Sinogram-affirmed Iterative Reconstruction Algorithm Research Articles

Application of low-dose hydro-CT using SAFIRE in the evaluation of esophageal cancer.

The esophageal cancer treatment strategy depends on the tumor stage according to the tumor, node and metastasis (TNM) classification. One of the methods recommended for esophageal cancer assessment is computed tomography (CT). The CT imaging is especially important for patients with contraindications for gastroscopy, which is the primary method used for assessing esophageal diseases. The aim of this retrospective study was to evaluate the inter-rater reliability of low-dose hydro-CT with a sinogram-affirmed iterative reconstruction algorithm (SAFIRE) used for the staging of esophageal cancer by 2 independent radiologists. We also evaluated the application of this method for the diagnosis of esophageal cancer. Low-dose hydro-CT was performed in 65 patients, and the raw data were reconstructed with SAFIRE. Obtained images were retrospectively interpreted by 2 independent and experienced radiologists. Histopathological results were used as the reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the diagnosis of esophageal cancer were calculated for hydro-CT. The examination of the inter-rater reliability level in the assessment of the esophageal cancer stage in the TNM classification was performed by calculating Cohen's kappa coefficient (κ) with square weights and standard errors (SEs) for kappa. Independence tests were also performed (Fisher's exact test - two-tailed, and Pearson's χ2 test). For the diagnosis of esophageal cancer with hydro-CT, a sensitivity of 93%, a specificity of 100%, a PPV of 100%, and a NPV of 88% were observed. In the statistical analyses for the T, N and M stages, κ values greater than 0.90 and significance levels of p < 0.001 were obtained. Hydro-CT using low-dose techniques may be a valuable diagnostic method for staging and diagnosis of esophageal cancer, especially in patients with contraindications for invasive procedures.

Computerized Tomography Imaging Omics under Iterative Reconstruction Algorithm in Diagnosis of Gastric Cancer

This study aimed to explore the application value of computed tomography (CT) imaging radiomics based on a sinogram-affirmed iterative reconstruction algorithm (SAFIRE) in the diagnosis of gastric cancer. 59 patients who were clinically diagnosed with gastric cancer were selected as research objects and arranged CT examinations. The images obtained were optimized by the SAFIRE for the staging of gastric cancer. The pathological biopsy results were used as the gold standard to evaluate its diagnostic effect and compared with the filtered back-projection (FBP) method. The results showed that the carrier-to-noise ratio (CNR) (0.979) and signal-to-noise ratio (SNR) (0.967) of the CT image after the algorithm processing were significantly higher than those (0.781, 0.744) before ( P &lt; 0.05 ). There was no significant difference in CT values between the FBP algorithm and S1, S2, and S3 ( P &gt; 0.05 ); the area under the curve (AUC) (0.999) and sensitivity (0.98) of the CT training group under the SAFIRE algorithm for gastric cancer classification were higher than those of the verification group (0.958, 0.92). The preoperative CT staging kappa value was consistent with the postoperative pathological diagnosis of 0.882. CT images guided by SAFIRE can objectively and noninvasively assess the tumor asymmetry, discover additional information from subjective evaluation beyond the naked eye, and perform reasonable staging diagnosis of gastric cancer, which was useful for clinicians to develop high-quality individualized treatment plans.

Values of Sinogram Affirmed Iterative Reconstruction Algorithm-Based Low-Dose Computed Tomography Imaging in Clinical Diagnosis of Cerebral Hemorrhage

