| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Kalra, Mannudeep, et al.
(author)
-
Iterative Reconstruction Techniques: The Be-All and End-All for CT Dose Reduction? Pictorial Synopsis of Different Vendor Techniques
- 2010
-
In: In Proceedings of RSNA 2010, LL-PHE 4076.
-
Conference paper (peer-reviewed)abstract
- Recently introduced IRT for clinical use allow dose reduction for adult and pediatric CT while maintaining or even enhancing image quality compared to filtered back projection based reconstruction. Specific adjustments of scanning protocols and fine-tuning of iterative settings are necessary to ensure optimum usage with understanding of its potential and disadvantages. This educational exhibit focuses on clinical illustrations to simplify application of IRT for reducing CT radiation dose
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Kalra, Mannudeep K., et al.
(author)
-
Radiation Dose Reduction with Sinogram Affirmed Iterative Reconstruction Technique for abdominal Computer Tomography
- 2012
-
In: Journal of Computer Assisted Tomography. - USA : Lippincott Williams & Wilkins. - 0363-8715. ; 36:3, s. 339-346
-
Journal article (peer-reviewed)abstract
- Purpose: The objective of this study was to assess the effect of Sinogram Affirmed Iterative Reconstruction (SAFIRE) and filtered back-projection (FBP) techniques on abdominal computed tomography (CT) performed with 50% and 75% radiation dose reductions.Methods: Twenty-four patients (mean age, 64 ± 14 years; male-female ratio, 10:14) gave informed consent for an institutional review board–approved prospective study involving acquisition of additional research images through the abdomen on 128-slice multi–detector-row CT (SOMATOM Definition Flash) at quality reference mAs of 100 (50% lower dose) and 50 (75% lower dose) over a scan length of 10 cm using combined modulation (CARE Dose 4D). Standard-of-care abdominal CT was performed at 200 quality reference mAs, with remaining parameters held constant. The 50- and 100-mAs data sets were reconstructed with FBP and at 4 SAFIRE settings (S1, S2, S3, S4). Higher number of SAFIRE settings denotes increased strength of the algorithm resulting in lower image noise. Two abdominal radiologists independently compared the FBP and SAFIRE images for lesion number, location, size and conspicuity, and visibility of small structures, image noise, and diagnostic confidence. Objective noise and Hounsfield units (HU) were measured in the liver and the descending aorta.Results: All 43 lesions were detected on both FBP and SAFIRE images. Minor blocky, pixelated appearance of 50% and 75% reduced dose images was noted at S3 and S4 SAFIRE but not at S1 and S2 settings. Subjective noise was suboptimal in both 50% and 75% lower-dose FBP images but was deemed acceptable on all SAFIRE settings. Sinogram Affirmed Iterative Reconstruction images were deemed acceptable in all patients at 50% lower dose and in 22 of 24 patients at 75% lower dose. As compared with 75% reduced dose FBP, objective noise was lower by 22.8% (22.9/29.7), 35% (19.3/29.7), 44.3% (16.7/29.3), and 54.8% (13.4/29.7) on S1 to S4 settings, respectively (P < 0.001).Conclusions: Sinogram Affirmed Iterative Reconstruction–enabled reconstruction provides abdominal CT images without loss in diagnostic value at 50% reduced dose and in some patients also at 75% reduced dose.
|
|
| 8. |
- Kalra, Mannudeep K., et al.
(author)
-
Sinogram-Affirmed Iterative Reconstruction of Low-Dose Chest CT: Effect on Image Quality and Radiation Dose
- 2013
-
In: American Journal of Roentgenology. - : American Roentgen Ray Society (ARRS). - 0361-803X .- 1546-3141. ; 201:2, s. W235-W244
-
Journal article (peer-reviewed)abstract
- OBJECTIVE. The purpose of this study is to compare sinogram-affirmed iterative reconstruction (SAFIRE) and filtered back projection (FBP) reconstruction of chest CT acquired with 65% radiation dose reduction.SUBJECTS AND METHODS. In this prospective study involving 24 patients (11 women and 13 men; mean [+/- SD] age, 66 +/- 10 years), two scan series were acquired using 100 and 40 Quality Reference mAs over a 10-cm scan length in the chest with a 128-MDCT scanner. The 40 Quality Reference mAs CT projection data were reconstructed with FBP and four settings of Safire (S1, S2, S3, and S4). Six image datasets (FBP with 100 and 40 Quality Reference mAs, and S1, S2, S3, S4 with 40 Quality Reference mAs) were displayed on a DICOM-compliant 55-inch 2-megapixel monitor for blinded evaluation by two thoracic radiologists for number and location of lesions, lesion size, lesion margins, visibility of small structures and fissures, and diagnostic confidence. Objective noise and CT values were measured in thoracic aorta for each image series, and the noise power spectrum was assessed. Data were analyzed with analysis of variance and Wilcoxon signed rank tests.RESULTS. All 186 lesions were seen on 40 Quality Reference mAs SAFIRE images. Diagnostic confidence on SAFIRE images was higher than that for FBP images. Except for the minor blotchy appearance on SAFIRE settings S3 and S4, no significant artifacts were noted. Objective noise with 40 Quality Reference mAs S1 images (21.1 +/- 6.1 SD of HU) was significantly lower than that for 40 Quality Reference mAs FBP images (28.5 +/- 8.1 SD of HU) (p andlt; 0.001). Noise power spectra were identical for SAFIRE and FBP with progressive noise reduction with higher iteration SAFIRE settings.CONCLUSION. Iterative reconstruction (SAFIRE) allows reducing the radiation exposure by approximately 65% without losing diagnostic information in chest CT.
|
|
| 9. |
- Kalra, Mannudeep, et al.
