Objective To investigate the image quality

radiation dose and diagnostic value of the low-tube-voltage high-pitch dual-source computed tomography (DSCT) with sinogram affirmed iterative reconstruction (SAFIRE) for non-enhanced abdominal and pelvic scans. Methods This institutional review board-approved prospective study included 64 patients who gave written informed consent for additional abdominal and pelvic scan with DSCT in the period from November to December 2012. The patients underwent standard non-enhanced CT scans (protocol 1) [tube voltage of 120 kVp/pitch of 0.9/filtered back-projection (FBP) reconstruction] followed by high-pitch non-enhanced CT scans (protocol 2) (100 kVp/3.0/SAFIRE). The total scan time

mean CT number

signal-to-noise ratio (SNR)

image quality

lesion detectability and radiation dose were compared between the two protocols. Results The total scan time of protocol 2 was significantly shorter than that of protocol 1 (1.4±0.1 seconds vs. 7.6±0.6 seconds

P<0.001). There was no significant difference between protocol 1 and protocol 2 in mean CT number of all organs (liver

55.4±6.3 HU vs. 56.1±6.8 HU

P=0.214; pancreas

43.6±5.9 HU vs. 43.7±5.8 HU

P=0.785; spleen

47.9±3.9 HU vs. 49.4±4.3 HU

P=0.128; kidney

32.2±2.3 HU vs. 33.1±2.3 HU

P=0.367; abdominal aorta

44.8±5.6 HU vs. 45.0±5.5 HU

P=0.499; psoas muscle

50.7±4.1 HU vs. 50.3±4.5 HU

P=0.279). SNR on images of protocol 2 was higher than that of protocol 1 (liver

5.0±1.2 vs. 4.5±1.1

P<0.001; pancreas

4.0±1.0 vs. 3.6±0.8

P<0.001; spleen

4.7±1.0 vs. 4.1±0.9

P<0.001; kidney

3.1±0.6 vs. 2.8±0.6

P<0.001; abdominal aorta

4.1±1.0 vs. 3.8±1.0

P<0.001; psoas muscle

4.5±1.1 vs. 4.3±1.2

P=0.012). The overall image noise of protocol 2 was lower than that of protocol 1 (9.8±3.1 HU vs. 11.1±3.0 HU

P<0.001). Image quality of protocol 2 was good but lower than that of protocol 1 (4.1±0.7 vs. 4.6±0.5

P<0.001). Protocol 2 perceived 229 of 234 lesions (97.9%) that were detected in protocol 1 in the abdomen and pelvis. Radiation dose of protocol 2 was lower than that of protocol 1 (4.4±0.4 mSv vs. 7.3±2.4 mSv

P<0.001) and the mean dose reduction was 41.4%. Conclusion The high-pitch DSCT with SAFIRE can shorten scan time and reduce radiation dose while preserving image quality in non-enhanced abdominal and pelvic scans.