In this study, the sinogram affirmed iterative reconstruction (SAFIRE) technology combined with low-dose computed tomography (CT) scanning technology was applied to scan patients with cerebral hemorrhage to evaluate the application value of this combined technology in the diagnosis of patients with cerebral hemorrhage. 132 patients with cerebral hemorrhage admitted to the hospital were selected randomly as the research objects in this study. According to the patients’ wishes, all of them were rolled into an experimental group and a control group. Besides, patients who were willing to use low-dose CT imaging scanning technology based on the SAFIRE algorithm were classified into the experimental group, and those who received simple low-dose CT scans were classified into the control group. Subjective score, objective score (mean CT value), image noise (SD), signal-to-noise ratio (SNR), and contrast-noise ratio (CNR) were used to analyze and compare the two groups of detection methods. The results showed the following: (1) The average result of CT images was 4.05 ± 0.28 points for the control group and 4.43 ± 0.59 points for the experimental group. According to the classification, the excellent and good rates of the experimental group (89.9%) were markedly higher than the rates of the control group (65.8%), with a statistically obvious difference ( P &lt; 0.05). (2) The standard deviation (SD), image signal-to-noise ratio (SNR), and contrast-noise ratio (CNR) results of gray matter, white matter, and cerebral hemorrhage lesions of patients from the experimental group were better than those of the control group, and the differences were statistically significant ( P &lt; 0.05). In conclusion, the image quality of a low-dose CT scan reconstructed by the SAFIRE algorithm was superior to that of a simple low-dose CT scan. In other words, the image quality of CT images could be guaranteed by the SAFIRE technology under the condition of reducing radiation dose. It enabled patients with cerebral hemorrhage to carry out diagnostic examinations with guaranteed accuracy under the risk of low radiation and provided better imaging services for patients with cerebral hemorrhage.

Cerebral computed tomographic angiography using third-generation reconstruction algorithm provides improved image quality with lower contrast and radiation dose.

We hypothesized that cerebral CT angiogram performed using third-generation reconstruction algorithm and lower contrast dose-low-kVp technique (LD-CTA) will provide better image quality when compared with regular contrast dose CTA at 120kVp using a sinogram-affirmed iterative reconstruction algorithm (ND-CTA). Retrospective imaging review of 100 consecutive patients (50 each in LD- and ND-CTA groups). Two readers independently assessed the subjective image quality across multiple vascular segments on a Likert-like scale. Differences in contrast dose, CT dose index (CTDI), and dose length product (DLP) were compared using Mann-Whitney U test. Fisher's exact test was used to compare subjective image quality. Similarly, contrast- and signal-to-noise ratios (CNR and SNR) were compared inthe mid-M1 MCA vessels bilaterally and the mid-basilar artery using Mann-Whitney U test. Interclass correlation coefficient (ICC) was calculated for the SNR/CNR values. Both observers showed excellent correlation in subjective image quality (mean percentage agreement of 95.2% for group 1 versus 89.2% for group 2). LD-CTA group showed better SNR and CNR (p < 0.0001) for both MCA vessels and the mid-basilar artery. Interclass correlation coefficient showed moderate correlation (0.51-0.63) between readers. LD-CTA group also used lower contrast (49cc versus 97cc in ND-CTA) and had lower radiation exposure (DLP/CTDI for both groups 268.3/80.7 vs 519.5/36.08, both < 0.0001). Next-generation reconstruction algorithm and low-kV scanning significantly improved image quality on cerebral CTA images despite lower contrast dose and, in addition, have lower radiation exposure.

Value of 100 kVp scan with sinogram-affirmed iterative reconstruction algorithm on a single-source CT system during whole-body CT for radiation and contrast medium dose reduction: an intra-individual feasibility study

To perform an intra-individual investigation of the usefulness of a contrast medium (CM) and radiation dose-reduction protocol using single-source computed tomography (CT) combined with 100 kVp and sinogram-affirmed iterative reconstruction (SAFIRE) for whole-body CT (WBCT; chest-abdomen-pelvis CT) in oncology patients. Forty-three oncology patients who had undergone WBCT under both 120 and 100 kVp protocols at different time points (mean interscan intervals: 98 days) were included retrospectively. The CM doses for the 120 and 100 kVp protocols were 600 and 480 mg iodine/kg, respectively; 120 kVp images were reconstructed with filtered back-projection (FBP), whereas 100 kVp images were reconstructed with FBP (100 kVp-F) and the SAFIRE (100 kVp-S). The size-specific dose estimate (SSDE), iodine load and image quality of each protocol were compared. The SSDE and iodine load of 100 kVp protocol were 34% and 21%, respectively, lower than of 120 kVp protocol (SSDE: 10.6±1.1 versus 16.1±1.8 mGy; iodine load: 24.8±4versus 31.5±5.5 g iodine, p<0.01). Contrast enhancement, objective image noise, contrast-to-noise-ratio, and visual score of 100 kVp-S were similar to or better than of 120 kVp protocol. Compared with the 120 kVp protocol, the combined use of 100 kVp and SAFIRE in WBCT for oncology assessment with an SSCT facilitated substantial reduction in the CM and radiation dose while maintaining image quality.

