Comparative evaluation of Iterative and FORE-Iterative reconstruction algorithms for PET/CT

Objective To explore the application value of automatic tube current modulation combined with iterative reconstruction algorithm (idose4) in low-dose computed tomography pulmonary angiography (CTPA). Methods A total of 80 patients with CTPA collected continuously were randomly divided into control group (n=40, 80 kV, 180 mAs) and experimental group (n=40, 80 kV, automatic tube current modulation). The data sets of control group were reconstructed with filtered-back-projection algorithm (group A), and the data sets of experimental group were reconstructed with filtered-back-projection algorithm (group B) and iterative reconstruction algorithm (group C). Subjective score, mean CT values of pulmonary artery, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were recorded. Effective dose (E) was compared. Results The E of experimental group was decreased by 36.8% compared to control group (t=-3.998, P 0.05). There was statistically significant difference for the SNR, CNR and image noise of 3 groups (F=10.411, 7.630, 13.021, P 0.05). Conclusions Using automatic tube current modulation combined with iterative reconstruction algorithm in low-dose CTPA could meet the requirements of image quality, and reduce the radiation dose to a certain extent. Key words: Computed tomography pulmonary angiography; Radiation dose; Iterative reconstruction; Automatic tube current modulation

We evaluated the feasibility of sub-millisievert (mSv) coronary CT angiography (CCTA) using low tube voltage, prospective ECG gating, and a knowledge-based iterative model reconstruction algorithm. Twenty-four non-obese healthy subjects (M:F 13:11; mean age 50.2±7.8years) were enrolled. Three sets of CT images were reconstructed using three different reconstruction methods: filtered back projection (FBP), iterative reconstruction (IR), and knowledge-based iterative model reconstruction (IMR). The scanning parameters were as follows: step-and-shoot axial scanning, 80kVp, and 200mAs. On the three sets of CT images, the attenuation and image noise values were measured at the aortic root. The signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) were calculated at the proximal right coronary artery and the left main coronary artery. The qualitative image quality of the CCTA with IMR was assessed using a 4-point grading scale (grade 1, poor; grade 4, excellent). The mean radiation dose of the CCTA was 0.89±0.09mSv. The attenuation values with IMR were not different from those of other reconstruction methods. The image noise with IMR was significantly lower than with IR and FBP. Compared to FBP, the noise reduction rate of IMR was 69%. The SNR and CNR of CCTA with IMR were significantly higher than with FBP or IR. On the qualitative analysis with IMR, all included segments were diagnostic (grades 2, 3, and 4), and the mean image quality score was 3.6±0.6. In conclusion, CCTA with low tube voltage, prospective ECG gating, and an IMR algorithm might be a feasible method that allows for sub-millisievert radiation doses and good image quality when used with non-obese subjects.

Reducing radiation dose and enhancing imaging quality of 4DCT for radiation therapy using iterative reconstruction algorithms

Iterative algorithms are gaining clinical acceptance in CT. We performed objective phantom-based image quality evaluation of five commercial iterative reconstruction algorithms available on four different multi-detector CT (MDCT) scanners at different dose levels as well as the conventional filtered back-projection (FBP) reconstruction. Using the Catphan500 phantom, we evaluated image noise, contrast-to-noise ratio (CNR), modulation transfer function (MTF) and noise-power spectrum (NPS). The algorithms were evaluated over a CTDIvol range of 0.75-18.7 mGy on four major MDCT scanners: GE DiscoveryCT750HD (algorithms: ASIR™ and VEO™); Siemens Somatom Definition AS+ (algorithm: SAFIRE™); Toshiba Aquilion64 (algorithm: AIDR3D™); and Philips Ingenuity iCT256 (algorithm: iDose4™). Images were reconstructed using FBP and the respective iterative algorithms on the four scanners. Use of iterative algorithms decreased image noise and increased CNR, relative to FBP. In the dose range of 1.3-1.5 mGy, noise reduction using iterative algorithms was in the range of 11%-51% on GE DiscoveryCT750HD, 10%-52% on Siemens Somatom Definition AS+, 49%-62% on Toshiba Aquilion64, and 13%-44% on Philips Ingenuity iCT256. The corresponding CNR increase was in the range 11%-105% on GE, 11%-106% on Siemens, 85%-145% on Toshiba and 13%-77% on Philips respectively. Most algorithms did not affect the MTF, except for VEO™ which produced an increase in the limiting resolution of up to 30%. A shift in the peak of the NPS curve towards lower frequencies and a decrease in NPS amplitude were obtained with all iterative algorithms. VEO™ required long reconstruction times, while all other algorithms produced reconstructions in real time. Compared to FBP, iterative algorithms reduced image noise and increased CNR. The iterative algorithms available on different scanners achieved different levels of noise reduction and CNR increase while spatial resolution improvements were obtained only with VEO™. This study is useful in that it provides performance assessment of the iterative algorithms available from several mainstream CT manufacturers.

