Wide-detector CT combined iterative reconstruction in pediatric low-dose scan of the paranasal sinus

BACKGROUND: Computed tomography (CT) is considered a standard modality for imaging the paranasal sinus (PS), but increasingly radiation dose is of concern, especially in children. Objective: This study aims to investigate the feasibility of using a 320-detector CT scanner with a 16 cm wide-detector combined with iterative reconstruction (IR) algorithm to further reduce radiation dose when scanning the PS. METHODS: A total of 90 children who underwent CT of the PS were randomly allocated into three groups namely, (1) the experimental group using low-dose wide-detector scan (n = 30, 9 +/- 4 years); (2) low-dose helical group (n = 30, 9 +/- 4 years); and (3) pediatric conventional group (n = 30, 8 +/- 4 years). Statistical software SPSS 19.0 was used for one-way ANOVA analysis of the general data (age, BMI), image quality, and radiation dose. Multiple comparisons of data without homogeneity of variance were analyzed by Bonferroni test and Tamhane's test. RESULTS: All patients underwent successful CT examinations. No significant differences in the general data and image quality evaluation were detected between three groups (all P values > 0.05). CTDIvol and DLP were 2.87 mGy and 32.58 mGy.cm in the experimental group, 4.92 mGy and 70.84 mGy.cm in the low-dose helical group, and 9.95 mGy and 131.83 mGy.cm in the conventional group, respectively, which were significantly different among these three groups as indicated by multiple comparisons (all P values < 0.05). In the experimental group, the effective radiation dose was 0.07 mSv, which was reduced by 76% and 56% comparing to the conventional group and the low-dose helical group, respectively. CONCLUSIONS: The 320-detector CT scanner equipped with the wide-detector combined with IR can further reduce radiation dose, while maintaining good image quality comparing to the low-dose helical or pediatric modes.