Detection of pulmonary embolism on computed tomography: improvement using a model-based iterative reconstruction...

Area of Science:

• Radiology
• Medical Imaging
• Cardiovascular Imaging

Background:

• Pulmonary embolism (PE) is a critical condition requiring accurate diagnosis.
• Computed tomography pulmonary angiography (CTPA) is a primary imaging modality for PE detection.
• Image reconstruction techniques significantly impact diagnostic performance in CTPA.

Purpose of the Study:

• To compare the effectiveness of model-based iterative reconstruction (MBIR) against hybrid iterative reconstruction (HIR) and filtered back projection (FBP) for PE detection in CTPA.
• To evaluate the impact of MBIR on diagnostic confidence and image quality parameters.

Main Methods:

• Fifty patients with suspected PE underwent CTPA at 100 kV.
• Images were reconstructed using FBP, HIR, and MBIR techniques.
• Seven experienced readers assessed image quality and PE presence, rating diagnostic confidence, noise, enhancement, and plastic appearance.

Main Results:

• MBIR demonstrated significantly higher pooled sensitivity for PE detection (82.5%) compared to FBP (76%) and HIR (78.6%).
• MBIR led to significant subjective improvements in diagnostic confidence, perceived noise, and enhancement compared to both FBP and HIR.
• Image accuracy was comparable across all reconstruction methods.

Conclusions:

• MBIR significantly enhances the detection of pulmonary embolism in CTPA.
• MBIR offers qualitative improvements in diagnostic confidence and image quality parameters over FBP and HIR.
• MBIR represents a valuable advancement in CTPA for PE diagnosis.