Low-dose abdominal CT: Comparison of low tube voltage with moderate-level iterative reconstruction and standard tube voltage, low tube current with high-level iterative reconstruction

AIM: To evaluate the quality of 100 kVp images with a hybrid iterative reconstruction algorithm level of 40% and 120 kVp (low-tube-current) images with a hybrid iterative reconstruction algorithm level of 60% in low-dose abdominal computed tomography (CT) using almost the same radiation dose. MATERIALS AND METHODS: This prospective study received institutional review board approval and written informed consent was obtained. One hundred and ten patients undergoing abdominal dynamic CT were randomly assigned to one of two protocols (100 and 120 kVp protocols). Radiation doses of the two protocols were almost identical. The 120 kVp images were post-processed with a hybrid iterative reconstruction algorithm level of 60% (i-120 kVp). The 100 kVp images were post-processed with a hybrid iterative reconstruction algorithm level of 40% (i-100 kVp). The effective dose (ED), image noise, CT attenuation, and signal-to-noise ratio (SNR) of the subcutaneous fat, muscle, liver, pancreas, and kidneys were compared between the protocols using Student's t-test. Qualitative analysis was also performed between the protocols. RESULTS: There were no significant differences in ED and SNR of any of the regions of interest (ROIs) between the protocols (p > 0.05). However, in the qualitative analysis, unnatural texture was significantly greater in the i-120 kVp than in the i-100 kVp protocol (p < 0.01). There were no other significant differences in the image quality between the protocols (p > 0.05). CONCLUSION: The combined use of low tube voltage and moderate-level iterative reconstruction techniques can be a more effective strategy for reducing patient radiation dose while attaining acceptable image quality than the use of standard tube voltage, low tube current with high-level iterative reconstruction. (C) 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.