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  • Title: Improvement of image quality and dose management in CT fluoroscopy by iterative 3D image reconstruction.
    Author: Grosser OS, Wybranski C, Kupitz D, Powerski M, Mohnike K, Pech M, Amthauer H, Ricke J.
    Journal: Eur Radiol; 2017 Sep; 27(9):3625-3634. PubMed ID: 28168371.
    Abstract:
    OBJECTIVES: The objective of this study was to assess the influence of an iterative CT reconstruction algorithm (IA), newly available for CT-fluoroscopy (CTF), on image noise, readers' confidence and effective dose compared to filtered back projection (FBP). METHODS: Data from 165 patients (FBP/IA = 82/74) with CTF in the thorax, abdomen and pelvis were included. Noise was analysed in a large-diameter vessel. The impact of reconstruction and variables (e.g. X-ray tube current I) influencing noise and effective dose were analysed by ANOVA and a pairwise t-test with Bonferroni-Holm correction. Noise and readers' confidence were evaluated by three readers. RESULTS: Noise was significantly influenced by reconstruction, I, body region and circumference (all p ≤ 0.0002). IA reduced the noise significantly compared to FBP (p = 0.02). The effect varied for body regions and circumferences (p ≤ 0.001). The effective dose was influenced by the reconstruction, body region, interventional procedure and I (all p ≤ 0.02). The inter-rater reliability for noise and readers' confidence was good (W ≥ 0.75, p < 0.0001). Noise and readers' confidence were significantly better in AIDR-3D compared to FBP (p ≤ 0.03). Generally, IA yielded a significant reduction of the median effective dose. CONCLUSION: The CTF reconstruction by IA showed a significant reduction in noise and effective dose while readers' confidence increased. KEY POINTS: • CTF is performed for image guidance in interventional radiology. • Patient exposure was estimated from DLP documented by the CT. • Iterative CT reconstruction is appropriate to reduce image noise in CTF. • Using iterative CT reconstruction, the effective dose was significantly reduced in abdominal interventions.
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