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Experiences With the Use of Iteratively Reconstructed Dose-Modified MDCT Angiography Examinations of Living Renal Donors

Andrabi, Yasir MD, MPH; Kambadakone, Avinash MD; Sahani, Dushyant V. MD

Journal of Computer Assisted Tomography: July/August 2014 - Volume 38 - Issue 4 - p 535–543
doi: 10.1097/RCT.0000000000000084
Abdominal Imaging

Purpose To evaluate the performance of iteratively reconstructed (IR) dose-modified (DM) multidetector computed tomography (MDCT) angiography (CTA) examinations of renal donors in comparison to standard dose filtered back projection (FBP) images.

Materials and Methods Eighty-five potential donors who underwent dual-phase CTA on 16-/64-MDCT scanners were retrospectively reviewed. Images from a 16-MDCT scanner were reconstructed with filtered back projection (group A, 47) and examinations from 64-MDCT with IR (group B, 38). Scan parameters were constant for both groups except for higher noise index (× 1.3) in group B. Images were interpreted for the relevant anatomy and IQ by 2 readers. Surgical report served as reference standard for operated kidneys, whereas for nonoperated kidneys, interobserver agreement was evaluated.

Results Radiation dose was 36% lower in group B compared to group A. All CTA examinations were rated for diagnostic quality with comparable IQ scores. In 48 operated kidneys, 10 surgically confirmed vascular anomalies were correctly identified by both readers. In the remaining 122 nonoperated kidneys, there was an excellent interobserver agreement.

Conclusions Iteratively reconstructed technique preserves high image quality and diagnostic performance at significantly lower radiation doses in DM kidney donor CTA examinations.

From the Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Received for publication November 8, 2013; accepted February 3, 2014.

Reprints: Dushyant V. Sahani, MD, Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White 270, Boston, MA 02114, USA (e-mail:

The authors declare no conflict of interest.

© 2014 by Lippincott Williams & Wilkins