Iterative Reconstruction Results in Larger Computed Tomography Measurements of Iliofemoral Artery Diameter in Patients Referred for Transcatheter Aortic Valve Replacement

OBJECTIVES: We hypothesized that improved iterative reconstruction increases image quality and reduces artifacts for iliofemoral artery computed tomography imaging in patients referred for transcatheter aortic valve replacement (TAVR). METHODS: We examined 56 consecutive patients undergoing computed tomography for possible TAVR and compared image quality and iliofemoral artery size between adaptive statistical iterative reconstructions (ASIRs) and improved model-based iterative reconstructions (MBIRs). RESULTS: Model-based iterative reconstruction (vs ASIR) was associated with improved (P < 0.001 for each) image quality (3.4 ± 0.8 vs 2.8 ± 1.0), beam hardening (3.5 ± 0.8 vs 3.0 ± 1.1), and wall definition (3.6 ± 0.6 vs 3.1 ± 0.8). Image signal-to-noise ratios (20.4 ± 10.1 vs 13.7 ± 6.6, P < 0.001) were also increased with MBIR as compared with ASIR. Mean iliofemoral artery size was larger using MBIR compared with ASIR (left, 7.7 ± 1.5 vs 7.4 ± 1.7 mm, P < 0.001; right, 7.8 ± 1.2 vs 7.4 ± 1.5 mm, P = 0.008). CONCLUSIONS: In patients referred for TAVR, improved MBIR resulted in higher image quality, reduced artifacts, and larger iliofemoral artery diameters compared with standard iterative reconstructions.