title: Optimizing image quality for pediatric torso computed tomography: the use of advanced iterative reconstruction and wide-detector scanning techniques.
abstract: OBJECTIVE
  To compare radiation exposure and image quality in children undergoing torso helical acquisition computed tomography (CT) using filtered back projection (FBP) or adaptive iterative dose reduction (AIDR) 3D reconstruction algorithms. A secondary purpose is to compare radiation exposure and image quality in children undergoing torso CT acquired with helical or wide-detector techniques reconstructed with AIDR 3D.
  
  
  METHODS
  The study was approved by the institutional review board. Phase 1 included 200 helical torso CT studies: 100 using FBP and 100 using AIDR 3D. The size-specific dose estimate (SSDE) was calculated for each study. Region of interest (ROI) noise measurements were recorded in the thorax, abdomen, and pelvis for each study. Unpaired t tests compared SSDE and image noise for each group. Phase 2 included 100 wide-detector CT torso studies using AIDR 3D. Size-specific dose estimate and ROI noise measurements were calculated. Unpaired t tests compared helical and wide-detector SSDE and ROI. Additional t tests looked for age- and weight-specific differences in the helical and wide-detector groups.
  
  
  RESULTS
  Phase 1: AIDR 3D showed significant reduction in SSDE (P = 0.0001) and significant improvement in image quality. Phase 2: no significant difference in SSDE was observed. Children younger than 6 years had a significant reduction in SSDE with wide-detector technique (P = 0.0445) with no loss in image quality.
  
  
  CONCLUSIONS
  Adaptive iterative dose reduction 3D produces significant reduction in radiation dose without degradation to image quality compared with FBP. Significant dose reduction without loss of image quality can also be obtained in younger, smaller children using wide-detector technique.
authors.affiliation: From the Department of Radiology, Arkansas Children's Hospital, Little Rock, AR.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Buchmann
authors.forename: S
authors.initials: S
authors.lastname: Bruce Greenberg
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D013902:Radiography, Thoracic / Q000379:methods*; D011874:Radiometry; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D060726:Torso / Q000000981:diagnostic imaging*