Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Incremental Image Noise Reduction in Coronary CT Angiography Using a Deep Learning-Based Technique with Iterative Reconstruction

  • Jung Hee Hong (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Eun-Ah Park (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Whal Lee (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Chulkyun Ahn (Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University) ;
  • Jong-Hyo Kim (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital)
  • Received : 2019.09.24
  • Accepted : 2020.03.20
  • Published : 2020.10.01
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Abstract

Objective: To assess the feasibility of applying a deep learning-based denoising technique to coronary CT angiography (CCTA) along with iterative reconstruction for additional noise reduction. Materials and Methods: We retrospectively enrolled 82 consecutive patients (male:female = 60:22; mean age, 67.0 ± 10.8 years) who had undergone both CCTA and invasive coronary artery angiography from March 2017 to June 2018. All included patients underwent CCTA with iterative reconstruction (ADMIRE level 3, Siemens Healthineers). We developed a deep learning based denoising technique (ClariCT.AI, ClariPI), which was based on a modified U-net type convolutional neural net model designed to predict the possible occurrence of low-dose noise in the originals. Denoised images were obtained by subtracting the predicted noise from the originals. Image noise, CT attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were objectively calculated. The edge rise distance (ERD) was measured as an indicator of image sharpness. Two blinded readers subjectively graded the image quality using a 5-point scale. Diagnostic performance of the CCTA was evaluated based on the presence or absence of significant stenosis (≥ 50% lumen reduction). Results: Objective image qualities (original vs. denoised: image noise, 67.22 ± 25.74 vs. 52.64 ± 27.40; SNR [left main], 21.91 ± 6.38 vs. 30.35 ± 10.46; CNR [left main], 23.24 ± 6.52 vs. 31.93 ± 10.72; all p < 0.001) and subjective image quality (2.45 ± 0.62 vs. 3.65 ± 0.60, p < 0.001) improved significantly in the denoised images. The average ERDs of the denoised images were significantly smaller than those of originals (0.98 ± 0.08 vs. 0.09 ± 0.08, p < 0.001). With regard to diagnostic accuracy, no significant differences were observed among paired comparisons. Conclusion: Application of the deep learning technique along with iterative reconstruction can enhance the noise reduction performance with a significant improvement in objective and subjective image qualities of CCTA images.

Keywords

References

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