Abstract
Objectives
The aim of this study was to investigate the radiation dose and image quality of a whole-body low-dose CT (WBLDCT) using spectral shaping at 100 kV (Sn 100 kV) for the assessment of osteolytic lesions in patients with multiple myeloma.
Methods
Thirty consecutive patients were retrospectively selected, who underwent a WBLDCT on a third-generation dual-source CT (DSCT) (Sn 100 kV, ref. mAs: 130). They were matched with patients, who were examined on a second-generation DSCT with a standard low-dose protocol (100 kV, ref. mAs: 111). Objective and subjective image quality, radiation exposure as well as the frequency of osteolytic lesions were evaluated.
Results
All scans were of diagnostic image quality. Subjective overall image quality was significantly higher in the study group (p = 0.0003). Objective image analysis revealed that signal intensities, signal-to-noise ratio and contrast-to-noise ratio of the bony structures were equal or significantly higher in the control group. There was no significant difference in the frequency of osteolytic lesions (p = 0.259). The median effective dose of the study protocol was significantly lower (1.45 mSv vs. 5.65 mSv; p < 0.0001).
Conclusion
WBLDCT with Sn 100 kV can obtain sufficient image quality for the depiction of osteolytic lesions while reducing the radiation dose by approximately 74%.
Key points
• Spectral shaping using tin filtration is beneficial for whole-body low-dose CT
• Sn 100 kV yields sufficient image quality for depiction of osteolytic lesions
• Whole-body low-dose CT can be performed with a median dose of 1.5 mSv
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Abbreviations
- ADMIRE:
-
Advanced Modeled Iterative Reconstruction
- BMI:
-
Body mass index
- CNR:
-
Contrast-to-noise ratio
- CT:
-
Computed tomography
- CTDIvol :
-
Volumetric CT dose index
- DLP:
-
Dose length product
- ED:
-
Effective dose
- HU:
-
Hounsfield unit
- IQR:
-
Interquartile range
- IR:
-
Iterative reconstruction
- MM:
-
Multiple myeloma
- ROI:
-
Region of interest
- SAFIRE:
-
Sinogram Affirmed Iterative Reconstruction
- SD:
-
Standard deviation
- SNR:
-
Signal-to-noise ratio
- WBLDCT:
-
Whole-body low-dose CT
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The scientific guarantor of this publication is Kai Nassenstein, MD.
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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
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No complex statistical methods were necessary for this paper.
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The study was approved by the local ethics committee.
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Written informed consent was waived by the Institutional Review Board due to the retrospective character of the study and anonymised data evaluation.
Methodology
• retrospective
• observational
• performed at one institution
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Suntharalingam, S., Mikat, C., Wetter, A. et al. Whole-body ultra-low dose CT using spectral shaping for detection of osteolytic lesion in multiple myeloma. Eur Radiol 28, 2273–2280 (2018). https://doi.org/10.1007/s00330-017-5243-8
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DOI: https://doi.org/10.1007/s00330-017-5243-8