{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T10:23:09Z","timestamp":1771669389962,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T00:00:00Z","timestamp":1671235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T00:00:00Z","timestamp":1671235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004083","name":"Ministry of Science ICT and Future Planning","doi-asserted-by":"publisher","award":["NRF-2021R1G1A1091351"],"award-info":[{"award-number":["NRF-2021R1G1A1091351"]}],"id":[{"id":"10.13039\/501100004083","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Knowing the lowest acceptable radiation dose of multiphase hepatic CT may allow us to reduce the radiation dose for detecting HCC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To prospectively assess the image quality and diagnostic performance of low-dose and ultra-low-dose multiphase hepatic computed tomography using a dual-source CT scanner.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Three reconstructed different dose scan images (standard-dose, low-dose, and ultra-low-dose) of hepatic multiphase CT were obtained from 67 patients with a dual-source CT scanner. The image quality and the diagnostic performance of the three radiation dose CT scans of the hepatic focal lesion (\u2265\u20090.5\u00a0cm) were analyzed by two independent readers using the Liver Imaging Reporting and Data System.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Qualitative image quality and signal-to-noise ratio were significantly different among the radiation doses (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In total, 154 lesions comprising 32 hepatocellular carcinomas (HCC) and 122 non-HCC were included. The sensitivities of SDCT, LDCT, and ULDCT were 90.6%(29\/32), 81.3%(26\/32), and 56.2%(18\/32), respectively. The accuracies of SDCT, LDCT, and ULDCT were 98.1%(151\/154), 96.1%(148\/154), and 89.6%(138\/154), respectively. On per-lesion analysis, SDCT and LDCT did not show significantly different sensitivity and accuracy in diagnosing HCC (<jats:italic>p<\/jats:italic>\u2009=\u20090.250 and 0.250).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The diagnostic performance of dynamic hepatic LDCT with 33% reduced radiation dose in comparison to SDCT would be acceptable even though its image quality was qualitatively and quantitatively inferior. However, few HCCs could be overlooked. Therefore, with caution, radiation dose reduction by one-third could be implemented for follow-up CT scans for patients suspected of having HCC with caution and further studies are needed in the future.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-022-00947-7","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T09:03:46Z","timestamp":1671440626000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prospective evaluation of low-dose multiphase hepatic computed tomography for detecting and characterizing hepatocellular carcinoma in patients with chronic liver disease"],"prefix":"10.1186","volume":"22","author":[{"given":"Eun Sun","family":"Choi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Sil","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeong Kyong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Ah","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seongyong","family":"Pak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,12,17]]},"reference":[{"issue":"4","key":"947_CR1","doi-asserted-by":"publisher","first-page":"816","DOI":"10.2214\/AJR.11.8100","volume":"199","author":"YE Chung","year":"2012","unstructured":"Chung YE, Kim M-J, Park M-S, Choi J-Y, Lim JS, Kim KA, Kim KW. The impact of CT follow-up interval on stages of hepatocellular carcinomas detected during the surveillance of patients with liver cirrhosis. Am J Roentgenol. 2012;199(4):816\u201321.","journal-title":"Am J Roentgenol"},{"key":"947_CR2","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1148\/radiol.2018181494","volume":"289","author":"V Chernyak","year":"2018","unstructured":"Chernyak V, Fowler KJ, Kamaya A, Kielar AZ, Elsayes KM, Bashir MR, Kono Y, Do RK, Mitchell DG, Singal AG, Tang A. Liver imaging reporting and data system (LI-RADS) version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology. 2018;289:816\u201330.","journal-title":"Radiology"},{"issue":"3","key":"947_CR3","doi-asserted-by":"publisher","first-page":"673","DOI":"10.2214\/AJR.04.1513","volume":"186","author":"S Rizzo","year":"2006","unstructured":"Rizzo S, Kalra M, Schmidt B, Dalal T, Suess C, Flohr T, Blake M. Saini SJAJoR: comparison of angular and combined automatic tube current modulation techniques with constant tube current CT of the abdomen and pelvis. AJR Am J Roentgenol. 