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. 2019 Sep 23;10(1):95.
doi: 10.1186/s13244-019-0769-8.

Development and validation of image quality scoring criteria (IQSC) for pediatric CT: a preliminary study

Atul M Padole  1 , Pallavi Sagar  1 , Sjirk J Westra  1 , Ruth Lim  1 , Katherine Nimkin  1 , Mannudeep K Kalra  1 , Michael S Gee  1 , Madan M Rehani  2
Affiliations

Development and validation of image quality scoring criteria (IQSC) for pediatric CT: a preliminary study

Atul M Padole et al. Insights Imaging. .

Abstract

Objective: To develop and assess the value and limitations of an image quality scoring criteria (IQSC) for pediatric CT exams.

Methods: IQSC was developed for subjective assessment of image quality using the scoring scale from 0 to 4, with 0 indicating desired anatomy or features not seen, 3 for adequate image quality, and 4 depicting higher than needed image quality. Pediatric CT examinations from 30 separate patients were selected, five each for routine chest, routine abdomen, kidney stone, appendicitis, craniosynostosis, and ventriculoperitoneal (VP) shunt. Five board-certified pediatric radiologists independently performed image quality evaluation using the proposed IQSC. The kappa statistics were used to assess the interobserver variability.

Results: All five radiologists gave a score of 3 to two-third (67%) of all CT exams, followed by a score of 4 for 29% of CT exams, and 2 for 4% exams. The median image quality scores for all exams were 3 and the interobserver agreement among five readers (acceptable image quality [scores 3 or 4] vs sub-optimal image quality ([scores 1 and 2]) was moderate to very good (kappa 0.4-1). For all five radiologists, the lesion detection was adequate for all CT exams.

Conclusions: The image quality scoring criteria covering routine and some clinical indication-based imaging scenarios for pediatric CT examinations has potential to offer a simple and practical tool for assessing image quality with a reasonable degree of interobserver agreement. A more extensive and multi-centric study is recommended to establish wider usefulness of these criteria.

Keywords: Clinical indications; Image quality scoring criteria; Pediatric CT; Radiation dose optimization; Radiation protection.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Transverse chest CT image of a 4-year-old girl (15 kg, CTDIvol 1.4 mGy). There is a subcentimeter nodule in the right lower lobe (arrow). Median IQSC score was 3
Fig. 2
Fig. 2
Transverse abdomen CT image of a 14 yrs. M (42 kg) acquired at 4.4 mGy. Interloop abscess (arrow) and overall image quality scored optimal (scores 3 or 4) by all readers
Fig. 3
Fig. 3
Transverse abdomen CT image (kidney stone protocol) of a 17-year-old female (53 kg) acquired at 2.3 mGy. Left kidney stone (arrow) and overall image quality scored optimal by four-fifths of the readers and sub-optimal by one-fifths of the readers. However, a diagnosis of kidney stone was unaffected by all readers. Median IQSC score was 3
Fig. 4
Fig. 4
Coronal abdomen CT image (appendicitis protocol) of an 11-year-old male (42 kg) acquired at 6 mGy. Acute appendicitis (arrow) and overall image quality scored optimal (score 3 or 4) by all readers
Fig. 5
Fig. 5
Coronal head CT image (craniosynostosis protocol) of a 4-month-old male (7 kg) acquired at 1.5 mGy. Anterior fontanelle without evidence of craniosynostosis (arrow) and overall image quality scored optimal by all readers
Fig. 6
Fig. 6
Transverse head CT image (VP shunt patency protocol) of a 7-year-old female (20 kg) acquired at 6 mGy. Hydrocephalus with VP shunt (arrow) and overall image quality scored optimal by all readers
Fig. 7
Fig. 7
Frequency graph of subjective image quality score (1–4) for five study readers
See this image and copyright information in PMC

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