(author)
-
Whole spine CT for evaluation of scoliosis in children : feasibility of sub-milliSievert scanning protocol
- 2013
-
In: Acta Radiologica. - : Sage Publications. - 0284-1851 .- 1600-0455. ; 54:2, s. 226-230
-
Journal article (peer-reviewed)abstract
- Background Optimization of CT radiation dose is important for children due to their higher risk of radiation-induced adverse effects. Anatomical structures with high inherent contrast, such as bones can be imaged at very low radiation doses by optimizing scan parameters. Purpose To assess feasibility of sub-milliSievert whole spine CT scanning protocol for evaluation of scoliosis in children. Material and Methods With approval of the ethical board, we performed whole spine CT for evaluation of scoliosis in 22 children (age range, 3–18 years; mean age, 13 years; 13 girls, 9 boys) on a 128-slice dual source multidetector-row CT scanner. Lowest possible quality reference mAs value (image quality factor for xy-z automatic exposure control or xyz-AEC, CARE Dose 4D) was selected on a per patient basis. Remaining parameters were held constant at 3.0:1 pitch, 128 × 0.6 mm detector collimation, 115.2 mm table feed per gantry rotation, 100 kVp, and 1 and 3 mm reconstructed sections. Average mAs, projected estimated dose savings with AEC, computed tomography dose index volume (CTDI vol), and dose length product (DLP) were recorded. Artifacts were graded on a four-point scale (1, no artifacts; 4, severe artifacts). Ability to identify vertebral and pedicular contours, and measure pedicular width and degree of vertebral rotation was graded on a three-point scale (1, unacceptable; 3, excellent). Results All CT examinations were deemed as reliable for identifying vertebral and pedicular contours as well as for measuring pedicular width (5.9 ± 1.6 mm) and degree of vertebral rotation (28.7 ± 23.4°). Mean objective image noise and signal to noise ratio (SNR) were 57.5 ± 21.5 and 4.7 ± 2.3, respectively. With a mean quality reference mAs of 13, the scanner employed an average actual effective mAs of 10 ± 3.8 (range, 6–18 mAs) with an estimated radiation dose saving of 43.5 ± 16.3% with xyz-AEC compared with fixed mAs. The mean CTDI, DLP, and estimated effective doses were 0.4 ± 0.1 mGy (0.2–0.7 mGy), 21 ± 10 mGy.cm (8–41 mGy.cm), and 0.3 ± 0.1 mSv (0.12–0.64 mSv), respectively. Conclusion Radiation dose for whole spine CT for evaluation of scoliosis in children can be minimized to less than one-third of a milliSievert while maintaining diagnostic image quality.
|
|
| 10. |
- Palm, Fredrik, et al.
(author)
-
Renomedullary Blood Flow And Blood Volume Are Increased During Vasopressin Escape
- 2010
-
Conference paper (peer-reviewed)abstract
- Hyponatremia is a common electrolyte disorder usually caused by inappropriate vasopressin (AVP) levels relative to serum osmolality. The degree of the hyponatremia is limited by "escape" from AVP-induced antidiuresis, characterized by increased urine volume and decreased urine osmolality independently of circulating AVP. The mechanisms mediating escape are not fully understood, but we have hypothesized that increased renomedullary blood flow (BF) contributes to this process. We therefore investigated intrarenal BF and blood volume distribution in rats with and without escape.Adult male Sprague-Dawley rats (n=10) were infused with DDAVP (5 ng/h) to produce maximal antidiuresis. Half were fed a liquid diet (AIN-76) to produce escape; half were fed a solid diet to prevent escape. After 5 days, all rats were anesthetized with Inactin and high resolution images (voxel size 97x97x600 µm) of renal BF were acquired using a Siemens Definition Dual Source CT. Iopromide (0.15 ml/rat) was rapidly injected iv and the contrast over the kidney area was collected during 30 s. Data were evaluated by analyzing local renal contrast density utilizing the Siemens Syngo body perfusion tool and correlated to the aorta. Cortical and medullary BF were 709±41 and 251±50 ml/100ml/min respectively in non-escaped rats. Cortical BF in escaped rats was similar (588±81 ml/100ml/min), but medullary BF was increased compared to non-escaped rats (666±105 ml/100ml/min). Blood volumes were similar in the two groups in cortex (42±1 vs. 49±6 ml/100ml), but elevated in the medulla of escaped rats (70±3 vs 18±3 ml/100ml).Our results demonstrate that escape is accompanied by markedly elevated renomedullary BF and volume. Elevated BF to the renal medulla results in reduced interstitial osmolality, and may also contribute to the down-regulation of aquarporin-2 water channels known to accompany escape. These results therefore provide a potential mechanistic explanation for the reduced ability to concentrate urine during AVP escape.
|
|
