• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.240-252
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• 2023

Purpose To assess the effect of deep learning image reconstruction (DLIR) for head CT in pediatric patients. Materials and Methods We collected 126 pediatric head CT images, which were reconstructed using filtered back projection, iterative reconstruction using adaptive statistical iterative reconstruction (ASiR)-V, and all three levels of DLIR (TrueFidelity; GE Healthcare). Each image set group was divided into four subgroups according to the patients' ages. Clinical and dose-related data were reviewed. Quantitative parameters, including the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), and qualitative parameters, including noise, gray matter-white matter (GM-WM) differentiation, sharpness, artifact, acceptability, and unfamiliar texture change were evaluated and compared. Results The SNR and CNR of each level in each age group increased among strength levels of DLIR. High-level DLIR showed a significantly improved SNR and CNR (p < 0.05). Sequential reduction of noise, improvement of GM-WM differentiation, and improvement of sharpness was noted among strength levels of DLIR. Those of high-level DLIR showed a similar value as that with ASiR-V. Artifact and acceptability did not show a significant difference among the adapted levels of DLIR. Conclusion Adaptation of high-level DLIR for the pediatric head CT can significantly reduce image noise. Modification is needed while processing artifacts.

• Korean Journal of Radiology
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• v.22 no.1
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• pp.131-138
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• 2021

Objective: Iterative reconstruction degrades image quality. Thus, further advances in image reconstruction are necessary to overcome some limitations of this technique in low-dose computed tomography (LDCT) scan of the chest. Deep-learning image reconstruction (DLIR) is a new method used to reduce dose while maintaining image quality. The purposes of this study was to evaluate image quality and noise of LDCT scan images reconstructed with DLIR and compare with those of images reconstructed with the adaptive statistical iterative reconstruction-Veo at a level of 30% (ASiR-V 30%). Materials and Methods: This retrospective study included 58 patients who underwent LDCT scan for lung cancer screening. Datasets were reconstructed with ASiR-V 30% and DLIR at medium and high levels (DLIR-M and DLIR-H, respectively). The objective image signal and noise, which represented mean attenuation value and standard deviation in Hounsfield units for the lungs, mediastinum, liver, and background air, and subjective image contrast, image noise, and conspicuity of structures were evaluated. The differences between CT scan images subjected to ASiR-V 30%, DLIR-M, and DLIR-H were evaluated. Results: Based on the objective analysis, the image signals did not significantly differ among ASiR-V 30%, DLIR-M, and DLIR-H (p = 0.949, 0.737, 0.366, and 0.358 in the lungs, mediastinum, liver, and background air, respectively). However, the noise was significantly lower in DLIR-M and DLIR-H than in ASiR-V 30% (all p < 0.001). DLIR had higher signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) than ASiR-V 30% (p = 0.027, < 0.001, and < 0.001 in the SNR of the lungs, mediastinum, and liver, respectively; all p < 0.001 in the CNR). According to the subjective analysis, DLIR had higher image contrast and lower image noise than ASiR-V 30% (all p < 0.001). DLIR was superior to ASiR-V 30% in identifying the pulmonary arteries and veins, trachea and bronchi, lymph nodes, and pleura and pericardium (all p < 0.001). Conclusion: DLIR significantly reduced the image noise in chest LDCT scan images compared with ASiR-V 30% while maintaining superior image quality.

• Journal of the Korean Society of Radiology
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• v.16 no.4
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• pp.387-394
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• 2022

120 kVp FBP reconstruction image standard by using raw data after scanning by changing tube voltage among the NECK CT protocols that are broad applied in clinical practice using a human phantom including thyroid gland The usefulness of the DLIR reconstruction technique was investigated. As a result, CTDIvol decreased when the DLIR reconstruction technique was applied, and in particular, the image quality obtained under the same standard scanning conditions at a lower dose for ASIR-V and DLIR reconstruction was reached than when FBP was applied at the same kVp In addition, as a result of SNR and CNR analysis, the DLIR reconstructed image was analyzed with high SNR and CNR values, and SSIM analysis, the SSIM index of the 100 kVp, DLIR reconstructed image was measured to be close to 1, and it was analyzed that the similarity of the reconstructed image to the original image was high (p>0.05). If the results of this study are used to supplement clinical image evaluation and further develop an algorithm applicable to various anatomical structures, it is thought that it will be useful for clinical application as it is possible to maintain the image quality while lowering the examination dose.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.819-825
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• 2023

In this study, among chest CT examination conditions, the tube voltage was changed to 100 and 80 kVp and the reconstruction algorithm was changed to FBP, ASIR-V, and DLIR to compare and analyze changes in examination dose and image quality. As a result, when applying ASIR-V and DLIR at a tube voltage of 100 kVp, which is lower than the existing tube voltage, the dose is lowered while achieving image quality most similar to that when applying 120 kVp and FBP. especially, DLIR reconstructed images had excellent SNR and CNR at all tube voltages. In addition, the SSIM index was analyzed to be closest to 1, showing the highest similarity to the original image. Therefore, when performing repeated chest CT examinations, the application of DLIR can reduce the examination dose by about 29.7%, which is expected to help solve some of the biggest problems with CT examinations, namely radiation exposure due to the examination.

