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Dynamic Computed Tomography of Locally Advanced Pancreatic Cancer: Effect of Low Tube Voltage and a Hybrid Iterative Reconstruction Algorithm on Image Quality

Yamamura, Sadahiro MD*; Oda, Seitaro MD*; Utsunomiya, Daisuke MD*; Funama, Yoshinori PhD; Imuta, Masanori MD*; Namimoto, Tomohiro MD*; Hirai, Toshinori MD*; Chikamoto, Akira MD; Baba, Hideo MD; Yamashita, Yasuyuki MD*

Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e318296db2b
Abdominal Imaging

Objective: The objective of this study was to evaluate the effect of a low-tube-voltage technique and hybrid iterative reconstruction (HIR) on image quality at dynamic computed tomography (CT) of the pancreas.

Methods: The study included 18 consecutive patients (10 women, 8 men; mean age, 68.5 ± 9.5 years) with locally advanced pancreatic cancer who received chemotherapy and had stable disease during the 100- and 120-kV CT studies. The 120-kV images were reconstructed using filtered back projection, and the 100-kV images were postprocessed using filtered back projection and HIR. Scans obtained during 3 pancreatic phases were subjected to quantitative and qualitative analysis.

Results: The mean effective dose was significantly lower under the 100- than the 120-kV protocols (29.2 ± 3.6 vs 52.1 ± 5.1 mSv; P < 0.01). The mean contrast-to-noise ratio of the pancreatic cancer and the visual scores were significantly higher under 100 kV with HIR than those under the other 2 protocols (P < 0.01).

Conclusions: Use of low tube voltage and HIR can provide significantly improved image quality at pancreatic dynamic CT.

Author Information

From the Departments of *Diagnostic Radiology, †Medical Physics, and ‡Gastroenterological Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.

Received for publication February 8, 2013; accepted April 12, 2013.

Reprints: Seitaro Oda, MD, Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan (e-mail:

The authors have no direct or indirect financial interest in the products under investigation or subject matter discussed in this article.

© 2013 by Lippincott Williams & Wilkins