Feasibility of Ultra-low Radiation and Contrast Medium Dosage in Aortic CTA Using Deep Learning Reconstruction at 60 kVp: An Image Quality Assessment

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology Pub Date : 2025-03-01 DOI:10.1016/j.acra.2024.10.042

Ke Qi MM , Chensi Xu ME , Dian Yuan MM , Yicun Zhang MM , Mengyuan Zhang MM , Weiting Zhang MM , Jiong Zhang MM , Bojun You MM , Jianbo Gao PhD , Jie Liu MM

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引用次数: 0

Abstract

Objective

To assess the viability of using ultra-low radiation and contrast medium (CM) dosage in aortic computed tomography angiography (CTA) through the application of low tube voltage (60 kVp) and a novel deep learning image reconstruction algorithm (ClearInfinity, DLIR-CI).

Methods

Iodine attenuation curves obtained from a phantom study informed the administration of CM protocols. Non-obese participants undergoing aortic CTA were prospectively allocated into two groups and then obtained three reconstruction groups. The conventional group (100 kVp-CV group) underwent imaging at 100 kVp and received 210 mg iodine/kg in combination with a hybrid iterative reconstruction algorithm (ClearView, HIR-CV). The experimental group was imaged at 60 kVp with 105 mg iodine/kg, while images were reconstructed with HIR-CV (60 kVp-CV group) and with DLIR-CI (60 kVp-CI group). Student's t-test was used to compare differences in CM protocol and radiation dose. One-way ANOVA compared CT attenuation, image noise, SNR, and CNR among the three reconstruction groups, while the Kruskal–Wallis H test assessed subjective image quality scores. Post hoc analysis was performed with Bonferroni correction for multiple comparisons, and consistency analysis conducted in subjective image quality assessment was measured using Cohen's kappa.

Results

The radiation dose (1.12 ± 0.23 mSv vs. 2.03 ± 0.82 mSv) and CM dosage (19.04 ± 3.03 mL vs. 38.11 ± 6.47 mL) provided the reduction of 45% and 50% in the experimental group compared to the conventional group. The CT attenuation, SNR, and CNR of 60 kVp-CI were superior to or equal to those of 100 kVp-CV. Compared to the 60 kVp-CV group, images in 60 kVp-CI showed higher SNR and CNR (all P < 0.001). There was no difference between the 60 kVp-CI and 100 kVp-CV group in terms of the subjective image quality of the aorta in various locations (all P > 0.05), with 60 kVp-CI images were deemed diagnostically sufficient across all vascular segments.

Conclusion

For non-obese patients, the combined use of 60 kVp and DLIR-CI algorithm can be preserving image quality while enabling radiation dose and contrast medium savings for aortic CTA compared to 100 kVp using HIR-CV.

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在 60 kVp 下使用深度学习重建技术在主动脉 CTA 中实现超低辐射和造影剂剂量的可行性：图像质量评估。

目的通过应用低管电压（60kVp）和新型深度学习图像重建算法（ClearInfinity，DLIR-CI），评估在主动脉计算机断层扫描血管造影术（CTA）中使用超低辐射和造影剂（CM）剂量的可行性：方法：从模型研究中获得的碘衰减曲线为 CM 方案的实施提供了依据。接受主动脉 CTA 检查的非肥胖参与者被前瞻性地分为两组，然后获得三个重建组。传统组（100kVp-CV 组）在 100kVp 下进行成像，接受 210 毫克碘/千克的碘治疗，并结合混合迭代重建算法（ClearView，HIR-CV）。实验组在 60kVp 下进行成像，碘剂量为 105 毫克/千克，同时使用 HIR-CV （60kVp-CV 组）和 DLIR-CI （60kVp-CI 组）重建图像。采用学生 t 检验比较 CM 方案和辐射剂量的差异。单因素方差分析比较了三个重建组的 CT 衰减、图像噪声、信噪比和 CNR，Kruskal-Wallis H 检验评估了主观图像质量评分。采用 Bonferroni 校正进行多重比较的事后分析，并使用 Cohen's kappa 对主观图像质量评估进行一致性分析：结果：与传统组相比，实验组的辐射剂量（1.12±0.23mSv vs. 2.03±0.82mSv）和CM剂量（19.04±3.03mL vs. 38.11±6.47mL）分别减少了45%和50%。60kVp-CI 的 CT 衰减、信噪比和 CNR 优于或等于 100kVp-CV 的 CT 衰减、信噪比和 CNR。与 60kVp-CV 组相比，60kVp-CI 组的图像显示出更高的 SNR 和 CNR（均为 P 0.05），60kVp-CI 组的图像在所有血管节段都被认为具有足够的诊断价值：对于非肥胖患者，与使用 HIR-CV 的 100kVp 相比，联合使用 60kVp 和 DLIR-CI 算法可在保持图像质量的同时节省主动脉 CTA 的辐射剂量和造影剂。

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

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.