Abstract
BackgroundFull iterative reconstruction algorithm is available, but its diagnostic quality in pediatric cardiac CT is unknown.ObjectiveTo compare the imaging quality of two algorithms, full and hybrid iterative reconstruction, in pediatric cardiac CT.Materials and methodsWe included 49 children with congenital cardiac anomalies who underwent cardiac CT. We compared quality of images reconstructed using the two algorithms (full and hybrid iterative reconstruction) based on a 3-point scale for the delineation of the following anatomical structures: atrial septum, ventricular septum, right atrium, right ventricle, left atrium, left ventricle, main pulmonary artery, ascending aorta, aortic arch including the patent ductus arteriosus, descending aorta, right coronary artery and left main trunk. We evaluated beam-hardening artifacts from contrast-enhancement material using a 3-point scale, and we evaluated the overall image quality using a 5-point scale. We also compared image noise, signal-to-noise ratio and contrast-to-noise ratio between the algorithms.ResultsThe overall image quality was significantly higher with full iterative reconstruction than with hybrid iterative reconstruction (3.67±0.79 vs. 3.31±0.89, P=0.0072). The evaluation scores for most of the gross structures were higher with full iterative reconstruction than with hybrid iterative reconstruction. There was no significant difference between full and hybrid iterative reconstruction for the presence of beam-hardening artifacts. Image noise was significantly lower in full iterative reconstruction, while signal-to-noise ratio and contrast-to-noise ratio were significantly higher in full iterative reconstruction.ConclusionThe diagnostic quality was superior in images with cardiac CT reconstructed with electrocardiogram-gated full iterative reconstruction.
Highlights
Cardiac CT is increasingly used for the diagnosis of infantile and pediatric heart disease [1,2,3]
A low radiation dose was achieved by the proposed protocol, as indicated by the average effective dose of 0.37±0.23 mSv and average Size-specific dose estimates (SSDEs) of 1.36±0.69 mGy
The evaluation scores were higher with full iterative reconstruction than with hybrid iterative reconstruction
Summary
Cardiac CT is increasingly used for the diagnosis of infantile and pediatric heart disease [1,2,3]. Several technologies have been introduced to reduce the radiation dose in diagnostic imaging, such as prospective electrocardiogram-triggering [4,5,6,7,8] and iterative reconstruction methods, which enable good image quality at lower radiation exposure in pediatric CT [9,10,11,12,13,14,15,16,17]. Major CT vendors have developed hybrid iterative reconstruction techniques that are a combination of iterative reconstruction and filtered back-projection [18, 19]. Full iterative reconstruction techniques are based on both forward and backward projection. Images are created using the projection data. With forward projection steps projection data are created using the image data. Full iterative reconstruction algorithm is available, but its diagnostic quality in pediatric cardiac CT is unknown
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