Deep learning reconstruction versus iterative reconstruction for cardiac CT angiography in a stroke imaging protocol: reduced radiation dose and improved image quality

To assess the radiation dose and image quality of cardiac computed tomography angiography (CCTA) in an acute stroke imaging protocol using a deep learning reconstruction (DLR) method compared to a hybrid iterative reconstruction algorithm. Retrospective analysis of 296 consecutive patients admitted...

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Vydané v:Quantitative imaging in medicine and surgery Ročník 11; číslo 1; s. 392
Hlavní autori: Bernard, Angélique, Comby, Pierre-Olivier, Lemogne, Brivaël, Haioun, Karim, Ricolfi, Frédéric, Chevallier, Olivier, Loffroy, Romaric
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: China 01.01.2021
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Abstract To assess the radiation dose and image quality of cardiac computed tomography angiography (CCTA) in an acute stroke imaging protocol using a deep learning reconstruction (DLR) method compared to a hybrid iterative reconstruction algorithm. Retrospective analysis of 296 consecutive patients admitted to the emergency department for stroke suspicion. All patients underwent a stroke CT imaging protocol including a non-enhanced brain CT, a brain perfusion CT imaging if necessary, a CT angiography (CTA) of the supra-aortic vessels, a CCTA and a post-contrast brain CT. The CCTA was performed with a prospectively ECG-gated volume acquisition. Among all CT scans performed, 143 were reconstructed with an iterative reconstruction algorithm (AIDR 3D, adaptive iterative dose reduction three dimensional) and 146 with a DLR algorithm (AiCE, advanced intelligent clear-IQ engine). Image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality (IQ) scored from 1 to 4 were assessed. Dose-length product (DLP), volume CT dose index (CTDIvol) and effective dose (ED) were obtained. The radiation dose was significantly lower with AiCE than with AIDR 3D (DLP =106.4±50.0 176.1±37.1 mGy·cm, CTDIvol =6.9±3.2 11.5±2.2 mGy, and ED =1.5±0.7 2.5±0.5 mSv) (P<0.001). The median SNR and CNR were higher [9.9 (IQR, 8.1-12.3); and 12.6 (IQR, 10.5-15.5), respectively], with AiCE than with AIDR 3D [6.5 (IQR, 5.2-8.5); and 8.4 (IQR, 6.7-11.0), respectively] (P<0.001). SNR and CNR were increased by 51% and 49%, respectively, with AiCE compared to AIDR 3D. The image quality was significantly better with AiCE (mean IQ score =3.4±0.7) than with AIDR 3D (mean IQ score =3±0.9) (P<0.001). The use of a DLR algorithm for cardiac CTA in an acute stroke imaging protocol reduced the radiation dose by about 40% and improved the image quality by about 50% compared to an iterative reconstruction algorithm.
AbstractList To assess the radiation dose and image quality of cardiac computed tomography angiography (CCTA) in an acute stroke imaging protocol using a deep learning reconstruction (DLR) method compared to a hybrid iterative reconstruction algorithm.BACKGROUNDTo assess the radiation dose and image quality of cardiac computed tomography angiography (CCTA) in an acute stroke imaging protocol using a deep learning reconstruction (DLR) method compared to a hybrid iterative reconstruction algorithm.Retrospective analysis of 296 consecutive patients admitted to the emergency department for stroke suspicion. All patients underwent a stroke CT imaging protocol including a non-enhanced brain CT, a brain perfusion CT imaging if necessary, a CT angiography (CTA) of the supra-aortic vessels, a CCTA and a post-contrast brain CT. The CCTA was performed with a prospectively ECG-gated volume acquisition. Among all CT scans performed, 143 were reconstructed with an iterative reconstruction algorithm (AIDR 3D, adaptive iterative dose reduction three dimensional) and 146 with a DLR algorithm (AiCE, advanced intelligent clear-IQ engine). Image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality (IQ) scored from 1 to 4 were assessed. Dose-length product (DLP), volume CT dose index (CTDIvol) and effective dose (ED) were obtained.METHODSRetrospective analysis of 296 consecutive patients admitted to the emergency department for stroke suspicion. All patients underwent a stroke CT imaging protocol including a non-enhanced brain CT, a brain perfusion CT imaging if necessary, a CT angiography (CTA) of the supra-aortic vessels, a CCTA and a post-contrast brain CT. The CCTA was performed with a prospectively ECG-gated volume acquisition. Among all CT scans performed, 143 were reconstructed with an iterative reconstruction algorithm (AIDR 3D, adaptive iterative dose reduction three dimensional) and 146 with a DLR algorithm (AiCE, advanced intelligent clear-IQ engine). Image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality (IQ) scored from 1 to 4 were assessed. Dose-length product (DLP), volume CT dose index (CTDIvol) and effective dose (ED) were obtained.The radiation dose was significantly lower with AiCE than with AIDR 3D (DLP =106.4±50.0 vs. 176.1±37.1 mGy·cm, CTDIvol =6.9±3.2 vs. 11.5±2.2 mGy, and ED =1.5±0.7 vs. 2.5±0.5 mSv) (P<0.001). The median SNR and CNR were higher [9.9 (IQR, 8.1-12.3); and 12.6 (IQR, 