Physician Preference Between Low-Dose Computed Tomography With a Sinogram-Affirmed Iterative Reconstruction Algorithm and Routine-Dose Computed Tomography With Filtered Back Projection in Abdominopelvic Imaging

Abstract

The aim of this study was to directly compare the preference between low-dose sinogram-affirmed iterative reconstruction (SAFIRE) and routine filtered back projection (FBP) abdominopelvic computed tomography (CT). A retrospective review identified 41 subjects who had undergone 2 different CT examinations at different times (a CT with reduced radiation dose SAFIRE and also a CT with routine-dose FBP). Radiation dose, patient size, and image noise were recorded. Two independent readers assessed the paired CT studies for preference in image quality in regard to 3 clinically relevant diagnostic endpoints (bowel pathology, biliary pathology, and general purpose). Radiation dose was significantly lower for SAFIRE (mean, 7.6 mGy; range, 4.1-15.4 mGy) than FBP (12.9 mGy; 6.7-31.6 mGy) (P < 0.001). Sinogram-affirmed iterative reconstruction was preferred for the general purpose and bowel evaluations, particularly when the level of radiation dose reduction was less than 33%. The preference for interpretation of the biliary system was equivocal, especially when the level of radiation reduction was increased greater than 33%. Filtered back projection was preferred when SAFIRE had a radiation reduction from FBP of greater than 50%. For abdominopelvic CT, low-dose CT with SAFIRE may produce preferred image quality over FBP up to levels of 50% dose reduction.