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Systematic Evaluation of Low-dose MDCT for Planning Purposes of Lumbosacral Periradicular Infiltrations.

Authors
  • Sollmann, Nico1, 2
  • Mei, Kai3
  • Schön, Simon4
  • Riederer, Isabelle4
  • Kopp, Felix K3
  • Löffler, Maximilian T4
  • Probst, Monika4
  • Rummeny, Ernst J3
  • Zimmer, Claus4
  • Kirschke, Jan S4, 5
  • Noël, Peter B3, 6
  • Baum, Thomas4
  • 1 Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. [email protected] , (Germany)
  • 2 TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. [email protected] , (Germany)
  • 3 Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. , (Germany)
  • 4 Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. , (Germany)
  • 5 TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. , (Germany)
  • 6 Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, One Silverstein, 19104, Philadelphia, PA, USA.
Type
Published Article
Journal
Clinical neuroradiology
Publication Date
Dec 01, 2020
Volume
30
Issue
4
Pages
749–759
Identifiers
DOI: 10.1007/s00062-019-00844-7
PMID: 31696279
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To evaluate image quality and confidence for planning of periradicular infiltrations using virtually lowered tube currents and in-house developed iterative reconstruction (IR) for multidetector computed tomography (MDCT). A total of 20 patients (mean age 54.9 ± 13.1 years) underwent MDCT for planning purposes of periradicular infiltrations at the lumbosacral spine (120 kVp and 100 mAs). Planning scans were simulated as if they were performed at 50% (D50), 10% (D10), 5% (D5), and 1% (D1) of the tube current of original scanning. Image reconstruction was achieved with two levels of IR (A: similar in appearance to clinical reconstructions, B: 10 times stronger noise reduction). Qualitative image evaluation was performed by two readers (R1 and R2) considering overall image quality and artifacts, image contrast, determination of nerve root, and confidence for intervention planning (scoring: 1 high, 2 medium, and 3 low confidence). Level A of IR was favorable regarding overall image quality, artifacts, image contrast, and nerve root depiction according to both readers, with preserved good to excellent scores down to D10 scans. The confidence for intervention planning was not significantly different (p > 0.05) between scans with tube currents virtually lowered down to 10% as compared to the original scans when using level A of IR (R1: 1.2 ± 0.4, R2: 1.1 ± 0.3). Inter-reader agreement for planning confidence was good to excellent (range of weighted Cohen's kappa: 0.62-1.00). The use of MDCT for planning purposes of lumbosacral periradicular infiltrations may be possible with tube currents lowered down to 10% of standard dose (equal to 10 mAs) without limitations in planning confidence.

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