10.5-15.5), respectively], with AiCE than with AIDR 3D [6.5 (IQR, 5.2-8.5); and 8.4 (IQR, 6.7-11.0), respectively] (P<0.001). SNR and CNR were increased by 51% and 49%, respectively, with AiCE compared to AIDR 3D. The image quality was significantly better with AiCE (mean IQ score =3.4±0.7) than with AIDR 3D (mean IQ score =3±0.9) (P<0.001).RESULTSThe radiation dose was significantly lower with AiCE than with AIDR 3D (DLP =106.4±50.0 vs. 176.1±37.1 mGy·cm, CTDIvol =6.9±3.2 vs. 11.5±2.2 mGy, and ED =1.5±0.7 vs. 2.5±0.5 mSv) (P<0.001). The median SNR and CNR were higher [9.9 (IQR, 8.1-12.3); and 12.6 (IQR, 10.5-15.5), respectively], with AiCE than with AIDR 3D [6.5 (IQR, 5.2-8.5); and 8.4 (IQR, 6.7-11.0), respectively] (P<0.001). SNR and CNR were increased by 51% and 49%, respectively, with AiCE compared to AIDR 3D. The image quality was significantly better with AiCE (mean IQ score =3.4±0.7) than with AIDR 3D (mean IQ score =3±0.9) (P<0.001).The use of a DLR algorithm for cardiac CTA in an acute stroke imaging protocol reduced the radiation dose by about 40% and improved the image quality by about 50% compared to an iterative reconstruction algorithm.CONCLUSIONSThe use of a DLR algorithm for cardiac CTA in an acute stroke imaging protocol reduced the radiation dose by about 40% and improved the image quality by about 50% compared to an iterative reconstruction algorithm.
To assess the radiation dose and image quality of cardiac computed tomography angiography (CCTA) in an acute stroke imaging protocol using a deep learning reconstruction (DLR) method compared to a hybrid iterative reconstruction algorithm. Retrospective analysis of 296 consecutive patients admitted to the emergency department for stroke suspicion. All patients underwent a stroke CT imaging protocol including a non-enhanced brain CT, a brain perfusion CT imaging if necessary, a CT angiography (CTA) of the supra-aortic vessels, a CCTA and a post-contrast brain CT. The CCTA was performed with a prospectively ECG-gated volume acquisition. Among all CT scans performed, 143 were reconstructed with an iterative reconstruction algorithm (AIDR 3D, adaptive iterative dose reduction three dimensional) and 146 with a DLR algorithm (AiCE, advanced intelligent clear-IQ engine). Image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality (IQ) scored from 1 to 4 were assessed. Dose-length product (DLP), volume CT dose index (CTDIvol) and effective dose (ED) were obtained. The radiation dose was significantly lower with AiCE than with AIDR 3D (DLP =106.4±50.0 176.1±37.1 mGy·cm, CTDIvol =6.9±3.2 11.5±2.2 mGy, and ED =1.5±0.7 2.5±0.5 mSv) (P<0.001). The median SNR and CNR were higher [9.9 (IQR, 8.1-12.3); and 12.6 (IQR, 10.5-15.5), respectively], with AiCE than with AIDR 3D [6.5 (IQR, 5.2-8.5); and 8.4 (IQR, 6.7-11.0), respectively] (P<0.001). SNR and CNR were increased by 51% and 49%, respectively, with AiCE compared to AIDR 3D. The image quality was significantly better with AiCE (mean IQ score =3.4±0.7) than with AIDR 3D (mean IQ score =3±0.9) (P<0.001). The use of a DLR algorithm for cardiac CTA in an acute stroke imaging protocol reduced the radiation dose by about 40% and improved the image quality by about 50% compared to an iterative reconstruction algorithm.
Author Loffroy, Romaric
Ricolfi, Frédéric
Haioun, Karim
Bernard, Angélique
Lemogne, Brivaël
Comby, Pierre-Olivier
Chevallier, Olivier
Author_xml – sequence: 1
  givenname: Angélique
  surname: Bernard
  fullname: Bernard, Angélique
  organization: Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, Dijon, France
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  givenname: Pierre-Olivier
  surname: Comby
  fullname: Comby, Pierre-Olivier
  organization: Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, Dijon, France
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  surname: Lemogne
  fullname: Lemogne, Brivaël
  organization: Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, Dijon, France
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  surname: Haioun
  fullname: Haioun, Karim
  organization: Computed Tomography Division, Canon Medical Systems France, Suresnes, France
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  givenname: Frédéric
  surname: Ricolfi
  fullname: Ricolfi, Frédéric
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  givenname: Olivier
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  givenname: Romaric
  surname: Loffroy
  fullname: Loffroy, Romaric
  organization: Department of Cardiovascular and Interventional Radiology, ImViA Laboratory-EA 7535, François-Mitterrand University Hospital, Dijon, France
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33392038$$D View this record in MEDLINE/PubMed
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Keywords deep learning
Computed tomography angiography (CTA)
image reconstruction
artificial intelligence
cardiac imaging
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Title Deep learning reconstruction versus iterative reconstruction for cardiac CT angiography in a stroke imaging protocol: reduced radiation dose and improved image quality
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