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Value of knowledge-based iterative model reconstruction in low-kV 256-slice coronary CTA

Publication
Philips CT Clinical Science Philips Healthcare • USA

Yuki H, Utsunomiya D, Funama Y, Tokuyasu S, Namimoto T, Hirai T, Itatani R, Katahira K, Oshima S, Yamashita Y.

* This article was originally published in the Journal of Cardiovascular Computed Tomography (Volume 8 2014).
Background
Most current iterative reconstruction algorithms for CT imaging are a mixture of iterative reconstruction and filtered back projection. The value of “fully” iterative reconstruction in coronary CT angiography remains poorly understood.

Objective
We aimed to assess the value of the knowledge-based iterative model reconstruction (IMR) algorithm on the qualitative and quantitative image quality at 256-slice cardiac CT.

Methods
We enrolled 21 patients (mean age: 69 ± 11 years) who underwent retrospectively ECG gated coronary CT angiography at 100 kVp tube voltage. Images were reconstructed with the filtered back projection (FBP), hybrid iterative reconstruction (IR), and IMR algorithms. CT attenuation and the contrast-to-noise ratio (CNR) of the coronary arteries were calculated. With the use of a 4-point scale, two reviewers visually evaluated the coronary arteries and cardiac structures.

Results
The mean CT attenuation of the proximal coronary arteries was 369.3 ± 73.6 HU, 363.9 ± 75.3 HU, and 363.3 ± 74.5 HU, respectively, for FBP, hybrid IR, and IMR and was not significantly different. The image noise of the proximal coronary arteries was significantly lower with IMR (11.3 ± 2.8 HU) than FBP (51.9 ± 12.9 HU) and hybrid IR (23.2 ± 5.2 HU). The mean CNR of the proximal coronary arteries was 9.4 ± 2.4, 20.2 ± 4.7, and 41.8 ± 9.5 with FBP, hybrid IR and IMR, respectively; it was significantly higher with IMR. The best subjective image quality for coronary vessels was obtained with IMR (proximal vessels: FBP, 2.6 ± 0.5; hybrid IR, 3.4 ± 0.5; IMR, 3.8 ± 0.4; distal vessels: FBP, 2.3 ± 0.5; hybrid IR. 3.1 ± 0.5; IMR, 3.7 ± 0.5). IMR also yielded the best visualization for cardiac systems, that is myocardium and heart valves.

Conclusion
The novel knowledge-based IMR algorithm yields significantly improved CNR and better subjective image quality of coronary vessels and cardiac systems with reliable CT number measurements for cardiac CT imaging.
For more information about this publication, check out the PubMed listing for this article.


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Publication
iCT
Cardiac, coronary angiography, coronary arteries, ECG-gated, Extended Brilliance Workspace 4.0, FBP reconstruction, image quality, IMR, iterative model reconstruction, iterative reconstruction, retrospective, Retrospective gating, Vascular
 

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