Deep learning reconstruction algorithm and high-concentration contrast medium: feasibility of a double-low protocol in coronary computed tomography angiography.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2025-04-01 Epub Date: 2024-09-19 DOI:10.1007/s00330-024-11059-x

Damiano Caruso, Domenico De Santis, Giuseppe Tremamunno, Curzio Santangeli, Tiziano Polidori, Giovanna G Bona, Marta Zerunian, Antonella Del Gaudio, Luca Pugliese, Andrea Laghi

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引用次数: 0

Abstract

Objective: To evaluate radiation dose and image quality of a double-low CCTA protocol reconstructed utilizing high-strength deep learning image reconstructions (DLIR-H) compared to standard adaptive statistical iterative reconstruction (ASiR-V) protocol in non-obese patients.

Materials and methods: From June to October 2022, consecutive patients, undergoing clinically indicated CCTA, with BMI < 30 kg/m² were prospectively included and randomly assigned into three groups: group A (100 kVp, ASiR-V 50%, iodine delivery rate [IDR] = 1.8 g/s), group B (80 kVp, DLIR-H, IDR = 1.4 g/s), and group C (80 kVp, DLIR-H, IDR = 1.2 g/s). High-concentration contrast medium was administered. Image quality analysis was evaluated by two radiologists. Radiation and contrast dose, and objective and subjective image quality were compared across the three groups.

Results: The final population consisted of 255 patients (64 ± 10 years, 161 men), 85 per group. Group B yielded 42% radiation dose reduction (2.36 ± 0.9 mSv) compared to group A (4.07 ± 1.2 mSv; p < 0.001) and achieved a higher signal-to-noise ratio (30.5 ± 11.5), contrast-to-noise-ratio (27.8 ± 11), and subjective image quality (Likert scale score: 4, interquartile range: 3-4) compared to group A and group C (all p ≤ 0.001). Contrast medium dose in group C (44.8 ± 4.4 mL) was lower than group A (57.7 ± 6.2 mL) and B (50.4 ± 4.3 mL), all the comparisons were statistically different (all p < 0.001).

Conclusion: DLIR-H combined with 80-kVp CCTA with an IDR 1.4 significantly reduces radiation and contrast medium exposure while improving image quality compared to conventional 100-kVp with 1.8 IDR protocol in non-obese patients.

Clinical relevance statement: Low radiation and low contrast medium dose coronary CT angiography protocol is feasible with high-strength deep learning reconstruction and high-concentration contrast medium without compromising image quality.

Key points: Minimizing the radiation and contrast medium dose while maintaining CT image quality is highly desirable. High-strength deep learning iterative reconstruction protocol yielded 42% radiation dose reduction compared to conventional protocol. "Double-low" coronary CTA is feasible with high-strength deep learning reconstruction without compromising image quality in non-obese patients.

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深度学习重建算法和高浓度造影剂：冠状动脉计算机断层扫描血管造影双低方案的可行性。

目的评估利用高强度深度学习图像重建（DLIR-H）重建的双低CCTA方案与标准自适应统计迭代重建（ASiR-V）方案在非肥胖患者中的辐射剂量和图像质量：从2022年6月到10月，对接受临床指征CCTA的BMI为2的连续患者进行前瞻性纳入，并随机分配到三组：A组（100 kVp，ASiR-V 50%，碘给药率[IDR] = 1.8 g/s）、B组（80 kVp，DLIR-H，IDR = 1.4 g/s）和C组（80 kVp，DLIR-H，IDR = 1.2 g/s）。使用高浓度造影剂。图像质量分析由两名放射科医生进行评估。比较了三组的辐射和造影剂剂量、客观和主观图像质量：最终共有 255 名患者（64 ± 10 岁，161 名男性），每组 85 人。与 A 组（4.07±1.2 mSv；P 结论）相比，B 组的辐射剂量减少了 42% （2.36±0.9 mSv）：在非肥胖患者中，DLIR-H 结合 IDR 为 1.4 的 80 kVp CCTA 与传统的 IDR 为 1.8 的 100 kVp 相比，可显著减少辐射和造影剂暴露，同时提高图像质量：低辐射和低造影剂剂量的冠状动脉 CT 血管造影方案是可行的，可采用高强度深度学习重建和高浓度造影剂，且不会影响图像质量：在保持 CT 图像质量的同时，最大限度地减少辐射和造影剂剂量是非常理想的。高强度深度学习迭代重建方案比传统方案减少了42%的辐射剂量。在不影响图像质量的前提下，对非肥胖患者进行高强度深度学习重建可实现 "双低 "冠状动脉CTA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.