AUTHOR=Yamamoto Yuta , Tanabe Yuki , Kurata Akira , Yamamoto Shuhei , Kido Tomoyuki , Uetani Teruyoshi , Ikeda Shuntaro , Nakano Shota , Yamaguchi Osamu , Kido Teruhito TITLE=Feasibility of four-dimensional similarity filter for radiation dose reduction in dynamic myocardial computed tomography perfusion imaging JOURNAL=Frontiers in Radiology VOLUME=Volume 3 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/radiology/articles/10.3389/fradi.2023.1214521 DOI=10.3389/fradi.2023.1214521 ISSN=2673-8740 ABSTRACT=Rationale and Objectives: We aimed to evaluate the impact of four-dimensional noise reduction filtering using a four-dimensional similarity filter (4D-SF) on radiation dose reduction in dynamic myocardial computed tomography perfusion (CTP).Materials and Methods: Forty-three patients who underwent dynamic myocardial CTP using 320-row computed tomography (CT) were included in the study. The original images were reconstructed using iterative reconstruction (IR). Three different CTP datasets with simulated noise, corresponding to 25%, 50%, and 75% reduction of the original dose (300 mA), were reconstructed using a combination of IR and 4D-SF. The signal-to-noise ratio (SNR) and contrastto-noise ratio (CNR) were assessed, and CT-derived myocardial blood flow (CT-MBF) was quantified. The results were compared between the original and simulated images with radiation dose reduction.The median SNR (first quartile-third quartile) at the original, 25%-, 50%-, and 75%dose reduced-simulated images with 4D-SF was 8.3 (6.5-10.2), 16.5 (11.9-21.7), 15.6 (11.0-20.1), and 12.8 (8.8-18.1) and that of , respectively. All the dose-reduced-simulated CTPs with 4D-SF had significantly higher image quality scores in SNR and CNR than the original ones (25%-, 50%-, and 75%-dose reduced vs original images, p < 0.05, in each). The CT-MBF in 75%-dose reduced-simulated CTP was significantly lower than 25%-, 50%-dose-reduced-simulated, and original CTPs (vs 75%dose reduced-simulated images, p < 0.05, in each).4D-SF has the potential to reduce the radiation dose associated with dynamic myocardial CTP imaging by half, without impairing the robustness of MBF quantification.