Influence of exposure parameters and iterative reconstruction on automatic airway segmentation and analysis on MDCT—An ex vivo phantom study

OBJECTIVES: To evaluate the influence of exposure parameters and raw-data-based iterative reconstruction (IR) on computer-aided segmentation and quantitative analysis of the tracheobronchial tree on multidetector computed tomography (MDCT). MATERIAL AND METHODS: 10 porcine heart-lung-explants were mounted inside a dedicated chest phantom. MDCT was performed at 120kV and 80kV with 120, 60, 30 and 12 mAs each. All scans were reconstructed with filtered back projection (FBP) or IR, resulting in a total of 160 datasets. The maximum number of detected airway segments, most peripheral airway generation detected, generation-specific airway wall thickness (WT), total diameter (TD) and normalized wall thickness (pi10) were compared. RESULTS: The number of detected airway segments decreased slightly with dose (324.8±118 at 120kV/120mAs vs. 288.9±130 at 80kV/30mAs with FBP, p<0.05) and was not changed by IR. The 20(th) generation was constantly detected as most peripheral. WT did not change significantly with exposure parameters and reconstruction algorithm across all generations: range 1(st) generation 2.4–2.7mm, 5(th) 1.0–1.1mm, and 10(th) 0.7mm with FBP; 1(st) 2.3–2.4mm, 5(th) 1.0–1.1mm, and 10(th) 0.7–0.8mm with IR. pi10 was not affected as well (range 0.32–0.34mm). CONCLUSIONS: Exposure parameters and IR had no relevant influence on measured airway parameters even for WT <1mm. Thus, no systematic errors would be expected using automatic airway analysis with low-dose MDCT and IR.