Iterative reconstruction technique vs filter back projection: Utility for quantitative bronchial assessment on low-dose thin-section MDCT in patients with/without chronic obstructive pulmonary disease

Objectives: The aim of this study was to evaluate the utility of the iterative reconstruction (IR) technique for quantitative bronchial assessment during low-dose computed tomography (CT) as a substitute for standard-dose CT in patients with/without chronic obstructive pulmonary disease. Methods: Fifty patients (mean age, 69.2; mean % predicted FEV1, 79.4) underwent standard-dose CT (150mAs) and low-dose CT (25mAs). Except for tube current, the imaging parameters were identical for both protocols. Standard-dose CT was reconstructed using filtered back-projection (FBP), and low-dose CT was reconstructed using IR and FBP. For quantitative bronchial assessment, the wall area percentage (WA%) of the sub-segmental bronchi and the airway luminal volume percentage (LV%) from the main bronchus to the peripheral bronchi were acquired in each dataset. The correlation and agreement of WA% and LV% between standard-dose CT and both low-dose CTs were statistically evaluated. Results: WA% and LV% between standard-dose CT and both low-dose CTs were significant correlated (r > 0.77, p < 0.00001); however, only the LV% agreement between SD-CT and low-dose CT reconstructed with IR was moderate (concordance correlation coefficient = 0.93); the other agreement was poor (concordance correlation coefficient <0.90). Conclusions: Quantitative bronchial assessment via low-dose CT has potential as a substitute for standard-dose CT by using IR and airway luminal volumetry techniques. • Quantitative bronchial assessment of COPD using low-dose CT is possible. • Airway luminal volumetry with iterative reconstruction is insusceptible to dose reduction. • Filtered back-projection is susceptible to the effect of dose reduction. • Wall area percentage assessment is easily influenced by dose reduction.