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- 저자 : Bamberg Fabian (검색결과 2 건)
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Storz, Corinna,Kolb, Manuel,Kim, Jong Hyo,Weiss, Jakob,Kunz, Wolfgang G.,Nikolaou, Konstantin,Bamberg, Fabian,Othman, Ahmed E. Elsevier 2018 Academic radiology Vol.25 No.3
<P><B>Rationale and Objectives</B></P> <P>To determine the intraindividual impact of radiation dose reduction in abdominal computed tomography (CT) on diagnostic performance in patients with suspected appendicitis.</P> <P><B>Materials and Methods</B></P> <P>This study was approved by the institutional review board. Seventy-five patients who underwent standard contrast-enhanced abdominal CT for suspected appendicitis between 2004 and 2009 were retrospectively included. Low-dose CT reconstructions with 75%, 50%, and 25% of the original radiation dose level were generated by applying realistic reduced-dose simulation. Two blinded, independent readers assessed image quality, signal-to-noise ratio, and diagnostic confidence on each dataset. Diagnostic accuracy for detection of appendicitis and complications were calculated for each reader. Paired univariate tests were used to determine intraindividual differences.</P> <P><B>Results</B></P> <P>Among 75 subjects included in the analysis (57% female, mean age: 41 ± 18 years), the prevalence of histopathologically confirmed appendicitis was 59%. Signal-to-noise ratio and subjective image quality of 50% and 25% reduced-dose CTs were significantly lower than the reference datasets (all <I>P</I> < .005). Appendicitis was correctly identified in all reference and low-dose datasets (sensitivity: 100%, negative predictive value: 100%). Presence of complications was correctly detected in all reference, 75%, and 50% datasets, but was decreased in 25% datasets (sensitivity: 77.8% and negative predictive value: 97.4%). Diagnostic confidence was high for original and 75% datasets, but significantly lower for 50% and 25% datasets (<I>P</I> < .001).</P> <P><B>Conclusions</B></P> <P>Our results indicate that diagnostic accuracy in abdominal CT acquisitions acquired at 75% and 50% of radiation dose is maintained in patients with suspected appendicitis, whereas further reduction of radiation exposition is associated with decreased diagnostic performance.</P>
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Rau Alexander,Neubauer Jakob,Taleb Laetitia,Stein Thomas,Schuermann Till,Rau Stephan,Faby Sebastian,Wenger Sina,Engelhardt Monika,Bamberg Fabian,Weiss Jakob 대한영상의학회 2023 Korean Journal of Radiology Vol.24 No.10
Objective: Computed tomography (CT) is an established method for the diagnosis, staging, and treatment of multiple myeloma. Here, we investigated the potential of photon-counting detector computed tomography (PCD-CT) in terms of image quality, diagnostic confidence, and radiation dose compared with energy-integrating detector CT (EID-CT). Materials and Methods: In this prospective study, patients with known multiple myeloma underwent clinically indicated whole-body PCD-CT. The image quality of PCD-CT was assessed qualitatively by three independent radiologists for overall image quality, edge sharpness, image noise, lesion conspicuity, and diagnostic confidence using a 5-point Likert scale (5 = excellent), and quantitatively for signal homogeneity using the coefficient of variation (CV) of Hounsfield Units (HU) values and modulation transfer function (MTF) via the full width at half maximum (FWHM) in the frequency space. The results were compared with those of the current clinical standard EID-CT protocols as controls. Additionally, the radiation dose (CTDIvol) was determined. Results: We enrolled 35 patients with multiple myeloma (mean age 69.8 ± 9.1 years; 18 [51%] males). Qualitative image analysis revealed superior scores (median [interquartile range]) for PCD-CT regarding overall image quality (4.0 [4.0–5.0] vs. 4.0 [3.0–4.0]), edge sharpness (4.0 [4.0–5.0] vs. 4.0 [3.0–4.0]), image noise (4.0 [4.0–4.0] vs. 3.0 [3.0–4.0]), lesion conspicuity (4.0 [4.0–5.0] vs. 4.0 [3.0–4.0]), and diagnostic confidence (4.0 [4.0–5.0] vs. 4.0 [3.0–4.0]) compared with EID-CT (P ≤ 0.004). In quantitative image analyses, PCD-CT compared with EID-CT revealed a substantially lower FWHM (2.89 vs. 25.68 cy/pixel) and a significantly more homogeneous signal (mean CV ± standard deviation [SD], 0.99 ± 0.65 vs. 1.66 ± 0.5; P < 0.001) at a significantly lower radiation dose (mean CTDIvol ± SD, 3.33 ± 0.82 vs. 7.19 ± 3.57 mGy; P < 0.001). Conclusion: Whole-body PCD-CT provides significantly higher subjective and objective image quality at significantly reduced radiation doses than the current clinical standard EID-CT protocols, along with readily available multi-spectral data, facilitating the potential for further advanced post-processing.
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