Deep learning-based reconstruction improves the image quality of low-dose CT enterography in patients with inflammatory bowel disease.

Purpose: Lifelong re-examination of CT enterography (CTE) in patients with inflammatory bowel disease (IBD) may be necessary, and reducing radiation exposure during CT examinations is crucial. We investigated the potential application of deep learning reconstruction (DLR) in CTE to reduce radiation dose and improve image quality in IBD.

Methods: Thirty-six patients with known or suspected IBD were prospectively recruited to the low-dose CTE (LDCTE) group, while forty patients were retrospectively selected from previous clinical standard-dose CTE (STDCTE) scans as controls. STDCTE images were reconstructed with hybrid-IR (adaptive iterative dose reduction 3-dimensional [AIDR3D], standard setting); LDCTE images were reconstructed with AIDR3D and DLR (Advanced Intelligence ClearIQ Engine [AiCE], Body mild/standard/strong, Sharp Body mild/standard/strong setting). The effective radiation dose (ED), image noise, signal-to-noise ratio (SNR), overall image quality, subjective image noise, and diagnostic effectiveness were compared between the LDCTE and STDCTE groups.

Results: Compared with STDCTE, the ED of LDCTE was lower by 54.1% (p<0.001). Compared with STDCTE-AIDR3D, LDCTE-AIDR3D reconstruction objective image noise and SNR were greater (p<0.05), the subjective overall image quality was lower (p<0.05), and the diagnostic efficiency was lower (AUC=0.52, p<0.05). The SNRs of reconstructedimages of LDCTE-AiCE Body Strong and LDCTE-AiCE Body Sharp standard/strong groups were greater than that of STDCTE-AIDR3D group (all p<0.05), and the diagnostic performance was better than or comparable to that of STDCTE; the AUCs were 0.83, 0.76 and 0.76, respectively CONCLUSION: Compared with STDCTE with AIDR3D, LDCTE with DLR effectively reduced the radiation dose and improve image quality in IBD patients.