Low-dose computed tomography with 4th-generation iterative reconstruction algorithm in assessment of oncologic patients

AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients. METHODS Fifty-one patients with known malignant diseases which underwent, during clinical follow-up, both standarddose and low-dose whole-body CT scans were enrolled. Low-dose CT was performed on 256-row scanner, with 120 kV and automated m A modulation, and iterative reconstruction algorithm. Standard-dose CT was performed on 16-rows scanner, with 120 kV, 200-400 m As(depending on patient weight). We evaluated density values and signal-to-noise ratio, along with image noise(SD), sharpness and diagnostic quality with 4-point scale.RESULTS Density values in liver, spleen and aorta were higher in lowdose images(liver 112.55 HU vs 103.90 HU, P < 0.001), as SD values in liver and spleen(liver 16.81 vs 14.41). Volumetric-Computed-Tomographic-Dose-Index(CTDIvol) and Dose-Length-Product(DLP) were significantly lower in low-dose CT as compared to standard-dose(DLP 1025.6 m Gy*cm vs 1429.2 m Gy*cm, P < 0.001) with overall dose reduction of 28.9%. Qualitative analysis did not reveal significant differences in image noise and diagnostic quality.CONCLUSION Automatic tube-current modulation combined with hybriditerative algorithm allows radiation dose reduction of 28.9% without loss of diagnostic quality, being useful in reducing dose exposure in oncologic patients.