title: Pilot study of detection, radiologist confidence and image quality with sinogram-affirmed iterative reconstruction at half-routine dose level.
abstract: OBJECTIVE
  The objective of this study was to determine the effect of Sinogram-Affirmed Iterative Reconstruction (SAFIRE) on radiological detection, diagnostic confidence, and image quality at half-dose, contrast-enhanced abdominopelvic computed tomography.
  
  
  METHODS
  Forty dual-source examinations were reconstructed using routine-dose with filtered back projection, half-dose filtered back projection, and half-dose SAFIRE. Three radiologists detected lesions in abdominopelvic organs, reporting findings of potential medical significance, diagnostic confidence, and image quality.
  
  
  RESULTS
  There was greater than 78% concordance between full- and half-dose images ± SAFIRE, and no difference in the detection of lesions within organs between half-dose images ± SAFIRE (P = 0.22 - 1.0). Detection of potentially important findings varied by reader, but not between dose/reconstruction methods. Diagnostic confidence varied widely (P < 0.001 to P > 0.91). Sinogram-Affirmed Iterative Reconstruction significantly improved image quality in the pelvis (P ≤ 0.04).
  
  
  CONCLUSIONS
  Half-dose images ± SAFIRE had organ-specific detections similar to routine-dose images. Sinogram-Affirmed Iterative Reconstruction improved image quality in the pelvis, but diagnostic confidence and image quality scores in the abdomen depended on the reader.
authors.affiliation: Departments of Radiology, Mayo Clinic, Rochester, MN 55905, USA. fletcher.joel@mayo.edu
authors.forename: Joel G
authors.initials: JG
authors.lastname: Fletcher
authors.forename: William R
authors.initials: WR
authors.lastname: Krueger
authors.forename: David M
authors.initials: DM
authors.lastname: Hough
authors.forename: James E
authors.initials: JE
authors.lastname: Huprich
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Fidler
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.forename: Maria M
authors.initials: MM
authors.lastname: Shiung
authors.forename: W Scott
authors.initials: WS
authors.lastname: Harmsen
authors.forename: Katharine L
authors.initials: KL
authors.lastname: Grant
authors.forename: Cynthia H
authors.initials: CH
authors.lastname: McCollough
mesh_terms: D002983:Clinical Competence; D015331:Cohort Studies; D003287:Contrast Media; D006801:Humans; D010865:Pilot Projects; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D011860:Radiography, Abdominal / Q000379:methods*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media