Double Dose Reduction in the Equilibrium Phase of Chest-Pelvic CT With Low Tube Voltage and Forward-Projected Model-Based Iterative Reconstruction Solution

Objectives This study aimed to examine whether a new imaging method (80-kV forward-projected model-based iterative reconstruction solution [FIRST] protocol) that uses a combination of low tube voltage and FIRST can reduce radiation dose and contrast medium volume by comparing the quality of the resulting image with that of the image obtained by 120-kV adaptive iterative dose reduction 3D protocol in the equilibrium phase of chest-pelvic computed tomography (CT). Subjects and methods Twenty-seven patients underwent CT by both protocols on different days. Two radiologists subjectively assessed image quality by scoring axial images for sharpness, contrast enhancement, noise, artifacts, and overall quality. The mean CT values, standard deviations, contrast-to-noise ratios, and signal-to-noise ratios in the liver, aorta, and erector spinae muscles were used for objective assessment. Radiation dose parameters included the CT dose index volume, dose-length product, effective dose, and size-specific dose estimate. Results were compared for different body mass index categories. Results The 80-kV FIRST protocol helped achieve mean reductions of 36.3%, 35.7%, and 36.6% in CT dose index volume, effective dose, and size-specific dose estimate, respectively (p < 0.01). Therefore, this protocol was regarded as comparable to the conventional protocol in image quality, except for visual sharpness. Conclusions The 80-kV FIRST protocol is capable of reducing radiation dose and contrast medium volume compared to the adaptive iterative dose reduction 3D protocol in the equilibrium phase of chest-pelvic CT.