Detection of Bladder Cancer: Comparison of Low-Dose Scans with AIDR 3D and Routine-Dose Scans with FBP on the Excretory Phase in CT Urography.

Objective: To prospectively compare the detection of bladder cancer between low-dose scans with adaptive iterative dose reduction three dimensional projection (AIDR 3D) and routine-dose scans with filtered back projection (FBP) on the excretory phase (EP) in CT urography. Methods: 42 patients were included. Routine-and low-dose EP were performed in each patient. Routine-dose images were reconstructed with FBP, and low-dose images were reconstructed with AIDR 3D. Two radiologists scored confidence levels for the presence or absence of bladder cancer using a 5-point scale. The CT dose index of each EP was measured, and the dose reduction was calculated. Results: Sensitivity, specificity and accuracy were 86.4%, 95.0% and 90.5% on routine-dose scans and were 86.4%, 90.0% and 88.1% on low-dose scans, respectively. There was no significant difference (p; not significant, 1.00 and 1.00, respectively). The average CT dose index was 8.07 and 2.63mGy on routine-and low-dose scans, and the ratio of dose reduction was 67.6%. Conclusion: The detection of bladder cancer on low-dose scans with AIDR 3D is almost equal to that on routine-dose scans with FBP on the EP, with nearly 70% dose reduction. Advances in knowledge: Using AIDR 3D, the radiation dose may be reduced on the EP in CT urography for the detection of bladder cancer.