Can sinogram-affirmed iterative reconstruction improve the detection of small hypervascular liver nodules with
Luca Facchetti1, Luca Berta, Lorella Mascaro
1From the *Department of Radiology, University of Brescia, Brescia, Italy; and †Medical Physics Unit, Imaging Department, Spedali Civili di Brescia, Brescia, Italy.
Objective:
To optimize a dual-energy computed tomographic protocol with sinogram-affirmed iterative reconstruction algorithms for improving small nodules detection.
Methods:
The raw data of a dual-energy computed tomographic arterial acquisition of a cirrhotic patient were reconstructed with a standard filtered back projection (B20f) and 3 iterative (I26, I30, I31) kernels with different strength (S3-S5). The 80-kilovolt (peak) (kVp) and the linear blended (DE_0.5) images (80-140 kVp) were analyzed. For each series, 8-subcentimeter low-contrast lesions were simulated within the liver. Four radiologists performed a detectability test and rated the image quality (5-point scales) in all images.
Results:
The sensitivity increased from 31% (B20f) to 87.5% with sinogram-affirmed iterative reconstruction S5 kernels without a difference between 80-kVp and DE_0.5 series (W test, P = 0.062). The highest image quality rating was 3.8 (B20 DE_0.5), without difference from DE_0.5 I30-S5 and I26-S3.
Conclusions:
Iterative reconstructions increase the sensitivity for detecting abdominal lesions, even in the 80-kVp series. The kernel I30-S5 was considered the best.
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