2006;186(3):673\u20139.","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"947_CR4","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1148\/radiol.2303021726","volume":"230","author":"MK Kalra","year":"2004","unstructured":"Kalra MK, Maher MM, Toth TL, Hamberg LM, Blake MA, Shepard J-A, Saini SJR. Strategies for CT radiation dose optimization. Radiology. 2004;230(3):619\u201328.","journal-title":"Radiology"},{"issue":"3","key":"947_CR5","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1097\/RLI.0b013e31823a86d5","volume":"47","author":"H-C Becker","year":"2012","unstructured":"Becker H-C, Augart D, Karpitschka M, Ulzheimer S, Bamberg F, Morhard D, Neumaier K, Graser A, Johnson T, Reiser M. Radiation exposure and image quality of normal computed tomography brain images acquired with automated and organ-based tube current modulation multiband filtering and iterative reconstruction. Invest Radiol. 2012;47(3):202\u20137.","journal-title":"Invest Radiol"},{"issue":"1","key":"947_CR6","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1148\/radiol.2363041220","volume":"237","author":"TH Mulkens","year":"2005","unstructured":"Mulkens TH, Bellinck P, Baeyaert M, Ghysen D, Van Dijck X, Mussen E, Venstermans C. Termote J-LJR: use of an automatic exposure control mechanism for dose optimization in multi-detector row CT examinations: clinical evaluation. Radiology. 2005;237(1):213\u201323.","journal-title":"Radiology"},{"issue":"2","key":"947_CR7","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.ejmp.2008.01.012","volume":"24","author":"WA Kalender","year":"2008","unstructured":"Kalender WA, Buchenau S, Deak P, Kellermeier M, Langner O, van Straten M, Vollmar S, Wilharm SJPM. Technical approaches to the optimisation of CT. Phys Med. 2008;24(2):71\u20139.","journal-title":"Phys Med"},{"issue":"2","key":"947_CR8","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1148\/rg.262055138","volume":"26","author":"CH McCollough","year":"2006","unstructured":"McCollough CH, Bruesewitz MR, Kofler JMJR Jr. CT dose reduction and dose management tools: overview of available options. Radiographics. 2006;26(2):503\u201312.","journal-title":"Radiographics"},{"issue":"6","key":"947_CR9","doi-asserted-by":"publisher","first-page":"2464","DOI":"10.1007\/s00330-017-5113-4","volume":"28","author":"B Kataria","year":"2018","unstructured":"Kataria B, Althen JN, Smedby O, Persson A, Sokjer H, Sandborg M. Assessment of image quality in abdominal CT: potential dose reduction with model-based iterative reconstruction. Eur Radiol. 2018;28(6):2464\u201373.","journal-title":"Eur Radiol"},{"issue":"2","key":"947_CR10","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1148\/radiol.2018181657","volume":"290","author":"CT Jensen","year":"2019","unstructured":"Jensen CT, Wagner-Bartak NA, Vu LN, Liu X, Raval B, Martinez D, Wei W, Cheng Y, Samei E, Gupta S. Detection of colorectal hepatic metastases is superior at standard radiation dose CT versus reduced dose CT. Radiology. 2019;290(2):400\u20139.","journal-title":"Radiology"},{"issue":"2","key":"947_CR11","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/s10140-018-1658-z","volume":"26","author":"F Moloney","year":"2019","unstructured":"Moloney F, James K, Twomey M, Ryan D, Grey TM, Downes A, Kavanagh RG, Moore N, Murphy MJ, Bye J, et al. Low-dose CT imaging of the acute abdomen using model-based iterative reconstruction: a prospective study. Emerg Radiol. 2019;26(2):169\u201377.","journal-title":"Emerg Radiol"},{"issue":"10","key":"947_CR12","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1016\/j.acra.2018.01.014","volume":"25","author":"S Ellmann","year":"2018","unstructured":"Ellmann S, Kammerer F, Allmendinger T, Hammon M, Janka R, Lell M, Uder M, Kramer M. Advanced modeled iterative reconstruction (ADMIRE) facilitates radiation dose reduction in abdominal CT. Acad Radiol. 2018;25(10):1277\u201384.","journal-title":"Acad Radiol"},{"issue":"5","key":"947_CR13","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1159\/000506834","volume":"9","author":"JH Yoon","year":"2020","unstructured":"Yoon JH, Lee JM, Lee DH, Joo I, Jeon JH, Ahn SJ, Kim S-T, Cho EJ, Lee J-H, Yu SJJLC. A comparison of biannual two-phase low-dose liver CT and US for HCC surveillance in a group at high risk of HCC development. Liver Cancer. 