Abstract

The purpose of this study was to compare the subjective image quality, image noise, and
radiation dose of chest CT images reconstructed with a 30% blend of iterative reconstruction and
70% conventional filtered back projection (FBP) with those of images generated with 100% FBP.
Clinically indicated chest CT examinations of 292 consecutively registered patients were
prospectively alternately assigned to two scanners on which different reconstruction techniques
were used: adaptive statistical iterative reconstruction (ASIR) blended with FBP and 100% FBP.
Both acquisitions were performed with dose modulation (noise index, 25 for ASIR and 21 for FBP).
Patient demographics and habitus were recorded. Two radiologists blinded to the reconstruction
algorithm independently scored subjective image quality on a 3-point Likert scale and measured
image noise and radiation dose. Compared with FBP images, ASIR images had significantly lower
subjective image quality (p = 0.01), less image noise (p = 0.02), and less radiation dose (p <
0.0001). The CT dose index of the ASIR cohort (11.3 ± 51) was significantly lower than that of the
100% FBP cohort (15.4 ± 6.3) (p < 0.0001). Interobserver agreement on subjective image quality
was excellent for both ASIR and FBP (Cronbach α, 0.92, p < 0.0001; Cronbach α, 0.85, p <
0.0001). In clinically indicated chest CT examinations, ASIR images had better image quality and
less image noise at a lower radiation dose than images acquired with a conventional FBP
reconstruction algorithm.

Questions:

1. What is the best possible title for the abstract?

Answer:
A Prospective Evaluation of Dose Reduction and Image Quality in Chest CT Using
Adaptive Statistical Iterative Reconstruction

2. What is the background or the introductory sentence of the abstract?

Answer:
Compared with chest radiography, CT has greater diagnostic accuracy in a range
of clinical situations. This fact has driven the remarkable increase in CT examinations in
the United States from 3 million in the early 1980s to 67 million in 2006. This improvement
in image quality, however, is associated with a 100- to 600-fold increase in radiation dose
compared with conventional radiography. Surveys have shown a sevenfold increase in
medical radiation dose between the early 1980s and 2006, the rose of medical radiation
approximately equaling that of background radiation exposure. This dramatic increase in
dose has appropriately garnered public attention because of the known association
between ionizing radiation and malignancy. It has been estimated that the use of CT may
be responsible for approximately 2% of all incident cancer cases in the United States. A
number of CT dose reduction techniques have been developed with the goal of preserving
image quality while reducing radiation dose. Because the primary effect of reduced
radiation dose is increased image noise, useful dose reduction techniques minimize the
effect of reduced dose on noise. The capability of reducing noise theoretically should allow
 tube current reduction and use of a higher noise index without degradation of image
quality.

3. What are the objective of this study?

Answer:
To compare the subjective image quality, image noise, and radiation dose of chest
CT images reconstructed with a 30% blend of iterative reconstruction and 70%
conventional filtered back projection (FBP) with those of images generated with 100%
FBP.

4. Why is the researchers doing in this study?

Answer:
Clinically indicated chest CT examinations of 292 consecutively registered patients
were prospectively alternately assigned to two scanners on which different reconstruction
techniques were used: adaptive statistical iterative reconstruction (ASIR) blended with
FBP and 100% FBP. Both acquisitions were performed with dose modulation (noise index,
25 for ASIR and 21 for FBP). Patient demographics and habitus were recorded. Two
radiologists blinded to the reconstruction algorithm independently scored subjective image
quality on a 3-point Likert scale and measured image noise and radiation dose.

5. What are the results of their study?

Answer:
ASIR images had significantly lower subjective image quality, less image noise,
and less radiation dose.

6. What is the conclusion of their study?

Answer:
In clinically indicated chest CT examinations, ASIR images had better image
quality and less image noise at a lower radiation dose than images acquired with a
conventional FBP reconstruction algorithm.

7. What are the new emphasize and important aspects that clearly state in the
concluded sentences of this study?
Answer:
In consecutive chest CT examinations, ASIR enabled significant radiation dose
reduction without compromise of image quality and study interpretability. Data support the
use of ASIR as an additional radiation dose reduction tool. Causes of growing concern
about the increased use of CT and the potential stochastic effects of ionizing radiation,
radiologists must consider all dose reduction techniques when prescribing CT protocols.