Reducing radiographic retake rates with ultra-low dose pre-shots using deep learning-based noise reduction: A prospective clinical study
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Updated: Nov 4, 2026
X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
K Mori1, R Sekiguchi1, M Suzaki1
1Department of Radiological Technology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan.
Introduction:
The pre-shot technique is an effective approach to lower retake radiography rates; however, it is limited by increased patient radiation exposure. This study aimed to evaluate the impact of an ultra-low-dose pre-shot enabled by deep learning-based noise reduction (Advanced Intelligent Clear-IQ Engine: AiCE) on reducing retake rates in wrist radiography.
Methods:
A CXDI-810C (Canon Medical Systems) was used as the X-ray detector. Phantom images simulating lateral wrist pre-shots with and without AiCE were acquired under fixed imaging conditions using an additional 1.0 mm copper filter. The tube current-time product was reduced from 2.8 mAs to 0.5 mAs. Fifteen radiological technologists determined the optimal imaging condition using a five-point confidence scale, with scores below three considered insufficient for retake decision-making. A prospective clinical evaluation was then conducted, comparing retake rates between a non-pre-shot group (n = 542) and a pre-shot group (n = 325). The entrance surface air kerma (Ka,e) was estimated from phantom measurements.
Results:
Without AiCE, no imaging condition met the threshold required for retake decision-making. Conversely, with AiCE, a tube current-time product of 1.6 mAs achieved acceptable image quality (3.29 ± 0.47), with all evaluators assigning scores ≥3; therefore, it was selected as the optimal condition. In the clinical evaluation, the retake rate markedly decreased from 14.38% to 0.61%. The pre-shot Ka,e was 0.11 ± 0.03 μGy, corresponding to only 0.15% of the standard lateral wrist radiography dose.
Conclusion:
AiCE-enabled ultra-low-dose pre-shot imaging dramatically reduced retake rates while requiring minimal additional radiation dose.
Implications For Practice:
The ultra-low-dose pre-shot using AiCE represents a highly effective strategy to minimize retake imaging with negligible dose penalty, offering substantial potential for dose optimization and improved workflow efficiency in clinical radiography.