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SU-E-I-82: Improving CT Image Quality for Radiation Therapy Using Iterative Reconstruction Algorithms and Slightly Increasing Imaging Doses. Med Phys 2014 Jun;41(6):149



Pubmed ID



PURPOSE: Iterative reconstruction (IR) algorithms are developed to improve CT image quality (IQ) by reducing noise without diminishing spatial resolution or contrast. For CT in radiation therapy (RT), slightly increasing imaging dose to improve IQ may be justified if it can substantially enhance structure delineation. The purpose of this study is to investigate and to quantify the IQ enhancement as a result of increasing imaging doses and using IR algorithms.

METHODS: CT images were acquired for phantoms, built to evaluate IQ metrics including spatial resolution, contrast and noise, with a variety of imaging protocols using a CT scanner (Definition AS Open, Siemens) installed inside a Linac room. Representative patients were scanned once the protocols were optimized. Both phantom and patient scans were reconstructed using the Sinogram Affirmed Iterative Reconstruction (SAFIRE) and the Filtered Back Projection (FBP) methods. IQ metrics of the obtained CTs were compared.

RESULTS: IR techniques are demonstrated to preserve spatial resolution as measured by the point spread function and reduce noise in comparison to traditional FBP. Driven by the reduction in noise, the contrast to noise ratio is doubled by adopting the highest SAFIRE strength. As expected, increasing imaging dose reduces noise for both SAFIRE and FBP reconstructions. The contrast to noise increases from 3 to 5 by increasing the dose by a factor of 4. Similar IQ improvement was observed on the CTs for selected patients with pancreas and prostrate cancers.

CONCLUSION: The IR techniques produce a measurable enhancement to CT IQ by reducing the noise. Increasing imaging dose further reduces noise independent of the IR techniques. The improved CT enables more accurate delineation of tumors and/or organs at risk during RT planning and delivery guidance.

Author List

Noid G, Chen G, Tai A, Li X


An Tai PhD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin

jenkins-FCD Prod-480 9a4deaf152b0b06dd18151814fff2e18f6c05280