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Low radiation dose abdominal CT with IMR: Clinical impact on thin slice images

Philips CT Clinical Science Philips Healthcare • USA

Nakaura T, Tokuyasu S, Kidoh M, Itatani R, Harada K, Yamashita Y.

Recently, low radiation dose abdominal CT has become clinically available through techniques such as iterative reconstruction techniques and low kVp imaging. However, increased image noise is a serious problem in the thin slice images. The purpose of this study was to evaluate the usefulness of the recent introduced iterative model reconstruction (IMR, Philips Healthcare) in low dose abdominal CT with the thin slice images.

Method and Materials
This prospective study received institutional review board approval; prior informed consent to participate was obtained from all patients. This study enrolled 36 patients who were imaged with low radiation dose abdominal and pelvis CT at the 100 kVp setting. We reconstructed clinical studies with filtered back projection (FBP), hybrid-iterative reconstruction (iDose⁴, Philips Healthcare) and IMR with 1, 3 and 5 mm slice thickness. We compared the image noise and the rate of increase of image noise in 1 and 3 mm thickness images from 5 mm thickness images between the reconstruction methods using the Sceheffe test. Two independent readers assessed image contrast, image noise, image sharpness and overall image quality on a 4-point scale about 1 mm thickness images with each reconstruction technique.

The mean radiation dose of patients was 4.6 mSv ±1.5. The rate of increase in noise in 1 mm thickness images (FBP: 2.21±0.23 and iDose⁴: 2.16±0.30) and 3 mm thickness images (FBP: 1.30±0.13 and iDose⁴: 1.29±0.21) were almost inversely proportional to the square-root of the rate of decrease in slice thickness in FBP and iDose⁴ reconstruction and the differences were not significant (p>0.05). However, the rate of increase in image noise in thin slice images with IMR reconstruction (1 mm: 1.47±0.17 and 3 mm: 1.18±0.13) were significantly lower than other reconstruction techniques (p<0.05). The image noise of 1mm thickness images with IMR reconstruction (8.8±1.8) was significantly lower than that of 5 mm thickness images with FBP (26.5±6.0) and iDose⁴ reconstruction(10.8±2.7) (p<0.05). The visual scores in image noise and overall image quality with IMR were significantly higher than those with other reconstruction images (p<0.05).

IMR reconstruction offers dramatic noise reduction in low dose abdominal CT especially at thin slice images as compared with FBP and iDose⁴.

Clinical Relevance/Application
We did not need to increase the radiation dose for thin slice images with IMR technique.

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Jan 20, 2014

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abdomen, Body, FBP reconstruction, image quality, IMR, iterative model reconstruction, iterative reconstruction, low dose

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