Impact of Iterative Reconstruction Algorithms on Image Quality and Radiation Dose in Computed Tomography Scan of Patients with Malignant Pancreatic Lesions

Background: The objective of this study was to investigate the influence of iterative reconstruction (IR) algorithm on radiation dose and image quality of computed tomography (CT) scans of patients with malignant pancreatic lesions by designing a new protocol. Methods: The pancreas CT was performed on ۴۰ patients (۲۳ males and ۱۷ females) with a ۱۶۰‑slice CT scan machine. The pancreatic parenchymal phase was performed in two stages: one with a usual dose of radiation and the other one after using a reduced dose of radiation. The images obtained with usual dose were reconstructed with Filtered Back Projection (FBP) method (Protocol A); and the images obtained with the reduced dose were reconstructed with both FBP (Protocol B) and IR method (Protocol C). The quality of images and radiation dose were compared among the three protocols. Results: Image noise was significantly lower with Protocol C (۱۰.۸۰) than with Protocol A (۱۴.۹۸) and Protocol B (۲۰.۶۰) (P < ۰.۰۰۱). Signal‑to‑noise ratio and contrast‑to‑noise ratio were significantly higher with Protocol C than with Protocol A and Protocol B (P < ۰.۰۰۱). Protocol A and Protocol C were not significantly different in terms of image quality scores. Effective dose was reduced by approximately ۴۸% in Protocol C compared with Protocol A (۱.۲۰ ± ۰.۵۳ mSv vs. ۲.۳۳ ± ۰.۸۶ mSv, P < ۰.۰۰۱). Conclusion: Results of this study showed that applying the IR method compared to the FBP method can improve objective image quality, maintain subjective image quality, and reduce the radiation dose of the patients undergo pancreas CT.