Potential radiation dose reduction in computed tomography with deep learning reconstruction: a retrospective...

To evaluate whether deep learning reconstruction (DLR) can reduce the radiation dose in routine clinical computed tomography (CT) scans compared with iterative reconstruction (IR) while maintaining or improving image quality. The study assesses DLR's consistency and effectiveness across four distinct CT protocols-chest, head, chest-abdomen-pelvis (CAP) oncology, and lower limb CT angiography (CTA)-representing a wide range of clinical applications.

Our study is retrospective and monocentric. It involves a total population of 13,060 patients who underwent a CT scan using either a DLR algorithm (CT-DLR) or an IR algorithm (CT-IR) in one of four different CT acquisition protocols. Image quality was evaluated qualitatively and quantitatively by measuring standardized signal-to-noise ratio and contrast-to-noise ratio values. Assessment was performed on a subsample of 200 patients (25 per protocol per group).

The overall reduction in radiation dose for the CT-DLR group compared with the CT-IR group was approximately 20%. By protocol, dose reductions were 22% for chest CT, 21% for CAP oncology, 20% for lower limb CTA, and 19% for head CT. The CT-DLR group exhibited superior subjective and objective image quality to the CT-IR group.

DLR algorithms allow for a significant reduction in radiation dose while achieving higher image quality compared with IR algorithms.

This large-scale study confirms that DLR can significantly reduce the radiation dose in routine CT imaging while maintaining or enhancing diagnostic image quality. Its consistent performance across multiple protocols supports broader clinical adoption. Notably, the greatest dose reductions were observed in high-use protocols such as chest and CAP CT, underscoring DLR's potential to improve both individual patient care and long-term population-level radiation safety.