CAREdose 4D Application in Brain CT Scan: The Effect on Dose and Image Quality
,
Abstract
Purpose: This study aimed to investigate the effect of CAREdose4D on the dose and image quality in Brain Computed Tomography (CT).
Materials and Methods: Noise, Signal-to-Noise Ratio (SNR), and Contrast-to-Noise Ratio (CNR) for Gray Matter (GM), White Matter (WM), Cerebrospinal Fluid (CSF), and skull bones were investigated in brain CT scans of 60 patients. In addition, a phantom study was conducted to examine the effect of CAREdose 4D on the same subject in the brain, chest, abdomen, and pelvic CT protocols. Volume CT dose index (CTDIvol) and Dose Length Product (DLP) were recorded for each scan. Data were analyzed by T-test and Mann-Whitney statistical test with a significance level of less than 0.05.
Results: The following results were obtained in active and passive modes of CAREdose 4D in brain CT of patients, respectively: CTDIvol, 15.76±3.94 and 16.96±2.14 mGy (p<0.05); DLP, 253.81±84.69 and 252.73±43.26 mGy.cm (p>0.05). There was no significant difference between SNRs and noise of various tissues of the brain (p>0.05) but CNR difference for gray matter, white matter, and cerebrospinal fluid (CSF) was significant (p<0.05). In the phantom study, SNR decreased in the active status of CAREdose 4D for the head in sequential and spiral modes, Chest, abdomen and pelvis by 7%, 84%, 45%, 20%, and 22%, respectively.
Conclusion: CAREdose 4D reduces the dose without having an adverse effect on noise and SNR in brain CT scans. It is recommended newbies and untrained technicians to use CAREdose 4D.
1- Lora Mishra, Rini Behera, Satabdi Pattanaik, and Naomi Ranjan Singh, "Role of CT scan in medical and dental imaging." in Biomedical Imaging Instrumentation: Elsevier, (2022), pp. 13-32.
2- Shumei Ma, Boyu Kong, Bing Liu, and Xiaodong Liu, "Biological effects of low-dose radiation from computed tomography scanning." International Journal of Radiation Biology, Vol. 89 (No. 5), pp. 326-33, (2013).
3- Rostampour N, Jafari S, Saeb M, Keshtkar M, Shokrani P, and Almasi T. "Assessment of skyshine photon dose rates from 9 and 18MV medical linear accelerators." International Journal of Radiation Research., vol. 16(No.4), pp 499-503, (2018).
4- Cheki M, Jafari S, Najafi M, Mahmoudzadeh A. "Glucosamine protects rat bone marrow cells against cisplatin-induced genotoxicity and cytotoxicity." Anti-Cancer Agents in Medicinal Chemistry, vol. 19(No.14), pp.1695-702, (2019).
5- A Lara, M Osorio, B Olvera, YO Villafañez, R García, and T Rivera, "Importance of patient radiation protection in computed tomography procedures." in Journal of Physics: Conference Series, (2019), Vol. 1221 (No. 1): IOP Publishing, p. 012065.
6- Daniel W Entrikin, Jonathon A Leipsic, and J Jeffrey Carr, "Optimization of radiation dose reduction in cardiac computed tomographic angiography." Cardiology in Review, Vol. 19 (No. 4), pp. 163-76, (2011).
7- Jafari S, Tavakoli MB, Zarrabi A. " Lomustine loaded superparamagnetic iron oxide nanoparticles conjugated with folic acid for treatment of glioblastoma multiforma (GBM)." Journal of Pharmaceutical Research. vol. 19 (No.2), pp.134, (2020).
8- Pedro Vilela and Howard A Rowley, "Brain ischemia: CT and MRI techniques in acute ischemic stroke." European journal of radiology, Vol. 96pp. 162-72, (2017).
9- Saminderjit Kular and Andrew Martin, "A primer in interpretation of head CT scans." British Journal of Hospital Medicine, Vol. 80 (No. 11), pp. C156-C61, (2019).
10- Leena M Hamberg, James T Rhea, George J Hunter, and James H Thrall, "Multi–detector row CT: radiation dose characteristics." Radiology, Vol. 226 (No. 3), pp. 762-72, (2003).
