Model-based CT performance assessment and optimization for iodinated and noniodinated imaging tasks as a function of kVp and body size.

PURPOSE: The goal of this study was to assess the comparative performance of iterative reconstruction in space (IRIS) and filtered back projection (FBP) reconstruction algorithms in terms of image quality and dose across kVps and phantom sizes.
METHODS: The ACR CT phantom (model 464) was supplemented with the addition of an iodinated spherical capsule (1.5 mm diameter, 3.4 mg iodine per ml) to simulate the contrast filled structures and with an additional circular attachment consisting of an array of 500 um brass beads for spatial resolution measurements. A larger sized phantom was also created by wrapping the original phantom with additional tissue equivalent material of 4 cm thickness. The phantoms were imaged on a 64 detector array multidetector computed tomography scanner (Somatom Definition, Siemens, Germany) using clinically applicable protocols (0.5 s rotation time; 80, 100, 120, and 140 kVp; 64 to 640 mA; 220 to 250 mm field of view). Images were reconstructed using the FBP and the IRIS algorithms. Combining measurements of image noise and spatial resolution with a task function, a figure of merit (FOM) for image quality was generated taking into account the type of visualization required from the image for the detection of either large or small image features with and without iodine content. The FOM was further reported in terms of area under the receiver operating characteristic (ROC) curve (AZ) to predict the comparative diagnostic performance of the two algorithms at different dose levels.
RESULTS: For a given dose level, the predicted AZ for IRIS consistently outperformed that of FBP. At comparative AZ, depending on protocol and task, the dose requirement for the optimal technique (optimized kVp with IRIS) was 2-3 times lower than that for standard technique (120 kVp with FBP). The potential for dose reduction was found to be higher when performing small feature detection tasks in comparison to larger feature detection tasks. The optimal kVp was from 80 to 100 kVp for the small phantom, 100 to 120 kVp for the larger phantom.
CONCLUSIONS: Overall, greater dose reduction may be achieved with IRIS compared to FBP, with enhanced advantage at thinner slice reconstructions. The results highlight how IRIS may offer a superior balance between image quality and dose across a range of imaging tasks, thus enabling dose reduction at constant quality or image quality improvement at constant dose. The prediction of the investigation can be used toward effective design of subsequent clinical studies.