title: Feasibility of low-dose CT with model-based iterative image reconstruction in follow-up of patients with testicular cancer.
abstract: OBJECTIVE
  We examine the performance of pure model-based iterative reconstruction with reduced-dose CT in follow-up of patients with early-stage testicular cancer.
  
  
  METHODS
  Sixteen patients (mean age 35.6 ± 7.4 years) with stage I or II testicular cancer underwent conventional dose (CD) and low-dose (LD) CT acquisition during CT surveillance. LD data was reconstructed with model-based iterative reconstruction (LD-MBIR). Datasets were objectively and subjectively analysed at 8 anatomical levels. Two blinded clinical reads were compared to gold-standard assessment for diagnostic accuracy.
  
  
  RESULTS
  Mean radiation dose reduction of 67.1% was recorded. Mean dose measurements for LD-MBIR were: thorax - 66 ± 11 mGy cm (DLP), 1.0 ± 0.2 mSv (ED), 2.0 ± 0.4 mGy (SSDE); abdominopelvic - 128 ± 38 mGy cm (DLP), 1.9 ± 0.6 mSv (ED), 3.0 ± 0.6 mGy (SSDE). Objective noise and signal-to-noise ratio values were comparable between the CD and LD-MBIR images. LD-MBIR images were superior (p < 0.001) with regard to subjective noise, streak artefact, 2-plane contrast resolution, 2-plane spatial resolution and diagnostic acceptability. All patients were correctly categorised as positive, indeterminate or negative for metastatic disease by 2 readers on LD-MBIR and CD datasets.
  
  
  CONCLUSIONS
  MBIR facilitated a 67% reduction in radiation dose whilst producing images that were comparable or superior to conventional dose studies without loss of diagnostic utility.
authors.affiliation: Department of Radiology, Cork University Hospital, Cork, Ireland; Department of Radiology, University College Cork, Cork, Ireland; Department of Radiology, Mercy University Hospital, Cork, Ireland.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Murphy
authors.affiliation: Department of Radiology, University College Cork, Cork, Ireland; Department of Radiology, Mercy University Hospital, Cork, Ireland.
authors.forename: Lee
authors.initials: L
authors.lastname: Crush
authors.affiliation: Department of Radiology, Cork University Hospital, Cork, Ireland; Department of Radiology, Mercy University Hospital, Cork, Ireland.
authors.forename: Siobhan B
authors.initials: SB
authors.lastname: O'Neill
authors.affiliation: Department of Electrical and Electronic Engineering, University College Cork, Cork, Ireland.
authors.forename: James
authors.initials: J
authors.lastname: Foody
authors.affiliation: Department of Radiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Micheál
authors.initials: M
authors.lastname: Breen
authors.affiliation: Department of Radiology, Mercy University Hospital, Cork, Ireland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Brady
authors.affiliation: Department of Radiation Oncology, Cork University Hospital, Cork, Ireland.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Kelly
authors.affiliation: Department of Medical Oncology, Cork and Mercy University Hospitals, Cork, Ireland.
authors.forename: Derek G
authors.initials: DG
authors.lastname: Power
authors.affiliation: Department of Urology, Mercy University Hospital, Cork, Ireland.
authors.forename: Paul
authors.initials: P
authors.lastname: Sweeney
authors.affiliation: General Electric Healthcare Technologies, Herdfordshire, UK.
authors.forename: Jackie
authors.initials: J
authors.lastname: Bye
authors.affiliation: Department of Radiology, Cork University Hospital, Cork, Ireland; Department of Radiology, University College Cork, Cork, Ireland; Department of Radiology, Mercy University Hospital, Cork, Ireland.
authors.forename: Owen J
authors.initials: OJ
authors.lastname: O'Connor
authors.affiliation: Department of Radiology, Cork University Hospital, Cork, Ireland; Department of Radiology, University College Cork, Cork, Ireland; Department of Radiology, Mercy University Hospital, Cork, Ireland.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Maher
authors.affiliation: Department of Radiology, Cork University Hospital, Cork, Ireland.
authors.forename: Kevin N
authors.initials: KN
authors.lastname: O'Regan
keywords: Iterative reconstruction; Low-dose computed tomography; Model-based iterative reconstruction; Radiation dose; Testicular cancer