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Low-dose CT of the lung: potential value of iterative reconstructions

  • Computed Tomography
  • Published:
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Abstract

Objectives

To prospectively assess the impact of sinogram-affirmed iterative reconstruction (SAFIRE) on image quality of nonenhanced low-dose lung CT as compared to filtered back projection (FBP).

Methods

Nonenhanced low-dose chest CT (tube current-time product: 30 mAs) was performed on 30 patients at 100 kVp and on 30 patients at 80 kVp. Images were reconstructed with FBP and SAFIRE. Two blinded, independent readers measured image noise; two readers assessed image quality of normal anatomic lung structures on a five-point scale. Radiation dose parameters were recorded.

Results

Image noise in datasets reconstructed with FBP (57.4 ± 15.9) was significantly higher than with SAFIRE (31.7 ± 9.8, P < 0.001). Image quality was significantly superior with SAFIRE than with FBP (P < 0.01), without significant difference between FBP at 100 kVp and SAFIRE at 80 kVp (P = 0.68). Diagnostic image quality was present with FBP in 96% of images at 100 kVp and 88% at 80 kVp, and with SAFIRE in 100% at 100 kVp and 98% at 80 kVp. There were significantly more datasets with diagnostic image quality with SAFIRE than with FBP (P < 0.01). Mean CTDIvol and effective doses were 1.5 ± 0.7 mGy·cm and 0.7 ± 0.2 mSv at 100 kVp, and 1.4 ± 2.8 mGy·cm and 0.5 ± 0.2 mSv at 80 kVp (P < 0.001, both).

Conclusions

Use of SAFIRE in low-dose lung CT reduces noise, improves image quality, and renders more studies diagnostic as compared to FBP.

Key Points

• Low-dose computed tomography is an important thoracic investigation tool.

• Radiation dose can be less than 1 mSv with iterative reconstructions.

• Iterative reconstructions render more low-dose lung CTs diagnostic compared to conventional reconstructions.

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Authors and Affiliations

  1. Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland

    Stephan Baumueller, Anna Winklehner, Christoph Karlo, Robert Goetti, Thomas Frauenfelder & Hatem Alkadhi

  2. Computed Tomography Division, Siemens Healthcare, Forchheim, Germany

    Thomas Flohr

  3. Pulmonary Division, Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland

    Erich W. Russi

Authors
  1. Stephan Baumueller
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  2. Anna Winklehner
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  3. Christoph Karlo
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  4. Robert Goetti
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  5. Thomas Flohr
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  6. Erich W. Russi
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  7. Thomas Frauenfelder
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  8. Hatem Alkadhi
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Corresponding author

Correspondence to Hatem Alkadhi.

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Baumueller, S., Winklehner, A., Karlo, C. et al. Low-dose CT of the lung: potential value of iterative reconstructions. Eur Radiol 22, 2597–2606 (2012). https://doi.org/10.1007/s00330-012-2524-0

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  • DOI: https://doi.org/10.1007/s00330-012-2524-0

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