• Angeliki Neroladaki, Diomidis Botsikas, Sana Boudabbous, Christoph D Becker, and Xavier Montet.
• Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 4, Switzerland.
• Eur Radiol. 2013 Feb 1; 23 (2): 360-6.

ObjectivesThe purpose of this study was to assess the diagnostic image quality of ultra-low-dose chest computed tomography (ULD-CT) obtained with a radiation dose comparable to chest radiography and reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR) in comparison with standard dose diagnostic CT (SDD-CT) or low-dose diagnostic CT (LDD-CT) reconstructed with FBP alone.MethodsUnenhanced chest CT images of 42 patients acquired with ULD-CT were compared with images obtained with SDD-CT or LDD-CT in the same examination. Noise measurements and image quality, based on conspicuity of chest lesions on all CT data sets were assessed on a five-point scale.ResultsThe radiation dose of ULD-CT was 0.16 ± 0.006 mSv compared with 11.2 ± 2.7 mSv for SDD-CT (P < 0.0001) and 2.7 ± 0.9 mSv for LDD-CT. Image quality of ULD-CT increased significantly when using MBIR compared with FBP or ASIR (P < 0.001). ULD-CT reconstructed with MBIR enabled to detect as many non-calcified pulmonary nodules as seen on SDD-CT or LDD-CT. However, image quality of ULD-CT was clearly inferior for characterisation of ground glass opacities or emphysema.ConclusionModel-based iterative reconstruction allows detection of pulmonary nodules with ULD-CT with radiation exposure in the range of a posterior to anterior (PA) and lateral chest X-ray.

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