Observer Performance in the Detection and Classification of Malignant Hepatic Nodules and Masses with CT Image-Space Denoising and Iterative Reconstruction

被引：54

作者：

Fletcher, Joel G. ^{[1
]}

Yu, Lifeng ^{[1
]}

Li, Zhoubo ^{[1
]}

Manduca, Armando ^{[2
]}

Blezek, Daniel J. ^{[3
]}

Hough, David M. ^{[1
]}

Venkatesh, Sudhakar K. ^{[1
]}

Brickner, Gregory C. ^{[5
]}

Cernigliaro, Joseph C. ^{[6
]}

Hara, Amy K. ^{[7
]}

Fidler, Jeff L. ^{[1
]}

Lake, David S. ^{[2
]}

Shiung, Maria ^{[1
]}

Lewis, David ^{[1
]}

Leng, Shuai ^{[1
]}

Augustine, Kurt E. ^{[2
]}

Carter, Rickey E. ^{[4
]}

Holmes, David R., III ^{[2
]}

McCollough, Cynthia H. ^{[1
]}

机构：

[1] Mayo Clin, Dept Radiol, Rochester, MN 55905 USA

[2] Mayo Clin, Dept Physiol & Biomed Engn, Rochester, MN 55905 USA

[3] Mayo Clin, Dept Informat Technol, Rochester, MN 55905 USA

[4] Mayo Clin, Dept Biomed Stat & Informat, Rochester, MN 55905 USA

[5] Mayo Clin, Dept Radiol, Eau Claire, WI USA

[6] Mayo Clin, Dept Radiol, Jacksonville, FL 32224 USA

[7] Mayo Clin, Dept Radiol, Scottsdale, AZ USA

来源：

RADIOLOGY | 2015年 / 276卷 / 02期

基金：

美国国家卫生研究院;

关键词：

RADIATION-DOSE REDUCTION; FILTERED BACK-PROJECTION; LOW TUBE VOLTAGE; ABDOMINAL CT; NOISE-REDUCTION; DIAGNOSTIC PERFORMANCE; QUALITY; ALGORITHM; SELECTION; EXPOSURE;

D O I：

10.1148/radiol.2015141991

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Purpose: To determine if lower-dose computed tomographic (CT) scans obtained with adaptive image-based noise reduction (adaptive nonlocal means [ANLM]) or iterative reconstruction (sinogram-affirmed iterative reconstruction [SAFIRE]) result in reduced observer performance in the detection of malignant hepatic nodules and masses compared with routine-dose scans obtained with filtered back projection (FBP). Materials and Methods: This study was approved by the institutional review board and was compliant with HIPAA. Informed consent was obtained from patients for the retrospective use of medical records for research purposes. CT projection data from 33 abdominal and 27 liver or pancreas CT examinations were collected (median volume CT dose index, 13.8 and 24.0 mGy, respectively). Hepatic malignancy was defined by progression or regression or with histopathologic findings. Lower-dose data were created by using a validated noise insertion method (10.4 mGy for abdominal CT and 14.6 mGy for liver or pancreas CT) and images reconstructed with FBP, ANLM, and SAFIRE. Four readers evaluated routine-dose FBP images and all lower-dose images, circumscribing liver lesions and selecting diagnosis. The jackknife free-response receiver operating characteristic figure of merit (FOM) was calculated on a per-malignant nodule or permass basis. Noninferiority was defined by the lower limit of the 95% confidence interval (CI) of the difference between lower-dose and routine-dose FOMs being less than -0.10. Results: Twenty-nine patients had 62 malignant hepatic nodules and masses. Estimated FOM differences between lower-dose FBP and lower-dose ANLM versus routine-dose FBP were noninferior (difference: -0.041 [95% CI: -0.090, 0.009] and -0.003 [95% CI: -0.052, 0.047], respectively). In patients with dedicated liver scans, lower-dose ANLM images were noninferior (difference: +0.015 [95% CI: -0.077, 0.106]), whereas lower-dose FBP images were not (difference -0.049 [95% CI: -0.140, 0.043]). In 37 patients with SAFIRE reconstructions, the three lower-dose alternatives were found to be noninferior to the routine-dose FBP. Conclusion: At moderate levels of dose reduction, lower-dose FBP images without ANLM or SAFIRE were noninferior to routine-dose images for abdominal CT but not for liver or pancreas CT. (C) RSNA, 2015

引用

页码：465 / 478

页数：14

共 40 条

[1] Effect of Altering Automatic Exposure Control Settings and Quality Reference mAs on Radiation Dose, Image Quality, and Diagnostic Efficacy in MDCT Enterography of Active Inflammatory Crohn's Disease [J].