Marie-Louise Aurumskjöld

Improvements to image quality using hybrid and model-based iterative reconstructions: a phantom study.

Background The number of computed tomography (CT) examinations is increasing and leading to an increase in total patient exposure. It is therefore important to optimize CT scan imaging conditions in order to reduce the radiation dose. The introduction of iterative reconstruction methods has enabled an improvement in image quality and a reduction in radiation dose. Purpose To investigate how image quality depends on reconstruction method and to discuss patient dose reduction resulting from the use of hybrid and model-based iterative reconstruction. Material and Methods An image quality phantom (Catphan® 600) and an anthropomorphic torso phantom were examined on a Philips Brilliance iCT. The image quality was evaluated in terms of CT numbers, noise, noise power spectra (NPS), contrast-to-noise ratio (CNR), low-contrast resolution, and spatial resolution for different scan parameters and dose levels. The images were reconstructed using filtered back projection (FBP) and different settings of hybrid (iDose4) and model-based (IMR) iterative reconstruction methods. Results iDose4 decreased the noise by 15–45% compared with FBP depending on the level of iDose4. The IMR reduced the noise even further, by 60–75% compared to FBP. The results are independent of dose. The NPS showed changes in the noise distribution for different reconstruction methods. The low-contrast resolution and CNR were improved with iDose4, and the improvement was even greater with IMR. Conclusion There is great potential to reduce noise and thereby improve image quality by using hybrid or, in particular, model-based iterative reconstruction methods, or to lower radiation dose and maintain image quality.

An investigation of the iterative reconstruction method iDose 4 on a Philips CT Brilliance 64 using a Catphan 600 phantom

The number of CT examinations giving a relatively high patient exposure is increasing. It is therefore important to optimize the imaging conditions at these investigations. Many steps have been taken to reduce the radiation doses in CT examinations. Currently much work is related to iterative image reconstruction methods as alternative to the filtered back projection method. The aim of this work was to evaluate quality parameters in images from a CT (Philips Brilliance 64) equipped with the iterative reconstruction method iDose4 using a Catphan 600 phantom with and without body simulating ring. CT scans using abdomen protocol were taken with various tube currents and tube voltage and keeping collimation and pitch unchanged for all scans. All collected data were reconstructed with different levels of iDose4 (Level 2, 4, 6) and traditional filtered back projection. Image quality parameters were evaluated using AutoQA Lite TM (Version 2.3 2007 Iris QA, LLC). Results from the study shows that the iterative reconstruction method decreases the noise with 15-45% compared with filtered back projection depending on which level of iDose4 is used. The percentage reduction in noise level is the same with and without body simulating ring. Low contrast was improved with iDose4 and spatial resolution is only marginally affected by the method of reconstruction. However by reducing the image noise, the detectability can be improved. Our conclusion is that there is great potential to reduce the noise and thereby improve the image quality by using iterative reconstruction methods. This can also be used to lower radiation dose and maintain image quality or improve image quality.

MODEL-BASED ITERATIVE RECONSTRUCTION ENABLES THE EVALUATION OF THIN-SLICE COMPUTED TOMOGRAPHY IMAGES WITHOUT DEGRADING IMAGE QUALITY OR INCREASING RADIATION DOSE.

Computed tomography (CT) is one of the most important modalities in a radiological department. This technique not only produces images that enable radiological reports with high diagnostic confidence, but it may also provide an elevated radiation dose to the patient. The radiation dose can be reduced by using advanced image reconstruction algorithms. This study was performed on a Brilliance iCT, equipped with iDose(4) iterative reconstruction and an iterative model-based reconstruction (IMR) method. The purpose was to investigate the effect of reduced slice thickness combined with an IMR method on image quality compared with standard slice thickness with iDose(4) reconstruction. The results of objective and subjective image quality evaluations showed that a thinner slice combined with IMR can improve the image quality and reduce partial volume artefacts compared with the standard slice thickness with iDose(4) In conclusion, IMR enables reduction of the slice thickness while maintaining or even improving image quality versus iDose(4).

A PHANTOM STUDY SHOWING THE IMPORTANCE OF COMPRESSION IN CONVENTIONAL DIAGNOSTIC X-RAY EXAMINATIONS.

