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ToinvestigatetheeffectofCAREkVtechniquecombinedwithsinogram-affirmediterativereconstruction(SAFIRE)on imagequalityandradiationdoseinchestCTscanning. Methods 120casesundergonechestCTscanningwerechosen.PatientswererandomlydividedintogroupA(60cases)andgroup B(60cases).ThetubevoltageofgroupAwas120kVp,usedthefilteredbackprojection(FBP)reconstructiontechniques.The referencetubevoltageofgroupBwas120kVp,usedtheCAREkVandtheSAFIRE(value=3)techniques.CTdoseindexofvolume(CTDIvol),doselengthproduct(DLP),effectivedose(ED),imagenoise(SD),signal-to-noiseratio(SNR),contrast-to-noiseratio(CNR) werecomparedbetweenthetwogroups.Imagequalitywasscoredsubjectivelybytwoexperiencedradiologists,andthe consistencyofdiagnosisweretestwithKappa. Results Theaverageof CTDIvol[(5.18±0.8)mGy],DLP[(178.86±31.86)mGy·cm],ED[(2.5±0.45)mSv]ofgroupAwerelowerthanthose ofgroupB[(6.01±1.07)mGy],[(217.64±40.21)mGy·cm],[(3.05±0.56)mSv],withstatisticallysignificantdifferenceinbothgroup(all P<0.05).Theaverageof articulationessternoclavicularisSD(5.94±0.5),thebifurcationoftracheaSD(6.05±0.61),theleftventricleSD(5.63±0.78)ofgroupAwerelowerthanthoseofgroupB(8.63±1.09),(8.61±0.9),(8.32±1.17),withstatisticallysignificant differenceinbothgroup(allP<0.05).Theaverageof articulationessternoclavicularisSNR(8.5±1.36),thebifurcationoftrachea SNR(6.68±1.12),theleftventricleSNR(7.31±1.51)ofgroupAwerehigherthanthoseofgroupB(6.02±1.05),(4.66±0.74),(5.32±1.33),withstatisticallysignificantdifferenceinbothgroup(allP<0.05).Theaverageof tracheabifurcationCNR(23.99±2.52)washigherthanthisofgroupB(13.77±2.15),withstatisticallysignificantdifferenceinbothgroup(allP<0.05). Conclusion CAREkVtechniquecombinedwithSAFIREinchestCTscanningcouldsignificantlyreducetheradiationdosebased onmaintainingthequalityofCTimage.