Choosing the best reconstruction technique in abdominal computed tomography: a systematic approach

There is uncertainty regarding the effect of iterative reconstruction (IR) techniques and other reconstruction algorithms on image quality. The aim of this study was to optimize image quality in relation to radiation dose in computed tomography (CT) liver examinations by comparing images reconstructed with different abdominal filters with and without IR.

An anthropomorphic phantom was scanned on a Toshiba Aquilion ONE CT scanner. Images at 2 different dose levels were reconstructed with 12 different body reconstruction filters, all with both filtered back-projection and Adaptive Iterative Dose Reduction 3 dimensional. Receiver operating characteristic curves were constructed. The 2 reconstruction combinations with the highest scores from the phantom study were evaluated in a second comparison of clinical images. Six liver examinations were reconstructed with both filters and evaluated using visual grading analysis.

Two combinations of reconstruction filters and IR were the only 2 options among the 8 best images at both dose levels (area under the curve, 0.96 and 0.94 for 15 mGy as well as 0.86 and 0.84 for 10 mGy). In the patient study, one of these filters in combination with IR scored slightly higher than the other in combination with IR (mean score, 2.60 and 2.57, respectively; P = 0.56). Iterative reconstruction did not significantly increase lesion detectability for any of the filters.

This study indicates that the preferred choice for reconstruction of CT liver examinations performed with the Toshiba Aquilion ONE should be the FC18 filter with IR, although the IR technique did not significantly improve lesion detectability and did not compensate for the dose reduction in this study.