title: Emergency assessment of patients with acute abdominal pain using low-dose CT with iterative reconstruction: a comparative study.
abstract: OBJECTIVE
  To determine if radiation dose delivered by contrast-enhanced CT (CECT) for acute abdominal pain can be reduced to the dose administered in abdominal radiography (<2.5 mSv) using low-dose CT (LDCT) with iterative reconstruction algorithms.
  
  
  METHODS
  One hundred and fifty-one consecutive patients requiring CECT for acute abdominal pain were included, and their body mass index (BMI) was calculated. CECT was immediately followed by LDCT. LDCT series was processed using 1) 40% iterative reconstruction algorithm blended with filtered back projection (LDCT-IR-FBP) and 2) model-based iterative reconstruction algorithm (LDCT-MBIR). LDCT-IR-FBP and LDCT-MBIR images were reviewed independently by two board-certified radiologists (Raters 1 and 2).
  
  
  RESULTS
  Abdominal pathology was revealed on CECT in 120 (79%) patients. In those with BMI <30, accuracies for correct diagnosis by Rater 1 with LDCT-IR-FBP and LDCT-MBIR, when compared to CECT, were 95.4% (104/109) and 99% (108/109), respectively, and 92.7% (101/109) and 100% (109/109) for Rater 2. In patients with BMI ≥30, accuracies with LDCT-IR-FBP and LDCT-MBIR were 88.1% (37/42) and 90.5% (38/42) for Rater 1 and 78.6% (33/42) and 92.9% (39/42) for Rater 2.
  
  
  CONCLUSIONS
  The radiation dose delivered by CT to non-obese patients with acute abdominal pain can be safely reduced to levels close to standard radiography using LDCT-MBIR.
  
  
  CONCLUSIONS
  • LDCT-MBIR (<2.5 mSv) can be used to assess acute abdominal pain. • LDCT-MBIR (<2.5 mSv) cannot safely assess acute abdominal pain in obese patients. • LDCT-IR-FBP (<2.5 mSv) cannot safely assess patients with acute abdominal pain.
authors.affiliation: Department of Radiology, University Hospital of Geneva, 4 rue Gabrielle Perret-Gentil, 1211, Geneva, Switzerland. pierre-alexandre.poletti@hcuge.ch.
authors.forename: Pierre-Alexandre
authors.initials: PA
authors.lastname: Poletti
authors.affiliation: Department of Radiology, University Hospital of Geneva, 4 rue Gabrielle Perret-Gentil, 1211, Geneva, Switzerland.
authors.forename: Minerva
authors.initials: M
authors.lastname: Becker
authors.affiliation: Department of Radiology, University Hospital of Geneva, 4 rue Gabrielle Perret-Gentil, 1211, Geneva, Switzerland.
authors.forename: Christoph D
authors.initials: CD
authors.lastname: Becker
authors.affiliation: Department of Community, Primary Care and Emergency Medicine, University Hospital of Geneva, Geneva, Switzerland.
authors.forename: Alice
authors.initials: A
authors.lastname: Halfon Poletti
authors.affiliation: Department of Community, Primary Care and Emergency Medicine, University Hospital of Geneva, Geneva, Switzerland.
authors.forename: Olivier T
authors.initials: OT
authors.lastname: Rutschmann
authors.affiliation: Department of Radiology, University Hospital of Geneva, 4 rue Gabrielle Perret-Gentil, 1211, Geneva, Switzerland.
authors.forename: Habib
authors.initials: H
authors.lastname: Zaidi
authors.affiliation: Division of Clinical Epidemiology, University Hospital of Geneva, Geneva, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Perneger
authors.affiliation: Department of Radiology, University Hospital of Geneva, 4 rue Gabrielle Perret-Gentil, 1211, Geneva, Switzerland.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Platon
mesh_terms: D000006:Abdomen, Acute / Q000000981:diagnostic imaging* / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015992:Body Mass Index; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D011860:Radiography, Abdominal / Q000379:methods; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
keywords: Acute abdomen; CT; Emergencies; Iterative reconstruction; Radiation dose