Iterative reconstruction (IR) is a relatively recent development in CT scanner technology. All the major manufacturers have integrated it into their product lines as well as registered a trademarked name for their individual IR software: ASiR (GE), IRIS (Siemens), iDose (Philips), AIDR (Toshiba).
It's always great to see CT technology take new steps and open new possibilities but, for anyone running a system that doesn't have the latest technology, the introduction of new features begs the question, "Do I need it right now?"
As much as we'd love to give a simple yes-or-no answer, whether or not your facility needs iterative reconstruction depends on your short-term goals.
Meeting Regulatory Standards
As you may have read in previous articles, facilities using CT scanners have until 2016 to come into compliance with standard XR-29 or incur a 5% reduction in reimbursements. This reduction will increase to 15% in 2017.
Iterative reconstruction (IR) is NOT a requirement of standard XR-29. According to the Medical Imaging and Technology Alliance (MITA), the association that developed XR-29, CT systems must have the following features enabled to be compliant:
- DICOM radiation dose structured report
- CT dose check
- Automatic exposure controls
- Pediatric and adult reference protocols
You can read about these features in more detail here.
There are a number of active CT scanner systems that meet these requirements without having IR technology installed on them. However, regardless of the features that are currently enabled on your CT, we recommend that every facility operating a CT access the full text of XR-29 to be absolutely certain of your equipment's compliance.
Staying in Step with Current Technology
Perhaps your equipment upgrade schedule revolves more around technological advancement than regulatory compliance. If this is the case, you may be considering an IR-enabled system based on the benefits it can provide to your patients and physicians. While we won't go so far as to call it a panacea, IR is a good way to get better images out of your CT while lowering its radiation dose. IR capabilities have been shown to reduce dose, image noise, and reconstruction artifacts and are a must-have for those who want to be on the leading edge of CT technology.
Ultimately, both compliance and advancement are goals of every facility that uses a CT scanner. More and more facilities will upgrade their equipment into compliance with XR-29 and IR capabilities will come standard on more and more CT systems. What will differ is the timeframe until adoption.
For the immediate future, the answers to the title question are these:
- Does a site need iterative reconstruction to serve patients without incurring monetary penalties? No.
- Should iterative reconstruction be enabled at any site that wants to be on the "cutting edge" of CT technology? Yes.
Written by David Harns
David Harns is the CT Product Specialist at Block Imaging. His goal is to provide people with service that makes the experience of purchasing imaging equipment worry-free. Outside the office, David follows Michigan State University athletics closely. He also loves to travel with his wife and four sons -- including to their favorite destination: Camp Arcadia on Lake Michigan.