ISSN: 1899-0967
Polish Journal of Radiology
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2018
vol. 83
 
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abstract:
Original paper

Computed tomography urography with iterative reconstruction algorithm in congenital urinary tract abnormalities in children – association of radiation dose with image quality

Przemysław Bombiński, Michał Brzewski, Stanisław Warchoł, Agnieszka Biejat, Marcin Banasiuk, Marek Gołębiowski

© Pol J Radiol 2018; 83: e175-e182
Online publish date: 2018/04/27
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Purpose
To assess the extent to which a radiation dose can be lowered without compromising image quality and diagnostic confidence in congenital urinary tract abnormalities in children by using a CT scanner with an iterative reconstruction algorithm.

Material and methods
120 CT urography image series were analysed retrospectively. Image series were divided into four study groups depending on effective radiation dose (group 1: 0.8-2 mSv; group 2: 2-4 mSv; group 3: 4-6 mSv; group 4: 6-11 mSv). Objective and subjective image quality were investigated. In objective analysis, measurements of attenuation and standard deviation (SD) in five regions of interest (ROIs) were performed in 109 excretory image series, and image noise was evaluated. In subjective analysis, two independent radiologists evaluated 138 kidney units for subjective image quality and diagnostic confidence.

Results
There were no significant differences in image noise in objective evaluation between the following study groups: 2 vs. 3 and 3 vs. 4 in all ROIs (with the only exception in spleen SD measurement between study groups 2 vs. 3), while there was significantly more image noise in group 2 in comparison to group 4. For all other ROIs in all study groups, there was more image noise on lower dose images. There were no significant differences in pairwise comparisons between study groups in subjective image quality. Diagnostic confidence was not significantly different between all study groups.

Conclusions
Low-dose CT urography can be a valuable method in congenital urinary tract abnormalities in children. Despite poorer image quality, diagnostic confidence is not significantly compromised in examinations performed with lower radiation doses.

keywords:

radiation dosage, congenital anomalies of kidney and urinary tract (CAKUT), children, diagnostic techniques – urological, multidetector computed tomography, radiology

