Comparison of Iterative Model Reconstruction versus Filtered Back-Projection in Pediatric Emergency Head CT: Dose, Image Quality, and Image-Reconstruction Times

This is the authors' abstract. We don't add key points for this paper.

BACKGROUND AND PURPOSE: Noncontrast CT of the head is the initial imaging test for traumatic brain injury, stroke, or suspected nonaccidental trauma. Low-dose head CT protocols using filtered back-projection are susceptible to increased noise and decreased image quality. Iterative reconstruction noise suppression allows the use of lower-dose techniques with maintained image quality. We review our experience with children undergoing emergency head CT examinations reconstructed using knowledge-based iterative model reconstruction versus standard filtered back-projection, comparing reconstruction times, radiation dose, and objective and subjective image quality. MATERIALS AND METHODS: This was a retrospective study comparing 173 children scanned using standard age-based noncontrast head CT protocols reconstructed with filtered back-projection with 190 children scanned using low-dose protocols reconstructed with iterative model reconstruction. ROIs placed on the frontal white matter and thalamus yielded signal-to-noise and contrast-to-noise ratios. Volume CT dose index and study reconstruction times were recorded. Random subgroups of patients were selected for subjective image-quality review. CONCLUSIONS: In children referred for emergency noncontrast head CT, optimized low-dose protocols with iterative model reconstruction allowed us to significantly reduce the relative dose, on average, 22% compared with filtered back-projection, with significantly improved objective and subjective image quality.