TY - JOUR
T1 - CT radiation dose reduction in patients with total hip arthroplasties using model-based iterative reconstruction and orthopaedic metal artefact reduction
AU - Wellenberg, Ruud H. H.
AU - van Osch, Jochen A. C.
AU - Boelhouwers, Henk J.
AU - Edens, Mireille A.
AU - Streekstra, Geert J.
AU - Ettema, Harmen B.
AU - Boomsma, Martijn F.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objective: To evaluate the impact of radiation dose reduction on image quality in patients with metal-on-metal total hip arthroplasties (THAs) using model-based iterative reconstruction (MBIR) combined with orthopaedic metal artefact reduction (O-MAR). Materials and methods: Patients with metal-on-metal THAs received a pelvic CT with a full (FD) and a reduced radiation dose (RD) with −20%, −40%, −57%, or −80% CT radiation dose respectively, when assigned to group 1, 2, 3, or 4 respectively. FD acquisitions were reconstructed with iterative reconstruction, iDose 4 . RD acquisitions were additionally reconstructed with iterative model-based reconstruction (IMR) levels 1–3 with different levels of noise suppression. CT numbers, noise and contrast-to-noise ratios were measured in muscle, fat and bladder. Subjective image quality was evaluated on seven aspects including artefacts, osseous structures, prosthetic components and soft tissues. Results: Seventy-six patients were randomly assigned to one of the four groups. While reducing radiation dose by 20%, 40%, 57%, or 80% in combination with IMR, CT numbers remained constant. Compared with iDose 4 , the noise decreased (p < 0.001) and contrast-to-noise ratios increased (p < 0.001) with IMR. O-MAR improved CT number accuracy in the bladder and reduced noise in the bladder, muscle and fat (p < 0.01). Subjective image quality was rated lower on RD IMR images than FD iDose 4 images on all seven aspects (p < 0.05) and was not related to the applied radiation dose reduction. Conclusion: In RD IMR with O-MAR images, CT numbers remained constant, noise decreased and contrast-to-noise ratios between muscle and fat increased compared with FD iDose 4 with O-MAR images in patients with metal-on-metal THAs. Subjective image quality reduced, regardless of the degree of radiation dose reduction.
AB - Objective: To evaluate the impact of radiation dose reduction on image quality in patients with metal-on-metal total hip arthroplasties (THAs) using model-based iterative reconstruction (MBIR) combined with orthopaedic metal artefact reduction (O-MAR). Materials and methods: Patients with metal-on-metal THAs received a pelvic CT with a full (FD) and a reduced radiation dose (RD) with −20%, −40%, −57%, or −80% CT radiation dose respectively, when assigned to group 1, 2, 3, or 4 respectively. FD acquisitions were reconstructed with iterative reconstruction, iDose 4 . RD acquisitions were additionally reconstructed with iterative model-based reconstruction (IMR) levels 1–3 with different levels of noise suppression. CT numbers, noise and contrast-to-noise ratios were measured in muscle, fat and bladder. Subjective image quality was evaluated on seven aspects including artefacts, osseous structures, prosthetic components and soft tissues. Results: Seventy-six patients were randomly assigned to one of the four groups. While reducing radiation dose by 20%, 40%, 57%, or 80% in combination with IMR, CT numbers remained constant. Compared with iDose 4 , the noise decreased (p < 0.001) and contrast-to-noise ratios increased (p < 0.001) with IMR. O-MAR improved CT number accuracy in the bladder and reduced noise in the bladder, muscle and fat (p < 0.01). Subjective image quality was rated lower on RD IMR images than FD iDose 4 images on all seven aspects (p < 0.05) and was not related to the applied radiation dose reduction. Conclusion: In RD IMR with O-MAR images, CT numbers remained constant, noise decreased and contrast-to-noise ratios between muscle and fat increased compared with FD iDose 4 with O-MAR images in patients with metal-on-metal THAs. Subjective image quality reduced, regardless of the degree of radiation dose reduction.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064641095&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31016340
U2 - https://doi.org/10.1007/s00256-019-03206-z
DO - https://doi.org/10.1007/s00256-019-03206-z
M3 - Article
C2 - 31016340
SN - 0364-2348
VL - 48
SP - 1775
EP - 1785
JO - Skeletal Radiology
JF - Skeletal Radiology
IS - 11
ER -