Feasibility of low-dose CT with model-based iterative image reconstruction in follow-up of patients with testicular cancer.

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Murphy, Kevin P.
Crush, Lee
O'Neill, Siobhán B.
Foody, James
Breen, Micheál
Brady, Adrian
Kelly, Paul J.
Power, Derek G.
Sweeney, Paul
Bye, Jackie
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Purpose: We examine the performance of pure model-based iterative reconstruction with reduced-dose CT in follow-up of patients with early-stage testicular cancer. Methods: Sixteen patients (mean age 35.6 ± 7.4 years) with stage I or II testicular cancer underwent conventional dose (CD) and low-dose (LD) CT acquisition during CT surveillance. LD data was reconstructed with model-based iterative reconstruction (LD–MBIR). Datasets were objectively and subjectively analysed at 8 anatomical levels. Two blinded clinical reads were compared to gold-standard assessment for diagnostic accuracy. Results: Mean radiation dose reduction of 67.1% was recorded. Mean dose measurements for LD–MBIR were: thorax – 66 ± 11 mGy cm (DLP), 1.0 ± 0.2 mSv (ED), 2.0 ± 0.4 mGy (SSDE); abdominopelvic – 128 ± 38 mGy cm (DLP), 1.9 ± 0.6 mSv (ED), 3.0 ± 0.6 mGy (SSDE). Objective noise and signal-to-noise ratio values were comparable between the CD and LD–MBIR images. LD–MBIR images were superior (p < 0.001) with regard to subjective noise, streak artefact, 2-plane contrast resolution, 2-plane spatial resolution and diagnostic acceptability. All patients were correctly categorised as positive, indeterminate or negative for metastatic disease by 2 readers on LD–MBIR and CD datasets. Conclusions: MBIR facilitated a 67% reduction in radiation dose whilst producing images that were comparable or superior to conventional dose studies without loss of diagnostic utility.
Radiation dose , Computed tomography , Low dose CT , Testicular cancer , Low-dose computed tomography , Iterative reconstruction , Model-based iterative reconstruction
Murphy, K. P., Crush, L., O’Neill, S. B., Foody, J., Breen, M., Brady, A., Kelly, P. J., Power, D. G., Sweeney, P., Bye, J., O’Connor, O. J., Maher, M. M. and O’Regan, K. N. (2016) 'Feasibility of low-dose CT with model-based iterative image reconstruction in follow-up of patients with testicular cancer', European Journal of Radiology Open, 3, pp. 38-45. doi: 10.1016/j.ejro.2016.01.002