Abstract
To determine the level of iterative reconstruction required to reduce increased image noise associated with low tube potential computed tomography (CT). Fifty patients underwent CT colonography with a supine scan at 120kVp and a prone scan at 100kVp with other scan parameters unchanged. Both scans were reconstructed with filtered back projection (FBP) and increasing levels of adaptive statistical iterative reconstruction (ASiR) at 30%, 60%, and 90%. Mean noise, soft tissue and tagged fluid attenuation, contrast, and contrast-to-noise ratio (CNR) were collected from reconstructions at both 120 and 100kVp and compared using a generalised linear mixed model. Decreasing tube potential from 120 to 100kVp significantly increased image noise by 30-34% and tagged fluid attenuation by 120HU at all ASiR levels (p<0.0001, all measures). Increasing ASiR from 0% (FBP) to 30%, 60%, and 90% resulted in significant decreases in noise and increases in CNR at both tube potentials (p<0.001, all comparisons). Compared to 120kVp FBP, ASiR greater than 30% at 100kVp yielded similar or lower image noise. Iterative reconstruction adequately compensates for increased image noise associated with low tube potential imaging while improving CNR. An ASiR level of approximately 50% at 100kVp yields similar noise to 120kVp without ASiR.
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