Journal Club: July 2010

AJR Am J Roentgenol. 2010 Jul;195(1):126-31.

Reducing the radiation dose for CT colonography using adaptive statistical iterative reconstruction: A pilot study.

Flicek KT, Hara AK, Silva AC, Wu Q, Peter MB, Johnson CD.


OBJECTIVE: The purpose of our study was to evaluate the feasibility of preserving image quality during CT colonography (CTC) using a reduced radiation dose with adaptive statistical iterative reconstruction (ASIR).

MATERIALS AND METHODS: A proven colon phantom was imaged at standard dose settings (50 mAs) and at reduced doses (10-40 mAs) using six different ASIR levels (0-100%). We assessed 2D and 3D image quality and noise to determine the optimal dose and ASIR setting. Eighteen patients were then scanned with a standard CTC dose (50 mAs) in the supine position and at a reduced dose of 25 mAs with 40% ASIR in the prone position. Three radiologists blinded to the scanning techniques assessed 2D and 3D image quality and noise at three different colon locations. A score difference of > or = 1 was considered clinically important. Actual noise measures were compared between the standard-dose and low-dose acquisitions.

RESULTS: The phantom study showed image noise reduction that correlated with a higher percentage of ASIR. In patients, no significant image quality differences were identified between standard- and low-dose images using 40% ASIR. Overall image quality was reduced for both image sets as body mass index increased. Measured image noise was less with the low-dose technique using ASIR.

CONCLUSION: The results of this pilot study show that the radiation dose during CTC can be reduced 50% below currently accepted low-dose techniques without significantly affecting image quality when ASIR is used. Further evaluation in a larger patient group is warranted.