Non-contrast cerebral computed tomography (CT) is frequently performed as a first-line diagnostic approach in patients with suspected ischemic stroke. The purpose of this study was to evaluate the performance of hybrid and model-based iterative image reconstruction for standard-dose (SD) and low-dose (LD) non-contrast cerebral imaging by multi-detector CT (MDCT). We retrospectively analyzed 131 patients with suspected ischemic stroke (mean age: 74.2 ± 14.3 years, 67 females) who underwent initial MDCT with a SD protocol (300 mAs) as well as follow-up MDCT after a maximum of 10 days with a LD protocol (200 mAs). Ischemic demarcation was detected in 26 patients for initial and in 64 patients for follow-up imaging, with diffusion-weighted magnetic resonance imaging (MRI) confirming ischemia in all of those patients. The non-contrast cerebral MDCT images were reconstructed using hybrid (Philips “iDose4”) and model-based iterative (Philips “IMR3”) reconstruction algorithms. Two readers assessed overall image quality, anatomic detail, differentiation of gray matter (GM)/white matter (WM), and conspicuity of ischemic demarcation, if any. Quantitative assessment included signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) calculations for WM, GM, and demarcated areas. Ischemic demarcation was detected in all MDCT images of affected patients by both readers, irrespective of the reconstruction method used. For LD imaging, anatomic detail and GM/WM differentiation was significantly better when using the model-based iterative compared to the hybrid reconstruction method. Furthermore, CNR of GM/WM as well as the SNR of WM and GM of healthy brain tissue were significantly higher for LD images with model-based iterative reconstruction when compared to SD or LD images reconstructed with the hybrid algorithm. For patients with ischemic demarcation, there was a significant difference between images using hybrid versus model-based iterative reconstruction for CNR of ischemic/contralateral unaffected areas (mean ± standard deviation: SD_IMR: 4.4 ± 3.1, SD_iDose: 3.5 ± 2.3, P < 0.0001; LD_IMR: 4.6 ± 2.9, LD_iDose: 3.2 ± 2.1, P < 0.0001). In conclusion, model-based iterative reconstruction provides higher CNR and SNR without significant loss of image quality for non-enhanced cerebral MDCT.

The adverse effect of low-dose CT on image quality may be mitigated using iterative reconstructions. The purpose of this study was to evaluate the performance of the full model-based iterative reconstruction (MBIR) and adaptive statistical reconstruction (ASIR) algorithms in low radiation dose and low contrast dose abdominal contrast-enhanced CT (CECT) in children. A total of 59 children (32 males and 27 females) undergoing low radiation dose (100kVp) and low contrast dose (270 mgI/ml) abdominal CECT were enrolled. The median age was 4.0years (ranging from 0.3 to 13years). The raw data were reconstructed with MBIR, ASIR and filtered back-projection (FBP) algorithms into 6 groups (MBIR, 100%ASIR, 80%ASIR, 60%ASIR, 40%ASIR and FBP). The CT numbers, standard deviations, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of liver, pancreas, kidney and abdominal aorta were measured. Two radiologists independently evaluated the subjective image quality including the overall image noise and structure display ability on a 4-point scale with 3 being clinically acceptable. The measurements among the reconstruction groups were compared using one-way ANOVA. The overall image noise score and display ability were 4.00 ± 0.00 and 4.00 ± 0.00 with MBIR and 3.27 ± 0.33 and 3.25 ± 0.43 with ASIR100%, respectively, which met the diagnostic requirement; other reconstructions couldn't meet the diagnostic requirements. Compared with FBP images, the noise of MBIR images was reduced by 62.86-65.73% for the respective organs (F = 48.15-80.47, P < 0.05), and CNR increased by 151.38-170.69% (F = 22.94-38.02, P < 0.05). MBIR or ASIR100% improves the image quality of low radiation dose and contrast dose abdominal CT in children to meet the diagnostic requirements, and MBIR has the best performance.

