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Comparison of Hybrid and Pure Iterative Reconstruction Techniques With Conventional Filtered Back Projection: Dose Reduction Potential in the Abdomen

Singh, Sarabjeet MD*; Kalra, Mannudeep K. MD*; Do, Synho PhD*; Thibault, Jean Baptiste PhD; Pien, Homer PhD*; Connor, Owen O. J. MD*; Blake, Michael A. MD*

Journal of Computer Assisted Tomography: May/June 2012 - Volume 36 - Issue 3 - p 347–353
doi: 10.1097/RCT.0b013e31824e639e
Dose Reduction Studies

Purpose: Assess the effect of filtered back projection (FBP) and hybrid (adaptive statistical iterative reconstruction [ASIR]) and pure (model-based iterative reconstruction [MBIR]) iterative reconstructions on abdominal computed tomography (CT) acquired with 75% radiation dose reduction.

Materials and Methods: In an institutional review board–approved prospective study, 10 patients (mean [standard deviation] age, 60 (8) years; 4 men and 6 women) gave informed consent for acquisition of additional abdominal images on 64-slice multidetector-row CT (GE 750HD, GE Healthcare). Scanning was repeated over a 10-cm scan length at 200 and 50 milliampere second (mA s), with remaining parameters held constant at 120 kilovolt (peak), 0.984:1 pitch, and standard reconstruction kernel. Projection data were deidentified, exported, and reconstructed to obtain 4 data sets (200-mA s FBP, 50-mA s FBP, 50-mA s ASIR, 50-mA s MBIR), which were evaluated by 2 abdominal radiologists for lesions and subjective image quality. Objective noise and noise spectral density were measured for each image series.

Results: Among the 10 patients, the maximum weight recorded was 123 kg, with maximum transverse diameter measured as 43.7 cm. Lesion conspicuity at 50-mA s MBIR was better than on 50-mA s FBP and ASIR images (P < 0.01). Image noise was rated as suboptimal on low-dose FBP and ASIR but deemed acceptable in MBIR images. Objective noise with 50-mA s MBIR was 2 to 3 folds lower compared to 50-mA s ASIR, 50-mA s FBP, and 200-mA s FBP (P < 0.0001). Noise spectral density analyses demonstrated that ASIR retains the noise spectrum signature of FBP, whereas MBIR has much lower noise with a more regularized noise spectrum pattern.

Conclusion: Model-based iterative reconstruction renders acceptable image quality and diagnostic confidence in 50- mA s abdominal CT images, whereas FBP and ASIR images are associated with suboptimal image quality at this radiation dose level.

From the *Massachusetts General Hospital Imaging, Massachusetts General Hospital, Boston MA; and †GE Healthcare, Waukesha, WI.

Received for publication July 29, 2011; accepted December 6, 2011.

Reprints: Sarabjeet Singh, MD, Massachusetts General Hospital Imaging, Massachusetts General Hospital, Boston, MA 02114 (e-mail:

MKK has received research grant from GE Healthcare. JBT is an employee of GE Healthcare.

Two other coauthors (HP and SD) have received research grants from Siemens and Philips within the past 12 months. The remaining coauthors have no pertinent financial disclosures and had complete and unrestricted access to the study data and manuscript.

© 2012 Lippincott Williams & Wilkins, Inc.