To compare image quality and radiation dose using Adaptive Statistical Iterative Reconstruction (ASiR) and Filtered Back Projection (FBP) in patients weighing ≥91 kg.
In this Institution Review Board-approved retrospective study, single-phase contrast-enhanced abdominopelvic CT examinations of 100 adults weighing ≥91 kg (mean body weight: 107.6 ± 17.4 kg range: 91–181.9 kg) with (1) ASiR and (2) FBP were reviewed by two readers in a blinded fashion for subjective measures of image quality (using a subjective standardized numerical scale and objective noise) and for radiation exposure. Imaging parameters and radiation dose results of the two techniques were compared within weight and BMI sub-categories.
All examinations were found to be of adequate quality. Both subjective (mean = 1.4 ± 0.5 vs. 1.6 ± 0.6, P < 0.05) and objective noise (13.0 ± 3.2 vs.19.5 ± 5.7, P < 0.0001) were lower with ASiR. Average radiation dose reduction of 31.5 % was achieved using ASiR (mean CTDIvol. ASiR: 13.5 ± 7.3 mGy; FBP: 19.7 ± 9.0 mGy, P < 0.0001). Other measures of image quality were comparable between the two techniques. Trends for all parameters were similar in patients across weight and BMI sub-categories.
In obese individuals, abdominal CT images reconstructed using ASiR provide diagnostic images with reduced image noise at lower radiation dose.
• CT images in obese adults are noisy, even with high radiation dose.
• Newer iterative reconstruction techniques have theoretical advantages in obese patients.
• Adaptive statistical iterative reconstruction should reduce image noise and radiation dose.
• This has been proven in abdominopelvic CT images of obese patients.
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Desai, G.S., Uppot, R.N., Yu, E.W. et al. Impact of iterative reconstruction on image quality and radiation dose in multidetector CT of large body size adults. Eur Radiol 22, 1631–1640 (2012). https://doi.org/10.1007/s00330-012-2424-3