title: Reducing abdominal CT radiation dose with the adaptive statistical iterative reconstruction technique in children: a feasibility study.
abstract: BACKGROUND
  The use of the adaptive statistical iterative reconstruction (ASIR) algorithm has been shown to reduce radiation doses in adults undergoing abdominal CT studies while preserving image quality. To our knowledge, no studies have been done to validate the use of ASIR in children.
  
  
  OBJECTIVE
  To retrospectively evaluate differences in radiation dose and image quality in pediatric CT abdominal studies utilizing 40% ASIR compared with filtered-back projection (FBP).
  
  
  METHODS
  Eleven patients (mean age 8.5 years, range 2-17 years) had separate 40% ASIR and FBP enhanced abdominal CT studies on different days between July 2009 and October 2010. The ASIR studies utilized a 38% mA reduction in addition to our pediatric protocol mAs. Study volume CT dose indexes (CTDI(vol)) and dose-length products (DLP) were recorded. A consistent representative image was obtained from each study. The images were independently evaluated by two radiologists in a blinded manner for diagnostic utility, image sharpness and image noise.
  
  
  RESULTS
  The average CTDI(vol) and DLP for the 40% ASIR studies were 4.25 mGy and 185.04 mGy-cm, compared with 6.75 mGy and 275.79 mGy-cm for the FBP studies, representing 37% and 33% reductions in both, respectively. The radiologists' assessments of subjective image quality did not demonstrate any significant differences between the ASIR and FBP images.
  
  
  CONCLUSIONS
  In our experience, the use of 40% ASIR with a 38% decrease in mA lowers the radiation dose for children undergoing enhanced abdominal examinations by an average of 33%, while maintaining diagnostically acceptable images.
authors: Department of Radiology, The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA. gavorona@gmail.com
authors: Gregory A
authors: GA
authors: Vorona
authors: Rafael C
authors: RC
authors: Ceschin
authors: Barbara L
authors: BL
authors: Clayton
authors: Tom
authors: T
authors: Sutcavage
authors: Sameh S
authors: SS
authors: Tadros
authors: Ashok
authors: A
authors: Panigrahy
references: Radiology. 2010 Nov;257(2):373-83
references: 20829535
references: AJR Am J Roentgenol. 2010 Jan;194(1):191-9
references: 20028923
references: AJR Am J Roentgenol. 2010 Sep;195(3):713-9
references: 20729451
references: AJR Am J Roentgenol. 2009 Sep;193(3):764-71
references: 19696291
references: AJR Am J Roentgenol. 2010 Jul;195(1):126-31
references: 20566805
references: Radiology. 1997 Dec;205(3):853-8
references: 9393547
references: Eur Radiol. 2004 Jun;14(6):995-9
references: 15052502
references: AJR Am J Roentgenol. 2003 Feb;180(2):407-11
references: 12540443
references: Radiology. 2010 Jan;254(1):145-53
references: 20032149
references: Pediatr Radiol. 2009 Jun;39 Suppl 3:385-90
references: 19440758
references: AJR Am J Roentgenol. 2010 Nov;195(5):1095-9
references: 20966312
references: AJR Am J Roentgenol. 2010 Apr;194(4):868-73
references: 20308484
references: Radiology. 2010 Jul;256(1):261-9
references: 20574099
references: Invest Radiol. 2010 Apr;45(4):202-10
references: 20177389
references: AJR Am J Roentgenol. 2010 Sep;195(3):655-60
references: 20729443
references: J Comput Assist Tomogr. 2010 Jan;34(1):40-5
references: 20118720
references: AJR Am J Roentgenol. 2008 Jan;190(1):W54-61
references: 18094273