11- Frank J Thornton, Erik K Paulson, Terry T Yoshizumi, Donald P Frush, and Rendon C Nelson, "Single versus multi–detector row CT: comparison of radiation doses and dose profiles." Academic radiology, Vol. 10 (No. 4), pp. 379-85, (2003).
12- U Wedegärtner, H Thurmann, R Schmidt, and G Adam, "Radiation exposure of the head, midface and pelvis in multi-slice CT (MSCT): comparison with single-slice CT (SSCT)." Rofo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, Vol. 175 (No. 2), pp. 234-38, (2003).
13- Tracy A Jaffe, Jenny K Hoang, Terry T Yoshizumi, Greta Toncheva, Carolyn Lowry, and Carl Ravin, "Radiation dose for routine clinical adult brain CT: variability on different scanners at one institution." American Journal of Roentgenology, Vol. 195 (No. 2), p. 433, (2010).
14- Thomas C Gerber, Ronald S Kuzo, and Richard L Morin, "Techniques and parameters for estimating radiation exposure and dose in cardiac computed tomography." The international journal of cardiovascular imaging, Vol. 21pp. 165-76, (2005).
15- K Matsubara, "Computed tomography dosimetry: from basic to state-of-the-art techniques." Med Phys, Vol. 5(2017).
16- Reza Afzalipour, Hamid Abdollahi, MS Hajializadeh, Salman Jafari, and Seied Rabi Mahdavi, "Estimation of diagnostic reference levels for children computed tomography: a study in Tehran, Iran." International Journal of Radiation Research, Vol. 17 (No. 3), pp. 407-13, (2019).
17- S Jafari, M Karimi, H Khosravi, R Goodarzi, and M Pourkaveh, "Establishment of diagnostic reference levels for computed tomography scanning in hamadan." Journal of Biomedical Physics & Engineering, Vol. 10 (No. 6), p. 792, (2020).
18- Manoj Diwakar and Manoj Kumar, "A review on CT image noise and its denoising." Biomedical Signal Processing and Control, Vol. 42pp. 73-88, (2018).
19- MA Habibzadeh, Mohammad Reza Ay, AR Kamali Asl, H Ghadiri, and Habib Zaidi, "Impact of miscentering on patient dose and image noise in x-ray CT imaging: phantom and clinical studies." Physica Medica, Vol. 28 (No. 3), pp. 191-99, (2012).
20- Amy K Hara, Robert G Paden, Alvin C Silva, Jennifer L Kujak, Holly J Lawder, and William Pavlicek, "Iterative reconstruction technique for reducing body radiation dose at CT: feasibility study." American Journal of Roentgenology, Vol. 193 (No. 3), pp. 764-71, (2009).
21- Mannudeep K Kalra et al., "Radiation dose reduction with sinogram affirmed iterative reconstruction technique for abdominal computed tomography." Journal of computer assisted tomography, Vol. 36 (No. 3), pp. 339-46, (2012).
22- François Pontana et al., "Chest computed tomography using iterative reconstruction vs filtered back projection (Part 2): image quality of low-dose CT examinations in 80 patients." European radiology, Vol. 21pp. 636-43, (2011).
23- Anna Winklehner et al., "Raw data-based iterative reconstruction in body CTA: evaluation of radiation dose saving potential." European radiology, Vol. 21pp. 2521-26, (2011).
24- Lin Wang et al., "CARE Dose 4D combined with sinogram‐affirmed iterative reconstruction improved the image quality and reduced the radiation dose in low dose CT of the small intestine." Journal of Applied Clinical Medical Physics, Vol. 20 (No. 1), pp. 293-307, (2019).
25- J Greffier et al., "Dose reduction with iterative reconstruction in multi-detector CT: what is the impact on deformation of circular structures in phantom study?" Diagnostic and interventional imaging, Vol. 97 (No. 2), pp. 187-96, (2016).
26- Ni Larasati Kartika Sari, Merry Suzana, Muzilman Muslim, and Dewi Muliyati, "Analysis of the effect of care dose 4D software use on image quality and radiation dose on the CT scan abdomen." Spektra: Jurnal Fisika dan Aplikasinya, Vol. 5 (No. 1), pp. 31-40, (2020).
