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Effects of Radiation Dose Reduction on Diagnostic Accuracy of Abdominal CT in Young Adults with Suspected Acute Diverticulitis: A Retrospective Intraindividual Analysis
- Source :
- Academic radiology. 26(6)
- Publication Year :
- 2018
-
Abstract
- To assess the effects of radiation dose reduction on image quality and diagnostic accuracy of abdominal computed tomography (CT) in young adults with suspected acute diverticulitis.Fifty-four patients ≤40 years who received contrast-enhanced abdominal CT for suspected acute diverticulitis were included. Low-dose CT (LDCT) datasets (25%, 50%, and 75% of the original dose) were generated using sinogram synthesis and quantum noise modeling. A five-point scale was used to assess images qualitatively (overall image quality, noise, artefacts, and sharpness) and for diagnostic confidence (5 being the best possible outcome). Furthermore, the diagnostic accuracy was determined for the presence of acute diverticulitis.Among 54 patients (mean age: 35.2 ± 5.3 years, 77.8% male), the prevalence of acute diverticulitis was high (57.4%). Subjective image quality was highest for original datasets and lowest for LDCT datasets with 25% of the original dose (median [interquartile range]: 5 [5] vs. 3 [2-3], p0.001). Diagnostic confidence was high for all datasets down to 50% of the original dose, while 25% LDCT datasets were associated with a significantly decreased diagnostic confidence (p0.001). Diagnostic accuracy was high for all LDCT and original datasets (sensitivity: 100%, negative predictive value [NPV]: 100% for 75% and 100% dose levels; sensitivity: 96.8%, NPV: 95.8% for 50% dose level; sensitivity: 93.6%, NPV: 91.7% for 25% dose level, respectively). Inter-rater agreement regarding the detection of diverticulitis was almost perfect at doses ≥50% (kappa:0.81), while lower for datasets of 25% of the original radiation dose agreement (kappa: 0.67-0.78).Radiation dose reduction down to 50% of the original radiation exposure permits high image quality, diagnostic confidence, and accuracy for the assessment of acute diverticulitis in abdominal CT in young adults without the use of iterative reconstruction algorithms.
- Subjects :
- Adult
Male
Radiography, Abdominal
medicine.medical_specialty
Image quality
Abdominal ct
Diagnostic accuracy
Radiation Dosage
Sensitivity and Specificity
Interquartile range
medicine
Humans
Radiology, Nuclear Medicine and imaging
Young adult
Diverticulitis
Retrospective Studies
Acute diverticulitis
business.industry
Radiation dose
Reproducibility of Results
Dose-Response Relationship, Radiation
Radiographic Image Enhancement
Female
Radiology
business
Tomography, X-Ray Computed
Kappa
Subjects
Details
- ISSN :
- 18784046
- Volume :
- 26
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Academic radiology
- Accession number :
- edsair.doi.dedup.....a9a6a1179fd8f0d71da5499571aa9d58