Can low-dose CT with iterative reconstruction reduce both the radiation dose and the amount of iodine contrast medium in a dynamic CT study of the liver?
Can low-dose CT with iterative reconstruction reduce both the radiation dose and the amount of iodine contrast medium in a dynamic CT study of the liver?
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DOI：
10.1016/j.ejrad.2013.12.014
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发表时间：
2014-04-01
影响因子：
3.3
通讯作者：
Murakami, Takamichi
中科院分区：
文献类型：
--
作者：
Takahashi, Hiroto;Okada, Masahiro;Murakami, Takamichi
目的：探讨低剂量动态CT肝脏迭代重建是否可以减少辐射剂量和造影剂的量。材料和方法：这项研究是由我们的机构审查委员会批准。113名患者被随机分配到两组之一。A组/B组（58/55例患者）分别在120/100 kV、0/40%自适应统计迭代重建（ASIR）、600/480 mg I/kg造影剂剂量下进行肝脏动态CT扫描。根据制造商的体模数据估计辐射暴露。比较两组肝细胞癌（HCC）的肝实质、血管及瘤肝对比度的增强值。结果：A组/B组平均CT剂量指数为6.38/4.04 mGy，剂量长度乘积为194.54/124.57 mGy/cm。直径大于1cm的肝癌增强后各时相的平均强化值及肿瘤与肝脏的对比度两组间差异无显著性（P > 0.05）。延迟期B组血管强化值明显高于A组（P < 0.05）。两组阅片者对延迟期肝实质和HCC的可信度差异无统计学意义（P > 0.05）。结论：与常规动态CT相比，低剂量动态CT结合ASIR技术可降低辐射剂量和造影剂用量，且图像质量无明显下降。(C)2013爱思唯尔爱尔兰有限公司保留所有权利。
Purpose: To investigate whether low-dose dynamic CT of the liver with iterative reconstruction can reduce both the radiation dose and the amount of contrast medium.Materials and methods: This study was approved by our institutional review board. 113 patients were randomly assigned to one of two groups. Group A/group B (fifty-eight/fifty-five patients) underwent liver dynamic CT at 120/100 kV, with 0/40% adaptive statistical iterative reconstruction (ASIR), with a contrast dose of 600/480 mg I/kg, respectively. Radiation exposure was estimated based on the manufacturer's phantom data. The enhancement value of the hepatic parenchyma, vessels and the tumor-to-liver contrast of hepatocellular carcinomas (HCCs) were compared between two groups. Two readers independently assessed the CT images of the hepatic parenchyma and HCCs.Results: The mean CT dose indices: 6.38/4.04 mGy, the dose-length products: 194.54/124.57 mGy cm, for group A/group B. The mean enhancement value of the hepatic parenchyma and the tumor-to-liver contrast of HCCs with diameters greater than 1 cm in the post-contrast all phases did not differ significantly between two groups (P > 0.05). The enhancement values of vessels in group B were significantly higher than that in group A in the delayed phases (P < 0.05). Two reader's confidence levels for the hepatic parenchyma in the delayed phases and HCCs did not differ significantly between the groups (P > 0.05).Conclusions: Low-dose dynamic CT with ASIR can reduce both the radiation dose and the amount of contrast medium without image quality degradation, compared to conventional dynamic CT without ASIR. (C) 2013 Elsevier Ireland Ltd. All rights reserved.