title: Ultra-low-dose CT with model-based iterative reconstruction (MBIR): detection of ground-glass nodules in an anthropomorphic phantom study.
abstract: OBJECTIVE
  The authors sought to evaluate the effect of model-based iterative reconstruction (MBIR) on the sensitivity of ground-glass nodule (GGN) detection at different dose levels.
  
  
  METHODS
  Fifty-four artificial GGN were randomly divided into three sets, each positioned in an anthropomorphic phantom. The three sets were evaluated on standard-dose (SD, 350 mA), low-dose (LD, 35 mA) and ultra-low-dose (ULD, 10 mA) CT scans (100 kV, 64 × 0.625 mm, 0.5 s), and each scan was reconstructed twice with filtered back projection (FBP) and MBIR. Three radiologists independently evaluated the scans for GGN presence and size. SD + FBP was considered the reference standard. A region of interest (ROI) was used to calculate signal-to-noise ratio (SNR) and contrast-to-noise ratio normalised to dose (CNRD). McNemar's test, Bland-Altman analysis and t test were used for statistical assessment (p < 0.05).
  
  
  RESULTS
  The mean diameter of the 54 GGNs was 9.2 mm (range 3.7-17.3 mm). For the three readers, no statistically significant differences were observed in the sensitivity of GGN detection between LD + MBIR, ULD + MBIR and SD + FBP (p > 0.05). Bland-Altman analysis showed a good reader agreement (±1.5 mm) for GGN size between SD + FBP and ULD + MBIR. For low dose and ultra-low dose, the SNR and CNRD were significantly higher with MBIR (p < 0.0001). The effective dose was 97.1 % lower with ultra-low dose (0.15 mSv) than standard dose (5.15 mSv).
  
  
  CONCLUSIONS
  The detection of GGN with MBIR at low-dose and ultra-low-dose CT does not differ significantly from standard-dose CT with FBP in an anthropomorphic phantom.
authors: Department of Medical Imaging and Radiological Sciences, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy, cristiano.rampinelli@ieo.it.
authors: Cristiano
authors: C
authors: Rampinelli
authors: Daniela
authors: D
authors: Origgi
authors: Vittoria
authors: V
authors: Vecchi
authors: Luigi
authors: L
authors: Funicelli
authors: Sara
authors: S
authors: Raimondi
authors: Paul
authors: P
authors: Deak
authors: Massimo
authors: M
authors: Bellomi
mesh_terms: D007091:Image Processing, Computer-Assisted; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008953:Models, Anatomic; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000379:methods*
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