Low-Dose CT Examinations in Crohn's Disease: Impact on Image Quality, Diagnostic Performance, and Radiation Dose

2010 ◽  
Vol 195 (1) ◽  
pp. 78-88 ◽  
Author(s):  
Avinash R. Kambadakone ◽  
Priyanka Prakash ◽  
Peter F. Hahn ◽  
Dushyant V. Sahani
2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Richard G. Kavanagh ◽  
John O’Grady ◽  
Brian W. Carey ◽  
Patrick D. McLaughlin ◽  
Siobhan B. O’Neill ◽  
...  

Magnetic resonance imaging (MRI) is the mainstay method for the radiological imaging of the small bowel in patients with inflammatory bowel disease without the use of ionizing radiation. There are circumstances where imaging using ionizing radiation is required, particularly in the acute setting. This usually takes the form of computed tomography (CT). There has been a significant increase in the utilization of computed tomography (CT) for patients with Crohn’s disease as patients are frequently diagnosed at a relatively young age and require repeated imaging. Between seven and eleven percent of patients with IBD are exposed to high cumulative effective radiation doses (CEDs) (>35–75 mSv), mostly patients with Crohn’s disease (Newnham E 2007, Levi Z 2009, Hou JK 2014, Estay C 2015). This is primarily due to the more widespread and repeated use of CT, which accounts for 77% of radiation dose exposure amongst patients with Crohn’s disease (Desmond et al., 2008). Reports of the projected cancer risks from the increasing CT use (Berrington et al., 2007) have led to increased patient awareness regarding the potential health risks from ionizing radiation (Coakley et al., 2011). Our responsibilities as physicians caring for these patients include education regarding radiation risk and, when an investigation that utilizes ionizing radiation is required, to keep radiation doses as low as reasonably achievable: the “ALARA” principle. Recent advances in CT technology have facilitated substantial radiation dose reductions in many clinical settings, and several studies have demonstrated significantly decreased radiation doses in Crohn’s disease patients while maintaining diagnostic image quality. However, there is a balance to be struck between reducing radiation exposure and maintaining satisfactory image quality; if radiation dose is reduced excessively, the resulting CT images can be of poor quality and may be nondiagnostic. In this paper, we summarize the available evidence related to imaging of Crohn’s disease, radiation exposure, and risk, and we report recent advances in low-dose CT technology that have particular relevance.


2015 ◽  
Vol 204 (6) ◽  
pp. 1197-1202 ◽  
Author(s):  
Yookyung Kim ◽  
Yoon Kyung Kim ◽  
Bo Eun Lee ◽  
Seok Jeong Lee ◽  
Yon Ju Ryu ◽  
...  

2017 ◽  
Vol 59 (5) ◽  
pp. 553-559 ◽  
Author(s):  
Yun Hye Ju ◽  
Geewon Lee ◽  
Ji Won Lee ◽  
Seung Baek Hong ◽  
Young Ju Suh ◽  
...  

Background Reducing radiation dose inevitably increases image noise, and thus, it is important in low-dose computed tomography (CT) to maintain image quality and lesion detection performance. Purpose To assess image quality and lesion conspicuity of ultra-low-dose CT with model-based iterative reconstruction (MBIR) and to determine a suitable protocol for lung screening CT. Material and Methods A total of 120 heavy smokers underwent lung screening CT and were randomly and equally assigned to one of five groups: group 1 = 120 kVp, 25 mAs, with FBP reconstruction; group 2 = 120 kVp, 10 mAs, with MBIR; group 3 = 100 kVp, 15 mAs, with MBIR; group 4 = 100 kVp, 10 mAs, with MBIR; and group 5 = 100 kVp, 5 mAs, with MBIR. Two radiologists evaluated intergroup differences with respect to radiation dose, image noise, image quality, and lesion conspicuity using the Kruskal–Wallis test and the Chi-square test. Results Effective doses were 61–87% lower in groups 2–5 than in group 1. Image noises in groups 1 and 5 were significantly higher than in the other groups ( P < 0.001). Overall image quality was best in group 1, but diagnostic acceptability of overall image qualities in groups 1–3 was not significantly different (all P values > 0.05). Lesion conspicuities were similar in groups 1–4, but were significantly poorer in group 5. Conclusion Lung screening CT with MBIR obtained at 100 kVp and 15 mAs enables a ∼60% reduction in radiation dose versus low-dose CT, while maintaining image quality and lesion conspicuity.


Author(s):  
Lu Tian ◽  
Longlun Wang ◽  
Yong Qin ◽  
Jinhua Cai

Background: Low dose CT has become a promising examination method for the diagnosis of Congenital heart disease (CHD) in children because it has a low radiation dose, but it has not been widely accepted as an alternative to standard-dose CT in clinical applications due to concerns about image quality. Therefore, we suggest that the diagnostic accuracy, image quality, and radiation dose of low-dose CT for CHD in children should be fully explored through a metaanalysis of existing studies. Methods: A comprehensive search was performed to identify relevant English and Chinese articles (from inception to May 2019). All selected studies concerned the diagnosis of CHD in children using low-dose CT. The accuracy of low-dose CT was determined by calculating pooled estimates of sensitivity, specificity, diagnostic odds ratio, and likelihood ratio. Pooling was conducted using a bivariate generalized linear mixed model. Forest plots and summary receiver operating characteristic (SROC) curves were generated. Results: Ten studies, accounting for 577 patients, met the eligibility criteria. The pooled sensitivity and specificity were 0.95 (95% confidence interval (CI) 0.92-0.97) and 1.00 (95% CI 1.00- 1.00), respectively. The pooled diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio of low-dose CT were 12705.53 (95% CI 5065.00-31871.73), 671.29 (95% CI 264.77- 1701.97), and 0.05 (95% CI 0.03-0.08), respectively. Additionally, the area under the SROC curve was 1.00 (95% CI 0.99-1.00), suggesting that low-dose CT is an excellent diagnostic tool for CHD in children. Conclusion: Low-dose CT, especially with a prospective ECG-triggering mode, provides excellent imaging quality and high diagnostic accuracy for CHD in children.


2016 ◽  
Vol 71 (1) ◽  
pp. 64-73 ◽  
Author(s):  
W.H. Nijhof ◽  
E.J.M. Baltussen ◽  
I.M.J. Kant ◽  
G.J. Jager ◽  
C.H. Slump ◽  
...  

2021 ◽  
Vol 76 (2) ◽  
pp. 156.e19-156.e26
Author(s):  
S. Park ◽  
S.H. Park ◽  
J.H. Hwang ◽  
J.H. Kim ◽  
K.H. Lee ◽  
...  

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