To explore the application value of the reconstruction algorithm based on an iterative algorithm in the analysis of CT image and analyze the therapeutic effect of honey-fried Herba Ephedrae combined with Western medicine on acute exacerbation chronic obstructive pulmonary disease (AECOPD), a total of 96 AECOPD patients admitted to our hospital from January 2018 to December 2019 were selected as research subjects. According to a different treatment method, the subjects were divided into a control group (Ctrl group, conventional therapy) and an observation group (OG, conventional therapy + honey-fried Herba Ephedrae), with 48 in each group. The CT image algorithm was established based on the iterative algorithm, and the CT dose indexes of the reconstruction algorithm and the Filtered Back Projection (FBP) algorithm under the same conditions were compared ( P &lt; 0.05 ). After using CT to confirm the diagnosis of the subjects, the difference in indicators of forced expiratory volume in one second (FEV1), forced expiratory volume in one second to forced vital capacity ratio (FEV1%), and forced vital capacity (FVC), inflammatory factors of serum interleukin-8 (IL-8), serum interleukin-10 (IL-10), and tumor necrosis factor (TNF-α), the bronchial wall area, and the total treatment efficiency before and after different treatment was analyzed. The results suggested that the Computed Tomography Dose Index (CTDI) of iterative reconstruction (IR) algorithm when scanning different parts was higher than that of the FBP algorithm. The pulmonary function indexes and the expression of IL-8 and TNF-α in the OG were higher than those in the Ctrl group ( P &lt; 0.05 ); the bronchial wall area, bronchial wall area percentage, and IL-10 expression in the OG were all lower than those in the Ctrl group ( P &lt; 0.05 ). The effectiveness and improvement rates of the Ctrl group were 47.92% and 25%, respectively, significantly lower than those in the OG group, 56.25% and 31.25% ( P &lt; 0.05 ), and the total efficiency of the observation group was 87.5%, which was significantly higher than that in the Ctrl group (72.92%) ( P &lt; 0.05 ). In conclusion, based on the iterative algorithm, a CT reconstruction algorithm with better noise reduction performance was established, and the use of honey-fried Herba Ephedrae combined with Western medicine can improve the effective rate of treatment.

ObjectiveEvaluation of a new iterative reconstruction algorithm (IMR) for detection/rule-out of pulmonary embolism (PE) in ultra-low dose computed tomography pulmonary angiography (CTPA).MethodsLower dose CT data sets were simulated based on CTPA examinations of 16 patients with pulmonary embolism (PE) with dose levels (DL) of 50%, 25%, 12.5%, 6.3% or 3.1% of the original tube current setting. Original CT data sets and simulated low-dose data sets were reconstructed with three reconstruction algorithms: the standard reconstruction algorithm “filtered back projection” (FBP), the first generation iterative reconstruction algorithm iDose and the next generation iterative reconstruction algorithm “Iterative Model Reconstruction” (IMR). In total, 288 CTPA data sets (16 patients, 6 tube current levels, 3 different algorithms) were evaluated by two blinded radiologists regarding image quality, diagnostic confidence, detectability of PE and contrast-to-noise ratio (CNR).ResultsiDose and IMR showed better detectability of PE than FBP. With IMR, sensitivity for detection of PE was 100% down to a dose level of 12.5%. iDose and IMR showed superiority to FBP regarding all characteristics of subjective (diagnostic confidence in detection of PE, image quality, image noise, artefacts) and objective image quality. The minimum DL providing acceptable diagnostic performance was 12.5% (= 0.45 mSv) for IMR, 25% (= 0.89 mSv) for iDose and 100% (= 3.57 mSv) for FBP. CNR was significantly (p < 0.001) improved by IMR compared to FBP and iDose at all dose levels.ConclusionBy using IMR for detection of PE, dose reduction for CTPA of up to 75% is possible while maintaining full diagnostic confidence. This would result in a mean effective dose of approximately 0.9 mSv for CTPA.

To evaluate the image quality and radiation dose of low-dose (LD) computed tomography (LD-CT) combining with iterative model reconstruction (IMR) algorithm for response assessment in patients after treatment of malignant tumor compared with routine-dose CT (RD-CT). Forty-seven patients [mean age 57.8±10.9 years, 30 males, body mass index (BMI) 22.09±2.35 kg/m2] after treatment of malignant tumor underwent contrast-enhanced chest and abdomen CT twice for response assessment with an interval of 6 months according to clinical routine. The first CT scans were performed with RD protocol at 120 kVp and images were reconstructed with filtered back projection (FBP) algorithm; while the second scans were performed with LD protocol at 100 kVp and images were reconstructed with FBP and IMR algorithm respectively. All scans were performed using an automatic tube current modulation technique with 150 mAs as reference. Objective image quality including CT attenuation, image noise, and contrast to noise ratio (CNR), and subjective image quality including artifacts, noise, visualization of small structures and confidence of targeted lesions, as well as lesion detection were assessed and compared. Effective radiation dose of LD-CT scans was reduced 54.8% compared to RD-CT scans (26.89±3.35 vs. 12.14±2.09 mSv). Higher CT attenuation was found in both LD-IMR and LD-FBP images compared to RD-FBP images. Better subjective image quality and CNR as well as lower objective noise were found in LD-IMR images (all, P<0.05). Two small lesions with the diameter less than 1 cm were missed in LD-FBP images, which were able to be observed in LD-IMR images. IMR is able to help more than half of reduction of radiation dose without compromising the quality of diagnostic information in patients after treatment of malignant tumors to chest and abdomen CT for response assessment.

