Image quality assessment of artificial intelligence iterative reconstruction for low dose aortic CTA: A feasibility study of 70 kVp and reduced contrast medium volume. Issue 149 (April 2022)

• Record Type: Journal Article
• Authors: Li, Wanjiang; You, Yongchun; Zhong, Sihua; Shuai, Tao; Liao, Kai; Yu, Jianqun; Zhao, Jin; Li, Zhenlin; Lu, Chunyan
• Is Part Of: European journal of radiology. Issue 149(2022)
• Publication Date: 2022-04
• Subjects: Computed tomography angiography -- Artificial intelligence -- Radiation dosage; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110221
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: AIIR combines iterative reconstruction and deep learning techniques for image quality improvement. AIIR images are superior to the HIR images objectively and subjectively at low dose aortic CTA. Abstract: Purpose: To investigate the image quality and feasibility of a novel artificial intelligence iterative reconstruction (AIIR) algorithm for aortic computer tomography angiography (CTA) with a low radiation dose and contrast material (CM) dosage protocol in comparison with hybrid iterative reconstruction (HIR) algorithm for standard-of-care aortic CTA. Methods: Fifty consecutive patients (mean age 58 ± 14 years, mean BMI 24.5 ± 4.7 kg/m 2 ) with aortic diseases were prospectively enrolled. All patients underwent at least twice follow-up aortic CTA examinations. Standard dose CT (SDCT) was applied in the initial follow-up examination (100 kVp, auto mAs, contrast dose 0.8 mgL/kg), images were reconstructed with HIR (SDCT-HIR). In the second follow-up examination, patients underwent scanning with low dose CT (LDCT) (70 kVp, auto mAs, contrast dose 0.5 mgL/kg), images were reconstructed with HIR (LDCT-HIR) as well as AIIR (LDCT-AIIR). Attenuation values, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured for objective analysis. Subjective image quality was rated by two blinded radiologists using a 5-point scale. The effective radiation dose and CM dosage were also recorded. Results: The effective radiation dose (1.58 ± 0.17 mSv vs. 9.96 ± 1.05 mSv, P < 0.001) and CM dosage (34.38 ± 5.43 ml vs. 54.64 ± 8.63 ml, P < 0.001) achieved a remarkable reduction of 84.14% and 37.08% in the LDCT compared to the SDCT. The attenuation was similar among the three reconstructed images ( P > 0.05). Compared to LDCT-HIR images, LDCT-AIIR showed a lower noise and higher SNR and CNR. For qualitative analysis, there were no significant differences between the LDCT-AIIR and the SDCT-HIR images among four metrics ( P > 0.05). Conclusions: Compared to standard-of-care aortic CTA with HIR, the application of the AIIR algorithm allows for radiation dose and CM dosage reduction while preserving image quality on low dose aortic CTA.