Compression was earlier an important and well-managed part of the clinical routine, but during the past 15-20 y the use has diminished, except for mammography, where it is a prerequisite for having images of high quality and low radiation dose. According to national and European regulations and recommendations, it is important to apply the compression technique to obtain the optimal image quality and radiation dose in common conventional diagnostic examinations. Current experience of compression technique is, however, based on studies carried out a long time ago and with analogue imaging techniques. An anthropomorphic phantom was used to show the importance of compression in conventional X-ray examinations. The patient thicknesses on volunteers with and without compression was measured. This measurement was done to investigate compression potential on patients and to select suitable phantom thicknesses. The X-ray examinations that were included in the study were abdomen overview, lumbar spine and the pelvis. The results from the phantom study showed a large dependency of the kerma-area product value on the phantom thickness. The phantom study suggests that there is a potential for significant reduction of radiation dose to the patient by using compression also with modern X-ray techniques. A dose reduction of up to 50 % or even more may be obtained.

Evaluation of an iterative model-based reconstruction of pediatric abdominal CT with regard to image quality and radiation dose:

Background In pediatric patients, computed tomography (CT) is important in the medical chain of diagnosing and monitoring various diseases. Because children are more radiosensitive than adults, they require minimal radiation exposure. One way to achieve this goal is to implement new technical solutions, like iterative reconstruction. Purpose To evaluate the potential of a new, iterative, model-based method for reconstructing (IMR) pediatric abdominal CT at a low radiation dose and determine whether it maintains or improves image quality, compared to the current reconstruction method. Material and Methods Forty pediatric patients underwent abdominal CT. Twenty patients were examined with the standard dose settings and 20 patients were examined with a 32% lower radiation dose. Images from the standard examination were reconstructed with a hybrid iterative reconstruction method (iDose4), and images from the low-dose examinations were reconstructed with both iDose4 and IMR. Image quality was evaluated subjectively by three observers, according to modified EU image quality criteria, and evaluated objectively based on the noise observed in liver images. Results Visual grading characteristics analyses showed no difference in image quality between the standard dose examination reconstructed with iDose4 and the low dose examination reconstructed with IMR. IMR showed lower image noise in the liver compared to iDose4 images. Inter- and intra-observer variance was low: the intraclass coefficient was 0.66 (95% confidence interval = 0.60–0.71) for the three observers. Conclusion IMR provided image quality equivalent or superior to the standard iDose4 method for evaluating pediatric abdominal CT, even with a 32% dose reduction.

MODEL BASED ITERATIVE RECONSTRUCTION IMR GIVES POSSIBILITY TO EVALUATE THINNER SLICE THICKNESSES THAN CONVENTIONAL ITERATIVE RECONSTRUCTION iDOSE4 – A PHANTOM STUDY

Computed tomography (CT) is one of the most important modalities in a radiological department, which produces images with high diagnostic confidence, but in some cases contributes to a high radiation dose to the patient. The radiation dose can be reduced by the use of advanced image reconstruction algorithms. This study was done on a Philips Brilliance iCT with iterative reconstruction iDose4 and model-based iterative reconstruction IMR. The purpose was to investigate the effect on the image quality with thin slice images reconstructed with IMR, compared to standard slice thickness reconstructed with iDose4. Objective measurements of noise and contrast-to-noise ratio were performed using an image quality phantom, an anthropomorphic phantom and clinical cases. Subjective evaluations of low-contrast resolution were performed by observers using an image quality phantom. IMR gives strong noise reduction and enhanced low-contrast and thereby enable selection of thinner slice thickness. Objective evaluation of image noise shows that thin slices reconstructed with IMR provides lower noise than thicker slice images reconstructed with iDose4. With IMR the slice thickness is of less importance for the noise. With thinner slices the partial volume artefacts becomes less pronounced. In conclusion, we have shown that IMR enables reduction of the slice thickness and at the same time maintain or even reduce the noise level compared to iDose4 reconstruction with standard slice thickness. This will subsequently result in an improvement of image quality for images reconstructed with IMR.