Model-based iterative reconstruction and adaptive statistical iterative reconstruction: dose-reduced CT for detecting pancreatic calcification.
BACKGROUND
Iterative reconstruction methods have attracted attention for reducing radiation doses in computed tomography (CT).


OBJECTIVE
To investigate the detectability of pancreatic calcification using dose-reduced CT reconstructed with model-based iterative construction (MBIR) and adaptive statistical iterative reconstruction (ASIR).


METHODS
This prospective study approved by Institutional Review Board included 85 patients (57 men, 28 women; mean age, 69.9 years; mean body weight, 61.2 kg). Unenhanced CT was performed three times with different radiation doses (reference-dose CT [RDCT], low-dose CT [LDCT], ultralow-dose CT [ULDCT]). From RDCT, LDCT, and ULDCT, images were reconstructed with filtered-back projection (R-FBP, used for establishing reference standard), ASIR (L-ASIR), and MBIR and ASIR (UL-MBIR and UL-ASIR), respectively. A lesion (pancreatic calcification) detection test was performed by two blinded radiologists with a five-point certainty level scale.


RESULTS
Dose-length products of RDCT, LDCT, and ULDCT were 410, 97, and 36 mGy-cm, respectively. Nine patients had pancreatic calcification. The sensitivity for detecting pancreatic calcification with UL-MBIR was high (0.67-0.89) compared to L-ASIR or UL-ASIR (0.11-0.44), and a significant difference was seen between UL-MBIR and UL-ASIR for one reader (P = 0.014). The area under the receiver-operating characteristic curve for UL-MBIR (0.818-0.860) was comparable to that for L-ASIR (0.696-0.844). The specificity was lower with UL-MBIR (0.79-0.92) than with L-ASIR or UL-ASIR (0.96-0.99), and a significant difference was seen for one reader (P < 0.01).


CONCLUSIONS
In UL-MBIR, pancreatic calcification can be detected with high sensitivity, however, we should pay attention to the slightly lower specificity.
Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Koichiro
K
Yasaka
Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Masaki
M
Katsura
NTT Medical Center Tokyo, Tokyo, Japan.
Masaaki
M
Akahane
Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Jiro
J
Sato
Kanto Rosai Hospital, Kawasaki, Kanagawa, Japan.
Izuru
I
Matsuda
Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Kuni
K
Ohtomo
Abdomen/GI; adults; calcifications/calculi; computed tomography (CT); observer performance; pancreas