIRE Levels 2、3 和 4）。我们分析了剂量参数并测量了噪声。使用李克特量表（1 表示不可接受，4 表示完全可接受）评估肺病变和解剖结构的诊断信心和可检测性。
与全剂量相比，Sn96 组有效剂量降低至 16.7%，Sn64 组降低至 11.1%，Sn32 组降低至 5.5%（P<0.001）。Sn64 的噪声值与 FD 相比无统计学差异（45.7 与 38.9 亨氏单位[HU]；P=0.132），而 Sn32 的噪声值明显高于 Sn64（61.5 HU；P<0.001）。Sn64 在诊断信心（3.2）和肺病变可检测性（3.3）方面达到了>3 的李克特评分。对于大多数解剖结构的可检测性，FD 与 Sn64 之间无显著差异（P≥0.05）。
在儿童肺部双源 CT 中，光谱成形联合 ADMIRE 4 可使辐射剂量降低至全剂量方案的 10%左右，同时保持可接受的诊断质量。