2020;9(5):503\u201317.","journal-title":"Liver Cancer"},{"key":"947_CR14","doi-asserted-by":"crossref","unstructured":"Liver EAftSot. EASL Clinical Practice Guidelines: management of hepatocellular carcinoma. J Hepatol 2018;69:182\u2013236.","DOI":"10.1016\/j.jhep.2018.03.019"},{"key":"947_CR15","volume-title":"ICRP publication 103: recommendations of the ICRP","author":"MW Charles","year":"2008","unstructured":"Charles MW. ICRP publication 103: recommendations of the ICRP. Oxford: Oxford University Press; 2008."},{"key":"947_CR16","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.clinimag.2020.01.017","volume":"62","author":"SJ Choi","year":"2020","unstructured":"Choi SJ, Park SH, Shim YS, Hwang JH, Park S, Pak SY, You MW, Park SH. Comparison of image quality and focal lesion detection in abdominopelvic CT: potential dose reduction using advanced modelled iterative reconstruction. Clin Imaging. 2020;62:41\u20138.","journal-title":"Clin Imaging"},{"issue":"4","key":"947_CR17","doi-asserted-by":"publisher","first-page":"W434","DOI":"10.2214\/AJR.13.11973","volume":"203","author":"SD Kordolaimi","year":"2014","unstructured":"Kordolaimi SD, Saradeas I, Ploussi A, Pantos I, Argentos S, Efstathopoulos EP. Introduction of an effective method for the optimization of CT protocols using iterative reconstruction algorithms: comparison with patient data. AJR Am J Roentgenol. 2014;203(4):W434-439.","journal-title":"AJR Am J Roentgenol"},{"issue":"9","key":"947_CR18","doi-asserted-by":"publisher","first-page":"2279","DOI":"10.1007\/s00261-017-1140-5","volume":"42","author":"LN Morimoto","year":"2017","unstructured":"Morimoto LN, Kamaya A, Boulay-Coletta I, Fleischmann D, Molvin L, Tian L, Fisher G, Wang J, Willmann JK. Reduced dose CT with model-based iterative reconstruction compared to standard dose CT of the chest, abdomen, and pelvis in oncology patients: intra-individual comparison study on image quality and lesion conspicuity. Abdom Radiol (NY). 2017;42(9):2279\u201388.","journal-title":"Abdom Radiol (NY)"},{"issue":"4","key":"947_CR19","doi-asserted-by":"publisher","first-page":"2107","DOI":"10.1007\/s00330-018-5750-2","volume":"29","author":"P Leyendecker","year":"2019","unstructured":"Leyendecker P, Faucher V, Labani A, Noblet V, Lefebvre F, Magotteaux P, Ohana M, Roy C. Prospective evaluation of ultra-low-dose contrast-enhanced 100-kV abdominal computed tomography with tin filter: effect on radiation dose reduction and image quality with a third-generation dual-source CT system. Eur Radiol. 2019;29(4):2107\u201316.","journal-title":"Eur Radiol"},{"key":"947_CR20","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1016\/j.ejrad.2011.03.030","volume":"81","author":"W Stiller","year":"2012","unstructured":"Stiller W, Schwarzwaelder CB, Sommer CM, Veloza S, Radeleff BA, Kauczor HU. Dual-energy, standard and low-kVp contrast-enhanced CT-cholangiography: a comparative analysis of image quality and radiation exposure. Eur J Radiol. 2012;81:1405\u201312.","journal-title":"Eur J Radiol"},{"issue":"1","key":"947_CR21","doi-asserted-by":"publisher","first-page":"23","DOI":"10.20982\/tqmp.08.1.p023","volume":"8","author":"KA Hallgren","year":"2012","unstructured":"Hallgren KA. Computing inter-rater reliability for observational data: an overview and tutorial. Tutor Quant Methods Psychol. 2012;8(1):23.","journal-title":"Tutor Quant Methods Psychol"},{"issue":"2","key":"947_CR22","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1148\/radiol.2016160482","volume":"282","author":"TR McClellan","year":"2017","unstructured":"McClellan TR, Motosugi U, Middleton MS, Allen BC, Jaffe TA, Miller CM, Reeder SB, Sirlin CB, Bashir MRJR. Intravenous gadoxetate disodium administration reduces breath-holding capacity in the hepatic arterial phase: a multi-center randomized placebo-controlled trial. Radiology. 2017;282(2):361\u20138.","journal-title":"Radiology"},{"key":"947_CR23","doi-asserted-by":"publisher","first-page":"iv238","DOI":"10.1093\/annonc\/mdy308","volume":"29","author":"A Vogel","year":"2018","unstructured":"Vogel A, Cervantes A, Chau I, Daniele B, Llovet JM, Meyer T, Nault J-C, Neumann U, Ricke J, Sangro B. Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29:iv238\u201355.","journal-title":"Ann Oncol"},{"issue":"1","key":"947_CR24","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1002\/hep.29086","volume":"67","author":"JK Heimbach","year":"2018","unstructured":"Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, Zhu AX, Murad MH, Marrero JA. