Sub-millisievert CT colonography: effect of knowledge-based iterative reconstruction on the detection of colonic polyps

Objectives To assess the feasibility of ultra-low dose computed tomography colonography (CTC) using knowledge-based iterative reconstruction (IR) and to determine its effect on polyp detection. Methods Forty-nine prospectively-enrolled patients underwent ultra-low dose CTC in the supine (100 kVp/20...

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Veröffentlicht in:European radiology 2018-12, Vol.28 (12), p.5258-5266
Hauptverfasser: Kang, Hyo-Jin, Kim, Se Hyung, Shin, Cheong-Il, Joo, Ijin, Ryu, Hwaseong, Kim, Sang Gyun, Im, Jong Pil, Han, Joon Koo
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container_end_page 5266
container_issue 12
container_start_page 5258
container_title European radiology
container_volume 28
creator Kang, Hyo-Jin
Kim, Se Hyung
Shin, Cheong-Il
Joo, Ijin
Ryu, Hwaseong
Kim, Sang Gyun
Im, Jong Pil
Han, Joon Koo
description Objectives To assess the feasibility of ultra-low dose computed tomography colonography (CTC) using knowledge-based iterative reconstruction (IR) and to determine its effect on polyp detection. Methods Forty-nine prospectively-enrolled patients underwent ultra-low dose CTC in the supine (100 kVp/20 mAs) and prone positions (80 kVp/20 mAs), followed by same-day colonoscopy. Thereafter, images were reconstructed using filtered back projection (FBP) and knowledge-based IR (IMR; Philips Healthcare, Best, Netherlands) algorithms. Effective radiation dose of CTC was recorded. Pooled per-polyp sensitivity and positive predictive value of three radiologists was analysed and compared between FBP and IMR. Image quality was assessed on a five-point scale and image noise was recorded using standard deviations. Results Mean effective radiation dose of ultra-low dose CTC was 0.90 ± 0.06 mSv. Eighty-nine polyps were detected on colonoscopy (mean, 8.5 ± 4.7 mm). The pooled per-polyp sensitivity for polyps 6.0-9.9 mm ( n = 22) on CTC reconstructed with IMR (36/66, 54.5%) was not significantly different with that using FBP algorithm (34/66, 51.5%) ( p = 0.414). For polyps ≥10 mm ( n = 35), however, the pooled per-polyp sensitivity on CTC with IMR (73/105, 69.5%) was significantly higher than that with FBP (55/105, 52.4%) ( p < 0.001). In particular, the difference of per-polyp sensitivity was statistically significant in intermediate ( p = 0.014) and novice ( p = 0.003) reviewers. Furthermore, mean image noise of IMR (8.4 ± 6.2 HU) was significantly lower than that of FBP (37.5 ± 13.9 HU) ( p < 0.001) and image quality with IMR was significantly better than with FBP in all evaluated segments in all reviewers (all p s < 0.001). Conclusions Sub-mSv CTC reconstructed with IMR was feasible for the detection of clinically significant polyps, demonstrating 70% per-polyp sensitivity of polyps ≥10 mm, while allowing significant noise reduction and improvement in image quality compared with FBP reconstruction. Key Points • Sub-mSv CTC using IMR demonstrated 70% per-polyp sensitivity for polyps ≥10 mm. • CTC using IMR significantly outperformed CTC reconstructed with FBP. • IMR allows significantly more noise reduction and improvement in image quality than FBP.
