Keywords: Multidetector Computed Tomography Liver Deep-learning Image Reconstruction Radiation Exposure

Purpose: This clinical and phantom study aimed to evaluate the impact of deep learning-based reconstruction (DLR) on image quality and its radiation dose optimization capability for multiphase hepatic CT relative to hybrid iterative reconstruction (HIR). Methods: Task-based image quality was assessed with a physical evaluation phantom; the high-and low-contrast detectability of HIR and DLR images were computed from the noise power spectrum and task-based transfer function at five different size-specific dose estimate (SSDE) values in the range 5.3 to 18.0-mGy. For the clinical study, images of 73 patients who had undergone multiphase hepatic CT under both standard-dose (STD) and lower-dose (LD) examination protocols within a time interval of about four-months on average, were retro-spectively examined. STD images were reconstructed with HIR, while LD with HIR (LD-HIR) and DLR (LD-DLR). SSDE, quantitative image noise, and contrast-to-noise ratio (CNR) were compared between protocols. The noise magnitude, noise texture, streak artifact, image sharpness, interface smoothness, and overall image quality were subjectively rated by two independent radiologists. Results: In phantom study, the high-and low-contrast detectability of DLR images obtained at 5.3-mGy and 7.3-mGy, respectively, were slightly higher than those obtained with HIR at the STD protocol dose (18.0-mGy). In clinical study, LD-DLR yielded lower image noise, higher CNR, and higher subjective scores for all evaluation criteria than STD (all, p <= 0.05), despite having 52.8% lower SSDE (8.0 +/- 2.5 vs. 16.8 +/- 3.4-mGy). Conclusions: DLR improved the subjective and objective image quality of multiphase hepatic CT compared with HIR techniques, even at approximately half the radiation dose.

Automated summary

This study evaluated the impact of deep learning-based reconstruction (DLR) on image quality and radiation dose optimization for multiphase hepatic CT. The results showed that DLR improved the image quality compared to HIR techniques, even at lower radiation doses.