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Updated: May 13, 2026

X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
Pilot study of detection, radiologist confidence and image quality with sinogram-affirmed iterative reconstruction at
Joel G Fletcher1, William R Krueger, David M Hough
1Departments of Radiology, Mayo Clinic, Rochester, MN 55905, USA. fletcher.joel@mayo.edu
Objective:
The objective of this study was to determine the effect of Sinogram-Affirmed Iterative Reconstruction (SAFIRE) on radiological detection, diagnostic confidence, and image quality at half-dose, contrast-enhanced abdominopelvic computed tomography.
Methods:
Forty dual-source examinations were reconstructed using routine-dose with filtered back projection, half-dose filtered back projection, and half-dose SAFIRE. Three radiologists detected lesions in abdominopelvic organs, reporting findings of potential medical significance, diagnostic confidence, and image quality.
Results:
There was greater than 78% concordance between full- and half-dose images ± SAFIRE, and no difference in the detection of lesions within organs between half-dose images ± SAFIRE (P = 0.22 - 1.0). Detection of potentially important findings varied by reader, but not between dose/reconstruction methods. Diagnostic confidence varied widely (P < 0.001 to P > 0.91). Sinogram-Affirmed Iterative Reconstruction significantly improved image quality in the pelvis (P ≤ 0.04).
Conclusions:
Half-dose images ± SAFIRE had organ-specific detections similar to routine-dose images. Sinogram-Affirmed Iterative Reconstruction improved image quality in the pelvis, but diagnostic confidence and image quality scores in the abdomen depended on the reader.
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