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Impact of Radiation Dose Reduction on Image Quality in CT of Cervical Spine 2014

Category General Spine Santanu Chakraborty, MRCP, DMRD, FRCR
Satya Patro, MD
Adnan Sheikh, MD
Purpose Adaptive Statistical Iterative Reconstruction (ASIR) is one of the common radiation dose reduction techniques in clinical practice. The aim of this study is to evaluate the impact of using ASIR on the image quality and radiation dose in CT spine of patients with cervical spine blunt trauma. The comparison was made with the traditional Filtered Back Projection (FBP) technique. Materials & Methods We retrospectively reviewed a total of 78 patients, who underwent emergency cervical spine CT imaging at our institution for blunt cervical trauma. Out of 78 patients, 48 patients were imaged before the implementation of ASIR technique i.e. with traditional FBP technique. The remaining 30 patients were imaged after the implementation of ASIR technique. As per the vendor’s recommendation we used 30% ASIR and corresponding reduction in radiation dose. The patient demographics, radiation dose, objective image signal and noise were recorded. Two radiologists blinded to the techniques used graded the images for subjective noise, sharpness, diagnostic acceptability and artefacts. Results We found that the ASIR technique was able to reduce the CTDIvol & DLP by 50.3% and 54.5% respectively, compared to FBP technique. There was no significant difference of image noise and signal between the two groups. There was excellent inter observer agreement on the subjective image quality and diagnostic acceptability for both ASIR and FBP group. Conclusion Use of ASIR technique allowed significant radiation dose reduction in the evaluation of cervical spine without degrading the image quality. References 1. Radiation dose reduction with the adaptive statistical iterative reconstruction (ASIR) technique for chest CT in children: an intra-individual comparison. Lee SH, Kim MJ, Yoon CS, Lee MJ. Eur J Radiol. 2012 Sep;81(9):e938-43. doi: 10.1016/j.ejrad.2012.06.013. Epub 2012 Jul 12. 2. New scanning technique using Adaptive Statistical Iterative Reconstruction (ASIR) significantly reduced the radiation dose of cardiac CT. Tumur O, Soon K, Brown F, Mykytowycz M. J Med Imaging Radiat Oncol. 2013 Jun;57(3):292-6. doi: 10.1111/1754-9485.12019. Epub 2013 Jan 7.