AntiHalluciNet: A Potential Auditing Tool of the Behavior of Deep Learning Denoising Models in Low-Dose Computed Tomography.

Gaining the ability to audit the behavior of deep learning (DL) denoising models is of crucial importance to prevent potential hallucinations and adversarial clinical consequences. We present a preliminary version of AntiHalluciNet, which is designed to predict spurious structural components embedded in the residual noise from DL denoising models in low-dose CT and assess its feasibility for auditing the behavior of DL denoising models. We created a paired set of structure-embedded and pure noise images and trained AntiHalluciNet to predict spurious structures in the structure-embedded noise images. The performance of AntiHalluciNet was evaluated by using a newly devised residual structure index (RSI), which represents the prediction confidence based on the presence of structural components in the residual noise image. We also evaluated whether AntiHalluciNet could assess the image fidelity of a denoised image by using only a noise component instead of measuring the SSIM, which requires both reference and test images. Then, we explored the potential of AntiHalluciNet for auditing the behavior of DL denoising models. AntiHalluciNet was applied to three DL denoising models (two pre-trained models, RED-CNN and CTformer, and a commercial software, ClariCT.AI [version 1.2.3]), and whether AntiHalluciNet could discriminate between the noise purity performances of DL denoising models was assessed. AntiHalluciNet demonstrated an excellent performance in predicting the presence of structural components. The RSI values for the structural-embedded and pure noise images measured using the 50% low-dose dataset were 0.57 ± 31 and 0.02 ± 0.02, respectively, showing a substantial difference with a -value < 0.0001. The AntiHalluciNet-derived RSI could differentiate between the quality of the degraded denoised images, with measurement values of 0.27, 0.41, 0.48, and 0.52 for the 25%, 50%, 75%, and 100% mixing rates of the degradation component, which showed a higher differentiation potential compared with the SSIM values of 0.9603, 0.9579, 0.9490, and 0.9333. The RSI measurements from the residual images of the three DL denoising models showed a distinct distribution, being 0.28 ± 0.06, 0.21 ± 0.06, and 0.15 ± 0.03 for RED-CNN, CTformer, and ClariCT.AI, respectively. AntiHalluciNet has the potential to predict the structural components embedded in the residual noise from DL denoising models in low-dose CT. With AntiHalluciNet, it is feasible to audit the performance and behavior of DL denoising models in clinical environments where only residual noise images are available.