Dose Reduction using Iterative Reconstruction in CT Scanning

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When we decided to add CT scanning to our service offerings, we researched the market extensively. The brief was to find the right system that offered leading edge technology, high quality imaging and low radiation dosage. Luckily a whole new generation of CT scanners is just becoming available, which completely outclass previous technology.

As everyone knows, the biggest concern with CT scanning is the relatively high radiation dose received by the patient. Over the past few years with advances in computers and programming, CT radiation dose has been almost halved compared to earlier multislice systems using various techniques including automatic tube current optimization, and a noise-reduction technique called filtered back projection (FBP) in reconstructing the images from the raw data - but this has come at some cost to image quality.
CT scanners used by almost all of the major hospitals and private practices in Brisbane today use these techniques.

With the massive increases in processing power of new computers, along with refinements to the iterative reconstruction techniques, this IR process has finally become available.
The reductions in patient radiation dose using iterative reconstruction are in the order of 30-70% compared with even the most recent non-IR scanners, but with the added bonus of significantly improved image quality.

We have installed the latest CT scanner which utilises this technology - the new 'Gold Standard' in image quality and radiation dose reduction.

As an example, the radiation dose for a CT scan of the lumbar spine is now about the same as an ordinary x-ray examination - but provides infinitely more diagnostic information.

Iterative Reconstruction is also helpful in improving CT image quality for obese patients. On most conventional scanners, large body habitus introduces excessive image noise, rendering examinations of poorer quality than those for normal sized patients when standard scanner settings are used. Although radiation dose concerns are not such a priority in obese patients, automated tube current modulation that is routinely employed in all MDCT scanners is designed to maintain an operator-determined image quality standard, and results in increased radiation dose for obese patients rather than the decrease seen in smaller patients. By using iterative reconstruction, the image quality is substantially improved without excessive exposure to radiation.

There is a wealth of information on the internet about the benefits of iterative reconstruction compared to current techniques, and a paper is available for downloading here (requires Adobe Acrobat Reader):

Improved Image Quality in Clinical CT by AIDR   R.M.S.Joemai  2010 (PDF 189KB)

Links to more information:

Radiology  Adaptive Statistical Iterative Reconstruction Technique for Radiation Dose Reduction in Chest CT: A Pilot Study   Sarabjeet Singh, MBBS, MMST, Mannudeep K. Kalra, MD, Matthew D. Gilman, MD, Jiang Hsieh, PhD, Homer H. Pien, PhD, Subba R. Digumarthy, MD and Jo-Anne O. Shepard, MD

Diagnostic Imaging  Iterative reconstruction techniques cut CT dose  Greg Freiherr

American Journal of Roentgenology Iterative Reconstruction Technique for Reducing Body Radiation Dose at CT: Feasibility Study Amy K. Hara; Robert G. Paden; Alvin C. Silva; Jennifer L. Kujak; Holly J. Lawder; William Pavlicek

Aunt Minnie.com CT iterative reconstruction cuts radiation dose to eye lens Eric Barnes