Image texture, low contrast liver lesion detectability and impact on dose: Deep learning algorithm compared to partial model-based iterative reconstruction.

Abstract Objectives To compare deep learning (True Fidelity, TF) and partial model based Iterative Reconstruction (ASiR-V) algorithm for image texture, low contrast lesion detectability and potential dose reduction. Methods Anthropomorphic phantoms (mimicking non-overweight and overweight patient), containing lesions of 6 mm in diameter with 20HU contrast, were scanned at five different dose levels (2,6,10,15,20 mGy) on a CT system, using clinical routine protocols for liver lesion detection. Images were reconstructed using ASiR-V 0% (surrogate for FBP), 60 % and TF at low, medium and high strength. Noise texture was characterized by computing a normalized Noise Power Spectrum filtered by an eye filter. The similarity against FBP texture was evaluated using peak frequency difference (PFD) and root mean square deviation (RMSD). Low contrast detectability was assessed using a channelized Hotelling observer and the area under the ROC curve (AUC) was used as figure of merit. Potential dose reduction was calculated to obtain the same AUC for TF and ASiR-V. Results FBP-like noise texture was more preserved with TF (PFD from -0.043mm-1 to -0.09mm-1, RMSD from 0.12mm-1 to 0.21mm-1) than with ASiR-V (PFD equal to 0.12 mm-1, RMSD equal to 0.53mm-1), resulting in a sharper image. AUC was always higher with TF than ASIR-V. In average, TF compared to ASiR-V, enabled a radiation dose reduction potential of 7%, 25 % and 33 % for low, medium and high strength respectively. Conclusion Compared to ASIR-V, TF at high strength does not impact noise texture and maintains low contrast liver lesions detectability at significant lower dose.