Coronary CT angiography: comparison of a novel iterative reconstruction with filtered back projection for reconstruction of low-dose CT-Initial experience.

OBJECTIVE: To prospectively compare subjective and objective image quality in 20% tube current coronary CT angiography (cCTA) datasets between an iterative reconstruction algorithm (SAFIRE) and traditional filtered back projection (FBP).

MATERIALS AND METHODS: Twenty patients underwent a prospectively ECG-triggered dual-step cCTA protocol using 2nd generation dual-source CT (DSCT). CT raw data was reconstructed using standard FBP at full-dose (Group_1a) and 80% tube current reduced low-dose (Group_1b). The low-dose raw data was additionally reconstructed using iterative raw data reconstruction (Group_2). Attenuation and image noise were measured in three regions of interest and signal-to-noise-ratio (SNR) as well as contrast-to-noise-ratio (CNR) was calculated. Subjective diagnostic image quality was evaluated using a 4-point Likert scale.

RESULTS: Mean image noise of group_2 was lowered by 22% on average when compared to group_1b (p<0.0001-0.0033), while there were no significant differences in mean attenuation within the same anatomical regions. The lower image noise resulted in significantly higher SNR and CNR ratios in group_2 compared to group_1b (p<0.0001-0.0232). Subjective image quality of group_2 (1.88 ± 0.63) was also rated significantly higher when compared to group_1b (1.58 ± 0.63, p=0.004).

CONCLUSIONS: Image quality of 80% tube current reduced iteratively reconstructed cCTA raw data is significantly improved when compared to standard FBP and consequently may improve the diagnostic accuracy of cCTA.