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Diagnostic accuracy of ultra-low-dose CT for torsion measurement of the lower limb.

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Title: Diagnostic accuracy of ultra-low-dose CT for torsion measurement of the lower limb.
Authors: Keller, Gabriel1,2 (AUTHOR) gabriel.keller@med.uni-tuebingen.de, Afat, Saif1 (AUTHOR), Ahrend, Marc-Daniel3 (AUTHOR), Springer, Fabian1,2 (AUTHOR)
Source: European Radiology. Jun2021, Vol. 31 Issue 6, p3574-3581. 8p. 2 Black and White Photographs, 1 Diagram, 3 Charts, 1 Graph.
Subjects: Torsion abnormality (Anatomy), Compact bone, Radiation doses, Rear-screen projection, Likert scale, Musculoskeletal system
Abstract: Objectives: The study aimed to investigate the diagnostic performance of simulated ultra-low-dose CT (ULD-CT) for torsion measurement of the lower limb. Methods: Thirty retrospectively identified patients were included (32.3 ± 14.2 years; 14 women, 16 men). ULD-CT simulations were generated at dose levels of 100%, 10%, 5%, and 1% using two reconstruction methods: standard filtered back projection (FBP) and iterative reconstruction (ADMIRE). Two readers measured the lower limb torsion in all data sets. The readers also captured image noise in standardized anatomical landmarks. All data sets were evaluated regarding subjective diagnostic confidence (DC; 5-point Likert scale). Effective radiation dose of the original data sets and the simulated ULD-CT was compared. Results: There was no significant difference of measured lower limb torsion in any simulated dose level compared to the original data sets in both readers. Dose length product (DLP) of the original examinations was 402.1 ± 4.3 mGy cm, which resulted in an effective radiation dose of 4.00 ± 2.12 mSv. Calculated effective radiation dose in ULD-CT at 1% of the original dose was 0.04 mSv. Image noise increased significantly with dose reduction (p < 0.0001) and was dependent on the reconstructional method (p < 0.0001) with less noise using ADMIRE compared to FBP. Both readers rated DC at doses 100%, 10%, and 5% with 5.0/5: there were no ratings worse than 3/5 at 1% dose level. Conclusions: The results suggest that radiation dose reduction down to 1% of original CT dose levels may be achieved in CT torsion measurements of the lower limb without compromising diagnostic accuracy. Key Points: • Modern CT delivers exceptional high image quality in musculoskeletal imaging, especially for evaluation of osseous structures. • Usually, this high image quality is accompanied by significant radiation exposure to the patient and may not always be required for the intended purpose, e.g., pure delineation of cortical bone of the lower limb. • This study shows the tremendous prospects of radiation dose reduction without compromising diagnostic confidence in CT torsion measurement of the lower limb. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Diagnostic accuracy of ultra-low-dose CT for torsion measurement of the lower limb.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Keller%2C+Gabriel%22&quot;&gt;Keller, Gabriel&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; gabriel.keller@med.uni-tuebingen.de&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Afat%2C+Saif%22&quot;&gt;Afat, Saif&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ahrend%2C+Marc-Daniel%22&quot;&gt;Ahrend, Marc-Daniel&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Springer%2C+Fabian%22&quot;&gt;Springer, Fabian&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Radiology%22&quot;&gt;European Radiology&lt;/searchLink&gt;. Jun2021, Vol. 31 Issue 6, p3574-3581. 8p. 2 Black and White Photographs, 1 Diagram, 3 Charts, 1 Graph.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Torsion+abnormality+%28Anatomy%29%22&quot;&gt;Torsion abnormality (Anatomy)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Compact+bone%22&quot;&gt;Compact bone&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Radiation+doses%22&quot;&gt;Radiation doses&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Rear-screen+projection%22&quot;&gt;Rear-screen projection&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Likert+scale%22&quot;&gt;Likert scale&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Musculoskeletal+system%22&quot;&gt;Musculoskeletal system&lt;/searchLink&gt;
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  Label: Abstract
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  Data: Objectives: The study aimed to investigate the diagnostic performance of simulated ultra-low-dose CT (ULD-CT) for torsion measurement of the lower limb. Methods: Thirty retrospectively identified patients were included (32.3 &#177; 14.2 years; 14 women, 16 men). ULD-CT simulations were generated at dose levels of 100%, 10%, 5%, and 1% using two reconstruction methods: standard filtered back projection (FBP) and iterative reconstruction (ADMIRE). Two readers measured the lower limb torsion in all data sets. The readers also captured image noise in standardized anatomical landmarks. All data sets were evaluated regarding subjective diagnostic confidence (DC; 5-point Likert scale). Effective radiation dose of the original data sets and the simulated ULD-CT was compared. Results: There was no significant difference of measured lower limb torsion in any simulated dose level compared to the original data sets in both readers. Dose length product (DLP) of the original examinations was 402.1 &#177; 4.3 mGy cm, which resulted in an effective radiation dose of 4.00 &#177; 2.12 mSv. Calculated effective radiation dose in ULD-CT at 1% of the original dose was 0.04 mSv. Image noise increased significantly with dose reduction (p &lt; 0.0001) and was dependent on the reconstructional method (p &lt; 0.0001) with less noise using ADMIRE compared to FBP. Both readers rated DC at doses 100%, 10%, and 5% with 5.0/5: there were no ratings worse than 3/5 at 1% dose level. Conclusions: The results suggest that radiation dose reduction down to 1% of original CT dose levels may be achieved in CT torsion measurements of the lower limb without compromising diagnostic accuracy. Key Points: • Modern CT delivers exceptional high image quality in musculoskeletal imaging, especially for evaluation of osseous structures. • Usually, this high image quality is accompanied by significant radiation exposure to the patient and may not always be required for the intended purpose, e.g., pure delineation of cortical bone of the lower limb. • This study shows the tremendous prospects of radiation dose reduction without compromising diagnostic confidence in CT torsion measurement of the lower limb. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-020-07528-8
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      – Code: eng
        Text: English
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        PageCount: 8
        StartPage: 3574
    Subjects:
      – SubjectFull: Torsion abnormality (Anatomy)
        Type: general
      – SubjectFull: Compact bone
        Type: general
      – SubjectFull: Radiation doses
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      – SubjectFull: Rear-screen projection
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      – SubjectFull: Likert scale
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      – SubjectFull: Musculoskeletal system
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      – TitleFull: Diagnostic accuracy of ultra-low-dose CT for torsion measurement of the lower limb.
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              M: 06
              Text: Jun2021
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              Y: 2021
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