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Image quality of low mA CT pulmonary angiography reconstructed with model based iterative reconstruction versus standard CT pulmonary angiography reconstructed with filtered back projection: an equivalency trial

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To determine whether CT pulmonary angiography (CTPA) using low mA setting reconstructed with model-based iterative reconstruction (MBIR) is equivalent to routine CTPA reconstructed with filtered back projection (FBP).

Methods

This prospective study was approved by the institutional review board and patients provided written informed consent. Eighty-two patients were examined with a low mA MBIR-CTPA (100 kV, 20 mA) and 82 patients with a standard FBP-CTPA (100 kV, 250 mA). Region of interests were drawn in nine pulmonary vessels; signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. A five-point scale was used to subjectively evaluate the image quality of FBP-CTPA and low mA MBIR-CTPA.

Results

Compared to routine FBP-CTPA, low mA MBIR-CTPA showed no differences in the attenuation measured in nine pulmonary vessels, higher SNR (56 ± 19 vs 43 ± 20, p < 0.0001) and higher CNR (50 ± 17 vs 38 ± 18, p < 0.0001) despite a dose reduction of 93 % (p < 0.0001). The subjective image quality of low mA MBIR-CTPA was quoted as diagnostic in 98 % of the cases for patient with body mass index less than 30 kg/m2.

Conclusion

Low mA MBIR-CTPA is equivalent to routine FBP-CTPA and allows a significant dose reduction while improving SNR and CNR in the pulmonary vessels, as compared with routine FBP-CTPA.

Key Points

• Low mA MBIR-CTPA is equivalent to routine FBP-CTPA.

• MBIR-CTPA may be achieved with drastic (93 %) dose reduction.

• Low mA MBIR-CTPA should be studied in the setting of suspected PE.

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Abbreviations

CTPA:

Computed tomography pulmonary angiography

DLP:

Dose–length product

FBP:

Filtered back projection

MBIR:

Model-based iterative reconstruction

SSDE:

Size-specific dose estimate

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Acknowledgments

Statistical support was provided by the Clinical Research Center, University of Geneva and Geneva University Hospitals (Delphine Courvoisier). The scientific guarantor of this publication is Xavier Montet. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, experimental, performed at one institution.

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Authors and Affiliations

  1. Division of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 4, Switzerland

    Xavier Montet, Anne-Lise Hachulla, Angeliki Neroladaki, Diomidis Botsikas & Christoph D. Becker

  2. Division of Pulmonary Medicine, Geneva University Hospital, Gabrielle-Perret-Gentil, 4, 1211, Geneva 4, Switzerland

    Frederic Lador & Thierry Rochat

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  1. Xavier Montet
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  2. Anne-Lise Hachulla
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Correspondence to Xavier Montet.

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Montet, X., Hachulla, AL., Neroladaki, A. et al. Image quality of low mA CT pulmonary angiography reconstructed with model based iterative reconstruction versus standard CT pulmonary angiography reconstructed with filtered back projection: an equivalency trial. Eur Radiol 25, 1665–1671 (2015). https://doi.org/10.1007/s00330-014-3563-5

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  • DOI: https://doi.org/10.1007/s00330-014-3563-5

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