Tanabe Naoya, Kaji Shizuo, Shima Hiroshi, Shiraishi Yusuke, Maetani Tomoki, Oguma Tsuyoshi, Sato Susumu, Hirai Toyohiro
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Institute of Mathematics for Industry, Kyushu University, Fukuoka, Japan.
Front Artif Intell. 2022 Jan 17;4:769557. doi: 10.3389/frai.2021.769557. eCollection 2021.
Chest computed tomography (CT) is used to screen for lung cancer and evaluate pulmonary and extra-pulmonary abnormalities such as emphysema and coronary artery calcification, particularly in smokers. In real-world practice, lung abnormalities are visually assessed using high-contrast thin-slice images which are generated from raw scan data using sharp reconstruction kernels with the sacrifice of increased image noise. In contrast, accurate CT quantification requires low-contrast thin-slice images with low noise, which are generated using soft reconstruction kernels. However, only sharp-kernel thin-slice images are archived in many medical facilities due to limited data storage space. This study aimed to establish deep neural network (DNN) models to convert sharp-kernel images to soft-kernel-like images with a final goal to reuse historical chest CT images for robust quantitative measurements, particularly in completed previous longitudinal studies. By using pairs of sharp-kernel (input) and soft-kernel (ground-truth) images from 30 patients with chronic obstructive pulmonary disease (COPD), DNN models were trained. Then, the accuracy of kernel conversion based on the established DNN models was evaluated using CT from independent 30 smokers with and without COPD. Consequently, differences in CT values between new images converted from sharp-kernel images using the established DNN models and ground-truth soft-kernel images were comparable with the inter-scans variability derived from repeated phantom scans (6 times), showing that the conversion error was the same level as the measurement error of the CT device. Moreover, the Dice coefficients to quantify the similarity between low attenuation voxels on given images and the ground-truth soft-kernel images were significantly higher on the DNN-converted images than the Gaussian-filtered, median-filtered, and sharp-kernel images ( < 0.001). There were good agreements in quantitative measurements of emphysema, intramuscular adipose tissue, and coronary artery calcification between the converted and the ground-truth soft-kernel images. These findings demonstrate the validity of the new DNN model for kernel conversion and the clinical applicability of soft-kernel-like images converted from archived sharp-kernel images in previous clinical studies. The presented method to evaluate the validity of the established DNN model using repeated scans of phantom could be applied to various deep learning-based image conversions for robust quantitative evaluation.
胸部计算机断层扫描(CT)用于筛查肺癌,并评估肺部和肺外异常,如肺气肿和冠状动脉钙化,尤其是在吸烟者中。在实际临床实践中,肺部异常通过高对比度薄层图像进行视觉评估,这些图像是使用锐利重建内核从原始扫描数据生成的,但会牺牲图像噪声增加的代价。相比之下,准确的CT定量需要低噪声的低对比度薄层图像,这些图像是使用软组织重建内核生成的。然而,由于数据存储空间有限,许多医疗机构仅存档了锐利内核薄层图像。本研究旨在建立深度神经网络(DNN)模型,将锐利内核图像转换为类似软组织内核的图像,最终目标是重新利用历史胸部CT图像进行可靠的定量测量,特别是在已完成的既往纵向研究中。通过使用30例慢性阻塞性肺疾病(COPD)患者的锐利内核(输入)和软组织内核(真实对照)图像对,训练了DNN模型。然后,使用来自30名独立吸烟者(有或无COPD)的CT评估基于所建立DNN模型的内核转换准确性。结果,使用所建立的DNN模型从锐利内核图像转换而来的新图像与真实对照软组织内核图像之间的CT值差异与重复体模扫描(6次)得出的扫描间变异性相当,表明转换误差与CT设备的测量误差处于同一水平。此外,在DNN转换图像上,用于量化给定图像上低衰减体素与真实对照软组织内核图像之间相似性的Dice系数显著高于高斯滤波、中值滤波和锐利内核图像(<0.001)。在转换后的图像与真实对照软组织内核图像之间,肺气肿、肌肉内脂肪组织和冠状动脉钙化的定量测量结果具有良好的一致性。这些发现证明了新的DNN模型用于内核转换的有效性,以及在既往临床研究中从存档的锐利内核图像转换而来的类似软组织内核图像的临床适用性。所提出的使用体模重复扫描评估所建立DNN模型有效性的方法可应用于各种基于深度学习的图像转换,以进行可靠的定量评估。