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Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed Iterative Reconstruction–Based Ultra-Low-Dose CT for Surveillance

Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed... BACKGROUND AND PURPOSE: Patients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures. Our aim was to assess the acceptability of a dedicated, special-purpose sinogram-affirmed iterative reconstruction–based ultra-low-dose CT protocol for neurosurgical intensive care unit surveillance head CT examinations, comparing image quality with studies performed with our standard-of-care sinogram-affirmed iterative reconstruction low-dose CT and legacy filtered back-projection standard-dose CT protocols. MATERIAL AND METHODS: A retrospective analysis was performed of 54 head CT examinations: ultra-low-dose CT ( n = 22), low-dose CT ( n = 12), and standard-dose CT ( n = 20) in 22 patients in the neurosurgical intensive care unit. Standard-dose CT was reconstructed by using filtered back-projection on a Somatom Sensation 64 scanner. Ultra-low-dose CT and ultra-low-dose CT examinations were performed on a Siemens AS+128 scanner with commercially available sinogram-affirmed iterative reconstruction. Qualitative and quantitative parameters, including image quality and dose, were evaluated. RESULTS: Sinogram-affirmed iterative reconstruction ultra-low-dose CT represented a 68% lower dose index volume compared with filtered back-projection standard-dose CT techniques in the same patients while maintaining similar quality and SNR levels. Sinogram-affirmed iterative reconstruction low-dose CT offered higher image quality than filtered back-projection standard-dose CT ( P < .05) with no differences in SNR at a 24% lower dose index volume. Compared with low-dose CT, ultra-low-dose CT had significantly lower SNR ( P = .001) but demonstrated clinically satisfactory measures of image quality. CONCLUSIONS: In this cohort of patients in the neurosurgical intensive care unit, dedicated ultra-low-dose CT for surveillance head CT imaging led to a significant dose reduction while maintaining adequate image quality. ABBREVIATIONS: CTDI vol dose index volume FBP filtered back-projection IR iterative reconstruction LDCT low-dose CT NICU neurosurgical intensive care unit SAFIRE sinogram-affirmed iterative reconstruction SDCT standard-dose CT ULDCT ultra-low-dose CT http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed Iterative Reconstruction–Based Ultra-Low-Dose CT for Surveillance

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References (26)

Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2014 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A3861
pmid
24557704
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND AND PURPOSE: Patients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures. Our aim was to assess the acceptability of a dedicated, special-purpose sinogram-affirmed iterative reconstruction–based ultra-low-dose CT protocol for neurosurgical intensive care unit surveillance head CT examinations, comparing image quality with studies performed with our standard-of-care sinogram-affirmed iterative reconstruction low-dose CT and legacy filtered back-projection standard-dose CT protocols. MATERIAL AND METHODS: A retrospective analysis was performed of 54 head CT examinations: ultra-low-dose CT ( n = 22), low-dose CT ( n = 12), and standard-dose CT ( n = 20) in 22 patients in the neurosurgical intensive care unit. Standard-dose CT was reconstructed by using filtered back-projection on a Somatom Sensation 64 scanner. Ultra-low-dose CT and ultra-low-dose CT examinations were performed on a Siemens AS+128 scanner with commercially available sinogram-affirmed iterative reconstruction. Qualitative and quantitative parameters, including image quality and dose, were evaluated. RESULTS: Sinogram-affirmed iterative reconstruction ultra-low-dose CT represented a 68% lower dose index volume compared with filtered back-projection standard-dose CT techniques in the same patients while maintaining similar quality and SNR levels. Sinogram-affirmed iterative reconstruction low-dose CT offered higher image quality than filtered back-projection standard-dose CT ( P < .05) with no differences in SNR at a 24% lower dose index volume. Compared with low-dose CT, ultra-low-dose CT had significantly lower SNR ( P = .001) but demonstrated clinically satisfactory measures of image quality. CONCLUSIONS: In this cohort of patients in the neurosurgical intensive care unit, dedicated ultra-low-dose CT for surveillance head CT imaging led to a significant dose reduction while maintaining adequate image quality. ABBREVIATIONS: CTDI vol dose index volume FBP filtered back-projection IR iterative reconstruction LDCT low-dose CT NICU neurosurgical intensive care unit SAFIRE sinogram-affirmed iterative reconstruction SDCT standard-dose CT ULDCT ultra-low-dose CT

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Jul 1, 2014

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