Assessment of image quality in abdominal CT: potential dose reduction with model-based iterative reconstruction

To estimate potential dose reduction in abdominal CT by visually comparing images reconstructed with filtered back projection (FBP) and strengths of 3 and 5 of a specific MBIR. A dual-source scanner was used to obtain three data sets each for 50 recruited patients with 30, 70 and 100% tube loads (mean CTDIvol 1.9, 3.4 and 6.2 mGy). Six image criteria were assessed independently by five radiologists. Potential dose reduction was estimated with Visual Grading Regression (VGR). Comparing 30 and 70% tube load, improved image quality was observed as a significant strong effect of log tube load and reconstruction method with potential dose reduction relative to FBP of 22-47% for MBIR strength 3 (p < 0.001). For MBIR strength 5 no dose reduction was possible for image criteria 1 (liver parenchyma), but dose reduction between 34 and 74% was achieved for other criteria. Interobserver reliability showed agreement of 71-76% (kappa (w) 0.201-0.286) and intra-observer reliability of 82-96% (kappa (w) 0.525-0.783). MBIR showed improved image quality compared to FBP with positive correlation between MBIR strength and increasing potential dose reduction for all but one image criterion. aEuro cent MBIR's main advantage is its de-noising properties, which facilitates dose reduction. aEuro cent MBIR allows for potential dose reduction in relation to FBP. aEuro cent Visual Grading Regression (VGR) produces direct numerical estimates of potential dose reduction. aEuro cent MBIR strengths 3 and 5 dose reductions were 22-34 and 34-74%. aEuro cent MBIR strength 5 demonstrates inferior performance for liver parenchyma.