Image quality of Adaptive Iterative Dose Reduction 3D of coronary CT angiography of 640-slice CT: comparison with filtered back-projection

  • Roh-Eul Yoo
  • Eun-Ah ParkEmail author
  • Whal Lee
  • Hackjoon Shim
  • Yeo Koon Kim
  • Jin Wook Chung
  • Jae Hyung Park
Original Paper


To assess the image quality of coronary CT angiography (CCTA) of 640-slice CT reconstructed by Adaptive Iterative Dose Reduction (AIDR) three-dimensional (3D) in comparison with the conventional filtered back-projection (FBP). CCTA images of 51 patients were scanned at the lowest tube voltage possible on condition that the built-in automatic exposure control system could suggest the optimal tube current. They were, then, reconstructed with FBP and AIDR 3D (standard). Objective measurements including CT density, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were performed. Subjective assessment was done by two radiologists, using a 5-point scale (0:nondiagnostic-4:excellent) based on the 15-coronary segment model which was grouped into three parts as the proximal, mid, and distal segmental classes. Radiation dose was also measured. AIDR images showed lower noise than FBP images (45.0 ± 9.4 vs. 73.4 ± 14.6 HU, p < 0.001) without any significant difference in CT density (665.5 ± 131.7 vs. 668 ± 136.3 HU, p = 0.8). Both SNR (15.0 ± 2.1 vs. 9.2 ± 1.7) and CNR (16.8 ± 2.3 vs. 10.4 ± 1.8) were significantly higher for AIDR than FBP (p < 0.001). Total subjective image quality score was also significantly improved in AIDR compared with FBP (3.1 ± 0.6 vs. 1.6 ± 0.4, p < 0.001), with better interpretability of the mid and distal segmental classes (100 vs. 95 % for the mid, p < 0.001; 100 vs. 90 % for the distal, p < 0.001). Mean effective radiation dose was 2.0 ± 1.0 mSv. The AIDR 3D reconstruction algorithm reduced image noise by 39 % compared with the FBP without affecting CT density, thus improving SNR and CNR for CCTA. Its advantages in interpretability were also confirmed by subjective evaluation by experts.


Low-dose coronary CT angiography (CCTA) 640-multi-slice coronary CT angiography (CCTA) Iterative reconstruction Image quality Radiation dose 



Adaptive Iterative Dose Reduction


Adaptive Statistical Iterative Reconstruction


Beam hardening correction


Body mass index


Beats per minute


Contrast-to-noise ratio


Coronary CT angiography


First diagonal branch


Second diagonal branch


Dose-length product


Effective dose


Filtered back-projection


Heart rate


Hounsfield unit


Iterative reconstruction in image space


Left anterior descending artery


Left circumflex artery


Left main coronary artery


Obtuse marginalis


Posterior descending artery


Right coronary artery

R. intermedius

Ramus intermedius


Region of interest


Signal-to-noise ratio





This research was supported by Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (MEST) (K21002001824-11E0100-02910). Hackjoon Shim is an employee of TI Medical Systems, the distributor in Korea for Toshiba Medical Systems Corporation, Tochiki-ken, Japan.

Conflict of interest



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Copyright information

© Springer Science+Business Media, B.V. 2012

Authors and Affiliations

  • Roh-Eul Yoo
    • 1
  • Eun-Ah Park
    • 1
    • 2
    Email author
  • Whal Lee
    • 1
    • 2
  • Hackjoon Shim
    • 3
  • Yeo Koon Kim
    • 1
    • 2
  • Jin Wook Chung
    • 1
  • Jae Hyung Park
    • 1
    • 2
  1. 1.Department of Radiology, Institute of Radiation MedicineSeoul National University HospitalSeoulKorea
  2. 2.SNU-Duke Cardiovascular MR Research CenterSeoul National UniversitySeoulKorea
  3. 3.TI Medical SystemsSeoulKorea

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