深度学习重建DECT 55 keV成像用于胃肠道肿瘤
本前瞻性观察性研究纳入47例胃肠道肿瘤患者,比较DLIR重建的55 keV虚拟单能图像与ASiR-V40%重建的70 keV图像。结果显示DLIR-M和DLIR-H的CNR与SNR均优于ASiR-V40%,图像噪声不高于或低于后者,碘参数在各算法间等效。
要点
- DLIR-M和DLIR-H的55 keV图像质量与病灶显著性不劣于70 keV ASiR-V40%。
- 55 keV DLIR图像上测量碘参数与常规算法等效,可用于肿瘤碘定量。
- DLIR-L噪声最高、整体图像质量评分最低,不宜作为首选重建强度。
核心结论
- 55 keV DLIR-M和DLIR-H腹部DECT对胃肠道肿瘤的定性与定量表现不劣于甚至优于70 keV ASiR-V40%。
研究设计与样本
- 前瞻性观察性研究,纳入47例经DECT扫描的胃肠道肿瘤患者。
- 对比70 keV ASiR-V40%与55 keV DLIR-L、DLIR-M、DLIR-H四组图像。
- 由2名放射科医生对整体图像质量、病灶显著性和诊断信心进行定性评价。
关键影像表现/征象
- 动脉期与门脉期DLIR-H图像噪声均显著低于ASiR-V40%和DLIR-M。
- DLIR-M与ASiR-V40%之间图像噪声无显著差异。
- DLIR-L在所有算法中图像噪声最高、整体图像质量评分最低。
诊断标准与关键数值
- 两期DLIR-M和DLIR-H的CNR与SNR均显著高于ASiR-V40%,所有P≤0.001。
- 四组算法间肿瘤病灶碘参数比较均无显著差异,所有P>0.1。
临床应用与阅片要点
- 腹部肿瘤DECT可采用55 keV DLIR-M或DLIR-H替代70 keV ASiR-V40%成像。
- 55 keV DLIR图像上测量的碘参数可直接用于临床,无需因算法不同而校正。
- 避免使用DLIR-L,因其图像噪声最高、整体质量评分最低。
局限性
- 原文未报告本研究为单中心还是多中心设计。
- 样本量为47例,原文未报告样本量计算依据。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
英文原文(摘要)· 点击展开
AIM: To qualitatively and quantitatively compare dual-energy computed tomography (DECT)-derived 55 keV virtual monochromatic images (VMIs) using deep learning image reconstruction (DLIR) with 70 keV VMIs using adaptive statistical iterative reconstruction (ASiR-V) in the Gastrointestinal (GI) system tumors and to investigate whether DLIR can influence the measured iodine parameters.
MATERIALS AND METHODS: This prospective, observational study included 47 patients with GI system tumors who underwent DECT. Qualitative and quantitative assessment was performed on 70 keV VMIs using ASiR-V40%, and 55 keV VMIs using DLIR at low (DLIR-L), medium (DLIR-M), and high strength (DLIR-H). Quantitative evaluation included calculation of the contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR). Overall image quality, lesion conspicuity, and diagnostic confidence were evaluated qualitatively by 2 radiologists. Iodine parameters of tumor lesions were compared among four groups of algorithms.
RESULTS: There were no significant differences in the image noise between DLIR-M and ASiR-V40%, whereas image noise was significantly lower in DLIR-H than ASiR-V40% and DLIR-M (both phases, P < 0.001). DLIR-M and DLIR-H had significantly higher CNR and SNR compared with ASiR-V40% on both phases (all P ≤ 0.001). When compared to ASiR-V40%, DLIR-M and DLIR-H had similar or improved qualitative assessment metrics. DLIR-L yielded the highest image noise and the lowest overall image quality score among these algorithms. Lastly, the measured iodine parameters were equivalent among different algorithms (all P > 0.1).
CONCLUSION: Abdominal DECT at 55 keV with DLIR (-M and -H) provided qualitative and quantitative performance for GI tumor evaluation comparable to or exceeding that of ASiR-V 40% at 70 keV.
引用
- Liu, Yuan, Liang, et al. Deep learning reconstruction dual-energy computed tomography for gastrointestinal system tumors: low-kiloelectron volt imaging vs routine imaging. Clin Radiol. 2026. PMID: 42364263. doi:10.1016/j.crad.2026.107403
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。