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Methods Forty-nine prospectively-enrolled patients underwent ultra-low dose CTC in the supine (100 kVp/20 mAs) and prone positions (80 kVp/20 mAs), followed by same-day colonoscopy. Thereafter, images were reconstructed using filtered back projection (FBP) and knowledge-based IR (IMR; Philips Healthcare, Best, Netherlands) algorithms. Effective radiation dose of CTC was recorded. Pooled per-polyp sensitivity and positive predictive value of three radiologists was analysed and compared between FBP and IMR. Image quality was assessed on a five-point scale and image noise was recorded using standard deviations. Results Mean effective radiation dose of ultra-low dose CTC was 0.90 ± 0.06 mSv. Eighty-nine polyps were detected on colonoscopy (mean, 8.5 ± 4.7 mm). The pooled per-polyp sensitivity for polyps 6.0-9.9 mm ( n = 22) on CTC reconstructed with IMR (36/66, 54.5%) was not significantly different with that using FBP algorithm (34/66, 51.5%) ( p = 0.414). For polyps ≥10 mm ( n = 35), however, the pooled per-polyp sensitivity on CTC with IMR (73/105, 69.5%) was significantly higher than that with FBP (55/105, 52.4%) ( p &lt; 0.001). In particular, the difference of per-polyp sensitivity was statistically significant in intermediate ( p = 0.014) and novice ( p = 0.003) reviewers. Furthermore, mean image noise of IMR (8.4 ± 6.2 HU) was significantly lower than that of FBP (37.5 ± 13.9 HU) ( p &lt; 0.001) and image quality with IMR was significantly better than with FBP in all evaluated segments in all reviewers (all p s &lt; 0.001). Conclusions Sub-mSv CTC reconstructed with IMR was feasible for the detection of clinically significant polyps, demonstrating 70% per-polyp sensitivity of polyps ≥10 mm, while allowing significant noise reduction and improvement in image quality compared with FBP reconstruction. Key Points • Sub-mSv CTC using IMR demonstrated 70% per-polyp sensitivity for polyps ≥10 mm. • CTC using IMR significantly outperformed CTC reconstructed with FBP. • IMR allows significantly more noise reduction and improvement in image quality than FBP.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-018-5545-5</identifier><identifier>PMID: 29948063</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Algorithms ; Clinical Competence ; Colon ; Colonic Polyps - diagnosis ; Colonography, Computed Tomographic - methods ; Colonoscopy ; Computed tomography ; Diagnostic Radiology ; Feasibility studies ; Female ; Gastrointestinal ; Health care ; Humans ; Image filters ; Image quality ; Image reconstruction ; Imaging ; Internal Medicine ; Interventional Radiology ; Iterative methods ; Knowledge base ; Male ; Medical imaging ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Neuroradiology ; Noise ; Noise reduction ; Polyps ; Quality assessment ; Radiation ; Radiation Dosage ; Radiographic Image Interpretation, Computer-Assisted - methods ; Radiology ; Sensitivity ; Sensitivity analysis ; Statistical analysis ; Ultrasound</subject><ispartof>European radiology, 2018-12, Vol.28 (12), p.5258-5266</ispartof><rights>European Society of Radiology 2018</rights><rights>European Radiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-d79e9adb763ee0252fad82f7b97bc2c0f63fdfe3b4cd31b648f2d1777ba480d03</citedby><cites>FETCH-LOGICAL-c438t-d79e9adb763ee0252fad82f7b97bc2c0f63fdfe3b4cd31b648f2d1777ba480d03</cites><orcidid>0000-0003-1462-9689</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-018-5545-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-018-5545-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29948063$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kang, Hyo-Jin</creatorcontrib><creatorcontrib>Kim, Se Hyung</creatorcontrib><creatorcontrib>Shin, Cheong-Il</creatorcontrib><creatorcontrib>Joo, Ijin</creatorcontrib><creatorcontrib>Ryu, Hwaseong</creatorcontrib><creatorcontrib>Kim, Sang Gyun</creatorcontrib><creatorcontrib>Im, Jong Pil</creatorcontrib><creatorcontrib>Han, Joon Koo</creatorcontrib><title>Sub-millisievert CT colonography: effect of knowledge-based iterative reconstruction on the detection of colonic polyps</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives To assess the feasibility of ultra-low dose computed tomography colonography (CTC) using knowledge-based iterative reconstruction (IR) and to determine its effect on polyp detection. Methods Forty-nine prospectively-enrolled patients underwent ultra-low dose CTC in the supine (100 kVp/20 mAs) and prone positions (80 kVp/20 