Maintaining image quality and reducing dose in prospectively-triggered CT coronary angiography: A systematic review of the use of iterative reconstruction

Introduction
Coronary computed tomography angiography (CCTA) is a reliable, minimally invasive technique used in the diagnosis and characterisation of coronary artery disease. Within this modality iterative reconstruction has the potential to maintain image quality whilst reducing radiation dose.

Methods
A priori search terms and inclusion/exclusion criteria were developed.

Results
Three studies were included in the review which analysed a total of 227 participants. As CTDIvol decreased there was no significant change in objective image quality, although some subjective image quality scores decreased.

Discussion
The decrease of subjective image quality scores may be explained as a reaction to the difference in image appearance of the iterative reconstruction images; a potential reduction in dynamic range; and the number of scorers used.

Conclusion
Iterative reconstruction can be utilized as a tool to significantly reduce patients' exposure to ionising radiation; however there may be implications for radiologists/cardiologist in the interpretation of these images.