As low as diagnostically acceptable dose imaging in maxillofacial trauma: a reference quality approach

Gerlig Widmann; Hannes Schönthaler; Alexander Tartarotti; Gerald Degenhart; Romed Hörmann; Gudrun Feuchtner; Reinhilde Jacobs; Ruben Pauwels

doi:10.1259/dmfr.20220387

As low as diagnostically acceptable dose imaging in maxillofacial trauma: a reference quality approach

Gerlig Widmann, Hannes Schönthaler, Alexander Tartarotti, Gerald Degenhart, Romed Hörmann, Gudrun Feuchtner, Reinhilde Jacobs, Ruben Pauwels

Aarhus Institute of Advanced Studies

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

OBJECTIVES: As-low-as-diagnostically-acceptable (ALADA) doses are substantially lower than current diagnostic reference levels. To improve dose management, a reference quality approach was tested in which phantom quality metrics of a clinical ALADA dose reference protocol were used to benchmark potential ALADA dose protocols for various scanner models. METHODS: Spatial resolution, contrast resolution, contrast-to-noise ratio (CNR) and subjective noise and sharpness were evaluated for a clinical ALADA dose reference protocol at 80 kV and 40 mA (CTDIvol 2.66 mGy) and compared with test protocols of two CT scanners at 100 kV and 35 mA (3.08-3.44 mGy), 80 kV and 54-61 mA (2.65 mGy), 80 kV and 40 mA (1.73-1.92 mGy), and 80 kV and 21-23 mA (1.00-1.03 mGy) using different kernels, filtered backprojection and iterative reconstructions. The test protocols with the lowest dose showing quality metrics non-inferior to the reference protocol were verified in a cadaver study by determining the diagnostic accuracy of detection of maxillofacial fractures and CNR of the optical nerve and rectus inferior muscle. RESULTS: 36 different image series were analysed in the phantom study. Based on the phantom quality metrics, potential ALADA dose protocols at 1.73-1.92 mGy were selected. Compared with the reference images, the selected protocols showed non-inferiority in the detection and classification of maxillofacial fractures and non-inferior CNR of orbital soft tissues in the cadaver study. CONCLUSIONS: Reference quality metrics from clinical ALADA dose protocols may be used to guide selection of potential ALADA dose protocols of different CT scanners.

Original language	English
Article number	20220387
Journal	Dento maxillo facial radiology
Volume	52
Issue	3
Pages (from-to)	20220387
ISSN	0250-832X
DOIs	https://doi.org/10.1259/dmfr.20220387
Publication status	Published - Feb 2023

Keywords

Bone fractures
Comparative study
Diagnostic Imaging
Face
Radiation dose

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10.1259/dmfr.20220387Licence: CC BY-NC

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title = "As low as diagnostically acceptable dose imaging in maxillofacial trauma: a reference quality approach",

abstract = "OBJECTIVES: As-low-as-diagnostically-acceptable (ALADA) doses are substantially lower than current diagnostic reference levels. To improve dose management, a reference quality approach was tested in which phantom quality metrics of a clinical ALADA dose reference protocol were used to benchmark potential ALADA dose protocols for various scanner models. METHODS: Spatial resolution, contrast resolution, contrast-to-noise ratio (CNR) and subjective noise and sharpness were evaluated for a clinical ALADA dose reference protocol at 80 kV and 40 mA (CTDIvol 2.66 mGy) and compared with test protocols of two CT scanners at 100 kV and 35 mA (3.08-3.44 mGy), 80 kV and 54-61 mA (2.65 mGy), 80 kV and 40 mA (1.73-1.92 mGy), and 80 kV and 21-23 mA (1.00-1.03 mGy) using different kernels, filtered backprojection and iterative reconstructions. The test protocols with the lowest dose showing quality metrics non-inferior to the reference protocol were verified in a cadaver study by determining the diagnostic accuracy of detection of maxillofacial fractures and CNR of the optical nerve and rectus inferior muscle. RESULTS: 36 different image series were analysed in the phantom study. Based on the phantom quality metrics, potential ALADA dose protocols at 1.73-1.92 mGy were selected. Compared with the reference images, the selected protocols showed non-inferiority in the detection and classification of maxillofacial fractures and non-inferior CNR of orbital soft tissues in the cadaver study. CONCLUSIONS: Reference quality metrics from clinical ALADA dose protocols may be used to guide selection of potential ALADA dose protocols of different CT scanners.",

keywords = "Bone fractures, Comparative study, Diagnostic Imaging, Face, Radiation dose",

author = "Gerlig Widmann and Hannes Sch{\"o}nthaler and Alexander Tartarotti and Gerald Degenhart and Romed H{\"o}rmann and Gudrun Feuchtner and Reinhilde Jacobs and Ruben Pauwels",

year = "2023",

month = feb,

doi = "10.1259/dmfr.20220387",

language = "English",

volume = "52",

pages = "20220387",

journal = "Dento maxillo facial radiology",

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As low as diagnostically acceptable dose imaging in maxillofacial trauma: a reference quality approach. / Widmann, Gerlig; Schönthaler, Hannes; Tartarotti, Alexander et al.
In: Dento maxillo facial radiology, Vol. 52, No. 3, 20220387, 02.2023, p. 20220387.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - As low as diagnostically acceptable dose imaging in maxillofacial trauma