27- Marcus Söderberg and Sonny La, "Evaluation of adaptation strengths of CARE Dose 4D in pediatric CT." in Medical Imaging 2013: Physics of Medical Imaging, (2013), Vol. 8668: SPIE, pp. 844-49.
28- Holger Greess et al., "Dose reduction in CT examination of children by an attenuation-based on-line modulation of tube current (CARE Dose)." European radiology, Vol. 12pp. 1571-76, (2002).
29- Pooja Shah, Amish Sharma, Jayanti Gyawali, Sharma Paudel, Shanta Lall Shrestha, and Surendra Maharjan, "Dose optimization in computed tomography of brain using CARE kV and CARE Dose 4D." Radiography Open, Vol. 4 (No. 1), pp. 9-9, (2018).
2- Shumei Ma, Boyu Kong, Bing Liu, and Xiaodong Liu, "Biological effects of low-dose radiation from computed tomography scanning." International Journal of Radiation Biology, Vol. 89 (No. 5), pp. 326-33, (2013).
3- Rostampour N, Jafari S, Saeb M, Keshtkar M, Shokrani P, and Almasi T. "Assessment of skyshine photon dose rates from 9 and 18MV medical linear accelerators." International Journal of Radiation Research., vol. 16(No.4), pp 499-503, (2018).
4- Cheki M, Jafari S, Najafi M, Mahmoudzadeh A. "Glucosamine protects rat bone marrow cells against cisplatin-induced genotoxicity and cytotoxicity." Anti-Cancer Agents in Medicinal Chemistry, vol. 19(No.14), pp.1695-702, (2019).
5- A Lara, M Osorio, B Olvera, YO Villafañez, R García, and T Rivera, "Importance of patient radiation protection in computed tomography procedures." in Journal of Physics: Conference Series, (2019), Vol. 1221 (No. 1): IOP Publishing, p. 012065.
6- Daniel W Entrikin, Jonathon A Leipsic, and J Jeffrey Carr, "Optimization of radiation dose reduction in cardiac computed tomographic angiography." Cardiology in Review, Vol. 19 (No. 4), pp. 163-76, (2011).
7- Jafari S, Tavakoli MB, Zarrabi A. " Lomustine loaded superparamagnetic iron oxide nanoparticles conjugated with folic acid for treatment of glioblastoma multiforma (GBM)." Journal of Pharmaceutical Research. vol. 19 (No.2), pp.134, (2020).
8- Pedro Vilela and Howard A Rowley, "Brain ischemia: CT and MRI techniques in acute ischemic stroke." European journal of radiology, Vol. 96pp. 162-72, (2017).
9- Saminderjit Kular and Andrew Martin, "A primer in interpretation of head CT scans." British Journal of Hospital Medicine, Vol. 80 (No. 11), pp. C156-C61, (2019).
10- Leena M Hamberg, James T Rhea, George J Hunter, and James H Thrall, "Multi–detector row CT: radiation dose characteristics." Radiology, Vol. 226 (No. 3), pp. 762-72, (2003).
11- Frank J Thornton, Erik K Paulson, Terry T Yoshizumi, Donald P Frush, and Rendon C Nelson, "Single versus multi–detector row CT: comparison of radiation doses and dose profiles." Academic radiology, Vol. 10 (No. 4), pp. 379-85, (2003).
12- U Wedegärtner, H Thurmann, R Schmidt, and G Adam, "Radiation exposure of the head, midface and pelvis in multi-slice CT (MSCT): comparison with single-slice CT (SSCT)." Rofo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, Vol. 175 (No. 2), pp. 234-38, (2003).
13- Tracy A Jaffe, Jenny K Hoang, Terry T Yoshizumi, Greta Toncheva, Carolyn Lowry, and Carl Ravin, "Radiation dose for routine clinical adult brain CT: variability on different scanners at one institution." American Journal of Roentgenology, Vol. 195 (No. 2), p. 433, (2010).
14- Thomas C Gerber, Ronald S Kuzo, and Richard L Morin, "Techniques and parameters for estimating radiation exposure and dose in cardiac computed tomography." The international journal of cardiovascular imaging, Vol. 21pp. 165-76, (2005).
