Impact of deep learning-based image reconstruction on image quality and lesion visibility in renal computed tomography at different doses

BACKGROUND: Numerous computed tomography (CT) image reconstruction algorithms have been developed to improve image quality, and high-quality renal CT images are crucial to clinical diagnosis. This study evaluated the image quality and lesion visibility of deep learning-based image reconstruction (DLIR) compared with adaptive statistical iterative reconstruction-Veo (ASiR-V) in contrast-enhanced renal CT at different reconstruction strengths and doses. METHODS: From January 2020 to May 2021, we prospectively included 101 patients who underwent renal contrast-enhanced CT scanning (69 at 120 kV; 32 at 80 kV). All image data were reconstructed with ASiR-V (30% and 70%) and DLIR at low, medium, and high reconstruction strengths (DLIR-L, DLIR-M, and DLIR-H, respectively). The CT number, noise, noise reduction rate (NRR), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), overall image quality, and the proportion of acceptable images were compared. Lesions of DLIR groups were evaluated, and the conspicuity-to-noise ratio (C/N) was calculated. RESULTS: Quantitative values (noise, SNR, CNR, and NRR) significantly differed between all reconstructions at 120 and 80 kV (P<0.001) and between each reconstruction, except ASiR-V 70% vs. DLIR-M. At 120 kV, the overall image quality and the proportion of acceptable images significantly differed between all reconstructions (P<0.001) and between each reconstruction, except ASiR-V 30% vs. DLIR-L and ASiR-V 70% vs. DLIR-M. At 80 kV, the overall image quality significantly differed between all reconstructions (P<0.001) and between each reconstruction, except between ASiR-V 30%, ASiR-V 70%, and DLIR-L. Quantitative and qualitative values were highest in DLIR-H, while the values were close in DLIR-H (80 kV) vs. ASiR-V 70% (120 kV) and DLIR-M (80 kV) vs. ASiR-V 30% (120 kV). The lesion conspicuity and noise significantly differed in DLIR at 120 kV and 80 kV (P<0.001). C/N significantly differed in DLIR at 120 kV (P<0.001) but not at 80 kV. DLIR-L and DLIR-M exhibited much-improved lesion display (C/N >1), and DLIR-H exhibited much-improved noise (C/N <1) at 120 kV. CONCLUSIONS: DLIR significantly improved the image quality and lesion visibility of renal CT compared with ASiR-V, even at a low dose.