Pediatric CT dose reduction for suspected appendicitis: a practice quality improvement project using artificial Gaussian noise--part 1, computer simulations
The purpose of this study was to develop a departmental practice quality improvement project to systematically reduce CT doses for the evaluation of suspected pediatric appendicitis by introducing computer-generated gaussian noise. Two hundred MDCT abdominopelvic examinations of patients younger than 20 years performed with girth-based scanning parameters for suspected appendicitis were reviewed. Two judges selected 45 examinations in which the diagnosis of appendicitis was excluded (14, appendix not visualized; 31, normal appendix visualized). Gaussian noise was introduced into axial image series, creating five additional series acquired at 25-76% of the original dose. Two readers reviewed 270 image series for appendix visualization (4-point Likert scale and arrow localization). Volume CT dose index (CTDIvol) and size-specific dose estimate (SSDE) were calculated by use of patient girth. Confidence ratings and localization accuracy were analyzed with mixed models and nonparametric bootstrap analysis at a 0.05 significance level. The mean baseline SSDE for the 45 patients was 16 mGy (95% CI, 12-20 mGy), and the corresponding CTDIvol was 10 mGy (95% CI, 4-16 mGy). Changes in correct appendix localization frequencies were minor. There was no substantial trend with decreasing simulated dose level (p = 0.46). Confidence ratings decreased with increasing dose reduction (p = 0.007). The average decreases were -0.27 for the 25% simulated dose (p = 0.01), -0.17 for 33% (p = 0.03), and -0.03 for 43% (p = 0.65). Pediatric abdominal MDCT can be performed with 43% of the original dose (SSDE, 7 mGy; CTDIvol, 4.3 mGy) without substantially affecting visualization of a normal appendix..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:204 |
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| Enthalten in: |
American journal of roentgenology - 204(2015), 1, Seite W86-W94 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Callahan, Michael J [VerfasserIn] |
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| Links: |
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| RVK: |
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| doi: |
10.2214/AJR.14.12964 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC1966692412 |
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| 245 | 1 | 0 | |a Pediatric CT dose reduction for suspected appendicitis: a practice quality improvement project using artificial Gaussian noise--part 1, computer simulations |
| 264 | 1 | |c 2015 | |
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| 520 | |a The purpose of this study was to develop a departmental practice quality improvement project to systematically reduce CT doses for the evaluation of suspected pediatric appendicitis by introducing computer-generated gaussian noise. Two hundred MDCT abdominopelvic examinations of patients younger than 20 years performed with girth-based scanning parameters for suspected appendicitis were reviewed. Two judges selected 45 examinations in which the diagnosis of appendicitis was excluded (14, appendix not visualized; 31, normal appendix visualized). Gaussian noise was introduced into axial image series, creating five additional series acquired at 25-76% of the original dose. Two readers reviewed 270 image series for appendix visualization (4-point Likert scale and arrow localization). Volume CT dose index (CTDIvol) and size-specific dose estimate (SSDE) were calculated by use of patient girth. Confidence ratings and localization accuracy were analyzed with mixed models and nonparametric bootstrap analysis at a 0.05 significance level. The mean baseline SSDE for the 45 patients was 16 mGy (95% CI, 12-20 mGy), and the corresponding CTDIvol was 10 mGy (95% CI, 4-16 mGy). Changes in correct appendix localization frequencies were minor. There was no substantial trend with decreasing simulated dose level (p = 0.46). Confidence ratings decreased with increasing dose reduction (p = 0.007). The average decreases were -0.27 for the 25% simulated dose (p = 0.01), -0.17 for 33% (p = 0.03), and -0.03 for 43% (p = 0.65). Pediatric abdominal MDCT can be performed with 43% of the original dose (SSDE, 7 mGy; CTDIvol, 4.3 mGy) without substantially affecting visualization of a normal appendix. | ||
| 650 | 4 | |a Radiation Protection - methods | |
| 650 | 4 | |a Appendicitis - radiography | |
| 650 | 4 | |a Radiographic Image Enhancement - methods | |
| 650 | 4 | |a Radiographic Image Interpretation, Computer-Assisted - methods | |
| 650 | 4 | |a Tomography, X-Ray Computed - methods | |
| 700 | 1 | |a Kleinman, Patricia L |4 oth | |
| 700 | 1 | |a Strauss, Keith J |4 oth | |
| 700 | 1 | |a Bandos, Andriy |4 oth | |
| 700 | 1 | |a Taylor, George A |4 oth | |
| 700 | 1 | |a Tsai, Andy |4 oth | |
| 700 | 1 | |a Kleinman, Paul K |4 oth | |
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| 856 | 4 | 2 | |u http://www.ncbi.nlm.nih.gov/pubmed/25539280 |
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