A feasibility study of realizing low-dose abdominal CT using deep learning image reconstruction algorithm

OBJECTIVES To explore the feasibility of achieving diagnostic images in low-dose abdominal CT using a Deep Learning Image Reconstruction (DLIR) algorithm. METHODS Prospectively enrolled 47 patients requiring contrast-enhanced abdominal CT scans. The late-arterial phase scan was added and acquired using lower-dose mode (tube current range, 175-545 mA; 80 kVp for patients with BMI ≤24 kg/m2 and 100 kVp for patients with BMI >  24 kg/m2) and reconstructed with DLIR at medium setting (DLIR-M) and high setting (DLIR-H), ASIR-V at 0% (FBP), 40% and 80% strength. Both the quantitative measurement and qualitative analysis of the five types of reconstruction methods were compared. In addition, radiation dose and image quality between the early-arterial phase ASIR-V images using standard-dose and the late-arterial phase DLIR images using low-dose were compared. RESULTS For the late-arterial phase, all five reconstructions had similar CT value (P >  0.05). DLIR-H, DLIR-M and ASIR-V80% images significantly reduced the image noise and improved the image contrast noise ratio, compared with the standard ASIR-V40% images (P <  0.05). ASIR-V80% images had undesirable image characteristics with obvious "waxy" artifacts, while DLIR-H images maintained high spatial resolution and had the highest subjective image quality. Compared with the early-arterial scans, the late-arterial phase scans significantly reduced the radiation dose (P <  0.05), while the DLIR-H images exhibited lower image noise and good display of the specific image details of lesions. CONCLUSIONS DLIR algorithm improves image quality under low-dose scan condition and may be used to reduce the radiation dose without adversely affecting the image quality.