Impact of iterative reconstruction on image quality and radiation dose in multidetector CT of large body size adults.

ABSTRACT

OBJECTIVE: To compare image quality and radiation dose using Adaptive Statistical Iterative Reconstruction (ASiR) and Filtered Back Projection (FBP) in patients weighing ≥ 91 kg. METHODS: 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. RESULTS: 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. CONCLUSION: In obese individuals, abdominal CT images reconstructed using ASiR provide diagnostic images with reduced image noise at lower radiation dose. KEY POINTS • 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.