Impact of Sinogram Affirmed Iterative Reconstruction (SAFIRE) Algorithm on Image Quality with 70 kVp-Tube-Voltage Dual-Source CT Angiography in Children with Congenital Heart Disease

PURPOSE: To compare the image quality and diagnostic accuracy between sinogram affirmed iterative reconstruction (SAFIRE) algorithm and filtered back projection (FBP) reconstruction algorithm at 70 kVp-tube-voltage DSCT angiography in children with congenital heart disease (CHD). MATERIALS AND METHODS: Twenty-eight patients (mean age: 13 months; range: 2–48 months; male: 16; female: 12; mean weight: 8 kg) with CHD underwent 70 kVp DSCT angiography. Imaging data were reconstructed with both FBP and SAFIRE algorithms. Subjective image quality was evaluated on a five-point scale. The parameters of image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) on the objective image quality were compared for the two reconstruction algorithms. Surgery was performed in 20 patients, whereas conventional cardiac angiography (CCA) was performed in 8 patients. The diagnostic accuracy was evaluated on the surgical and/or CCA findings. The effective radiation doses were calculated. RESULTS: Compared to FBP algorithm, SAFIRE algorithm had significantly higher scores for subjective image quality (P<0.05), and lower image noise (P<0.05) as well as higher SNR &CNR values (P<0.05). There was no significant difference in the diagnostic accuracy between the FBP and SAFIRE algorithm (χ(2) = 1.793, P>0.05). The mean effective dose for 70 kVp DSCT angiography was 0.30±0.13 mSv. CONCLUSIONS: The SAFIRE algorithm can significantly reduce image noise and improve the image quality at 70 kVp DSCT angiography for the assessment of CHD in children.