Comparison of filtered back projection, hybrid iterative reconstruction, model-based iterative reconstruction, and virtual monoenergetic reconstruction images at both low-and standard-dose settings in measurement of emphysema volume and airway wall thickness: A CT phantom study

Objective: To evaluate the accuracy of emphysema volume (EV) and airway measurements (AMs) produced by various iterative reconstruction (IR) algorithms and virtual monoenergetic images (VME) at both low-and standard-dose settings. Materials and Methods: Computed tomography (CT) images were obtained on phantom at both low-(30 mAs at 120 kVp) and standard-doses (100 mAs at 120 kVp). Each CT scan was reconstructed using filtered back projection, hybrid IR (iDose ⁴ ; Philips Healthcare), model-based IR (IMR-R1, IMR-ST1, IMR-SP1; Philips Healthcare), and VME at 70 keV (VME70). The EV of each air column and wall area percentage (WA%) of each airway tube were measured in all algorithms. Absolute percentage measurement errors of EV (APE _vol ) and AM (APE _WA% ) were then calculated. Results: Emphysema volume was most accurately measured in IMR-R1 (APE _vol in low-dose, 0.053 ± 0.002; APE _vol in standard-dose, 0.047 ± 0.003; all p < 0.001) and AM was the most accurate in IMR-SP1 on both low-and standard-doses CT (APE _WA% in low-dose, 0.067 ± 0.002; APE _WA% in standard-dose, 0.06 ± 0.003; all p < 0.001). There were no significant differences in the APE _vol of IMR-R1 between low-and standard-doses (all p > 0.05). VME70 showed a significantly higher APE _vol than iDose ⁴ , IMR-R1, and IMR-ST1 (all p < 0.004). VME70 also showed a significantly higher APE _WA% compared with the other algorithms (all p < 0.001). Conclusion: IMR was the most accurate technique for measurement of both EV and airway wall thickness. However, VME70 did not show a significantly better accuracy compared with other algorithms.