Iterative Metallic Artifact Reduction for In-Plane Gonadal Shielding During Computed Tomographic Venography of Young Males

The purpose of this study was to evaluate a gonadal shield (GS) and iterative metallic artifact reduction (IMAR) during computed tomography scans, regarding the image quality and radiation dose. A phantom was imaged with and without a GS. Prospectively enrolled, young male patients underwent lower extremity computed tomography venography (precontrast imaging without the GS and postcontrast imaging with the GS). Radiation dose was measured each time, and the GS-applied images were reconstructed by weighted filtered back projection and IMAR. In the phantom study, image artifacts were significantly reduced by using IMAR (P = 0.031), whereas the GS reduced the radiation dose by 61.3%. In the clinical study (n = 29), IMAR mitigated artifacts from the GS, thus 96.6% of the IMAR image sets were clinically usable. Gonadal shielding reduced the radiation dose to the testes by 69.0%. The GS in conjunction with IMAR significantly reduced the radiation dose to the testes while maintaining the image quality.