TY - JOUR
T1 - Systematic Evaluation of Low-dose MDCT for Planning Purposes of Lumbosacral Periradicular Infiltrations
AU - Sollmann, Nico
AU - Mei, Kai
AU - Schön, Simon
AU - Riederer, Isabelle
AU - Kopp, Felix K.
AU - Löffler, Maximilian T.
AU - Probst, Monika
AU - Rummeny, Ernst J.
AU - Zimmer, Claus
AU - Kirschke, Jan S.
AU - Noël, Peter B.
AU - Baum, Thomas
N1 - Publisher Copyright:
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/12
Y1 - 2020/12
N2 - Purpose: To evaluate image quality and confidence for planning of periradicular infiltrations using virtually lowered tube currents and in-house developed iterative reconstruction (IR) for multidetector computed tomography (MDCT). Methods: A total of 20 patients (mean age 54.9 ± 13.1 years) underwent MDCT for planning purposes of periradicular infiltrations at the lumbosacral spine (120 kVp and 100 mAs). Planning scans were simulated as if they were performed at 50% (D50), 10% (D10), 5% (D5), and 1% (D1) of the tube current of original scanning. Image reconstruction was achieved with two levels of IR (A: similar in appearance to clinical reconstructions, B: 10 times stronger noise reduction). Qualitative image evaluation was performed by two readers (R1 and R2) considering overall image quality and artifacts, image contrast, determination of nerve root, and confidence for intervention planning (scoring: 1 high, 2 medium, and 3 low confidence). Results: Level A of IR was favorable regarding overall image quality, artifacts, image contrast, and nerve root depiction according to both readers, with preserved good to excellent scores down to D10 scans. The confidence for intervention planning was not significantly different (p > 0.05) between scans with tube currents virtually lowered down to 10% as compared to the original scans when using level A of IR (R1: 1.2 ± 0.4, R2: 1.1 ± 0.3). Inter-reader agreement for planning confidence was good to excellent (range of weighted Cohen’s kappa: 0.62–1.00). Conclusion: The use of MDCT for planning purposes of lumbosacral periradicular infiltrations may be possible with tube currents lowered down to 10% of standard dose (equal to 10 mAs) without limitations in planning confidence.
AB - Purpose: To evaluate image quality and confidence for planning of periradicular infiltrations using virtually lowered tube currents and in-house developed iterative reconstruction (IR) for multidetector computed tomography (MDCT). Methods: A total of 20 patients (mean age 54.9 ± 13.1 years) underwent MDCT for planning purposes of periradicular infiltrations at the lumbosacral spine (120 kVp and 100 mAs). Planning scans were simulated as if they were performed at 50% (D50), 10% (D10), 5% (D5), and 1% (D1) of the tube current of original scanning. Image reconstruction was achieved with two levels of IR (A: similar in appearance to clinical reconstructions, B: 10 times stronger noise reduction). Qualitative image evaluation was performed by two readers (R1 and R2) considering overall image quality and artifacts, image contrast, determination of nerve root, and confidence for intervention planning (scoring: 1 high, 2 medium, and 3 low confidence). Results: Level A of IR was favorable regarding overall image quality, artifacts, image contrast, and nerve root depiction according to both readers, with preserved good to excellent scores down to D10 scans. The confidence for intervention planning was not significantly different (p > 0.05) between scans with tube currents virtually lowered down to 10% as compared to the original scans when using level A of IR (R1: 1.2 ± 0.4, R2: 1.1 ± 0.3). Inter-reader agreement for planning confidence was good to excellent (range of weighted Cohen’s kappa: 0.62–1.00). Conclusion: The use of MDCT for planning purposes of lumbosacral periradicular infiltrations may be possible with tube currents lowered down to 10% of standard dose (equal to 10 mAs) without limitations in planning confidence.
KW - Image processing
KW - Interventional radiology
KW - Multidetector computed tomography
KW - Radiation dosage
KW - Spine
UR - http://www.scopus.com/inward/record.url?scp=85074851657&partnerID=8YFLogxK
U2 - 10.1007/s00062-019-00844-7
DO - 10.1007/s00062-019-00844-7
M3 - Article
C2 - 31696279
AN - SCOPUS:85074851657
SN - 1869-1439
VL - 30
SP - 749
EP - 759
JO - Clinical Neuroradiology
JF - Clinical Neuroradiology
IS - 4
ER -