Zaid Saadeh, Nadir Demirel, Kelly Horst, Vivek Iyer, Chi Wan Koo, Nicholas B. Larson, Cynthia H. McCollough, Daniel Oo, Yasmeen Tandon, Jamison Thorne, Zhongxing Zhou, Lifeng Yu, Nate C. Hull
Mayo Clinic
United States
Journal of Computer Assisted Tomography
J Comput Assist Tomogr 2025;
DOI: 10.1097/RCT.0000000000001804
Abstract
Objectives: To determine the feasibility of reduced-dose chest computed tomographic angiography (CTA) with convolutional neural network (CNN) denoising for detecting pulmonary arteriovenous malformations (pAVMs) in children with hereditary hemorrhagic telangiectasia (cwHHT).
Methods: Fifteen cwHHT underwent a chest CTA (ie, a controlled “study” dose). Noise was inserted to simulate a quarter dose (QD) exam. Images were reconstructed using iterative reconstruction (IR) and our self-trained CNN denoising model. For each case, 3 sets of images were created: study dose (SD)+IR, QD+IR, and QD+CNN. Two thoracic radiologists independently scored each set to assess quality, spatial resolution, artifacts, and the presence of pAVMs using 4-level ordinal scales. Quantitative assessments of image quality were performed using contrast-to-noise ratios (CNRs) with comparisons made between the experimental conditions.
Results: Thirteen of the 15 patients recruited with hereditary hemorrhagic telangiectasia (mean age: 9.3±4.5 y) were positive for pAVM by transthoracic contrast echocardiography. The sensitivities using QD+CNN were 0.85 and 1.00 for readers 1 and 2, respectively. This was compared with 0.69 and 0.84 using QD+IR versus 0.85 and 0.92 for SD+IR. Inter-reader agreement for pAVM detection utilizing QD+CNN was moderate and resulted in kappa=0.59 (P=0.012). The subjective assessments for QD+CNN were comparable to the SD technique. Regression analysis of reader scores revealed improved quality in QD+CNN versus QD+IR (P=0.001). Similarly, the QD+CNN condition demonstrated the highest CNRs.
Conclusions: Reduced-dose chest CTA with CNN denoising provides a level of sensitivity comparable to standard dose CTA and high CNRs for the detection of pAVMs in cwHHT.
Category
Pulmonary Arteriovenous Malformations
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
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