Improving image quality with model-based iterative reconstruction algorithm for chest CT in children with reduced contrast concentration

  • Jihang Sun
  • Di Hu
  • Yun Shen
  • Haiming Yang
  • Chenghao Chen
  • Jie Yin
  • Yun PengEmail author



To evaluate model-based iterative reconstruction (MBIR) in improving the image quality of chest CT in children with reduced concentration contrast medium (CM).


Fifty-six children (median age of 4 years) who received low-dose enhanced chest CT were enrolled as the study group and compared with the control group of 56 children. Both groups used the automatic tube current modulation to achieve age-based noise index values of 11–15 HU. The study group used 100 kVp and reduced CM concentration of 270 mgI/ml, and the images in this group were reconstructed with 50% adaptive statistical iterative reconstruction (ASIR) and MBIR. The control group used 120 kV and standard CM of 320 mgI/ml, and the images in this group were reconstructed with ASIR only. Subjective image quality and objective image quality of the three image sets were evaluated. The subjective quality included overall image noise, enhancement degree, lesion (including mediastinum mass, pulmonary space-occupying lesions, and parenchymal infiltrative lesions) conspicuity, and beam-hardening artifacts. The objective quality included the measurement of noise in the left ventricle and back muscle to calculate signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of ventricle.


There was no difference in radiation dose between the study (CTDIvol of 1.79 ± 1.45 mGy) and control (1.68 ± 0.92 mGy) groups (p = 0.65). However, the study group used 19.7% lower CM dose than the control group (5.84 ± 2.69 vs. 7.27 ± 3.80 gI), and the enhancement in all images met the diagnostic requirements. MBIR reduced image noise by 58.6% and increased SNR and CNR by 143.6% and 165.7%, respectively, compared to ASIR images in the control group. The two ASIR image sets had similar image quality.


MBIR improved the image quality of low-radiation-dose chest CT in children at 19.3% reduced CM dose.


Tomography X-ray computed Iterative reconstruction Low voltage Contrast agent Children 



This study was funded by Beijing Children’s Hospital Young Investigator Program (Grant Number BCH-YIPB-2016-06).

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Medical Radiology 2019

Authors and Affiliations

  • Jihang Sun
    • 1
  • Di Hu
    • 1
  • Yun Shen
    • 2
  • Haiming Yang
    • 3
  • Chenghao Chen
    • 4
  • Jie Yin
    • 1
  • Yun Peng
    • 1
    Email author
  1. 1.Department of Radiology, Imaging Center, Beijing Children’s HospitalCapital Medical UniversityBeijingChina
  2. 2.Department of RadiologyTokyo Women’s Medical University & Medical Center EastTokyoJapan
  3. 3.Respiratory Department, Beijing Children’s HospitalCapital Medical UniversityBeijingChina
  4. 4.Department of Thoracic Surgery, Beijing Children’s HospitalCapital Medical UniversityBeijingChina

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