Evaluation of reduced

Patients with acute non-traumatic abdominal pain often undergo abdominal computed tomography (CT). However, abdominal CT is associated with high radiation exposure. To evaluate diagnostic performance of a reduced-dose 100？kVp CT protocol with advanced modeled iterative reconstruction as compared to a linearly blended 120？kVp protocol for assessment of acute, non-traumatic abdominal pain. Two radiologists assessed 100？kVp and linearly blended 120？kVp series of 112 consecutive patients with acute non-traumatic pain (onset？<？48？h) regarding image quality, noise, and artifacts on a five-point Likert scale. Both radiologists assessed both series for abdominal pathologies and for diagnostic confidence. Both 100？kVp and linearly blended 120？kVp series were quantitatively evaluated regarding radiation dose and image noise. Comparative statistics and diagnostic accuracy was calculated using receiver operating curve (ROC) statistics, with final clinical diagnosis/clinical follow-up as reference standard. Image quality was high for both series without detectable significant differences (P？=？0.157). Image noise and artifacts were rated low for both series but significantly higher for 100？kVp (P？≤？0.021). Diagnostic accuracy was high for both series (120？kVp: area under the curve [AUC]？=？0.950, sensitivity？=？0.958, specificity？=？0.941; 100？kVp: AUC？≥？0.910, sensitivity？≥？0.937, specificity？=？0.882; P？≥？0.516) with almost perfect inter-rater agreement (Kappa？=？0.939). Diagnostic confidence was high for both dose levels without significant differences (100？kVp 5, range 4–5; 120？kVp 5, range 3–5; P？=？0.134). The 100？kVp series yielded 26.1% lower radiation dose compared with the 120？kVp series (5.72？±？2.23？mSv versus 7.75？±？3.02？mSv, P？<？0.001). Image noise was significantly higher in reduced-dose CT (13.3？±？2.4 HU versus 10.6？±？2.1 HU; P？<？0.001). Reduced-dose abdominal CT using 100？kVp yields excellent image quality and high diagnostic accuracy for the assessment of acute non-traumatic abdominal pain