Cardiovascular CT angiography in neonates and children: Image quality and potential for radiation dose reduction with iterative image reconstruction techniques
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To evaluate image quality (IQ) of low-radiation-dose paediatric cardiovascular CT angiography (CTA), comparing iterative reconstruction in image space (IRIS) and sinogram-affirmed iterative reconstruction (SAFIRE) with filtered back-projection (FBP) and estimate the potential for further dose reductions.
Forty neonates and children underwent low radiation CTA with or without ECG synchronisation. Data were reconstructed with FBP, IRIS and SAFIRE. For ECG-synchronised studies, half-dose image acquisitions were simulated. Signal noise was measured and IQ graded. Effective dose (ED) was estimated.
Mean absolute and relative image noise with IRIS and full-dose SAFIRE was lower than with FBP (P < 0.001), while SNR and CNR were higher (P < 0.001). Image noise was also lower and SNR and CNR higher in half-dose SAFIRE studies compared with full-and half-dose FBP studies (P < 0.001). IQ scores were higher for IRIS, full-dose SAFIRE and half-dose SAFIRE than for full-dose FBP and higher for half-dose SAFIRE than for half-dose FBP (P < 0.05). Median weight-specific ED was 0.3 mSv without and 1.36 mSv with ECG synchronisation. The estimated ED of half-dose SAFIRE studies was 0.68 mSv.
IR improves image noise, SNR, CNR and subjective IQ compared with FBP in low-radiation-dose paediatric CTA and allows further dose reductions without compromising diagnostic IQ.
• Iterative reconstruction techniques significantly improve non-invasive cardiovascular CT in children.
• Using half traditional radiation dose image quality is higher with iterative reconstruction.
• Iterative reconstruction techniques may allow further radiation reductions in paediatric cardiovascular CT.
KeywordsComputed tomography Congenital heart disease Radiation dose Iterative image reconstruction Pediatric imaging
Effective radiation dose equivalent
Filtered back projection
Iterative reconstruction in image space
Region of interest
Sinogram affirmed iterative reconstruction
UJS is a consultant for and receives research support from Bayer, Bracco, GE, Medrad and Siemens. The other authors have no conflicts of interest to disclose.
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