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Eur Radiol. 2017 Dec;27(12):5252-5259. doi: 10.1007/s00330-017-4825-9. Epub 2017 Apr 3.

Impact of model-based iterative reconstruction on low-contrast lesion detection and image quality in abdominal CT: a 12-reader-based comparative phantom study with filtered back projection at different tube voltages.

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Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Institute of Radiology, Hospital Centre of Biel, Biel, Switzerland.
Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Institute of Radiology, Cantonal Hospital Aarau, Aarau, Switzerland.



To evaluate the impact of model-based iterative reconstruction (MBIR) on image quality and low-contrast lesion detection compared with filtered back projection (FBP) in abdominal computed tomography (CT) of simulated medium and large patients at different tube voltages.


A phantom with 45 hypoattenuating lesions was placed in two water containers and scanned at 70, 80, 100, and 120 kVp. The 120-kVp protocol served as reference, and the volume CT dose index (CTDIvol) was kept constant for all protocols. The datasets were reconstructed with MBIR and FBP. Image noise and contrast-to-noise-ratio (CNR) were assessed. Low-contrast lesion detectability was evaluated by 12 radiologists.


MBIR decreased the image noise by 24% and 27%, and increased the CNR by 30% and 29% for the medium and large phantoms, respectively. Lower tube voltages increased the CNR by 58%, 46%, and 16% at 70, 80, and 100 kVp, respectively, compared with 120 kVp in the medium phantom and by 9%, 18% and 12% in the large phantom. No significant difference in lesion detection rate was observed (medium: 79-82%; large: 57-65%; P > 0.37).


Although MBIR improved quantitative image quality compared with FBP, it did not result in increased low-contrast lesion detection in abdominal CT at different tube voltages in simulated medium and large patients.


• MBIR improved quantitative image quality but not lesion detection compared with FBP. • Increased CNR by low tube voltages did not improve lesion detection. • Changes in image noise and CNR do not directly influence diagnostic accuracy.


Filtered back projection; Low-contrast detection; Model-based iterative reconstruction; Multidetector computed tomography; Radiological phantom

[Indexed for MEDLINE]

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