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Abdominal Radiology

Erschienen in:

14.09.2023 | Hepatobiliary

Deep learning-based iodine contrast-augmenting algorithm for low-contrast-dose liver CT to assess hypovascular hepatic metastasis

verfasst von: Taehee Lee, Jeong Hee Yoon, Jin Young Park, Jihyuk Lee, Jae Won Choi, Chulkyun Ahn, Jeong Min Lee

Erschienen in: Abdominal Radiology | Ausgabe 11/2023

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Abstract

Purpose

To investigate the image quality and diagnostic performance of low-contrast-dose liver CT using a deep learning-based iodine contrast-augmenting algorithm (DLICA) for hypovascular hepatic metastases.

Methods

This retrospective study included 128 patients who underwent contrast-enhanced dual-energy CT for hepatic metastasis surveillance between July 2019 and June 2022 using a 30% reduced iodine contrast dose in the portal phase. Three image types were reconstructed: 50-keV virtual monoenergetic images (50-keV VMI); linearly blended images simulating 120-kVp images (120-kVp); and post-processed 120-kVp images using DLICA (DLICA 120-kVp). Three reviewers evaluated lesion conspicuity, image contrast, and subjective image noise. We also measured image noise, contrast-to-noise ratios (CNRs), and signal-to-noise ratios (SNRs). The diagnostic performance for hepatic metastases was evaluated using a jackknife alternative free-response receiver operating characteristic method with the consensus of two independent radiologists as the reference standard.

Results

DLICA 120-kVp demonstrated significantly higher CNR of lesions to liver (5.7 ± 3.1 vs. 3.8 ± 2.1 vs. 3.8 ± 2.1) and higher SNR compared with 50-keV VMI and 120-kVp (p < 0.001 for all). DLICA 120-kVp had significantly lower image noise than 50-kVp VMI for all regions (p < 0.001 for all). DLICA 120-kVp also exhibited superior lesion conspicuity (4.0 [3.3–4.3] vs. 3.7 [3.0–4.0] vs. 3.7 [3.0–4.0]), higher image contrast, and lower subjective image noise compared with 50-keV VMI and 120-kVp (p < 0.001 for all). Although there was no significant difference in the figure of merit for lesion diagnosis among the three methods (p = 0.11), DLICA 120-kVp had a significantly higher figure of merit for lesions with a diameter < 20 mm than 50-keV VMI (0.677 vs. 0.648, p = 0.007). On a per-lesion basis, DLICA 120-kVp also demonstrated higher sensitivity than the 50-keV VMI (81.2% vs. 72.9%, p < 0.001). The specificities per lesion were not significantly different among the three algorithms (p = 0.15).

Conclusion

DLICA at 120-kVp provided superior lesion conspicuity and image quality and similar diagnostic performance for hypovascular hepatic metastases compared with 50-keV VMI.

Graphical abstract

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Titel: Deep learning-based iodine contrast-augmenting algorithm for low-contrast-dose liver CT to assess hypovascular hepatic metastasis
verfasst von: Taehee Lee
Jeong Hee Yoon
Jin Young Park
Jihyuk Lee
Jae Won Choi
Chulkyun Ahn
Jeong Min Lee
Publikationsdatum: 14.09.2023
Verlag: Springer US
Erschienen in: Abdominal Radiology / Ausgabe 11/2023
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-023-04039-0

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Deep learning-based iodine contrast-augmenting algorithm for low-contrast-dose liver CT to assess hypovascular hepatic metastasis