T2 - a reference quality approach

AU - Widmann, Gerlig

AU - Schönthaler, Hannes

AU - Tartarotti, Alexander

AU - Degenhart, Gerald

AU - Hörmann, Romed

AU - Feuchtner, Gudrun

AU - Jacobs, Reinhilde

AU - Pauwels, Ruben

PY - 2023/2

Y1 - 2023/2

N2 - OBJECTIVES: As-low-as-diagnostically-acceptable (ALADA) doses are substantially lower than current diagnostic reference levels. To improve dose management, a reference quality approach was tested in which phantom quality metrics of a clinical ALADA dose reference protocol were used to benchmark potential ALADA dose protocols for various scanner models. METHODS: Spatial resolution, contrast resolution, contrast-to-noise ratio (CNR) and subjective noise and sharpness were evaluated for a clinical ALADA dose reference protocol at 80 kV and 40 mA (CTDIvol 2.66 mGy) and compared with test protocols of two CT scanners at 100 kV and 35 mA (3.08-3.44 mGy), 80 kV and 54-61 mA (2.65 mGy), 80 kV and 40 mA (1.73-1.92 mGy), and 80 kV and 21-23 mA (1.00-1.03 mGy) using different kernels, filtered backprojection and iterative reconstructions. The test protocols with the lowest dose showing quality metrics non-inferior to the reference protocol were verified in a cadaver study by determining the diagnostic accuracy of detection of maxillofacial fractures and CNR of the optical nerve and rectus inferior muscle. RESULTS: 36 different image series were analysed in the phantom study. Based on the phantom quality metrics, potential ALADA dose protocols at 1.73-1.92 mGy were selected. Compared with the reference images, the selected protocols showed non-inferiority in the detection and classification of maxillofacial fractures and non-inferior CNR of orbital soft tissues in the cadaver study. CONCLUSIONS: Reference quality metrics from clinical ALADA dose protocols may be used to guide selection of potential ALADA dose protocols of different CT scanners.

AB - OBJECTIVES: As-low-as-diagnostically-acceptable (ALADA) doses are substantially lower than current diagnostic reference levels. To improve dose management, a reference quality approach was tested in which phantom quality metrics of a clinical ALADA dose reference protocol were used to benchmark potential ALADA dose protocols for various scanner models. METHODS: Spatial resolution, contrast resolution, contrast-to-noise ratio (CNR) and subjective noise and sharpness were evaluated for a clinical ALADA dose reference protocol at 80 kV and 40 mA (CTDIvol 2.66 mGy) and compared with test protocols of two CT scanners at 100 kV and 35 mA (3.08-3.44 mGy), 80 kV and 54-61 mA (2.65 mGy), 80 kV and 40 mA (1.73-1.92 mGy), and 80 kV and 21-23 mA (1.00-1.03 mGy) using different kernels, filtered backprojection and iterative reconstructions. The test protocols with the lowest dose showing quality metrics non-inferior to the reference protocol were verified in a cadaver study by determining the diagnostic accuracy of detection of maxillofacial fractures and CNR of the optical nerve and rectus inferior muscle. RESULTS: 36 different image series were analysed in the phantom study. Based on the phantom quality metrics, potential ALADA dose protocols at 1.73-1.92 mGy were selected. Compared with the reference images, the selected protocols showed non-inferiority in the detection and classification of maxillofacial fractures and non-inferior CNR of orbital soft tissues in the cadaver study. CONCLUSIONS: Reference quality metrics from clinical ALADA dose protocols may be used to guide selection of potential ALADA dose protocols of different CT scanners.

KW - Bone fractures

KW - Comparative study

KW - Diagnostic Imaging

KW - Face

KW - Radiation dose

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DO - 10.1259/dmfr.20220387

M3 - Journal article

C2 - 36688730

AN - SCOPUS:85148479342

SN - 0250-832X

VL - 52

SP - 20220387

JO - Dento maxillo facial radiology

JF - Dento maxillo facial radiology

IS - 3

M1 - 20220387

ER -

As low as diagnostically acceptable dose imaging in maxillofacial trauma: a reference quality approach

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