title: Paediatric cardiac CT examinations: impact of the iterative reconstruction method ASIR on image quality--preliminary findings.
abstract: BACKGROUND
  Radiation dose exposure is of particular concern in children due to the possible harmful effects of ionizing radiation. The adaptive statistical iterative reconstruction (ASIR) method is a promising new technique that reduces image noise and produces better overall image quality compared with routine-dose contrast-enhanced methods.
  
  
  OBJECTIVE
  To assess the benefits of ASIR on the diagnostic image quality in paediatric cardiac CT examinations.
  
  
  METHODS
  Four paediatric radiologists based at two major hospitals evaluated ten low-dose paediatric cardiac examinations (80 kVp, CTDI(vol) 4.8-7.9 mGy, DLP 37.1-178.9 mGy·cm). The average age of the cohort studied was 2.6 years (range 1 day to 7 years). Acquisitions were performed on a 64-MDCT scanner. All images were reconstructed at various ASIR percentages (0-100%). For each examination, radiologists scored 19 anatomical structures using the relative visual grading analysis method. To estimate the potential for dose reduction, acquisitions were also performed on a Catphan phantom and a paediatric phantom.
  
  
  RESULTS
  The best image quality for all clinical images was obtained with 20% and 40% ASIR (p < 0.001) whereas with ASIR above 50%, image quality significantly decreased (p < 0.001). With 100% ASIR, a strong noise-free appearance of the structures reduced image conspicuity. A potential for dose reduction of about 36% is predicted for a 2- to 3-year-old child when using 40% ASIR rather than the standard filtered back-projection method.
  
  
  CONCLUSIONS
  Reconstruction including 20% to 40% ASIR slightly improved the conspicuity of various paediatric cardiac structures in newborns and children with respect to conventional reconstruction (filtered back-projection) alone.
authors: Institute of Radiation Physics, University Hospital Center and University of Lausanne, Lausanne, Switzerland. frederic.mieville@chuv.ch
authors: Frédéric A
authors: FA
authors: Miéville
authors: François
authors: F
authors: Gudinchet
authors: Elena
authors: E
authors: Rizzo
authors: Phalla
authors: P
authors: Ou
authors: Francis
authors: F
authors: Brunelle
authors: François O
authors: FO
authors: Bochud
authors: Francis R
authors: FR
authors: Verdun
mesh_terms: D057791:Cardiac Imaging Techniques / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000151:congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019047:Phantoms, Imaging / Q000592:standards; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000592:standards; D014057:Tomography, X-Ray Computed