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Improved image quality and dose reduction in abdominal CT with deep-learning reconstruction algorithm: a phantom

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A new artificial intelligence deep-learning reconstruction (AI-DLR) algorithm significantly reduces image noise and enhances lesion detectability in abdominal CT scans. The Smooth AI-DLR level offers the best balance between low radiation dose and diagnostic image quality.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Artificial Intelligence in Healthcare

Background:

  • Iterative reconstruction (IR) algorithms are standard in abdominal CT, but advancements in artificial intelligence offer potential for improved image quality and dose reduction.
  • Deep learning reconstruction (DLR) presents a novel approach to image processing in CT.
  • Evaluating new AI-DLR algorithms against established IR methods is crucial for clinical adoption.

Purpose of the Study:

  • To compare the image quality and lesion detectability of a new AI-DLR algorithm (Precise Image) against a hybrid IR algorithm (iDose^4) in abdominal CT.
  • To assess the performance of AI-DLR across various clinical indications and radiation dose levels.
  • To determine the optimal AI-DLR setting for balancing image quality and radiation dose.

Main Methods:

  • Phantom-based CT acquisitions were performed at five dose levels (1.8–13 mGy).
  • Raw data were reconstructed using hybrid IR (iDose^4 level 4) and three AI-DLR levels (Smoother, Smooth, Standard).
  • Objective image quality metrics (noise power spectrum, task-based transfer function, detectability index) and subjective radiologist assessments were used.

Main Results:

  • AI-DLR, particularly the Smooth and Smoother levels, reduced image noise and improved lesion detectability (d') compared to hybrid IR.
  • Spatial resolution was enhanced by AI-DLR at standard and low-dose levels.
  • Radiologists found AI-DLR images satisfactory across dose levels, though the Smoother level was perceived as too smooth.

Conclusions:

  • The Smooth and Smoother levels of AI-DLR effectively reduce noise and improve lesion detection and spatial resolution in abdominal CT, even at low doses.
  • The Smooth AI-DLR level represents an optimal compromise between minimizing radiation exposure and maintaining adequate diagnostic image quality.
  • AI-DLR shows significant promise for enhancing abdominal CT imaging protocols.