Send to

Choose Destination
J Appl Clin Med Phys. 2019 Jan;20(1):293-307. doi: 10.1002/acm2.12502. Epub 2018 Dec 3.

CARE Dose 4D combined with sinogram-affirmed iterative reconstruction improved the image quality and reduced the radiation dose in low dose CT of the small intestine.

Author information

Department of Radiology, The Second Affiliated Hospital of Nantong University, Jiangsu, China.
Department of Epidemiology and Medical Statistics, School of Public Health Nantong University, Nantong, Jiangsu, China.
Department of Pathophysiology, Nantong University Medical School, Nantong, Jiangsu, China.
Clinical Medicine Research Center, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.



Multislice computed tomography (MSCT) has been used for diagnosis of small intestinal diseases. However, the radiation dose is a big problem. This study was to investigate whether CARE Dose 4D combined with sinogram-affirmed iterative reconstruction (SAFIRE) can provide better image quality at a lower dose for imaging small intestinal diseases compared to MSCT.


The noise reduction ability of SAFIRE was assessed by scanning the plain water mold using SOMATOM Definition Flash double-source spiral CT. CT images at each stage of radiography for 239 patients were obtained. The patients were divided into groups A and B were based on different tube voltage and current or the image recombination methods. The images were restructured using with filtered back projection (FBP) and SAFIRE (S1-S5). The contrast noise ratio (CNR), CT Dose index (CTDI), subjective scoring, and objective scoring were compared to obtain the best image and reformation parameters at different stages of CT.


Twenty-six restructuring patterns of tube voltage and current were obtained by FBP and SAFIRE. The average radiation dose using CARE Dose 4D combined with SAFIRE (S4-S5) reduced approximately 74.85% compared to conditions where the tube voltage of 100 kV and tube current of 131 mAs for patients with MSCT small intestinal CT enterography at plain CT scan, arterial stage, small intestine, and portal venous phase. The objective and subjective scoring were all significantly different among groups A and B at each stage.


Combination of CARE Dose 4D and SAFIRE is shown to decrease the radiation dose while maintaining image quality.


CARE Dose 4D; SAFIRE; image quality; radiation dose; small intestinal diseases

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center