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Model-based iterative reconstruction in pediatric chest CT: assessment of image quality in a prospective study of children with cystic fibrosis

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Abstract

Background

The potential effects of ionizing radiation are of particular concern in children. The model-based iterative reconstruction VEOTM is a technique commercialized to improve image quality and reduce noise compared with the filtered back-projection (FBP) method.

Objective

To evaluate the potential of VEOTM on diagnostic image quality and dose reduction in pediatric chest CT examinations.

Materials and methods

Twenty children (mean 11.4 years) with cystic fibrosis underwent either a standard CT or a moderately reduced-dose CT plus a minimum-dose CT performed at 100 kVp. Reduced-dose CT examinations consisted of two consecutive acquisitions: one moderately reduced-dose CT with increased noise index (NI = 70) and one minimum-dose CT at CTDIvol 0.14 mGy. Standard CTs were reconstructed using the FBP method while low-dose CTs were reconstructed using FBP and VEO. Two senior radiologists evaluated diagnostic image quality independently by scoring anatomical structures using a four-point scale (1 = excellent, 2 = clear, 3 = diminished, 4 = non-diagnostic). Standard deviation (SD) and signal-to-noise ratio (SNR) were also computed.

Results

At moderately reduced doses, VEO images had significantly lower SD (P < 0.001) and higher SNR (P < 0.05) in comparison to filtered back-projection images. Further improvements were obtained at minimum-dose CT. The best diagnostic image quality was obtained with VEO at minimum-dose CT for the small structures (subpleural vessels and lung fissures) (P < 0.001). The potential for dose reduction was dependent on the diagnostic task because of the modification of the image texture produced by this reconstruction.

Conclusions

At minimum-dose CT, VEO enables important dose reduction depending on the clinical indication and makes visible certain small structures that were not perceptible with filtered back-projection.

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Acknowledgments

We would like to thank Professor Olivier Hélénon, chairman of the adult radiology department in the Necker Children’s Hospital of Paris, for his assistance and for providing the machine time required to perform this study. This research was supported by the Swiss National Science Foundation grant [#320030-120382].

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Authors and Affiliations

  1. Institute of Radiation Physics, Lausanne University Hospital, Grand-Pré 1 , 1007, Lausanne, Switzerland

    Frédéric A. Miéville, François O. Bochud & Francis R. Verdun

  2. Department of Pediatric Radiology, Necker Children’s Hospital of Paris and University of Paris Descartes, Paris, France

    Laureline Berteloot & Francis Brunelle

  3. General Electric Medical Systems Europe, Paris, France

    Albane Grandjean & Paul Ayestaran

  4. Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland

    François Gudinchet & Sabine Schmidt

Authors
  1. Frédéric A. Miéville
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  2. Laureline Berteloot
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  3. Albane Grandjean
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  4. Paul Ayestaran
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  5. François Gudinchet
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  6. Sabine Schmidt
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  7. Francis Brunelle
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  8. François O. Bochud
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  9. Francis R. Verdun
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Correspondence to Frédéric A. Miéville.

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Miéville, F.A., Berteloot, L., Grandjean, A. et al. Model-based iterative reconstruction in pediatric chest CT: assessment of image quality in a prospective study of children with cystic fibrosis. Pediatr Radiol 43, 558–567 (2013). https://doi.org/10.1007/s00247-012-2554-4

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  • DOI: https://doi.org/10.1007/s00247-012-2554-4

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