European Radiology

, Volume 27, Issue 12, pp 5252–5259 | Cite as

Impact of model-based iterative reconstruction on low-contrast lesion detection and image quality in abdominal CT: a 12-reader-based comparative phantom study with filtered back projection at different tube voltages

  • André Euler
  • Bram Stieltjes
  • Zsolt Szucs-Farkas
  • Reto Eichenberger
  • Clemens Reisinger
  • Anna Hirschmann
  • Caroline Zaehringer
  • Achim Kircher
  • Matthias Streif
  • Sabine Bucher
  • David Buergler
  • Luigia D’Errico
  • Sebastién Kopp
  • Markus Wilhelm
  • Sebastian T. Schindera
Computed Tomography



To evaluate the impact of model-based iterative reconstruction (MBIR) on image quality and low-contrast lesion detection compared with filtered back projection (FBP) in abdominal computed tomography (CT) of simulated medium and large patients at different tube voltages.


A phantom with 45 hypoattenuating lesions was placed in two water containers and scanned at 70, 80, 100, and 120 kVp. The 120-kVp protocol served as reference, and the volume CT dose index (CTDIvol) was kept constant for all protocols. The datasets were reconstructed with MBIR and FBP. Image noise and contrast-to-noise-ratio (CNR) were assessed. Low-contrast lesion detectability was evaluated by 12 radiologists.


MBIR decreased the image noise by 24% and 27%, and increased the CNR by 30% and 29% for the medium and large phantoms, respectively. Lower tube voltages increased the CNR by 58%, 46%, and 16% at 70, 80, and 100 kVp, respectively, compared with 120 kVp in the medium phantom and by 9%, 18% and 12% in the large phantom. No significant difference in lesion detection rate was observed (medium: 79-82%; large: 57-65%; P > 0.37).


Although MBIR improved quantitative image quality compared with FBP, it did not result in increased low-contrast lesion detection in abdominal CT at different tube voltages in simulated medium and large patients.

Key Points

MBIR improved quantitative image quality but not lesion detection compared with FBP.

Increased CNR by low tube voltages did not improve lesion detection.

Changes in image noise and CNR do not directly influence diagnostic accuracy.


Multidetector computed tomography Radiological phantom Model-based iterative reconstruction Filtered back projection Low-contrast detection 


Compliance with ethical standards


The scientific guarantor of this publication is Sebastian T. Schindera.

Conflict of interest

Sebastian T. Schindera received a research grant by Siemens Healthcare and Bayer Healthcare


The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was not required because of the design as a phantom study.


• prospective

• experimental

• performed at one institution


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Copyright information

© European Society of Radiology 2017
corrected publication August 2017

Authors and Affiliations

  • André Euler
    • 1
  • Bram Stieltjes
    • 1
  • Zsolt Szucs-Farkas
    • 2
  • Reto Eichenberger
    • 1
  • Clemens Reisinger
    • 1
  • Anna Hirschmann
    • 1
  • Caroline Zaehringer
    • 1
  • Achim Kircher
    • 1
  • Matthias Streif
    • 1
  • Sabine Bucher
    • 1
  • David Buergler
    • 1
  • Luigia D’Errico
    • 1
  • Sebastién Kopp
    • 1
  • Markus Wilhelm
    • 1
  • Sebastian T. Schindera
    • 1
    • 3
  1. 1.Clinic of Radiology and Nuclear MedicineUniversity Hospital BaselBaselSwitzerland
  2. 2.Institute of RadiologyHospital Centre of BielBielSwitzerland
  3. 3.Institute of RadiologyCantonal Hospital AarauAarauSwitzerland

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