Application of deep learning image reconstruction-high algorithm in one-stop coronary and carotid-cerebrovascular CT angiography with low radiation and contrast doses

Wanjiang Li; Wenyu Huang; Peiyao Li; Yuting Wen; Tao Shuai; Yong He; Yongchun You; Jianqun Yu; Kaiyue Diao; Bin Song

doi:10.21037/qims-23-864

Application of deep learning image reconstruction-high algorithm in one-stop coronary and carotid-cerebrovascular CT angiography with low radiation and contrast doses

Quant Imaging Med Surg. 2024 Feb 1;14(2):1860-1872. doi: 10.21037/qims-23-864. Epub 2024 Jan 23.

Authors

Wanjiang Li^#¹, Wenyu Huang^#¹, Peiyao Li², Yuting Wen¹, Tao Shuai¹, Yong He³, Yongchun You¹, Jianqun Yu¹, Kaiyue Diao¹, Bin Song^{1

4}

Affiliations

¹ Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
² West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
⁴ Department of Radiology, Sanya Municipal People's Hospital, Sanya, China.

^# Contributed equally.

Abstract

Background: For patients with suspected simultaneous coronary and cerebrovascular atherosclerosis, conventional single-site computed tomography angiography (CTA) for both sites can result in nonnegligible radiation and contrast agent dose. The purpose of this study was to validate the feasibility of one-stop coronary and carotid-cerebrovascular CTA (C&CC-CTA) with a "double-low" (low radiation and contrast) dose protocol reconstructed with deep learning image reconstruction with high setting (DLIR-H) algorithm.

Methods: From February 2018 to January 2019, 60 patients referred to C&CC-CTA simultaneously in West China Hospital were recruited in this prospective cohort study. By random assignment, patients were divided into two groups: double-low dose group (n=30) used 80 kVp and 24 mgI/kg/s contrast dose with images reconstructed using DLIR-H; and routine-dose group (n=30) used 100 kVp and 32 mgI/kg/s contrast dose with images reconstructed using 50% adaptive statistical iterative reconstruction-V (ASIR-V50%). Radiation and contrast doses, subjective image quality score, CT attenuation values, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured and compared between the groups.

Results: The DLIR-H group used 30% less contrast dose (35.80±4.85 vs. 51.13±6.91 mL) and 48% less overall radiation dose (1.00±0.09 vs. 1.91±0.42 mSv) than the ASIR-V50% group (both P<0.001). There was no statistically significant difference on subjective quality score between the two groups (C-CTA: 4.38±0.67 vs. 4.17±0.81, P=0.337 and CC-CTA: 4.18±0.87 vs. 4.08±0.79, P=0.604). For coronary CTA, lower background noise (18.93±1.43 vs. 22.86±3.75 HU) was reached in DLIR-H group, and SNR and CNR at all assessed branches were significantly increased compared to ASIR-V50% group (all P<0.05), except SNR of left anterior descending (P>0.05). For carotid-cerebrovascular CTA, DLIR-H group was comparable in background noise (19.25±1.42 vs. 20.23±2.40 HU), SNR and CNR at all assessed branches with ASIR-V50% group (all P>0.05).

Conclusions: The "double-low" dose one-stop C&CC-CTA with DLIR-H obtained higher image quality compared with the routine-dose protocol with ASIR-V50% while achieving 48% and 30% reduction in radiation and contrast dose, respectively.

Keywords: Coronary artery disease (CAD); computed tomography angiography (CTA); image quality; stroke.