Feasibility of Sub-milliSievert Low-dose Computed Tomography with Deep Learning Image Reconstruction in Evaluating Pulmonary Subsolid Nodules: A Prospective Intra-individual Comparison Study

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

Academic Radiology Pub Date : 2025-04-01 DOI:10.1016/j.acra.2024.11.042

Huiyuan Zhu , Zike Huang , Qunhui Chen , Weiling Ma , Jiahui Yu , Shiqing Wang , Guangyu Tao , Jun Xing , Haixin Jiang , Xiwen Sun , Jing Liu , Hong Yu , Lin Zhu

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引用次数: 0

Abstract

Rationale and Objectives

To comprehensively assess the feasibility of low-dose computed tomography (LDCT) using deep learning image reconstruction (DLIR) for evaluating pulmonary subsolid nodules, which are challenging due to their susceptibility to noise.

Materials and Methods

Patients undergoing both standard-dose CT (SDCT) and LDCT between March and June 2023 were prospectively enrolled. LDCT images were reconstructed with high-strength DLIR (DLIR-H), medium-strength DLIR (DLIR-M), adaptive statistical iterative reconstruction-V level 50% (ASIR-V-50%), and filtered back projection (FBP); SDCT with FBP as the reference standard. Objective assessment, including image noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR), and subjective assessment using five-point scales by five radiologists were performed. Detection and false-positive rate of subsolid nodules, and morphologic features of nodules were recorded.

Results

102 patients (mean age, 57.0 ± 12.3 years) with 358 subsolid nodules in SDCT were enrolled. The mean effective dose of SDCT and LDCT were 5.37 ± 0.80 mSv and 0.86 ± 0.14 mSv, respectively (P < 0.001). DLIR-H showed the lowest noise, highest CNRs, SNRs, and subjective scores among LDCT groups (all P < 0.001), almost approaching comparability with SDCT. The detection rates for DLIR-H, DLIR-M, ASIR-V-50%, and FBP were 76.5%, 76.3%, 83.8%, and 72.1%, respectively (P < 0.001), with false-positive rate of 2.5%, 2.2%, 8.3%, and 1.1%, respectively (P < 0.001). DLIR-H showed the highest detection rates for morphologic features (79.4%–95.2%) compared to DLIR-M (74.6%–88.9%), ASIR-V-50% (72.0%–88.4%), and FBP (66.1%–84.1%) (all P ≤ 0.001).

Conclusion

Sub-milliSievert LDCT with DLIR-H offers substantial dose reduction without compromising image quality. It is promising for evaluating subsolid nodules with a high detection rate and better identification of morphologic features.

查看原文本刊更多论文

亚毫西弗低剂量计算机断层扫描与深度学习图像重建在评估肺部实性下结节中的可行性：一项前瞻性个体内比较研究。

理由和目的：全面评估使用深度学习图像重建（DLIR）的低剂量计算机断层扫描（LDCT）评估肺亚实性结节的可行性，这是由于其对噪声的敏感性而具有挑战性的。材料和方法：前瞻性纳入2023年3月至6月期间接受标准剂量CT （SDCT）和LDCT治疗的患者。采用高强度DLIR （DLIR- h）、中强度DLIR （DLIR- m）、自适应统计迭代重建- v级50% （ASIR-V-50%）和滤波后投影（FBP）重建LDCT图像；以FBP为参考标准的SDCT。客观评价包括图像噪声、对比噪声比（CNR）和信噪比（SNR），主观评价由5名放射科医生采用五分制进行。记录亚实性结节的检出率、假阳性率及结节的形态特征。结果：102例患者（平均年龄57.0±12.3岁），SDCT显示358个亚实性结节。SDCT和LDCT的平均有效剂量分别为5.37±0.80mSv和0.86±0.14mSv (P)。结论：亚毫西弗LDCT采用DLIR-H可在不影响图像质量的情况下显著降低剂量。该方法具有较高的检出率和较好的形态学特征识别能力，为评价亚实性结节提供了良好的前景。

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.