mAs), followed by same-day colonoscopy. Thereafter, images were reconstructed using filtered back projection (FBP) and knowledge-based IR (IMR; Philips Healthcare, Best, Netherlands) algorithms. Effective radiation dose of CTC was recorded. Pooled per-polyp sensitivity and positive predictive value of three radiologists was analysed and compared between FBP and IMR. Image quality was assessed on a five-point scale and image noise was recorded using standard deviations. Results Mean effective radiation dose of ultra-low dose CTC was 0.90 ± 0.06 mSv. Eighty-nine polyps were detected on colonoscopy (mean, 8.5 ± 4.7 mm). The pooled per-polyp sensitivity for polyps 6.0-9.9 mm ( n = 22) on CTC reconstructed with IMR (36/66, 54.5%) was not significantly different with that using FBP algorithm (34/66, 51.5%) ( p = 0.414). For polyps ≥10 mm ( n = 35), however, the pooled per-polyp sensitivity on CTC with IMR (73/105, 69.5%) was significantly higher than that with FBP (55/105, 52.4%) ( p &lt; 0.001). In particular, the difference of per-polyp sensitivity was statistically significant in intermediate ( p = 0.014) and novice ( p = 0.003) reviewers. Furthermore, mean image noise of IMR (8.4 ± 6.2 HU) was significantly lower than that of FBP (37.5 ± 13.9 HU) ( p &lt; 0.001) and image quality with IMR was significantly better than with FBP in all evaluated segments in all reviewers (all p s &lt; 0.001). Conclusions Sub-mSv CTC reconstructed with IMR was feasible for the detection of clinically significant polyps, demonstrating 70% per-polyp sensitivity of polyps ≥10 mm, while allowing significant noise reduction and improvement in image quality compared with FBP reconstruction. Key Points • Sub-mSv CTC using IMR demonstrated 70% per-polyp sensitivity for polyps ≥10 mm. • CTC using IMR significantly outperformed CTC reconstructed with FBP. • IMR allows significantly more noise reduction and improvement in image quality than FBP.</description><subject>Adult</subject><subject>Aged</subject><subject>Algorithms</subject><subject>Clinical Competence</subject><subject>Colon</subject><subject>Colonic Polyps - diagnosis</subject><subject>Colonography, Computed Tomographic - methods</subject><subject>Colonoscopy</subject><subject>Computed tomography</subject><subject>Diagnostic Radiology</subject><subject>Feasibility studies</subject><subject>Female</subject><subject>Gastrointestinal</subject><subject>Health care</subject><subject>Humans</subject><subject>Image filters</subject><subject>Image quality</subject><subject>Image reconstruction</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Iterative methods</subject><subject>Knowledge base</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Neuroradiology</subject><subject>Noise</subject><subject>Noise reduction</subject><subject>Polyps</subject><subject>Quality assessment</subject><subject>Radiation</subject><subject>Radiation Dosage</subject><subject>Radiographic Image Interpretation, Computer-Assisted - methods</subject><subject>Radiology</subject><subject>Sensitivity</subject><subject>Sensitivity analysis</subject><subject>Statistical analysis</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kU1r3DAQhkVpabZpf0AvRdBLL2pGX5bdW1nSDwjkkORsbGm0ceq1XElO2H9fLd62UCgIBkaP3tHwEPKWw0cOYC4SgJTAgNdMa6WZfkY2XEnBONTqOdlAI2tmmkadkVcpPQBAw5V5Sc5E6dVQyQ15ull6th_GcUgDPmLMdHtLbRjDFHaxm-8Pnyh6jzbT4OmPKTyN6HbI-i6ho0PG2OXhEWlEG6aU42LzECZaTr5H6jDjqeHX0MHSOYyHOb0mL3w3Jnxzqufk7svl7fYbu7r--n37-YpZJevMnGmw6VxvKokIQgvfuVp40zemt8KCr6R3HmWvrJO8r1TthePGmL4rCzqQ5-TDmjvH8HPBlNv9kCyOYzdhWFIroIK6qrTWBX3_D_oQljiV3xVKC60U8KZQfKVsDClF9O0ch30XDy2H9milXa20xUp7tNIek9-dkpd-j-7Pi98aCiBWIJWraYfx7-j_p_4CBQGZ7Q</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Kang, Hyo-Jin</creator><creator>Kim, Se Hyung</creator><creator>Shin, Cheong-Il</creator><creator>Joo, Ijin</creator><creator>Ryu, Hwaseong</creator><creator>Kim, Sang Gyun</creator><creator>Im, Jong Pil</creator><creator>Han, Joon Koo</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1462-9689</orcidid></search><sort><creationdate>20181201</creationdate><title>Sub-millisievert CT colonography: effect of knowledge-based iterative reconstruction on the detection of colonic polyps</title><author>Kang, Hyo-Jin ; Kim, Se Hyung ; Shin, Cheong-Il ; Joo, Ijin ; Ryu, Hwaseong ; Kim, Sang Gyun ; Im, Jong Pil ; Han, Joon Koo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-d79e9adb763ee0252fad82f7b97bc2c0f63fdfe3b4cd31b648f2d1777ba480d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Algorithms</topic><topic>Clinical