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22 March 2012 Diagnostic accuracy at several reduced radiation dose levels for CT imaging in the diagnosis of appendicitis
Di Zhang, Maryam Khatonabadi, Hyun Kim, Matilda Jude, Edward Zaragoza, Margaret Lee, Maitraya Patel, Cheryce Poon, Michael Douek, Denise Andrews-Tang, Laura Doepke, Shawn McNitt-Gray, Chris Cagnon, John DeMarco, Michael McNitt-Gray
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Proceedings Volume 8313, Medical Imaging 2012: Physics of Medical Imaging; 831347 (2012) https://doi.org/10.1117/12.911428
Event: SPIE Medical Imaging, 2012, San Diego, California, United States
Abstract
Purpose: While several studies have investigated the tradeoffs between radiation dose and image quality (noise) in CT imaging, the purpose of this study was to take this analysis a step further by investigating the tradeoffs between patient radiation dose (including organ dose) and diagnostic accuracy in diagnosis of appendicitis using CT. Methods: This study was IRB approved and utilized data from 20 patients who underwent clinical CT exams for indications of appendicitis. Medical record review established true diagnosis of appendicitis, with 10 positives and 10 negatives. A validated software tool used raw projection data from each scan to create simulated images at lower dose levels (70%, 50%, 30%, 20% of original). An observer study was performed with 6 radiologists reviewing each case at each dose level in random order over several sessions. Readers assessed image quality and provided confidence in their diagnosis of appendicitis, each on a 5 point scale. Liver doses at each case and each dose level were estimated using Monte Carlo simulation based methods. Results: Overall diagnostic accuracy varies across dose levels: 92%, 93%, 91%, 90% and 90% across the 100%, 70%, 50%, 30% and 20% dose levels respectively. And it is 93%, 95%, 88%, 90% and 90% across the 13.5-22mGy, 9.6-13.5mGy, 6.4-9.6mGy, 4-6.4mGy, and 2-4mGy liver dose ranges respectively. Only 4 out of 600 observations were rated "unacceptable" for image quality. Conclusion: The results from this pilot study indicate that the diagnostic accuracy does not change dramatically even at significantly reduced radiation dose.
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Di Zhang, Maryam Khatonabadi, Hyun Kim, Matilda Jude, Edward Zaragoza, Margaret Lee, Maitraya Patel, Cheryce Poon, Michael Douek, Denise Andrews-Tang, Laura Doepke, Shawn McNitt-Gray, Chris Cagnon, John DeMarco, and Michael McNitt-Gray "Diagnostic accuracy at several reduced radiation dose levels for CT imaging in the diagnosis of appendicitis", Proc. SPIE 8313, Medical Imaging 2012: Physics of Medical Imaging, 831347 (22 March 2012); https://doi.org/10.1117/12.911428
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KEYWORDS
Diagnostics
Image quality
Computed tomography
Liver
Monte Carlo methods
Scanners
Data modeling
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