Zhao Huiping,Lyu Peijie,Li Ying,Li Weiran,Wang Huixia,Gao Jianbo.Abdominal CT with low radiation dose in obese patients: application of wide-detector helical CT combined with adaptive statistical iterative reconstruction-V (ASIR-V)[J].Chinese Journal of Radiological Medicine and Protection,2018,38(5):379-385
Abdominal CT with low radiation dose in obese patients: application of wide-detector helical CT combined with adaptive statistical iterative reconstruction-V (ASIR-V)
Received:August 16, 2017  
DOI:10.3760/cma.j.issn.0254-5098.2018.05.011
KeyWords:Adaptive statistical iterative reconstruction-V  Wide-detector  Radiation dosage  Image quality  Obesity
FundProject:国家自然科学基金青年基金(81301220);河南省医学科技攻关计划普通项目(201403016)
Author NameAffiliationE-mail
Zhao Huiping Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China  
Lyu Peijie Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China  
Li Ying Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China  
Li Weiran Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China  
Wang Huixia Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China  
Gao Jianbo Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China cjr.gaojianbo@vip.163.com 
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Abstract::
      Objective To investigate the value of wide-detector helical CT combined with adaptive statistical iterative reconstruction-V (ASIR-V) in the low radiation dose CT examination of upper abdomen in obese patients. Methods In the first phantom experiment part, the optimal percentage of pre-and post-ASIR-V of abdominal scanning (120 kVp, NI=10 HU) were explored. The second human experiment was performed based on the phantom study, and our institutional review board approved this prospective study, each participant provided written informed consent. 87 obese patients (body mass index, BMI ≥ 30 kg/m2) underwent contrast-enhanced abdominal CT scan were randomly divided into two scan protocols[protocol A:n=43, 120 kVp, detector coverage of 80 mm, 40% pre-ASIR-V (group A1) and combined with 60% post-ASIR-V (group A2) respectively; protocol B, n=44, 120 kVp, detector coverage of 40 mm, 40% ASIR (group B)]. Quantitative parameters[image noise and contrast-to-noise ratio (CNR)] and qualitative visual parameters (overall image quality as graded on a 5-point scale) were compared. Weighted effective dose (E) were assessed. Results The optimal percentage of pre-and post-ASIR-V of abdominal scanning were 40% and 60%, respectively. The effective radiation dose in protocol A[(4.55 ±0.95) mSv] was decreased for 53% as compared with protocol B[(9.58 ±2.04) mSv] (t=-14.773, P<0.001). During the arterial phase and portal venous phase, except for the CNRs of liver, Group A2 showed higher CNRs (q=2.160-3.209, P<0.05), lower image noise(q=-4.212- -3.202, P<0.05), and higher overall image quality scores(Z=-5.155- -2.561, P<0.05) as compared with group A1 and group B. Group A1 showed similar CNRs, similar image noise(P>0.05), and lower overall image quality scores(Z=-3.298- -3.030, P<0.05) than group B. The overall image quality scores in group A were all greater than 3 point and met the clinical diagnostic level. Conclusions Compared with stand-detector helical CT in obese patients, the wide-detector helical CT combined with 40% pre-ASIR-V could reduce the radiation dose by 53%, and improve overall image quality by combining post-ASIR-V technique.
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