Radiation dose reduction using 100-kVp and a sinogram-affirmed iterative reconstruction algorithm in adolescent head CT: Impact on grey-white matter contrast and image noise.

To retrospectively evaluate the image quality and radiation dose of 100-kVp scans with sinogram-affirmed iterative reconstruction (IR) for unenhanced head CT in adolescents. Sixty-nine patients aged 12-17 years underwent head CT under 120- (n = 34) or 100-kVp (n = 35) protocols. The 120-kVp images were reconstructed with filtered back-projection (FBP), 100-kVp images with FBP (100-kVp-F) and sinogram-affirmed IR (100-kVp-S). We compared the effective dose (ED), grey-white matter (GM-WM) contrast, image noise, and contrast-to-noise ratio (CNR) between protocols in supratentorial (ST) and posterior fossa (PS). We also assessed GM-WM contrast, image noise, sharpness, artifacts, and overall image quality on a four-point scale. ED was 46% lower with 100- than 120-kVp (p < 0.001). GM-WM contrast was higher, and image noise was lower, on 100-kVp-S than 120-kVp at ST (p < 0.001). CNR of 100-kVp-S was higher than of 120-kVp (p < 0.001). GM-WM contrast of 100-kVp-S was subjectively rated as better than of 120-kVp (p < 0.001). There were no significant differences in the other criteria between 100-kVp-S and 120-kVp (p = 0.072-0.966). The 100-kVp with sinogram-affirmed IR facilitated dramatic radiation reduction and better GM-WM contrast without increasing image noise in adolescent head CT. • 100-kVp head CT provides 46% radiation dose reduction compared with 120-kVp. • 100-kVp scanning improves subjective and objective GM-WM contrast. • Sinogram-affirmed IR decreases head CT image noise, especially in supratentorial region. • 100-kVp protocol with sinogram-affirmed IR is suited for adolescent head CT.

Combined Use of Automatic Tube Voltage Selection and Current Modulation with Iterative Reconstruction for CT Evaluation of Small Hypervascular Hepatocellular Carcinomas: Effect on Lesion Conspicuity and Image Quality.

ObjectiveTo assess the lesion conspicuity and image quality in CT evaluation of small (≤ 3 cm) hepatocellular carcinomas (HCCs) using automatic tube voltage selection (ATVS) and automatic tube current modulation (ATCM) with or without iterative reconstruction.Materials and MethodsOne hundred and five patients with 123 HCC lesions were included. Fifty-seven patients were scanned using both ATVS and ATCM and images were reconstructed using either filtered back-projection (FBP) (group A1) or sinogram-affirmed iterative reconstruction (SAFIRE) (group A2). Forty-eight patients were imaged using only ATCM, with a fixed tube potential of 120 kVp and FBP reconstruction (group B). Quantitative parameters (image noise in Hounsfield unit and contrast-to-noise ratio of the aorta, the liver, and the hepatic tumors) and qualitative visual parameters (image noise, overall image quality, and lesion conspicuity as graded on a 5-point scale) were compared among the groups.ResultsGroup A2 scanned with the automatically chosen 80 kVp and 100 kVp tube voltages ranked the best in lesion conspicuity and subjective and objective image quality (p values ranging from < 0.001 to 0.004) among the three groups, except for overall image quality between group A2 and group B (p = 0.022). Group A1 showed higher image noise (p = 0.005) but similar lesion conspicuity and overall image quality as compared with group B. The radiation dose in group A was 19% lower than that in group B (p = 0.022).ConclusionCT scanning with combined use of ATVS and ATCM and image reconstruction with SAFIRE algorithm provides higher lesion conspicuity and better image quality for evaluating small hepatic HCCs with radiation dose reduction.

Impact of Sinogram Affirmed Iterative Reconstruction (SAFIRE) Algorithm on Image Quality with 70 kVp-Tube-Voltage Dual-Source CT Angiography in Children with Congenital Heart Disease

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.

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

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.