Abstract
PurposeTo compare the image quality and diagnostic accuracy between sinogram affirmed iterative reconstruction (SAFIRE) algorithm and filtered back projection (FBP) reconstruction algorithm at 70 kVp-tube-voltage DSCT angiography in children with congenital heart disease (CHD).Materials and MethodsTwenty-eight patients (mean age: 13 months; range: 2–48 months; male: 16; female: 12; mean weight: 8 kg) with CHD underwent 70 kVp DSCT angiography. Imaging data were reconstructed with both FBP and SAFIRE algorithms. Subjective image quality was evaluated on a five-point scale. The parameters of image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) on the objective image quality were compared for the two reconstruction algorithms. Surgery was performed in 20 patients, whereas conventional cardiac angiography (CCA) was performed in 8 patients. The diagnostic accuracy was evaluated on the surgical and/or CCA findings. The effective radiation doses were calculated.ResultsCompared to FBP algorithm, SAFIRE algorithm had significantly higher scores for subjective image quality (P<0.05), and lower image noise (P<0.05) as well as higher SNR &CNR values (P<0.05). There was no significant difference in the diagnostic accuracy between the FBP and SAFIRE algorithm (χ2 = 1.793, P>0.05). The mean effective dose for 70 kVp DSCT angiography was 0.30±0.13 mSv.ConclusionsThe SAFIRE algorithm can significantly reduce image noise and improve the image quality at 70 kVp DSCT angiography for the assessment of CHD in children.
Highlights
The recent innovations in multi-detector CT technology with improved spatial and temporal resolution have extended the application of cardiovascular imaging in the assessment of congenital heart disease (CHD) in children [1,2,3,4,5,6]
There was no significant difference in the diagnostic accuracy between the filtered back projection (FBP) and sinogram affirmed iterative reconstruction (SAFIRE) algorithm (x2 = 1.793, P.0.05)
The downside of the low-tube-voltage technique is an increase in the image noise, which can be compensated by increasing the tube current and using the iterative reconstruction (IR) algorithm [13]
Summary
The recent innovations in multi-detector CT technology with improved spatial and temporal resolution have extended the application of cardiovascular imaging in the assessment of congenital heart disease (CHD) in children [1,2,3,4,5,6]. Several dose reduction strategies, such as reduced tube voltage, automated tube current modulation, weight-adjusted tube current, minimization of z-axis coverage as well as use of the prospective ECG-triggering sequential mode and high-pitch mode, have been successfully implemented into paediatric cardiac CT angiography and have been shown to effectively lower the radiation dose [1,2,3,4,5,6,7,8]. The 80 kVp setting is routinely used for infants and small children CT examinations [3,4], using 70 kVp instead of 80 kVp should shift the mean photon energy of the x-ray beam closer to the k-edge of iodine and improve the contrast between vessels and the surroundings. Gnant R et al [14] demonstrated that neck CT at 70 kVp was feasible with 34% dose reduction compared to the standard protocol at 120 kVp
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