references:
Riccabona M, Avni FE, Dacher JN, et al. ESPR uroradiology task force and ESUR paediatric working group: imaging and procedural recommendations in paediatric uroradiology, part III. Minutes of the ESPR uroradiology task force minisymposium on intravenous urography, uro-CT and MR-urography in childhood. Pediatr Radiol 2010; 40: 1315-1320.
Battal B, Kocaoglu M, Akgun V, et al. Split-bolus MR urography: synchronous visualization of obstructing vessels and collecting system in children. Diagn Interv Radiol 2015; 21: 498-502.
Darge K, Higgins M, Hwang TJ, et al. Magnetic resonance and computed tomography in pediatric urology: an imaging overview for current and future daily practice. Radiol Clin North Am 2013; 51: 583-598.
Bombiński P, Warchoł S, Brzewski M, et al. Lower-dose CT urography (CTU) with iterative reconstruction technique in children – initial experience and examination protocol. Pol J Radiol 2014; 8: 137-144.
Strauss KJ, Goske MJ, Kaste SC, et al. Image gently: ten steps you can take to optimize image quality and lower CT dose for paediatric patients. AJR Am J Roentgenol 2010; 194: 868-873.
Nievelstein RAJ, van Dam IM, van der Molen AJ. Multidetector CT in children: current concepts and dose reduction strategies. Pediatric Radiology 2010; 40: 1324-1344.
Aurumskjöld ML, Söderberg M, Stålhammar F, et al. Evaluation of an iterative model-based reconstruction of pediatric abdominal CT with regard to image quality and radiation dose. Acta Radiol 2017 Jan 1: 284185117728415.
Jin M, Sanchez TR, Lamba R, et al. Accuracy and Radiation Dose Reduction of Limited-Range CT in the Evaluation of Acute Appendicitis in Pediatric Patients. Am J Roentgenol 2017; 209: 643-647.
Imai R, Miyazaki O, Horiuchi T, et al. Ultra-Low-Dose Fetal CT With Model-Based Iterative Reconstruction: A Prospective Pilot Study. AJR Am J Roentgenol 2017; 208: 1365-1372.
Sun J, Yu T, Liu J, et al. Image quality improvement using model-based iterative reconstruction in low dose chest CT for children with necrotizing pneumonia. BMC Med Imaging 2017; 17: 24.
Chen XF, Jiang F, Li L, et al. Application of low-dose dual-source computed tomography angiography in children with complex congenital heart disease. Exp Ther Med 2017; 14: 1177-1183.
Damasio MB, Darge K, Riccabona M. Multi-detector CT in the paediatric urinary tract. Eur J Radiol 2013; 82: 1118-1125.
Chung EM, Soderlund KA, Fagen KE. Imaging of the Pediatric Urinary System. Radiol Clin North Am 2017; 55: 337-357.
Arapakis I, Efstathopoulos E, Tsitsia V, et al. Using “iDose4” iterative reconstruction algorithm in adults’ chest-abdomen-pelvis CT examinations: effect on image quality in relation to patient radiation exposure. Br J Radiol 2014; 87: 20130613.
Thomas KE, Wang B. Age-specific effective doses for paediatric MSCT examinations at a large children’s hospital using DLP conversion coefficients: a simple estimation method. Pediatr Radiol 2008; 38: 645-656.
Dahlman P, van der Molen AJ, Magnusson M, et al. How much dose can be saved in three-phase CT urography? A combination of normal-dose corticomedullary phase with low-dose unenhanced and excretory phases. AJR Am J Roentgenol 2012; 199: 852-860.
Quaia E. Comparison between 80 kV, 100 kV and 120 kV CT protocols in the assessment of the therapeutic outcome in HCC. Liver Pancreat Sci 2016; DOI: 10.15761/LPS.1000101.
van der Molen AJ, Miclea RL, Geleijns J, et al. A Survey of Radiation Doses in CT Urography Before and After Implementation of Iterative Reconstruction. AJR Am J Roentgenol 2015; 205: 572-577.
Zhou Z, Chen H, Wei W, et al. Low kilovoltage peak (kVp) with an adaptive statistical iterative reconstruction algorithm in computed tomography urography: evaluation of image quality and radiation dose. Am J Trans Res 2016; 8: 3883-3892.
Gervaise A, Osemont B, Louis M, et al. Standard dose versus low-dose abdominal and pelvic CT: comparison between filtered back projection versus adaptive iterative dose reduction 3D. Diagn Interv Imaging 2014; 95: 47-53.
Buls N, Van Gompel G, Van Cauteren T, et al. Contrast agent and radiation dose reduction in abdominal CT by a combination of low tube voltage and advanced image reconstruction algorithms. Eur Radiol 2015; 25: 1023-1031.
Guimarães LS, Fletcher JG, Harmsen WS, et al. Appropriate patient selection at abdominal dual-energy CT using 80 kV: relationship between patient size, image noise, and image quality. Radiology 2010; 257: 732-742.
Berlin SC, Weinert DM, Vasavada PS, et al. Successful dose reduction using reduced tube voltage with hybrid iterative reconstruction in pediatric abdominal CT. Am J Roentgenol 2015; 205: 392-399.
Lee S, Jung SE, Rha SE, et al. Reducing radiation in CT urography for hematuria: Effect of using 100 kilovoltage protocol. Eur J Radiol 2012; 81: e830-834.
Riccabona M, Avni FE, Blickman JG, et al. Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol 2008; 38: 138.
Johnston JH, Podberesky DJ, Yoshizumi TT, et al. Comparison of radiation dose estimates, image noise, and scan duration in pediatric body imaging for volumetric and helical modes on 320-detector CT and helical mode on 64-detector CT. Pediatr Radiol 2013; 43: 1117-1127.
Pelc NJ. Recent and future directions in CT imaging. Ann Biomed Eng 2014; 42: 260-268.
Silva AC, Lawder HJ, Hara A, et al. Innovations in CT dose reduction strategy: application of the adaptive statistical iterative reconstruction algorithm. AJR 2010; 194: 191-199.
Khawaja RD, Singh S, Otrakji A, et al. Dose reduction in pediatric abdominal CT: use of iterative reconstruction techniques across different CT platforms. Pediatr Radiol 2015; 45: 1046-1055.
Jung SC, Kim SH, Cho JY. A comparison of the use of contrast media with different iodine concentrations for multidetector CT of the kidney. Korean J Radiol 2011; 12: 714-721.
Sussman SK, Illescas FF, Opalacz JP, et al. Renal streak artifact during contrast enhanced CT: comparison of high versus low osmolality contrast media. Abdom Imaging 1993; 18: 180-185.
Imai R, Miyazaki O, Horiuchi T, et al. Local diagnostic reference level based on size-specific dose estimates: assessment of pediatric abdominal/pelvic computed tomography at a Japanese national children’s hospital. Pediatr Radiol 2015; 45: 345-353.
ICRP 2007. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann ICRP 2007; 37 (2-4).
Shrimpton PC. Assessment of patient dose in CT. NRPBPE/1/2004. NRPB, Chilton 2004.
Hamza Y, Sulieman A, Abuderman A, et al. Evaluation of patient effective doses in CT urography, intravenous urography and renal scintigraphy. Radiat Prot Dosimetry 2015; 165: 452-456.
Cerwinka WH, Damien Grattan-Smith J, Kirsch AJ. Magnetic resonance urography in pediatric urology. J Pediatr Urol 2008; 4: 74-82.
Silverman S, Leyendecker J, Amis E. What is the current role of CT urography and MR urography in the evaluation of the urinary tract? Radiology 2009; 250: 309.
 
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