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Klemenz AC, Albrecht L, Manzke M, Dalmer A, Böttcher B, Surov A, Weber MA, Meinel FG. Improved image quality in CT pulmonary angiography using deep learning-based image reconstruction. Sci Rep 2024; 14:2494. [PMID: 38291105 PMCID: PMC10827738 DOI: 10.1038/s41598-024-52517-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
We investigated the effect of deep learning-based image reconstruction (DLIR) compared to iterative reconstruction on image quality in CT pulmonary angiography (CTPA) for suspected pulmonary embolism (PE). For 220 patients with suspected PE, CTPA studies were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASiR-V 30%, 60% and 90%) and DLIR (low, medium and high strength). Contrast-to-noise ratio (CNR) served as the primary parameter of objective image quality. Subgroup analyses were performed for normal weight, overweight and obese individuals. For patients with confirmed PE (n = 40), we further measured PE-specific CNR. Subjective image quality was assessed independently by two experienced radiologists. CNR was lowest for FBP and enhanced with increasing levels of ASiR-V and, even more with increasing strength of DLIR. High strength DLIR resulted in an additional improvement in CNR by 29-67% compared to ASiR-V 90% (p < 0.05). PE-specific CNR increased by 75% compared to ASiR-V 90% (p < 0.05). Subjective image quality was significantly higher for medium and high strength DLIR compared to all other image reconstructions (p < 0.05). In CT pulmonary angiography, DLIR significantly outperforms iterative reconstruction for increasing objective and subjective image quality. This may allow for further reductions in radiation exposure in suspected PE.
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Affiliation(s)
- Ann-Christin Klemenz
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Lasse Albrecht
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Mathias Manzke
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Antonia Dalmer
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Benjamin Böttcher
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Alexey Surov
- Department of Radiology, Mühlenkreiskliniken Minden, Ruhr-University Bochum, Bochum, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany.
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