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Gastrointestinal Imaging |
1 From the Depts of Radiology (R.E.v.G., H.W.V., C.Y.N., R.M.D., C.A.T., F.M.V., J.S.L., J.S.), Medical Physics (H.W.V.), Clinical Epidemiology and Biostatistics (A.S.G., P.M.M.B.), and Gastroenterology (J.F.W.B.), Academic Medical Ctr, Univ of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; and Pattern Recognition Group, Dept of Applied Physics, Technical Univ of Delft, the Netherlands (I.W.O.S., F.M.V.). From the 2000 RSNA scientific assembly. Received June 28, 2001; revision requested Aug 16; revision received Oct 12; accepted Dec 14. Address correspondence to R.E.v.G. (e-mail: r.e.vangelder@amc.uva.nl).
PURPOSE: To investigate the sensitivity and specificity of polyp detection and the image quality of computed tomographic (CT) colonography at different radiation dose levels and to study effective doses reported in literature on CT colonography.
MATERIALS AND METHODS: CT colonography and colonoscopy were performed with 100 mAs in 50 consecutive patients at high risk for colorectal cancer; 50- and 30-mAs CT colonographic examinations were simulated with controlled addition of noise to raw transmission measurements. One radiologist randomly evaluated all original and simulated images for the presence of polyps and scored image quality. Differences in image quality were assessed with the Wilcoxon rank test. Scan protocols from the literature and recent (unpublished) updates were collected.
RESULTS: In nine of 10 patients with polyps 5 mm in diameter or larger (sensitivity, 90%) and in seven of 17 patients with polyps smaller than 5 mm, polyps were correctly identified with CT colonography at all dose levels. Specificity for patients without polyps 5 mm or larger was 53%–60% at all dose levels and for patients without any polyps was 26% (at 100 and 50 mAs) and 48% (at 30 mAs). Image quality decreased significantly as the dose level decreased. The median effective doses (supine and prone positions) calculated from protocols reported in the literature and updates were 7.8 and 8.8 mSv, respectively.
CONCLUSION: Although image quality decreases significantly at 30 mAs (3.6 mSv), polyp detection remains unimpaired. The median dose for CT colonography at institutions that perform CT colonographic research is currently 8.8 mSv.
© RSNA, 2002
Index terms: Colon neoplasms, CT, 75.12115, 75.1282, 75.311 • Colonoscopy • Colon, CT, 75.12115, 75.1282, 75.311
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