title: Clinical impact of an adaptive statistical iterative reconstruction algorithm for detection of hypervascular liver tumours using a low tube voltage, high tube current MDCT technique.
abstract: OBJECTIVE
  To investigate the impact of an adaptive statistical iterative reconstruction (ASiR) algorithm on diagnostic accuracy and confidence for the diagnosis of hypervascular liver tumours, as well as the reader's perception of image quality, using a low tube voltage (80 kVp), high tube current computed tomography (CT) technique.
  
  
  METHODS
  Forty patients (29 men, 11 women) with 65 hypervascular liver tumours underwent dual energy CT. The 80 kV set of the dual energy acquisition was reconstructed with standard filtered backprojection (FBP) and ASiR at different blending levels. Lesion contrast-to-noise ratio (CNR), reader's confidence for lesion detection and characterisation, and reader's evaluation of image quality were recorded.
  
  
  RESULTS
  ASiR yielded significantly higher CNR values compared with FBP (P < 0.0001 for all comparisons). Reader's perception of lesion conspicuity and confidence in the diagnosis of malignancy were also higher with 60 % and 80 % ASiR, compared with FBP (P = 0.01 and < 0.001, respectively). Compared with FBP, ASiR yielded nearly significantly lower specificity for lesion detection and a substantial decrease in the reader's perception of image quality.
  
  
  CONCLUSIONS
  Compared with the standard FBP algorithm, ASiR significantly improves conspicuity of hypervascular liver lesions. This improvement may come at the cost of decreased specificity and reader's perception of image quality.
authors.affiliation: Department of Radiology, Duke University Medical Center, Erwin Road, Durham, NC, 27710, USA, danielemarin2@gmail.com.
authors.forename: Daniele
authors.initials: D
authors.lastname: Marin
authors.forename: Kingshuk Roy
authors.initials: KR
authors.lastname: Choudhury
authors.forename: Rajan T
authors.initials: RT
authors.lastname: Gupta
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Ho
authors.forename: Brian C
authors.initials: BC
authors.lastname: Allen
authors.forename: Sebastian T
authors.initials: ST
authors.lastname: Schindera
authors.forename: James G
authors.initials: JG
authors.lastname: Colsher
authors.forename: Ehsan
authors.initials: E
authors.lastname: Samei
authors.forename: Rendon C
authors.initials: RC
authors.lastname: Nelson
mesh_terms: D000368:Aged; D000465:Algorithms; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000556:secondary; D003287:Contrast Media; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media