Increasing iterative reconstruction strength at low tube voltage in coronary CT angiography protocols using 3D-printed and Catphan®500 phantoms

Purpose The purpose of this study was to investigate the effect of increasing iterative reconstruction (IR) algorithm strength at different tube voltages in coronary computed tomography angiography (CCTA) protocols using a three-dimensional (3D)-printed and Catphan (R) 500 phantoms. Methods A 3D-printed cardiac insert and Catphan 500 phantoms were scanned using CCTA protocols at 120 and 100 kVp tube voltages. All CT acquisitions were reconstructed using filtered back projection (FBP) and Adaptive Statistical Iterative Reconstruction (ASIR) algorithm at 40% and 60% strengths. Image quality characteristics such as image noise, signal-noise ratio (SNR), contrast-noise ratio (CNR), high spatial resolution, and low contrast resolution were analyzed. Results There was no significant difference (P > 0.05) between 120 and 100 kVp measures for image noise for FBP vs ASIR 60% (16.6 +/- 3.8 vs 16.7 +/- 4.8), SNR of ASIR 40% vs ASIR 60% (27.3 +/- 5.4 vs 26.4 +/- 4.8), and CNR of FBP vs ASIR 40% (31.3 +/- 3.9 vs 30.1 +/- 4.3), respectively. Based on the Modulation Transfer Function (MTF) analysis, there was a minimal change of image quality for each tube voltage but increases when higher strengths of ASIR were used. The best measure of low contrast detectability was observed at ASIR 60% at 120 kVp. Conclusions Changing the IR strength has yielded different image quality noise characteristics. In this study, the use of 100 kVp and ASIR 60% yielded comparable image quality noise characteristics to the standard CCTA protocols using 120 kVp of ASIR 40%. A combination of 3D-printed and Catphan(R)500 phantoms could be used to perform CT dose optimization protocols.