Image Quality and Diagnostic Performance of Low-Dose Liver CT with Deep Learning Reconstruction versus Standard-Dose CT.

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Abstract

“Just Accepted” papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. Purpose To compare the image quality and diagnostic capability in detecting malignant liver tumors of low-dose CT (LDCT, 33% dose) with deep learning-based de-noising (DLD) and standard-dose CT (SDCT, 100% dose) with model-based iterative reconstruction (MBIR). Materials and Methods In this prospective, multicenter, noninferiority study (Study identifier: NCT05804799), individuals referred for liver CT scans were enrolled from three tertiary referral hospitals between February 2021 and August 2022. All liver CT scans were conducted using a dual-source scanner with dose split into tubes A (67% dose) and B (33% dose). Blended images of tubes A and B were created using MBIR to produce SDCT images, whereas LDCT images used data from tube B and were reconstructed with DLD. Image noise in the liver was measured and compared between imaging techniques. Diagnostic performance of each technique in detecting malignant liver tumors was evaluated by three independent radiologists using the jackknife alternative free-response receiver operating characteristic analysis. Noninferiority of LDCT compared with SDCT was declared when the lower limit of the 95% CI for the difference in figure of merit (FOM) was greater than-0.10. Results 296 participants (196 male, 100 female; mean age, 60.5 ± [SD] 13.3 years) were included. The mean noise level in the liver was significantly lower for LDCT (10.1) compared with SDCT (10.7) (P < .001). Diagnostic performance was assessed in 246 participants (108 malignant tumors in 90 participants). The reader-averaged FOM was 0.880 for SDCT and 0.875 for LDCT (P = .35). The difference fell within the noninferiority margin (difference, -0.005; 95% CI, -0.024 to 0.012). Conclusion Compared with SDCT with MBIR, LDCT using 33% of the standard radiation dose with had reduced image noise and comparable diagnostic performance in detecting malignant liver tumors. ©RSNA, 2024.