Ultra-Low-Dose CTPA Using Sparse Sampling CT Combined with the U-Net for Deep Learning-Based Artifact Reduction: An Exploratory Study.

Journal: Journal of imaging informatics in medicine
Published Date: Aug 27, 2025

Abstract

This retrospective study evaluates U-Net-based artifact reduction for dose-reduced sparse-sampling CT (SpSCT) in terms of image quality and diagnostic performance using a reader study and automated detection. CT pulmonary angiograms from 89 patients were used to generate SpSCT data with 16 to 512 views. Twenty patients were reserved for a reader study and test set, the remaining 69 were used to train (53) and validate (16) a dual-frame U-Net for artifact reduction. U-Net post-processed images were assessed for image quality, diagnostic performance, and automated pulmonary embolism (PE) detection using the top-performing network from the 2020 RSNA PE detection challenge. Statistical comparisons were made using two-sided Wilcoxon signed-rank and DeLong two-sided tests. Post-processing with the dual-frame U-Net significantly improved image quality in the internal test set, with a structural similarity index of 0.634/0.378/0.234/0.152 for FBP and 0.894/0.892/0.866/0.778 for U-Net at 128/64/32/16 views, respectively. The reader study showed significantly enhanced image quality (3.15 vs. 3.53 for 256 views, 0.00 vs. 2.52 for 32 views), increased diagnostic confidence (0.00 vs. 2.38 for 32 views), and fewer artifacts across all subsets (P < 0.05). Diagnostic performance, measured by the Sørensen-Dice coefficient, was significantly better for 64- and 32-view images (0.23 vs. 0.44 and 0.00 vs. 0.09, P < 0.05). Automated PE detection was better at fewer views (64 views: 0.77 vs. 0.80, 16 views: 0.59 vs. 0.80), although the differences were not statistically significant. U-Net-based post-processing of SpSCT data significantly enhances image quality and diagnostic performance, supporting substantial dose reduction in CT pulmonary angiography.

Authors

  • Andreas Philipp Sauter
    Department of Diagnostic and Interventional Radiology, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
  • Johannes Thalhammer
    Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany.
  • Felix Meurer
    Musculoskeletal Radiology Section, TUM School of Medicine, Technical University of Munich, Ismaninger Str 22, 81675, Munich, Germany.
  • Tina Dorosti
    From the Department of Physics, School of Natural Sciences (J.T., M.S., T.D., F.P., D.P., F.S.), Munich Institute of Biomedical Engineering (J.T., M.S., T.D., T.L., F.P., D.P., F.S.), Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar (J.T., M.S., T.D., F.P., D.P.), Institute for Advanced Study (J.T., F.P., D.P.), and Computational Imaging and Inverse Problems, Department of Computer Science, School of Computation, Information, and Technology (T.L.), Technical University of Munich, Boltzmannstrasse 11, 85748 Garching, Germany.
  • Daniel Sasse
    Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
  • Jessica Ritter
    Department of Diagnostic and Interventional Radiology, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
  • Yannik Leonhardt
    From the Department of Radiology (C.E.v.S., V.S.S., Y.L., F.G.G., S.C.F., F.T.G., M.R.M., K.W., A.S.G.), Department for Orthopedics and Orthopedic Sports Medicine (N.J.W., C.K., R.v.E., R.B.), and Institute of Pathology (C.M.), Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany; and the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg, Germany (M.J., P.M.J., M.F.R.).
  • Franz Pfeiffer
    Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, München, Germany.
  • Florian Schaff
    Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany.
  • Daniela Pfeiffer
    Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, 81675, Germany.

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