title: Performance of iterative image reconstruction in CT of the paranasal sinuses: a phantom study.
abstract: OBJECTIVE
  CT in low dose technique is the criterion standard imaging modality for evaluation of the paranasal sinus. Our aim was to evaluate the dose-reduction potential of a recently available sinogram-affirmed iterative reconstruction technique, regarding noise, image quality, and time duration when evaluating this region.
  
  
  METHODS
  CT was performed on a phantom head at different tube voltages (120 kV, 100 kV) and currents (100 mAs, 50 mAs, 25 mAs). Each protocol was reconstructed (in soft tissue and bony kernel) by using standard filtered back-projection and 5 different SAFIRE strengths, and image noise was evaluated. Subjective image quality was evaluated on noise-aligned image triplets acquired at tube currents of 100% (FBP), 50% (SAFIRE), and 25% (SAFIRE) by using a 5-point scale (1 = worst, 5 = best). The time duration for image reconstruction was noted for calculations with FBP and SAFIRE.
  
  
  RESULTS
  SAFIRE reduced image noise by 15%-85%, depending on the iterative strength, rendering kernel, and dose parameters. Noise reduction was stronger at a bone kernel algorithm both in 1- and 3-mm images (P < .05). Subjective quality evaluation of the noise-adapted images showed preference for those acquired at 100% tube current with FBP (4.7-5.0) versus 50% dose with SAFIRE (3.4-4.4) versus 25% dose with SAFIRE (2.0-3.1). The time duration for FBP image sets was 2.9-6.6 images per second versus SAFIRE with 0.9-1.6 images per second.
  
  
  CONCLUSIONS
  For CT of the paranasal sinus, SAFIRE algorithms are suitable for image-noise reduction. Because image quality decreases with dosage, careful choice of the appropriate iterative method is necessary to achieve an optimal balance between image noise and quality.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt, Germany. boris.schell@googlemail.com
authors.forename: B
authors.initials: B
authors.lastname: Schulz
authors.forename: M
authors.initials: M
authors.lastname: Beeres
authors.forename: B
authors.initials: B
authors.lastname: Bodelle
authors.forename: R
authors.initials: R
authors.lastname: Bauer
authors.forename: F
authors.initials: F
authors.lastname: Al-Butmeh
authors.forename: A
authors.initials: A
authors.lastname: Thalhammer
authors.forename: T J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: J M
authors.initials: JM
authors.lastname: Kerl
mesh_terms: D000465:Algorithms; D006801:Humans; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging*; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*