Feasibility of Ultralow-Dose CT With Deep-Learning Reconstruction for Aneurysm Diameter Measurement in Post-EVAR...

Area of Science:

• Radiology
• Medical Imaging
• Cardiovascular Imaging

Background:

• Post-endovascular aneurysm repair (EVAR) surveillance is crucial for monitoring treatment success.
• Standard-dose computed tomography (SD-CT) is commonly used but involves significant radiation exposure.
• Ultralow-dose CT (ULD-CT) with deep-learning reconstruction (DLR) offers a potential alternative for reduced radiation dose.

Purpose of the Study:

• To evaluate the diagnostic accuracy and image quality of ULD-CT with DLR for post-EVAR surveillance.
• To compare ULD-CT with DLR against conventional SD-CT in terms of radiation dose and measurement precision.

Main Methods:

• A prospective study involving 44 patients undergoing post-EVAR surveillance.
• Comparison of ULD-CT with DLR against SD-CT (iterative reconstruction).
• Independent assessment of aneurysmal sac diameter and image quality by three blinded radiologists.

Main Results:

• ULD-CT significantly reduced radiation dose (CT dose index volume and dose-length product) compared to SD-CT (p<0.001).
• Aneurysmal sac diameter measurements showed high agreement between ULD-CT and SD-CT, with a mean difference of -0.37 mm.
• Image quality scores were lower for ULD-CT (3.3) than SD-CT (4.5) but measurements remained accurate.

Conclusions:

• ULD-CT with DLR provides sufficiently accurate measurements for post-EVAR surveillance.
• This technique offers substantial radiation reduction compared to SD-CT.
• ULD-CT with DLR has the potential for widespread adoption in clinical practice due to its software-based nature.