The Application of a New Model-Based Iterative Reconstruction in Low-Dose Upper Abdominal CT

To compare upper abdominal computed tomography (CT) image quality of new model-based iterative reconstruction (MBIR) with low-contrast resolution preference (MBIR_NR40), conventional MBIR (MBIR_c), and adaptive statistical iterative reconstruction (ASIR) at low dose with ASIR at routine-dose.

Study included phantom and 60 patients who had initial and follow-up CT scans. For patients, the delay phase was acquired at routine-dose (noise index = 10 HU) for the initial scan and low dose (noise index = 20 HU) for the follow-up. The low-dose CT was reconstructed with 40% and 60% ASIR, MBIR_c, and MBIR_NR40, while routine-dose CT was reconstructed with 40% ASIR. CT value and noise measurements of the subcutaneous fat, back muscle, liver, and spleen parenchyma were compared using one-way ANOVA. Two radiologists used semiquantitative 7-scale (-3 to +3) to rate image quality and artifacts.

The phantom study revealed superior low-contrast resolution with MBIR_NR40. For patient scans, the CT dose index for the low-dose CT was 3.00 ± 1.32 mGy, 75% lower than the 11.90 ± 4.75 mGy for the routine-dose CT. Image noise for the low-dose MBIR_NR40 images was significantly lower than the low-dose MBIR_c and ASIR images, and routine-dose ASIR images (p < 0.05). Subjective ratings showed higher image quality for low-dose MBIR_NR40, with lower noise, better low-contrast resolution for abdominal structures, and finer lesion contours than those of low-dose MBIR_c and ASIR images, and routine-dose ASIR images (p < 0.05).

MBIR_NR40 with low-contrast resolution preference provides significantly lower noise and better image quality than MBIR_c and ASIR in low-dose abdominal CT; significantly better objective and subjective image quality than the routine-dose ASIR with 75% dose reduction.