Comparison of submillisievert CT with standard-dose CT for urolithiasis. (August 2020)

• Record Type: Journal Article
• Authors: Shim, Young Sup; Park, So Hyun; Choi, Seung Joon; Ahn, Su Joa; Pak, Seong Yong; Jung, Han; Park, Seong Ho
• Is Part Of: Acta radiologica. Volume 61:Number 8(2020)
• Page Start: 1105
• Page End: 1115
• Publication Date: 2020-08
• Subjects: Urolithiasis -- computed tomography -- X-ray -- radiation dose reduction -- model-based iterative reconstruction -- iterative reconstruction technique; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185119890088
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Patients with renal stones receive multiple computed tomography (CT) examinations. We investigated whether submillisievert (sub-mSv) CT for stone detection could reduce radiation dose at exposure levels comparable to kidney, ureter, and bladder (KUB) radiography. Purpose: To evaluate the radiation dose exposure, diagnostic performance, and image quality of sub-mSv non-contrast CT using advanced modelled iterative reconstruction algorithm with spectral filtration for the detection of urolithiasis. Material and Methods: A total of 145 consecutive patients underwent non-contrast CT using a third-generation dual-source scanner to obtain two datasets, i.e. 16.7% (sub-mSv CT, tube detector A) and 100% (standard-dose CT, combination of tube detector A and B) tube loads with spectral filtration. The performance of sub-mSv CT for the detection of stones was analyzed by two readers and compared with that of standard-dose CT. Image quality was measured subjectively and objectively. Results: In total, 171 stones were detected in 79 patients. The mean effective radiation doses of sub-mSv CT was 0.3 mSv. The sensitivity and specificity values for diagnosis of stones measuring ≥3 mm was 95.1% and 100% for sub-mSv CT. The sensitivity and specificity for all stone detection was 74.9% and 97.8%, respectivey, for sub-mSv CT. The image quality was lower for sub-mSv CT than for standard-dose CT ( P < 0.01). Conclusion: Sub-mSv CT can be achieved with radiation doses close to KUB radiography. Sub-mSv CT with spectral filtration can be used to detect stones measuring ≥3 mm and be used as a follow-up imaging modality as an alternative to KUB radiography.