Structure-preserving low-dose computed tomography image denoising using a deep residual adaptive global context attention network

BACKGROUND: Low-dose computed tomography (LDCT) scans can effectively reduce the radiation damage to patients, but this is highly detrimental to CT image quality. Deep convolutional neural networks (CNNs) have shown their potential in improving LDCT image quality. However, the conventional CNN-based approaches rely fundamentally on the convolution operations, which are ineffective for modeling the correlations among nonlocal similar structures and the regionally distinct statistical properties in CT images. This modeling deficiency hampers the denoising performance for CT images derived in this manner. METHODS: In this paper, we propose an adaptive global context (AGC) modeling scheme to describe the nonlocal correlations and the regionally distinct statistics in CT images with negligible computation load. We further propose an AGC-based long-short residual encoder-decoder (AGC-LSRED) network for efficient LDCT image noise artifact-suppression tasks. Specifically, stacks of residual AGC attention blocks (RAGCBs) with long and short skip connections are constructed in the AGC-LSRED network, which allows valuable structural and positional information to be bypassed through these identity-based skip connections and thus eases the training of the deep denoising network. For training the AGC-LSRED network, we propose a compound loss that combines the L(1) loss, adversarial loss, and self-supervised multi-scale perceptual loss. RESULTS: Quantitative and qualitative experimental studies were performed to verify and validate the effectiveness of the proposed method. The simulation experiments demonstrated the proposed method exhibits the best result in terms of noise suppression [root-mean-square error (RMSE) =9.02; peak signal-to-noise ratio (PSNR) =33.17] and fine structure preservation [structural similarity index (SSIM) =0.925] compared with other competitive CNN-based methods. The experiments on real data illustrated that the proposed method has advantages over other methods in terms of radiologists’ subjective assessment scores (averaged scores =4.34). CONCLUSIONS: With the use of the AGC modeling scheme to characterize the structural information in CT images and of residual AGC-attention blocks with long and short skip connections to ease the network training, the proposed AGC-LSRED method achieves satisfactory results in preserving fine anatomical structures and suppressing noise in LDCT images.