Highlights
- •Tin prefiltration allows for considerable dose reduction in ultra-low-dose scans for detection of urinary calculi.
- •Sn100 kVp-based protocols may bear a radiation dose advantage over Sn150 kVp which is more frequently evaluated in literature.
- •With spectral shaping, image quality in ultra-low-dose settings remains comparable to standard low-dose scans.
Objectives
For detection of urinary calculi, unenhanced low-dose computed tomography is the method
of choice, outperforming radiography and ultrasound. This retrospective monocentric
study aims to compare a clinically established, dedicated low-dose imaging protocol
for detection of urinary calculi with an ultra-low-dose protocol employing tin prefiltration
at a standardized tube voltage of 100 kVp.
Methods
Two study arms included a total of 510 cases. The “low-dose group” was comprised of
290 individuals (96 women; age 49 ± 16 years; BMI 27.23 ± 5.60 kg/m2). The “ultra-low-dose group” with Sn100 kVp consisted of 220 patients (84 women;
age 47 ± 17 years; BMI 26.82 ± 5.62 kg/m2). No significant difference was ascertained for comparison of age (p = 0.132) and BMI (p = 0.207) between cohorts. For quantitative assessment of image quality, image noise
was assessed.
Results
No significant difference regarding frequency of calculi detection was found between
groups (p = 0.596). Compared to the low-dose protocol (3.08 mSv; IQR 2.22–4.02 mSv), effective
dose was reduced by 62.35% with the ultra-low-dose protocol employing spectral shaping
(1.16 mSv; IQR 0.89–1.54 mSv). Image noise was calculated at 18.90 (IQR 17.39–21.20)
for the low-dose protocol and at 18.69 (IQR 17.30–21.62) for the ultra-low-dose spectral
shaping protocol. No significant difference was ascertained for comparison between
groups (p = 0.793).
Conclusion
For urinary calculi detection, ultra-low-dose scans utilizing spectral shaping by
means of tin prefiltration at 100 kVp allow for considerable dose reduction of up
to 62% over conventional low-dose CT without compromising image quality.
Key Words
Abbreviations and acronyms:
ACR (American College of Radiology), BMI (body mass index), CT (computed tomography), ED (effective dose), HU (Hounsfield units), IR (iterative reconstruction), IQR (interquartile range), ROI (region of interest)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 10, 2022
Accepted:
July 14,
2022
Received in revised form:
July 14,
2022
Received:
June 21,
2022
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
