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Eur Radiol. 2017 Sep;27(9):3625-3634. doi: 10.1007/s00330-017-4754-7. Epub 2017 Feb 6.

Improvement of image quality and dose management in CT fluoroscopy by iterative 3D image reconstruction.

Author information

1
Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany. oliver.grosser@med.ovgu.de.
2
Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany.
3
Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany.
4
Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
5
Department of Nuclear Medicine, Charité, Berlin, Germany.

Abstract

OBJECTIVES:

The objective of this study was to assess the influence of an iterative CT reconstruction algorithm (IA), newly available for CT-fluoroscopy (CTF), on image noise, readers' confidence and effective dose compared to filtered back projection (FBP).

METHODS:

Data from 165 patients (FBP/IA = 82/74) with CTF in the thorax, abdomen and pelvis were included. Noise was analysed in a large-diameter vessel. The impact of reconstruction and variables (e.g. X-ray tube current I) influencing noise and effective dose were analysed by ANOVA and a pairwise t-test with Bonferroni-Holm correction. Noise and readers' confidence were evaluated by three readers.

RESULTS:

Noise was significantly influenced by reconstruction, I, body region and circumference (all p ≤ 0.0002). IA reduced the noise significantly compared to FBP (p = 0.02). The effect varied for body regions and circumferences (p ≤ 0.001). The effective dose was influenced by the reconstruction, body region, interventional procedure and I (all p ≤ 0.02). The inter-rater reliability for noise and readers' confidence was good (W ≥ 0.75, p < 0.0001). Noise and readers' confidence were significantly better in AIDR-3D compared to FBP (p ≤ 0.03). Generally, IA yielded a significant reduction of the median effective dose.

CONCLUSION:

The CTF reconstruction by IA showed a significant reduction in noise and effective dose while readers' confidence increased.

KEY POINTS:

• CTF is performed for image guidance in interventional radiology. • Patient exposure was estimated from DLP documented by the CT. • Iterative CT reconstruction is appropriate to reduce image noise in CTF. • Using iterative CT reconstruction, the effective dose was significantly reduced in abdominal interventions.

KEYWORDS:

CT fluoroscopy; Dose length product; Effective dose; Image noise; Iterative CT reconstruction

PMID:
28168371
DOI:
10.1007/s00330-017-4754-7
[Indexed for MEDLINE]

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