title: Low-dose CT with automatic tube current modulation, adaptive statistical iterative reconstruction, and low tube voltage for the diagnosis of renal colic: impact of body mass index.
abstract: OBJECTIVE
  The objective of our study was to evaluate the impact of body mass index (BMI) on dose, diagnostic performance, and image quality of a low-dose CT examination for renal colic.
  
  
  METHODS
  This retrospective study included all patients who underwent a low-dose CT examination for renal colic performed during the year 2012 with automatic tube current modulation, adaptive statistical iterative reconstruction, and a low tube voltage (kV). Three readers independently reviewed all images for the presence of renal colic and evaluated diagnostic confidence and image quality. The results and doses were compared among patients grouped by body mass index (BMI) and between patients with a BMI<25 and those with a BMI≥25.
  
  
  RESULTS
  Eighty-six patients were included in the study: 39 patients had a BMI<25 and 47 had a BMI≥25. No statistically significant difference was found between the accuracy rates for the diagnosis of renal colic when the rates of the three independent readers were averaged for both BMI groups (95.7% vs 96.4%, respectively; p=0.83). Image quality and diagnostic confidence scores were significantly better for patients with a BMI≥25 than for patients with a BMI<25 (mean image quality score, 3.7 vs 3.4, p<0.001; mean diagnostic confidence score, 2.8 vs 2.5, p<0.001). The mean radiation dose for patients with a BMI<25 was 2.4 mGy compared with 3.7 mGy for patients with a BMI≥25 (p<0.001).
  
  
  CONCLUSIONS
  The diagnostic performance of our low-dose CT protocol for renal colic was excellent for all patients, and image quality and diagnostic confidence were significantly better for patients with a BMI≥25. However, our protocol also required exposure to a greater dose of radiation for these overweight and obese patients.
authors.affiliation: 1 Department of Medical Imaging, Military Hospital Legouest, 27 Avenue de Plantières, BP 90001, Metz 57077, Cedex 3, France.
authors.forename: Alban
authors.initials: A
authors.lastname: Gervaise
authors.forename: Pierre
authors.initials: P
authors.lastname: Naulet
authors.forename: Florence
authors.initials: F
authors.lastname: Beuret
authors.forename: Christelle
authors.initials: C
authors.lastname: Henry
authors.forename: Matthieu
authors.initials: M
authors.lastname: Pernin
authors.forename: Yann
authors.initials: Y
authors.lastname: Portron
authors.forename: Marie
authors.initials: M
authors.lastname: Lapierre-Combes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D015992:Body Mass Index; D003627:Data Interpretation, Statistical; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011829:Radiation Dosage; D011835:Radiation Protection / Q000706:statistics & numerical data*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D056844:Renal Colic / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*