title: Impact of iterative reconstruction on the diagnosis of acute pulmonary embolism (PE) on reduced-dose chest CT angiograms.
abstract: OBJECTIVE
  To evaluate the impact of iterative reconstruction on the detectability of clots.
  
  
  METHODS
  Fifty-three patients were enrolled in a study comparing reduced-dose and full-dose images, available from the same dual-source data set. From each acquisition, three series of images were generated: (1) full-dose images (from both tubes), reconstructed with filtered back projection (FBP) (group 1; standard of reference), (2) reduced-dose images (from tube A only; 60 % dose reduction) reconstructed with FBP (group 2) and iterative reconstruction (SAFIRE) (group 3).
  
  
  RESULTS
  In group 1 (mean DLP: 264.6 mGy.cm), (1) PE was diagnosed in 8 patients (15 %) with 82 clots in the central (n = 5), segmental (n = 39) and subsegmental (n = 38) arteries and (2) mean level of noise was 30.56 ± 5.07. In group 2 (mean DLP: 105.8 mGy.cm), a significant increase in noise (44.56 ± 6.24; p < 0.0001) (1) hampered detection of PE in one patient and (2) altered detection of peripheral clots (12 false-negative and 2 false-positive results). In group 3, image noise was not significantly different from that in group 1 (p = 0.1525; effect size: 0.2683), with a similar detection of PE compared to group 1 (p = 1).
  
  
  CONCLUSIONS
  Reconstruction of reduced-dose images (60 % dose reduction) with SAFIRE provided image quality and diagnostic value comparable to those of full-dose FBP images.
  
  
  CONCLUSIONS
  • Iterative reconstruction does not alter the detection of endoluminal clots. • Iterative reconstruction allows dose reduction in the context of acute PE. • Iterative reconstruction allows radiologists to approach the prospects of submilliSievert CT.
authors: Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille 2 Nord de France, 59000, Lille, France.
authors: François
authors: F
authors: Pontana
authors: Simon
authors: S
authors: Henry
authors: Alain
authors: A
authors: Duhamel
authors: Jean-Baptiste
authors: JB
authors: Faivre
authors: Nunzia
authors: N
authors: Tacelli
authors: Julien
authors: J
authors: Pagniez
authors: Jacques
authors: J
authors: Remy
authors: Martine
authors: M
authors: Remy-Jardin
mesh_terms: D000465:Algorithms; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*
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