15- K Matsubara, "Computed tomography dosimetry: from basic to state-of-the-art techniques." Med Phys, Vol. 5(2017).
16- Reza Afzalipour, Hamid Abdollahi, MS Hajializadeh, Salman Jafari, and Seied Rabi Mahdavi, "Estimation of diagnostic reference levels for children computed tomography: a study in Tehran, Iran." International Journal of Radiation Research, Vol. 17 (No. 3), pp. 407-13, (2019).
17- S Jafari, M Karimi, H Khosravi, R Goodarzi, and M Pourkaveh, "Establishment of diagnostic reference levels for computed tomography scanning in hamadan." Journal of Biomedical Physics & Engineering, Vol. 10 (No. 6), p. 792, (2020).
18- Manoj Diwakar and Manoj Kumar, "A review on CT image noise and its denoising." Biomedical Signal Processing and Control, Vol. 42pp. 73-88, (2018).
19- MA Habibzadeh, Mohammad Reza Ay, AR Kamali Asl, H Ghadiri, and Habib Zaidi, "Impact of miscentering on patient dose and image noise in x-ray CT imaging: phantom and clinical studies." Physica Medica, Vol. 28 (No. 3), pp. 191-99, (2012).
20- Amy K Hara, Robert G Paden, Alvin C Silva, Jennifer L Kujak, Holly J Lawder, and William Pavlicek, "Iterative reconstruction technique for reducing body radiation dose at CT: feasibility study." American Journal of Roentgenology, Vol. 193 (No. 3), pp. 764-71, (2009).
21- Mannudeep K Kalra et al., "Radiation dose reduction with sinogram affirmed iterative reconstruction technique for abdominal computed tomography." Journal of computer assisted tomography, Vol. 36 (No. 3), pp. 339-46, (2012).
22- François Pontana et al., "Chest computed tomography using iterative reconstruction vs filtered back projection (Part 2): image quality of low-dose CT examinations in 80 patients." European radiology, Vol. 21pp. 636-43, (2011).
23- Anna Winklehner et al., "Raw data-based iterative reconstruction in body CTA: evaluation of radiation dose saving potential." European radiology, Vol. 21pp. 2521-26, (2011).
24- Lin Wang et al., "CARE Dose 4D combined with sinogram‐affirmed iterative reconstruction improved the image quality and reduced the radiation dose in low dose CT of the small intestine." Journal of Applied Clinical Medical Physics, Vol. 20 (No. 1), pp. 293-307, (2019).
25- J Greffier et al., "Dose reduction with iterative reconstruction in multi-detector CT: what is the impact on deformation of circular structures in phantom study?" Diagnostic and interventional imaging, Vol. 97 (No. 2), pp. 187-96, (2016).
26- Ni Larasati Kartika Sari, Merry Suzana, Muzilman Muslim, and Dewi Muliyati, "Analysis of the effect of care dose 4D software use on image quality and radiation dose on the CT scan abdomen." Spektra: Jurnal Fisika dan Aplikasinya, Vol. 5 (No. 1), pp. 31-40, (2020).
27- Marcus Söderberg and Sonny La, "Evaluation of adaptation strengths of CARE Dose 4D in pediatric CT." in Medical Imaging 2013: Physics of Medical Imaging, (2013), Vol. 8668: SPIE, pp. 844-49.
28- Holger Greess et al., "Dose reduction in CT examination of children by an attenuation-based on-line modulation of tube current (CARE Dose)." European radiology, Vol. 12pp. 1571-76, (2002).
29- Pooja Shah, Amish Sharma, Jayanti Gyawali, Sharma Paudel, Shanta Lall Shrestha, and Surendra Maharjan, "Dose optimization in computed tomography of brain using CARE kV and CARE Dose 4D." Radiography Open, Vol. 4 (No. 1), pp. 9-9, (2018).
| Files | ||
| Issue | Vol 11 No 3 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/fbt.v11i3.15884 | |
| Keywords | ||
| Brain Computed Tomography Dose Reduction Volume Computed Tomography Dose Index Image Quality | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Abdolmaleki MS, Jafari S, Nikzad S. CAREdose 4D Application in Brain CT Scan: The Effect on Dose and Image Quality. Frontiers Biomed Technol. 2024;11(3):415-422.
