title: Radiation dose and diagnostic image quality associated with iterative reconstruction in coronary CT angiography: A systematic review.
abstract: The aim of this systematic review is to evaluate the radiation dose reduction achieved using iterative reconstruction (IR) compared to filtered back projection (FBP) in coronary CT angiography (CCTA) and assess the impact on diagnostic image quality. A systematic search of seven electronic databases was performed to identify all studies using a developed keywords strategy. A total of 14 studies met the criteria and were included in a review analysis. The results showed that there was a significant reduction in radiation dose when using IR compared to FBP (P < 0.05). The mean and standard deviation (SD) difference of CTDIvol and dose-length-product (DLP) were 14.70 ± 6.87 mGy and 186 ± 120 mGy.cm respectively. The mean ± SD difference of effective dose (ED ) was 2.9 ± 1.7 mSv with the range from 1.0 to 5.0 mSv. The assessment of diagnostic image quality showed no significant difference (P > 0.05). The mean ± SD difference of image noise, signal-noise ratio (SNR) and contrast-noise ratio (CNR) were 1.05 ± 1.29 HU, 0.88 ± 0.56 and 0.63 ± 1.83 respectively. The mean ± SD percentages of overall image quality scores were 71.79 ± 12.29% (FBP) and 67.31 ± 22.96% (IR). The mean ± SD percentages of coronary segment analysis were 95.43 ± 2.57% (FBP) and 97.19 ± 2.62% (IR). In conclusion, this review analysis shows that CCTA with the use of IR leads to a significant reduction in radiation dose as compared to the use of FBP. Diagnostic image quality of IR at reduced dose (30-41%) is comparable to FBP at standard dose in the diagnosis of CAD.
authors.affiliation: Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.|Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Terengganu, Malaysia.
authors.forename: Kamarul Amin
authors.identifier: http://orcid.org/0000-0002-3568-9579
authors.initials: KA
authors.lastname: Abdullah
authors.affiliation: Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Mark F
authors.initials: MF
authors.lastname: McEntee
authors.affiliation: Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Warren
authors.initials: W
authors.lastname: Reed
authors.affiliation: Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Kench
mesh_terms: D000072226:Computed Tomography Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D016273:Occupational Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*
keywords: coronary CT angiography; coronary artery disease; dose reduction; filtered back projection; iterative reconstruction