Computed tomography in trauma patients using iterative reconstruction: reducing radiation exposure without loss of image quality

Acta Radiol. 2016 Mar;57(3):362-9. doi: 10.1177/0284185115580839. Epub 2015 Apr 6.


Background: Rising numbers of computed tomography (CT) examinations worldwide have led to a focus on dose reduction in the latest developments in CT technology. Iterative reconstruction (IR) models bear the potential to effectively reduce dose while maintaining adequate image quality.

Purpose: To assess the impact of adaptive statistical iterative reconstruction (ASIR) technique on dose reduction and image quality in a dedicated whole body CT (WBCT) protocol for trauma patients.

Material and methods: A total of 122 subjects with multiple trauma was prospectively included in our study. Subjects who had to undergo a WBCT following a severe trauma were randomly assigned to two different groups: Group A was examined with an ASIR protocol for the body series (n = 64), group B (n = 58) was examined using a standard filtered back projection (FBP) protocol. Image quality was assessed both quantitatively by calculating signal-to-noise ratio (SNR) and contrast-to-noise ratios (CNRs) and qualitatively by two observers who evaluated image quality using a 5-point scale system. Applied dose was analyzed as CTDIvol (mGy), total DLP (mGyxcm), and effective dose (mSv).

Results: Applied dose for the body series in group A was about 23% lower than in group B (P < 0.05). SNR and CNRs for different tissues were not significantly different. Subjective image quality ratings were excellent and showed no significant difference, with a high inter-reader agreement.

Conclusion: ASIR contributes to a relevant dose reduction without any loss of image quality in a dedicated WBCT protocol for patients with multiple trauma.

Keywords: Computed tomography (CT); iterative reconstruction; technology assessment; trauma.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Trauma / diagnostic imaging*
  • Observer Variation
  • Prospective Studies
  • Radiation Dosage*
  • Radiation Exposure / statistics & numerical data*
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Reproducibility of Results
  • Signal-To-Noise Ratio
  • Tomography, X-Ray Computed / methods*
  • Whole Body Imaging / methods*