AIM:To explore whether computer tomography coronary angiography(CTCA) using iterative reconstruction(IR) leads to significant radiation dose reduction without a significant loss in image interpretability compared to conventional filtered back projection(FBP).METHODS:A consecutive series of 200 patients referred to our institution to undergo CTCA constituted the study population.Patients were sequentially assigned to FBP or IR.All studies were acquired with a 256-slice CT scanner.A coronary segment was considered interpretable if image quality was adequate for evaluation of coronary lesions in all segments ≥ 1.5 mm.RESULTS:The mean age was 56.3±9.6 years and165(83%) were male,with no significant differences between groups.Most scans were acquired using prospective ECG triggering,without differences between groups(FBP 84%vs IR 82%;P=0.71).A total of 3198(94%) coronary segments were deemed of diagnostic quality.The percent assessable coronary segments was similar between groups(FBP 91.7%±4.0% vs IR92.5% ± 2.8%; P=0.12).Radiation dose was significantly lower in the IR group(2.8±1.4 mSvvs 4.6±3.0mSv;P<0.0001).Image noise(37.8±1.4 HUvs 38.2±2.4 HU; P=0.20) and signal density(461.7±51.9HU vs 462.2±51.2 HU; P=0.54) levels did not differ between FBP and IR groups,respectively.The IR group was associated to significant effective dose reductions,irrespective of the acquisition mode.CONCLUSION:Application of IR in CTCA preserves image interpretability despite a significant reduction in radiation dose.
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