Effect of a novel denoising technique on image quality and diagnostic accuracy in low-dose CT in patients with suspected appendicitis. Issue 116 (July 2019)

• Record Type: Journal Article
• Authors: Kolb, Manuel; Storz, Corinna; Kim, Jong Hyo; Weiss, Jakob; Afat, Saif; Nikolaou, Konstantin; Bamberg, Fabian; Othman, Ahmed E.
• Is Part Of: European journal of radiology. Issue 116(2019)
• Page Start: 198
• Page End: 204
• Publication Date: 2019-07
• Subjects: CI confidence interval -- CT computed tomography -- CTDIvol CT dose index for helical CT -- DICOM digital imaging and communications in medicine -- DLP dose length product -- HU Hounsfield Units -- MRI magnetic resonance imaging -- NPV negative predictive value -- PACS picture archiving and communication system -- PPV positive predictive value -- ROI region of interest -- SD standard deviation -- SNR Signal-to-Noise Ratio; Tomography -- X-Ray computed -- Diagnostic imaging -- Appendicitis; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2019.04.026
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Objectives: To determine the effect of a vendor unspecific, DICOM-based denoising technique on image quality and diagnostic performance in low-dose simulated abdominal computed tomography (CT) examinations in patients with suspected appendicitis. Methods and Materials: We included 51 patients who underwent contrast-enhanced abdominal CT with Filtered Back Projection due to suspected appendicitis. Realistic Low-Dose simulation generated low-dose datasets at 25% of the original exposition. QuantaStream Denoising, a novel DICOM-based technique denoised the simulated low-Dose datasets. Original (O100), low-dose (LD25) and denoised (DN25) datasets (n = 153) were evaluated regarding subjective image quality (5-point Likert scale; overall quality/image noise/diagnostic confidence), presence/absence of acute appendicitis, free abdominal air and abscess formation and objective image quality (Signal-to-Noise Ratio (SNR) and noise level) by two independent readers. Results: Subjective image quality was rated highest for O100, followed by DN25 and LD25 with significant differences (p = 0.001). Appendicitis was correctly identified in all datasets (n = 30). Appendicitis specific diagnostic confidence was highest for O100 (p = 0.001), followed by DN25 and LD25 without significant difference. All complications were correctly identified on O100 and DN25. On LD25, diagnostic accuracy decreased for abscess formations (sensitivity:0.714; specificity:1.0) and for free abdominal air (sensitivity:0.750; specificity:0.936). Regarding noise levels DN25 showed non-inferiority to O100. SNRs of O100 and DN25 showed no significant difference (p = 0.06). Conclusion: Our findings indicate that QuantaStream Denoising allows for maintained diagnostic image quality and diagnostic accuracy of low-dose abdominal CT examinations (25% of original exposition) in patients with suspected appendicitis without the need for raw sinogram data.