• Korean Journal of Radiology
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• v.23 no.4
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• pp.402-412
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• 2022

Objective: To evaluate the image quality and lesion detectability of lower-dose CT (LDCT) of the abdomen and pelvis obtained using a deep learning image reconstruction (DLIR) algorithm compared with those of standard-dose CT (SDCT) images. Materials and Methods: This retrospective study included 123 patients (mean age ± standard deviation, 63 ± 11 years; male:female, 70:53) who underwent contrast-enhanced abdominopelvic LDCT between May and August 2020 and had prior SDCT obtained using the same CT scanner within a year. LDCT images were reconstructed with hybrid iterative reconstruction (h-IR) and DLIR at medium and high strengths (DLIR-M and DLIR-H), while SDCT images were reconstructed with h-IR. For quantitative image quality analysis, image noise, signal-to-noise ratio, and contrast-to-noise ratio were measured in the liver, muscle, and aorta. Among the three different LDCT reconstruction algorithms, the one showing the smallest difference in quantitative parameters from those of SDCT images was selected for qualitative image quality analysis and lesion detectability evaluation. For qualitative analysis, overall image quality, image noise, image sharpness, image texture, and lesion conspicuity were graded using a 5-point scale by two radiologists. Observer performance in focal liver lesion detection was evaluated by comparing the jackknife free-response receiver operating characteristic figures-of-merit (FOM). Results: LDCT (35.1% dose reduction compared with SDCT) images obtained using DLIR-M showed similar quantitative measures to those of SDCT with h-IR images. All qualitative parameters of LDCT with DLIR-M images but image texture were similar to or significantly better than those of SDCT with h-IR images. The lesion detectability on LDCT with DLIR-M images was not significantly different from that of SDCT with h-IR images (reader-averaged FOM, 0.887 vs. 0.874, respectively; p = 0.581). Conclusion: Overall image quality and detectability of focal liver lesions is preserved in contrast-enhanced abdominopelvic LDCT obtained with DLIR-M relative to those in SDCT with h-IR.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.285-295
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• 2023

With the development of technology, efforts to reduce the exposure dose received by patients in CT scans are continuing with the development of new reconstruction techniques. Recently, deep learning reconstruction techniques have been developed to overcome the limitations of repetitive reconstruction techniques. This study aims to evaluate the usefulness of images according to reconstruction techniques in pediatric chest CT images. Patient study conducted a study on 85 pediatric patients who underwent chest CT scan at P-Hospital in Gyeongsangnam-do from January 1, 2021 to December 31, 2022. The phantom used in the Phantom Study is the Pediatrics Whole Body Phantom PBU-70. After the test, the images were reconstructed with FBP, ASIR-V (50%) and DLIR (TF-Medium, High), and the images were evaluated by obtaining SNR and CNR values by setting ROI of the same size. As a result, TF-H of deep learning reconstruction techniques had the lowest noise value compared to ASIR-V (50%) and TF-M in all experiments, and SNR and CNR had the highest values. In pediatric chest CT scans, TF images with deep learning reconstruction techniques were less noisy than ASiR-V images with adaptive statistical iterative reconstruction techniques, CNR and SNR were higher, and the quality of images was improved compared to conventional reconstruction techniques.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.297-303
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• 2023

Pediatric Computed Tomography (CT) examinations can often result in exam failures or the need for frequent retests due to the difficulty of cooperation from young patients. Deep Learning Image Reconstruction (DLIR) methods offer the potential to obtain diagnostically valuable images while reducing the retest rate in CT examinations of pediatric patients with high radiation sensitivity. In this study, we investigated the possibility of applying DLIR to reduce artifacts caused by respiration or motion and obtain clinically useful images in pediatric chest CT examinations. Retrospective analysis was conducted on chest CT examination data of 43 children under the age of 7 from P Hospital in Gyeongsangnam-do. The images reconstructed using Filtered Back Projection (FBP), Adaptive Statistical Iterative Reconstruction (ASIR-50), and the deep learning algorithm TrueFidelity-Middle (TF-M) were compared. Regions of interest (ROI) were drawn on the right ascending aorta (AA) and back muscle (BM) in contrast-enhanced chest images, and noise (standard deviation, SD) was measured using Hounsfield units (HU) in each image. Statistical analysis was performed using SPSS (ver. 22.0), analyzing the mean values of the three measurements with one-way analysis of variance (ANOVA). The results showed that the SD values for AA were FBP=25.65±3.75, ASIR-50=19.08±3.93, and TF-M=17.05±4.45 (F=66.72, p=0.00), while the SD values for BM were FBP=26.64±3.81, ASIR-50=19.19±3.37, and TF-M=19.87±4.25 (F=49.54, p=0.00). Post-hoc tests revealed significant differences among the three groups. DLIR using TF-M demonstrated significantly lower noise values compared to conventional reconstruction methods. Therefore, the application of the deep learning algorithm TrueFidelity-Middle (TF-M) is expected to be clinically valuable in pediatric chest CT examinations by reducing the degradation of image quality caused by respiration or motion.