title: CT urography in the urinary bladder: to compare excretory phase images using a low noise index and a high noise index with adaptive noise reduction filter.
abstract: BACKGROUND
  Although CT urography (CTU) is widely used for the evaluation of the entire urinary tract, the most important drawback is the radiation exposure.
  
  
  OBJECTIVE
  To evaluate the effect of a noise reduction filter (NRF) using a phantom and to quantitatively and qualitatively compare excretory phase (EP) images using a low noise index (NI) with those using a high NI and postprocessing NRF (pNRF).
  
  
  METHODS
  Each NI value was defined for a slice thickness of 5 mm, and reconstructed images with a slice thickness of 1.25 mm were assessed. Sixty patients who were at high risk of developing bladder tumors (BT) were divided into two groups according to whether their EP images were obtained using an NI of 9.88 (29 patients; group A) or an NI of 20 and pNRF (31 patients; group B). The CT dose index volume (CTDI(vol)) and the contrast-to-noise ratio (CNR) of the bladder with respect to the anterior pelvic fat were compared in both groups. Qualitative assessment of the urinary bladder for image noise, sharpness, streak artifacts, homogeneity, and the conspicuity of polypoid or sessile-shaped BTs with a short-axis diameter greater than 10 mm was performed using a 3-point scale.
  
  
  RESULTS
  The phantom study showed noise reduction of approximately 40% and 76% dose reduction between group A and group B. CTDI(vol) demonstrated a 73% reduction in group B (4.6 ± 1.1 mGy) compared with group A (16.9 ± 3.4 mGy). The CNR value was not significantly different (P = 0.60) between group A (16.1 ± 5.1) and group B (16.6 ± 7.6). Although group A was superior (P < 0.01) to group B with regard to image noise, other qualitative analyses did not show significant differences.
  
  
  CONCLUSIONS
  EP images using a high NI and pNRF were quantitatively and qualitatively comparable to those using a low NI, except with regard to image noise.
authors.affiliation: Department of Radiology, Showa University Fujigaoka Hospital, Yokohama, Japan. momiji@mtc.biglobe.ne.jp
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takeyama
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Ohgiya
authors.forename: Takaki
authors.initials: T
authors.lastname: Hayashi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Suzuki
authors.initials: S
authors.lastname: Yoshiaki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takasu
authors.forename: Junya
authors.initials: J
authors.lastname: Nakashima
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Kato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kinebuchi
authors.forename: Toshi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Takehiko
authors.initials: T
authors.lastname: Gokan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging*; D014567:Urography / Q000379:methods*