Cervical spinal computed tomography utilizing model-based iterative reconstruction reduces radiation to an equivalent of
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ORIGINAL ARTICLE
Cervical spinal computed tomography utilizing model‑based iterative reconstruction reduces radiation to an equivalent of three cervical X‑rays Kazutaka Masamoto1 · Shunsuke Fujibayashi1 · Bungo Otsuki1 · Yasuhiro Fukushima2 · Koji Koizumi2 · Takayoshi Shimizu1 · Yu Shimizu1 · Koichi Murata1 · Norimasa Ikeda1 · Shuichi Matsuda1 Received: 19 January 2020 / Revised: 4 April 2020 / Accepted: 14 April 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To evaluate radiation dose and image quality of cervical spinal computed tomography scanned with low-radiation dose (LD-CT) utilizing model-based iterative reconstruction (MBIR). Methods We retrospectively examined 14 patients (65.5 ± 13.9 years) who underwent both standard-radiation-dose CT (SDCT) reconstructed with hybrid iterative reconstruction and LD-CT of cervical spine. The radiation dose, objective image quality indicator, which includes signal-to-noise and contrast-to-noise, and subjective image quality score of the anatomical landmarks in the SD-CT and LD-CT were statistically compared. In addition, the measurement errors of the length of C3 vertebrae (height, anteroposterior length, inner and outer pedicle diameters) between SD-CT and LD-CT were analyzed. Results Radiation dose of LD-CT was reduced to one-sixth of the dose of SD-CT. The objective image quality indicator of LD-CT was significantly better than that of SD-CT. The subjective image quality of LD-CT was relatively worse than that of SD-CT but generally graded as clinically accepted or higher. There was no remarkable difference between SD-CT and LD-CT in the measurement value of height and anteroposterior length. Inner pedicle diameter was significantly (0.21 ± 0.13 mm) smaller, and outer pedicle diameter was (0.24 ± 0.14 mm) larger on LD-CT than on SD-CT. Conclusion Cervical spinal LD-CT that utilized MBIR enabled radical decrease in radiation dose and provided sufficient image quality for clinical use. This scanning protocol can be a good alternative for protecting patients from exposure to unnecessary radiation, especially when a patient requires multiple CT scans. Keywords Iterative reconstruction · Cervical spine · CT · Radiation dose · OPLL
Introduction Awareness of carcinogenesis due to radiation exposure during X-ray and computed tomography (CT) has been increasing among both patients and clinicians. In 2004, Gonzalez reported that diagnostic ionizing radiation was attributed to approximately 0.6–1.8% of cumulative risk of cancer to those aged 75 years in 13 developed countries, which is as * Kazutaka Masamoto [email protected]‑u.ac.jp 1
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara‑cho, Sakyo‑ku, Kyoto 606‑8507, Japan
Division of Clinical Radiology Service, Kyoto University Hospital, 54 Shogoin Kawahara‑cho, Sakyo‑ku, Kyoto 606‑8507, Japan
2
high as 3.2% in Japan [1]. Despite being a crucial problem, the benefit of early diagnosis from diagnostic X-ray was not considered
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