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Research ArticlePEDIATRICS

Low-Dose CT for Craniosynostosis: Preserving Diagnostic Benefit with Substantial Radiation Dose Reduction

J.C. Montoya, L.J. Eckel, D.R. DeLone, A.L. Kotsenas, F.E. Diehn, L. Yu, A.C. Bartley, R.E. Carter, C.H. McCollough and J.G. Fletcher
American Journal of Neuroradiology April 2017, 38 (4) 672-677; DOI: https://doi.org/10.3174/ajnr.A5063
J.C. Montoya
aFrom the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.)
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L.J. Eckel
aFrom the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.)
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D.R. DeLone
aFrom the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.)
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A.L. Kotsenas
aFrom the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.)
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F.E. Diehn
aFrom the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.)
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L. Yu
aFrom the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.)
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A.C. Bartley
bHealth Sciences Research (A.C.B., R.E.C.), Mayo Clinic, Rochester, Minnesota.
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R.E. Carter
bHealth Sciences Research (A.C.B., R.E.C.), Mayo Clinic, Rochester, Minnesota.
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C.H. McCollough
aFrom the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.)
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J.G. Fletcher
aFrom the Departments of Radiology (J.C.M., L.J.E., D.R.D., A.L.K., F.E.D., L.Y., C.H.M., J.G.F.)
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Article Figures & Data

Figures

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  • Fig 1.
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    Fig 1.

    Study schema.

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    Fig 2.

    Automatic exposure control in the head of a pediatric patient. The quality reference tube current–time product for this study is equal to 220 mAs, corresponding to a CTDIvol equal to 34 mGy. However, because automatic exposure control was used, the mean effective tube current–time product was 90 mAs, corresponding to a CTDIvol of 13.77 mGy.

  • Fig 3.
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    Fig 3.

    Axial and coronal images at routine dose and simulated lower radiation dose of a patient with left coronal craniosynostosis (A) and sagittal craniosynostosis (B).

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    Fig 4.

    3D volume-rendered images of a patient with sagittal craniosynostosis at routine dose and 2% routine dose, created from axial images (image thickness, 0.75 mm; interval, 0.70 mm; FOV, 250 mm; J30 kernel) by using 2 different shading methods (3D bone and 3D shining bone).

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    Fig 5.

    FOM and 95% CI for reader-specific evaluation of craniosynostosis by using 3D images only and 3D together with 2D images.

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    Fig 6.

    Average FOM and 95% CI from all readers for all radiation dose levels in 3D and 3D together with 2D evaluation.

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    Fig 7.

    Difference in FOM (with 95% CI) between each radiation dose level and reference standard in 3D and 3D together with 2D evaluation.

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    Fig 8.

    Stacked percent bar plot of image quality scores for each reader and radiation dose.

Tables

  • Figures
  • Figures of merit and 95% CI for reader-specific and multireader evaluation of craniosynostosis using 3D images only and 2D images together with 3D imagesa

    Routine25%10%2%
    3D Only2D + 3D3D Only2D + 3D3D Only2D + 3D3D Only2D + 3D
    Reader 10.89 (0.83–0.96)0.86 (0.78–0.94)0.94 (0.88–1.00)0.92 (0.87–0.98)0.91 (0.85–0.97)0.87 (0.75–0.98)0.90 (0.82–0.97)0.88 (0.80–0.96)
    Reader 20.93 (0.88–0.98)0.94 (0.90–0.99)0.92 (0.87–0.97)0.88 (0.82–0.94)0.86 (0.77–0.95)0.88 (0.80–0.97)0.85 (0.76–0.94)0.85 (0.75–0.94)
    Reader 30.95 (0.92–0.99)0.95 (0.92–0.98)0.90 (0.84–0.97)0.89 (0.82–0.95)0.92 (0.87–0.98)0.93 (0.88–0.98)0.85 (0.69–1.00)0.84 (0.68–1.00)
    Average0.92 (0.90–0.95)0.91 (0.89–0.95)0.92 (0.88–0.97)0.89 (0.86–0.94)0.89 (0.84–0.95)0.89 (0.83–0.96)0.86 (0.79–0.94)0.85 (0.76–0.95)
    • ↵a Data presented as FOM (95% CI).

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American Journal of Neuroradiology: 38 (4)
American Journal of Neuroradiology
Vol. 38, Issue 4
1 Apr 2017
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Low-Dose CT for Craniosynostosis: Preserving Diagnostic Benefit with Substantial Radiation Dose Reduction
J.C. Montoya, L.J. Eckel, D.R. DeLone, A.L. Kotsenas, F.E. Diehn, L. Yu, A.C. Bartley, R.E. Carter, C.H. McCollough, J.G. Fletcher
American Journal of Neuroradiology Apr 2017, 38 (4) 672-677; DOI: 10.3174/ajnr.A5063

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Low-Dose CT for Craniosynostosis: Preserving Diagnostic Benefit with Substantial Radiation Dose Reduction
J.C. Montoya, L.J. Eckel, D.R. DeLone, A.L. Kotsenas, F.E. Diehn, L. Yu, A.C. Bartley, R.E. Carter, C.H. McCollough, J.G. Fletcher
American Journal of Neuroradiology Apr 2017, 38 (4) 672-677; DOI: 10.3174/ajnr.A5063
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