Effect of iterative reconstruction algorithms on peripheral MDCT angiography virtual histology plaque volumes: have we been overestimating disease burden?

Our objective was to compare plaque volumes of multidetector computed tomographic images reconstructed using adaptive statistical iterative reconstruction (ASIR), model-based iterative reconstruction (MBIR), and filtered back projection (FBP). We reviewed 25 patients for a total of 50 extremities imaged on the same scanner. Calcified plaque FBP volume (3468.2±2634.8 mm3) was higher than ASIR (2548.1±2166.5 mm3). Calcified plaque FBP volume was higher than MBIR (mean=2345.7±1935.4 mm3). Our findings suggest that traditional FBP methods overestimate disease compared to newer reconstruction methods.