In this paper, a unified framework of iterative algebraic reconstruction for emission computed tomography (ECT) and its application to positron emission tomography (PET) is presented. The unified framework is based on an algebraic image restoration model and contains conventional iterative algebraic reconstruction algorithms: ART, SIRT, Landweber iteration (LWB), the generalized Landweber iteration (GLWB), the steepest descent method (STP), as well as iterative filtered backprojection (IFBP) reconstruction algorithms: Chang's method, Walters' method, and a modified iterative MAP. The framework provides an effective tool to systematically study conventional iterative algebraic algorithms and IFBP algorithms. Based on this framework, conventional iterative algebraic algorithms and IFBP algorithms are generalized. It is shown from the algebraic point of view that IFBP algorithms are not only excellent methods for correction of attenuation (either uniform or nonuniform) but are also good general iterative reconstruction algorithms (they can be applied to either attenuated or attenuation-free projections and converge very fast). The convergence behavior of iterative algebraic algorithms is discussed and insight is drawn into the fast convergence property of IFBP algorithms. A simulated PET system is used to evaluate IFBP algorithms and LWB in comparison with the maximum likelihood estimation via expectation maximization algorithm (MLE-EM) and the filtered backprojection (FBP) algorithm. The simulation results indicate that for both attenuation-free projection and attenuated projection cases IFBP algorithms have a significant computational advantage over LWB and MLE-EM, and have performance advantages over FBP in terms of contrast recovery and/or noise-to-signal ratios (NSRs) in regions of interest.

To evaluate the image quality produced by six different iterative reconstruction (IR) algorithms in four CT systems in the setting of brain CT, using different radiation dose levels and iterative image optimisation levels. An image quality phantom, supplied with a bone mimicking annulus, was examined using four CT systems from different vendors and four radiation dose levels. Acquisitions were reconstructed using conventional filtered back-projection (FBP), three levels of statistical IR and, when available, a model-based IR algorithm. The evaluated image quality parameters were CT numbers, uniformity, noise, noise-power spectra, low-contrast resolution and spatial resolution. Compared with FBP, noise reduction was achieved by all six IR algorithms at all radiation dose levels, with further improvement seen at higher IR levels. Noise-power spectra revealed changes in noise distribution relative to the FBP for most statistical IR algorithms, especially the two model-based IR algorithms. Compared with FBP, variable degrees of improvements were seen in both objective and subjective low-contrast resolutions for all IR algorithms. Spatial resolution was improved with both model-based IR algorithms and one of the statistical IR algorithms. The four statistical IR algorithms evaluated in the study all improved the general image quality compared with FBP, with improvement seen for most or all evaluated quality criteria. Further improvement was achieved with one of the model-based IR algorithms. The six evaluated IR algorithms all improve the image quality in brain CT but show different strengths and weaknesses.

BackgroundIterative computed tomography (CT) image reconstruction shows high potential for the preservation of image quality in diagnostic CT while reducing patients’ exposure; it has become available for low-dose CT (LD-CT) in high-end hybrid imaging systems (e.g. single-photon emission computed tomography [SPECT]-CT).PurposeTo examine the effect of an iterative CT reconstruction algorithm on image quality, image noise, detectability, and the reader’s confidence for LD-CT data by a subjective assessment.Material and MethodsThe LD-CT data were validated for 40 patients examined by an abdominal hybrid SPECT-CT (U = 120 kV, I = 40 mA, pitch = 1.375). LD-CT was reconstructed using either filtered back projection (FBP) or an iterative image reconstruction algorithm (Adaptive Statistical Iterative Reconstruction [ASIR]®) with different parameters (ASIR levels 50% and 100%). The data were validated by two independent blinded readers using a scoring system for image quality, image noise, detectability, and reader confidence, for a predefined set of 16 anatomic substructures.ResultsThe image quality was significantly improved by iterative reconstruction of the LD-CT data compared with FBP (P ≤ 0.0001). While detectability increased in only 2/16 structures (P ≤ 0.03), the reader’s confidence increased significantly due to iterative reconstruction (P ≤ 0.002). Meanwhile, at the ASIR level of 100%, the detectability in bone structure was highly reduced (P = 0.003).ConclusionAn ASIR level of 50% represents a good compromise in abdominal LD-CT image reconstruction. The specific ASIR level improved image quality (reduced image noise) and reader confidence, while preserving detectability of bone structure.

