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Physician Preference Between Low-Dose Computed Tomography With a Sinogram-Affirmed Iterative Reconstruction Algorithm and Routine-Dose Computed Tomography With Filtered Back Projection in Abdominopelvic Imaging

Hardie, Andrew D. MD; Tipnis, Sameer V. PhD; Rieter, William J. MD, PhD; Rissing, Michael S. MD; De Cecco, Carlo N. MD

Journal of Computer Assisted Tomography: November/December 2013 - Volume 37 - Issue 6 - p 932–936
doi: 10.1097/RCT.0000000000000024
Abdominal CT Techniques and Dose Optimization

Objective The aim of this study was to directly compare the preference between low-dose sinogram-affirmed iterative reconstruction (SAFIRE) and routine filtered back projection (FBP) abdominopelvic computed tomography (CT).

Methods A retrospective review identified 41 subjects who had undergone 2 different CT examinations at different times (a CT with reduced radiation dose SAFIRE and also a CT with routine-dose FBP). Radiation dose, patient size, and image noise were recorded. Two independent readers assessed the paired CT studies for preference in image quality in regard to 3 clinically relevant diagnostic endpoints (bowel pathology, biliary pathology, and general purpose).

Results Radiation dose was significantly lower for SAFIRE (mean, 7.6 mGy; range, 4.1–15.4 mGy) than FBP (12.9 mGy; 6.7–31.6 mGy) (P < 0.001). Sinogram-affirmed iterative reconstruction was preferred for the general purpose and bowel evaluations, particularly when the level of radiation dose reduction was less than 33%. The preference for interpretation of the biliary system was equivocal, especially when the level of radiation reduction was increased greater than 33%. Filtered back projection was preferred when SAFIRE had a radiation reduction from FBP of greater than 50%.

Conclusions For abdominopelvic CT, low-dose CT with SAFIRE may produce preferred image quality over FBP up to levels of 50% dose reduction.

From the Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC.

Received for publication August 7, 2013; accepted October 3, 2013.

Reprints: Andrew D. Hardie, MD, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, MSC 226, Charleston SC 29401 (e-mail:

The authors declare no conflict of interest.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.