BACKGROUND:CT radiation dose reduction results in increased noise or graininess of images which affects the diagnostic information. One of the approaches to lower radiation exposure to patients is to reduce image noise with the use of image processing software in low radiation dose images. PURPOSE:To assess image quality and accuracy of non-linear adaptive filters (NLAF) at low dose chest CT. MATERIAL AND METHODS:In an IRB approved prospective study, 24 patients (mean age, 63 ± 7.3 years; M:F ratio, 11:13) gave informed consent for acquisition of four additional chest CT image series at 150, 110, 75, and 40 mAs (baseline image series) on a 64-slice MDCT over an identical 10-cm length. NLAF was used to process three low dose (110, 75, and 40 mAs) image series (postprocessed image series). Two radiologists reviewed baseline and postprocessed images in a blinded manner for image quality. Objective noise, CT attenuation values, patient weight, transverse diameters, CTDIvol, and DLP were recorded. Statistical analysis was performed using parametric and non-parametric tests for comparing postprocessed and baseline images. RESULTS:No lesions were missed on baseline or postprocessed CT images (n = 80 lesions, 73 lesions <1 cm). At 40 mAs, subjective noise in mediastinal window settings were graded as unacceptable in baseline images and acceptable in postprocessed images. Visibility of smaller structures improved from suboptimal visibility in baseline images at 40 mAs to excellent in postprocessed images at 40 mAs. No major artifacts were seen due to NLAF postprocessing, except for minor beam hardening artifacts not affecting diagnostic decision-making (14/22) in both baseline and postprocessed image series. Diagnostic confidence for chest CT was improved to fully confident in postprocessed images at 40 mAs. Compared to baseline images, postprocessing reduced objective noise by 26% (14.2 ± 4.7/19.2 ± 6.4), 31.5% (15.2 ± 4.7/22.2 ± 5.7), and 41.5% (16.9 ± 6/28.9 ± 10.2) at 110 mAs, 75 mAs, and 40 mAs tube current-time product levels. CONCLUSION:Applications of NLAF can help reduce tube current down to 40 mAs for chest CT while maintaining lesion conspicuity and image quality.

译文

背景:降低CT辐射剂量会导致图像的噪点或颗粒感增加,从而影响诊断信息。降低对患者辐射的方法之一是在低辐射剂量图像中使用图像处理软件来降低图像噪声。
目的:评估低剂量胸部CT下非线性自适应滤波器(NLAF)的图像质量和准确性。
材料与方法:在一项IRB批准的前瞻性研究中,有24例患者(平均年龄63±7.3岁; M:F比为11:13)在150、110、75,在64片MDCT上,在相同的10厘米长度上为40 mAs(基准图像系列)。 NLAF用于处理三个低剂量(110、75和40 mAs)图像系列(后处理图像系列)。两位放射科医生以不知情的方式检查了基线和后处理图像的图像质量。记录客观噪声,CT衰减值,患者体重,横向直径,CTDIvol和DLP。使用参数测试和非参数测试进行统计分析,以比较后处理图像和基线图像。
结果:在基线或后处理的CT图像上均未遗漏任何病变(n = 80个病变,73个<1 cm的病变)。在40 mA时,纵隔窗口设置中的主观噪声在基线图像中被评定为不可接受,而在后处理图像中则被评定为可接受。较小结构的可见性从40 mAs的基线图像中的次佳可见度提高到40 mAs的后处理图像中的出色。由于NLAF后处理,没有看到主要的伪影,除了较小的光束硬化伪影不会影响基线和后处理图像系列中的诊断决策(14/22)。胸部CT的诊断置信度提高到40 mAs的后处理图像完全置信度。与基线图像相比,后处理在110 mAs时降低了26%(14.2±4.7 / 19.2±6.4),31.5%(15.2±4.7 / 22.2±5.7)和41.5%(16.9±6 / 28.9±10.2)的客观噪声, 75 mAs和40 mAs的管电流时间乘积电平。
结论:NLAF的应用可帮助将胸部CT的管电流降低至40 mAs,同时保持病变的显眼性和图像质量。

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