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67(1):358\u201380.","journal-title":"Hepatology"},{"issue":"4","key":"947_CR25","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1097\/RLI.0000000000000017","volume":"49","author":"V Vardhanabhuti","year":"2014","unstructured":"Vardhanabhuti V, Riordan RD, Mitchell GR, Hyde C, Roobottom CA. Image comparative assessment using iterative reconstructions: clinical comparison of low-dose abdominal\/pelvic computed tomography between adaptive statistical, model-based iterative reconstructions and traditional filtered back projection in 65 patients. Invest Radiol. 2014;49(4):209\u201316.","journal-title":"Invest Radiol"},{"issue":"3","key":"947_CR26","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1102\/1470-7330.2012.0044","volume":"12","author":"T Hennedige","year":"2013","unstructured":"Hennedige T, Venkatesh SK. Imaging of hepatocellular carcinoma: diagnosis, staging and treatment monitoring. Cancer Imaging. 2013;12(3):530\u201347.","journal-title":"Cancer Imaging"},{"issue":"25","key":"947_CR27","doi-asserted-by":"publisher","first-page":"e11142","DOI":"10.1097\/MD.0000000000011142","volume":"97","author":"B Kim","year":"2018","unstructured":"Kim B, Lee JH, Kim JK, Kim HJ, Kim YB, Lee D. The capsule appearance of hepatocellular carcinoma in gadoxetic acid-enhanced MR imaging: correlation with pathology and dynamic CT. Medicine (Baltimore). 2018;97(25):e11142\u2013e11142.","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"947_CR28","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1002\/1097-0142(19920701)70:1<45::AID-CNCR2820700108>3.0.CO;2-7","volume":"70","author":"IOL Ng","year":"1992","unstructured":"Ng IOL, Lai ECS, Fan ST, Ng MMT. Tumor encapsulation in hepatocellular carcinoma. A pathologic study of 189 cases. Cancer. 1992;70(1):45\u20139.","journal-title":"Cancer"},{"issue":"2","key":"947_CR29","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1148\/radiol.12111082","volume":"264","author":"T Nakaura","year":"2012","unstructured":"Nakaura T, Nakamura S, Maruyama N, Funama Y, Awai K, Harada K, Uemura S, Yamashita Y. Low contrast agent and radiation dose protocol for hepatic dynamic CT of thin adults at 256-detector row CT: effect of low tube voltage and hybrid iterative reconstruction algorithm on image quality. Radiology. 2012;264(2):445\u201354.","journal-title":"Radiology"},{"issue":"2","key":"947_CR30","doi-asserted-by":"publisher","first-page":"217.e217","DOI":"10.1016\/j.crad.2017.09.006","volume":"73","author":"Y Nagayama","year":"2018","unstructured":"Nagayama Y, Nakaura T, Oda S, Tsuji A, Urata J, Furusawa M, Tanoue S, Utsunomiya D, Yamashita Y. Value of 100 kVp scan with sinogram-affirmed iterative reconstruction algorithm on a single-source CT system during whole-body CT for radiation and contrast medium dose reduction: an intra-individual feasibility study. Clin Radiol. 2018;73(2):217.e217-217.e216.","journal-title":"Clin Radiol"},{"issue":"1","key":"947_CR31","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.ejrad.2014.09.022","volume":"84","author":"RDA Khawaja","year":"2015","unstructured":"Khawaja RDA, Singh S, Blake M, Harisinghani M, Choy G, Karosmangulu A, Padole A, Do S, Brown K, Thompson R, et al. Ultra-low dose abdominal MDCT: using a knowledge-based iterative model reconstruction technique for substantial dose reduction in a prospective clinical study. Eur J Radiol. 2015;84(1):2\u201310.","journal-title":"Eur J Radiol"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-022-00947-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-022-00947-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-022-00947-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T13:04:54Z","timestamp":1671541494000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedimaging.biomedcentral.com\/articles\/10.1186\/s12880-022-00947-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,17]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["947"],"URL":"https:\/\/doi.org\/10.1186\/s12880-022-00947-7","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,17]]},"assertion":[{"value":"23 August 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 December 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was performed in accordance with the Declaration of Helsinki and was approved by the institutional review board of Ewha Womans University Mokdong Hospital (IRB file number 2020-04-004). All information acquired was kept confidential and was only accessible by the researchers.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants signed a written informed consent document.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there is no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"219"}}