To evaluate a new iterative reconstruction (IR) algorithm for radiation dose, image quality (IQ), signal-to-noise-ratio (SNR), and contrast-to-noise-ratio (CNR) in multidetector computed tomography (MDCT) dynamic myocardial perfusion imaging (MPI). ECG-gated 256-slice MDCT dynamic MPI was performed in six pigs after subtotal balloon occlusion of one artery. Two 100 kVp protocols were compared: high dose (HD): 150 mAs; low dose (LD): 100 mAs. HD images were reconstructed with filtered back projection (FBP), LD images with FBP and different strengths of IR (L1, L4, and L7). IQ (5-point scale), SNR, and CNR (ischemic vs. normal myocardium) values derived from the HD (FBP) images and the different LD images were compared. Mean SNR values for myocardium were 16.3, 11.3, 13.1, 17.1, and 28.9 for the HD, LD (FBP), LD (L1), LD (L4), and LD (L7) reconstructions, respectively. Mean CNR values were 8.9, 6.3, 7.8, 9.3, and 12.8. IQ was scored as 4.6, 3.3, 4.4, 4.7, and 3.4, respectively. A significant loss of IQ was observed for the LD (L7) images compared to the HD (FBP) images (P < 0.05). Appropriate levels of iterative reconstruction can improve SNR and CNR, facilitating radiation dose savings in CT-MPI without influencing diagnostic quality. Iterative reconstruction (IR) can reduce radiation dose in myocardial perfusion CT. Our study also demonstrated improvements in image quality (noise, SNR, and CNR). Dynamic CT-MPI could help determine the hemodynamic significance of coronary artery disease. With dynamic CT MPI, myocardial blood flow can be determined quantitatively.

Electrical capacitance tomography (ECT) is used to obtain information about the distribution of a mixture of dielectric materials inside a vessel or pipe. ECT has several advantages over other reconstruction algorithms and has found many applications in the industrial fields. However, there are some difficulties with image reconstruction in ECT: The relationship between the permittivity distribution and measured capacitance is nonlinear. And inverse problem is ill-posed so that the inverse solution is sensitive to measurement error. To cope with these difficulties iterative image reconstruction algorithms have been developed. In general, the iterative reconstruction algorithms in ECT have comparatively good-quality in reconstructed images but result in intensive computational burden. This paper presents the iterative image reconstruction algorithm for ECT that can enhance the speed of image reconstruction without degradation in the quality of reconstructed image. The main contribution of the proposed algorithm is new weighting matrices, which are obtained by the interpolation of the grouped electrical field centre lines (EFCLs). Extensive simulation results have demonstrated that proposed algorithm provides improved reconstruction performance in terms of computational time and image quality.

This study aimed to evaluate the application value of personalized patient protocol technology (P3T) modular cardiac injection technique combined with the iterative reconstruction algorithm, sinogram-affirmed iterative reconstruction (SAFIRE) in coronary computed tomography angiography (CCTA). A retrospective analysis was performed on 40 patients who underwent CCTA at the Central Hospital Affiliated to Shandong First Medical University. Patients were divided into two groups: control group (n=20), which received the traditional contrast agent injection with fixed iodine load and injection flow rate, and filtered back projection reconstruction with filtered back projection (FBP), and experimental group (n=20), which employed a dosing protocol calculated based on P3T cardiac modular parameters, with SAFIRE strength 3 reconstruction. The two groups were compared regarding CT values (proximal, middle, and distal segments), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), coronary imaging quality score, contrast agent flow rate, injection volume, and effective radiation dose (ED). There were no significant differences in CT values of the right coronary artery, anterior descending artery, or circumflex artery at the proximal and middle segments between the two groups (P>0.05). However, the experimental group exhibited significantly higher CT values at the distal segments of these coronary arteries compared to the control group (P<0.05). SNR, CNR, and coronary imaging quality scores showed no significant differences between the two groups (P>0.05). The contrast agent flow rate and injection volume in the experimental group were significantly lower than those in the control group (P<0.05). Additionally, the volume CT dose index (CTDIvol), dose length product (DLP), and ED were significantly reduced in the experimental group compared to the control group (P<0.05). The combination of P3T technology with SAFIRE reconstruction in CCTA effectively reduces contrast agent flow rate, injection volume, and radiation dose without compromising image quality. This approach enables individualized, standardized, and consistent injection schemes.