Low-dose, wide-detector array thoracic aortic CT angiography using an iterative reconstruction technique results in improved image quality with lower noise and fewer artifacts

Rajiah, Prabhakar; Schoenhagen, Paul; Mehta, Dhruv; Ivanc, Thomas B.; Lieber, Michael L.; Soufan, Kassem; Desai, Milind Y.; Flamm, Scott D.; Halliburton, Sandra S.

doi:10.1016/j.jcct.2012.04.009

Cited by 24 publications

(19 citation statements)

References 18 publications

(36 reference statements)

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“…Techniques such as IRIS (Siemens Healthcare; Munich; Germany) interrogate only the reconstructed image. 30 IRIS is able to distinguish fine-grained noise from true anatomical structures; however is unable to significantly counteract streak-artefacts. 31 This is because streak-artefacts originate within the acquired-data and are amplified during the reconstruction process.…”

Section: Discussionmentioning

confidence: 99%

Maintaining image quality and reducing dose in prospectively-triggered CT coronary angiography: A systematic review of the use of iterative reconstruction

2016

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a b s t r a c tIntroduction: Coronary computed tomography angiography (CCTA) is a reliable, minimally invasive technique used in the diagnosis and characterisation of coronary artery disease. Within this modality iterative reconstruction has the potential to maintain image quality whilst reducing radiation dose. Methods: A priori search terms and inclusion/exclusion criteria were developed. Results: Three studies were included in the review which analysed a total of 227 participants. As CTDI vol decreased there was no significant change in objective image quality, although some subjective image quality scores decreased. Discussion: The decrease of subjective image quality scores may be explained as a reaction to the difference in image appearance of the iterative reconstruction images; a potential reduction in dynamic range; and the number of scorers used. Conclusion: Iterative reconstruction can be utilized as a tool to significantly reduce patients' exposure to ionising radiation; however there may be implications for radiologists/cardiologist in the interpretation of these images.

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Section: Discussionmentioning

confidence: 99%

Maintaining image quality and reducing dose in prospectively-triggered CT coronary angiography: A systematic review of the use of iterative reconstruction

2016

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“…IR algorithms have also demonstrated improved image quality in specific settings such as obesity, heavy coronary artery calcification and stenting as described below. IR algorithms, particularly those operating partially or fully in the raw (projection) data domain may be used to reduce several artifacts (38). In a study of 50 patients referred for evaluation of the thoracic aorta, iDose 4 reduced artifacts in the shoulder caused by photon starvation and improved image quality compared to FBP (38).…”

Section: Improving Image Qualitymentioning

confidence: 99%

The role of advanced reconstruction algorithms in cardiac CT

Halliburton

Tanabe

Partovi

et al. 2017

Cardiovasc. Diagn. Ther.

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Advanced non-linear iterative reconstruction (IR) algorithms have been introduced by all vendors as an alternative to traditional, linear filtered back projection (FBP) reconstruction ( Table 1). FBP is a simple reconstruction technique that requires relatively little computational processing, but is associated with higher noise and poor contrast resolution. Noise can be reduced in FBP only by increasing the radiation dose. IR algorithms operate by initially generating an expected dataset based on modeling, which is then compared to the actual, acquired dataset. Noise is detected and removed by using the difference between the anticipated and actual datasets using a process of iterative steps. All commercial IR algorithms employ statistics-model based de-noising in the image domain, raw (projection) data domain, or both. Statistics model-based algorithms operate by assigning a lower value to data with higher statistical uncertainty (noise). Some IR algorithms, described as partial model-based, additionally employ models of scanner geometry to estimate the acquired data. Full model-based IR algorithms, employ complete system models that include simulation of X-ray interaction with the imaged object. Statistics-model based algorithms can be utilized to either improve image quality at the same radiation dose or maintain image quality at a lower radiation dose compared to FBP. However, combining dose management with image quality improvements simultaneously is limited. Model-based IR can provide image quality improvements at lower doses. Model-based algorithms are also more likely to reduce other artifacts in addition to noise as well as improve spatial resolution.Although IR algorithms have been utilized in nuclear medicine for several decades, widespread use in CT is recent and facilitated by advances in computational processing. Cardiovascular CT imagers were early adopters of IR algorithms because most cardiovascular clinical targets are robust to changes in noise. Rigorous validation has come from both retrospective and prospective studies demonstrating non-inferiority of coronary CT data acquired at lower doses and reconstructed with IR techniques compared to standard dose data reconstructed with FBP. Other clinical studies have validated the diagnostic utility of low-dose coronary CT angiograms (CTA) reconstructed with IR algorithms using invasive coronary angiography (ICA) as a standard of reference (1-3).

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“…Several CTA protocols that reduce radiation dose without compromising diagnostic image quality have been described in the literature. These include using lower tube voltage (6,7), automatic tube voltage selection (8), highpitch (9)(10)(11)(12) or iterative reconstruction (IR) (13,14).…”

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confidence: 99%

“…To compensate for the increased noise levels at 70 kVp, we use an IR technique which effectively allows the reduction of image noise, therefore increasing SNR and CNR(13,23,24). As we used iterative image reconstruction in both groups, this effect is not taken into account.Although lower SNR, lower CNR, and higher image noise were found in thoracic CTA performed at 70 kVp, it is important to note that this protocol did not compromise diagnostic information, as both readers rated all CTA examinations as diagnostic.…”

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confidence: 99%

Seventy–Peak Kilovoltage High-Pitch Thoracic Aortic CT Angiography without ECG Gating

et al. 2015

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Low-dose, wide-detector array thoracic aortic CT angiography using an iterative reconstruction technique results in improved image quality with lower noise and fewer artifacts

Cited by 24 publications

References 18 publications

Maintaining image quality and reducing dose in prospectively-triggered CT coronary angiography: A systematic review of the use of iterative reconstruction

Maintaining image quality and reducing dose in prospectively-triggered CT coronary angiography: A systematic review of the use of iterative reconstruction

The role of advanced reconstruction algorithms in cardiac CT

Seventy–Peak Kilovoltage High-Pitch Thoracic Aortic CT Angiography without ECG Gating

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