Assessment of image quality in abdominal CT: potential dose reduction with model-based iterative reconstruction.

Purpose: To estimate potential dose reduction in abdominal CT by visually comparing images reconstructed with filtered back projection (FBP) and strengths of 3 and 5 of a specific MBIR.
Material and Methods: A dual-source scanner was used to obtain three data sets each for 50 recruited patients with 30, 70 and 100% tube loads (mean CTDI _vol 1.9, 3.4 and 6.2 mGy). Six image criteria were assessed independently by five radiologists. Potential dose reduction was estimated with Visual Grading Regression (VGR).
Results: Comparing 30 and 70% tube load, improved image quality was observed as a significant strong effect of log tube load and reconstruction method with potential dose reduction relative to FBP of 22-47% for MBIR strength 3 (p < 0.001). For MBIR strength 5 no dose reduction was possible for image criteria 1 (liver parenchyma), but dose reduction between 34 and 74% was achieved for other criteria. Interobserver reliability showed agreement of 71-76% (κ _w 0.201-0.286) and intra-observer reliability of 82-96% (κ _w 0.525-0.783).
Conclusion: MBIR showed improved image quality compared to FBP with positive correlation between MBIR strength and increasing potential dose reduction for all but one image criterion.
Key Points: • MBIR's main advantage is its de-noising properties, which facilitates dose reduction. • MBIR allows for potential dose reduction in relation to FBP. • Visual Grading Regression (VGR) produces direct numerical estimates of potential dose reduction. • MBIR strengths 3 and 5 dose reductions were 22-34 and 34-74%. • MBIR strength 5 demonstrates inferior performance for liver parenchyma.