Competence</topic><topic>Colon</topic><topic>Colonic Polyps - diagnosis</topic><topic>Colonography, Computed Tomographic - methods</topic><topic>Colonoscopy</topic><topic>Computed tomography</topic><topic>Diagnostic Radiology</topic><topic>Feasibility studies</topic><topic>Female</topic><topic>Gastrointestinal</topic><topic>Health care</topic><topic>Humans</topic><topic>Image filters</topic><topic>Image quality</topic><topic>Image reconstruction</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Iterative methods</topic><topic>Knowledge base</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine &amp; 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kang, Hyo-Jin</au><au>Kim, Se Hyung</au><au>Shin, Cheong-Il</au><au>Joo, Ijin</au><au>Ryu, Hwaseong</au><au>Kim, Sang Gyun</au><au>Im, Jong Pil</au><au>Han, Joon Koo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sub-millisievert CT colonography: effect of knowledge-based iterative reconstruction on the detection of colonic polyps</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>28</volume><issue>12</issue><spage>5258</spage><epage>5266</epage><pages>5258-5266</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives To assess the feasibility of ultra-low dose computed tomography colonography (CTC) using knowledge-based iterative reconstruction (IR) and to determine its effect on polyp detection. Methods Forty-nine prospectively-enrolled patients underwent ultra-low dose CTC in the supine (100 kVp/20 mAs) and prone positions (80 kVp/20 mAs), followed by same-day colonoscopy. Thereafter, images were reconstructed using filtered back projection (FBP) and knowledge-based IR (IMR; Philips Healthcare, Best, Netherlands) algorithms. Effective radiation dose of CTC was recorded. Pooled per-polyp sensitivity and positive predictive value of three radiologists was analysed and compared between FBP and IMR. Image quality was assessed on a five-point scale and image noise was recorded using standard deviations. Results Mean effective radiation dose of ultra-low dose CTC was 0.90 ± 0.06 mSv. Eighty-nine polyps were detected on colonoscopy (mean, 8.5 ± 4.7 mm). The pooled per-polyp sensitivity for polyps 6.0-9.9 mm ( n = 22) on CTC reconstructed with IMR (36/66, 54.5%) was not significantly different with that using FBP algorithm (34/66, 51.5%) ( p = 0.414). For polyps ≥10 mm ( n = 35), however, the pooled per-polyp sensitivity on CTC with IMR (73/105, 69.5%) was significantly higher than that with FBP (55/105, 52.4%) ( p &lt; 0.001). In particular, the difference of per-polyp sensitivity was statistically significant in intermediate ( p = 0.014) and novice ( p = 0.003) reviewers. Furthermore, mean image noise of IMR (8.4 ± 6.2 HU) was significantly lower than that of FBP (37.5 ± 13.9 HU) ( p &lt; 0.001) and image quality with IMR was significantly better than with FBP in all evaluated segments in all reviewers (all p s &lt; 0.001). Conclusions Sub-mSv CTC reconstructed with IMR was feasible for the detection of clinically significant polyps, demonstrating 70% per-polyp sensitivity of polyps ≥10 mm, while allowing significant noise reduction and improvement in image quality compared with FBP reconstruction. Key Points • Sub-mSv CTC using IMR demonstrated 70% per-polyp sensitivity for polyps ≥10 mm. • CTC using IMR significantly outperformed CTC reconstructed with FBP. • IMR allows significantly more noise reduction and improvement in image quality than FBP.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29948063</pmid><doi>10.1007/s00330-018-5545-5</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1462-9689</orcidid></addata></record>
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subjects Adult
Aged
Algorithms
Clinical Competence
Colon
Colonic Polyps - diagnosis
Colonography, Computed Tomographic - methods
Colonoscopy
Computed tomography
Diagnostic Radiology
Feasibility studies
Female
Gastrointestinal
Health care
Humans
Image filters
Image quality
Image reconstruction
Imaging
Internal Medicine
Interventional Radiology
Iterative methods
Knowledge base
Male
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Noise
Noise reduction
Polyps
Quality assessment
Radiation
Radiation Dosage
Radiographic Image Interpretation, Computer-Assisted - methods
Radiology
Sensitivity
Sensitivity analysis
Statistical analysis
Ultrasound
title Sub-millisievert CT colonography: effect of knowledge-based iterative reconstruction on the detection of colonic polyps
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