PMID- 30015591
OWN - NLM
STAT- MEDLINE
DCOM- 20190814
LR  - 20190814
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Linking)
VI  - 289
IP  - 2
DP  - 2018 Nov
TI  - CT Detectability of Small Low-Contrast Hypoattenuating Focal Lesions: Iterative 
      Reconstructions versus Filtered Back Projection.
PG  - 443-454
LID - 10.1148/radiol.2018180137 [doi]
AB  - Purpose To investigate performance in detectability of small (</=1 cm) low-contrast 
      hypoattenuating focal lesions by using filtered back projection (FBP) and 
      iterative reconstruction (IR) algorithms from two major CT vendors across a range 
      of 11 radiation exposures. Materials and Methods A low-contrast detectability 
      phantom consisting of 21 low-contrast hypoattenuating focal objects (seven sizes 
      between 2.4 and 10.0 mm, three contrast levels) embedded into a liver-equivalent 
      background was scanned at 11 radiation exposures (volume CT dose index range, 
      0.5-18.0 mGy; size-specific dose estimate [SSDE] range, 0.8-30.6 mGy) with four 
      high-end CT platforms. Data sets were reconstructed by using FBP and varied 
      strengths of image-based, model-based, and hybrid IRs. Sixteen observers 
      evaluated all data sets for lesion detectability by using a 
      two-alternative-forced-choice (2AFC) paradigm. Diagnostic performances were 
      evaluated by calculating area under the receiver operating characteristic curve 
      (AUC) and by performing noninferiority analyses. Results At benchmark exposure, 
      FBP yielded a mean AUC of 0.79 +/- 0.09 (standard deviation) across all platforms 
      which, on average, was approximately 2% lower than that observed with the 
      different IR algorithms, which showed an average AUC of 0.81 +/- 0.09 (P = .12). 
      Radiation decreases of 30%, 50%, and 80% resulted in similar declines of observer 
      detectability with FBP (mean AUC decrease, -0.02 +/- 0.05, -0.03 +/- 0.05, and -0.05 
      +/- 0.05, respectively) and all IR methods investigated (mean AUC decrease, -0.00 +/- 
      0.05, -0.04 +/- 0.05, and -0.04 +/- 0.05, respectively). For each radiation level and 
      CT platform, variance in performance across observers was greater than that 
      across reconstruction algorithms (P = .03). Conclusion Iterative reconstruction 
      algorithms have limited radiation optimization potential in detectability of 
      small low-contrast hypoattenuating focal lesions. This task may be further 
      complicated by a high degree of variation in radiologists' performances, 
      seemingly exceeding real performance differences among reconstruction algorithms. 
      (c) RSNA, 2018 Online supplemental material is available for this article.
FAU - Mileto, Achille
AU  - Mileto A
AUID- ORCID: 0000-0002-6341-7837
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Zamora, David A
AU  - Zamora DA
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Alessio, Adam M
AU  - Alessio AM
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Pereira, Carina
AU  - Pereira C
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Liu, Jin
AU  - Liu J
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Bhargava, Puneet
AU  - Bhargava P
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Carnell, Jonathan
AU  - Carnell J
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Cowan, Sophie M
AU  - Cowan SM
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Dighe, Manjiri K
AU  - Dighe MK
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Gunn, Martin L
AU  - Gunn ML
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Kim, Sooah
AU  - Kim S
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Kolokythas, Orpheus
AU  - Kolokythas O
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Lee, Jean H
AU  - Lee JH
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Maki, Jeffrey H
AU  - Maki JH
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Moshiri, Mariam
AU  - Moshiri M
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Nasrullah, Ayesha
AU  - Nasrullah A
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - O'Malley, Ryan B
AU  - O'Malley RB
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Schmiedl, Udo P
AU  - Schmiedl UP
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Soloff, Erik V
AU  - Soloff EV
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Toia, Giuseppe V
AU  - Toia GV
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Wang, Carolyn L
AU  - Wang CL
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
FAU - Kanal, Kalpana M
AU  - Kanal KM
AD  - From the Departments of Radiology (A.M., D.A.Z., A.M.A., P.B., J.C., S.M.C., 
      M.K.D., M.L.G., S.K., O.K., J.H.L., M.M., A.N., R.B.O., U.P.S., E.V.S., G.V.T., 
      C.L.W., K.M.K.) and Bioengineering (C.P., J.L.), University of Washington School 
      of Medicine, Box 357115, 1959 NE Pacific St, Seattle, WA 98195; and Department of 
      Radiology, University of Colorado-Denver, Aurora, Colo (J.H.M.).
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20180717
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
MH  - Algorithms
MH  - Liver/*diagnostic imaging
MH  - Observer Variation
MH  - Phantoms, Imaging
MH  - Radiation Dosage
MH  - Radiographic Image Interpretation, Computer-Assisted/*methods
MH  - Reproducibility of Results
MH  - Tomography, X-Ray Computed/*methods
EDAT- 2018/07/18 06:00
MHDA- 2019/08/15 06:00
CRDT- 2018/07/18 06:00
PHST- 2018/07/18 06:00 [pubmed]
PHST- 2019/08/15 06:00 [medline]
PHST- 2018/07/18 06:00 [entrez]
AID - 10.1148/radiol.2018180137 [doi]
PST - ppublish
SO  - Radiology. 2018 Nov;289(2):443-454. doi: 10.1148/radiol.2018180137. Epub 2018 Jul 
      17.