Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany.
Department of Radiology, Mühlenkreiskliniken Minden, Ruhr-University Bochum, Bochum, Germany.
Sci Rep. 2024 Jan 30;14(1):2494. doi: 10.1038/s41598-024-52517-2.
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.
我们研究了基于深度学习的图像重建（DLIR）与迭代重建在 CT 肺动脉造影（CTPA）用于疑似肺栓塞（PE）中的图像质量的影响。对 220 例疑似 PE 的患者，使用滤波反投影（FBP）、自适应统计迭代重建（ASiR-V 30%、60%和 90%）和 DLIR（低、中、高强度）对 CTPA 进行重建。对比噪声比（CNR）作为客观图像质量的主要参数。对正常体重、超重和肥胖个体进行亚组分析。对确诊为 PE（n=40）的患者，我们进一步测量了 PE 特异性 CNR。两位有经验的放射科医生独立评估了主观图像质量。CNR 在 FBP 时最低，随着 ASiR-V 水平的增加而增加，随着 DLIR 强度的增加而增加得更多。与 ASiR-V 90%相比，高强度 DLIR 使 CNR 额外提高了 29%-67%（p<0.05）。与 ASiR-V 90%相比，PE 特异性 CNR 增加了 75%（p<0.05）。与其他所有图像重建相比，中、高强度 DLIR 的主观图像质量明显更高（p<0.05）。在 CT 肺动脉造影中，DLIR 在提高客观和主观图像质量方面明显优于迭代重建。这可能允许在疑似 PE 中进一步降低辐射剂量。
