Application of low radiation dose scanning guided by CT combined with deep learning reconstruction algorithms in lung puncture biopsies

XU Long; LI Xin; ZHANG Li; YU Nan; DUAN Haifeng

doi:10.12122/j.issn.1674-4500.2025.01.07

Abstract：Objective To explore the feasibility and clinical value of low radiation dose scanning combined with deep learning reconstruction(DLIR)algorithm in CT-guided lung puncture biopsy.Methods Patients who underwent CT-guided lung puncture at the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from September 2023 to March 2024 were selected,and according to the different scanning protocols,60 lung puncture biopsy patients were divided into a conventional dose group(group A)and a low-dose group(group B).Group A was 100 kV,with a noise index(NI)=15;Group B had an NI=45;the rest of the scanning parameters were the same.The first and last whole-lung scans in the conventional dose group were scanned with the parameters of group A and B,respectively.They were used to evaluate the image quality improvement potential of the deep learning reconstruction algorithm(DLIR).The first whole-lung scan in group A was reconstructed with filtered back projection(FBP)and weighted 50%adaptive statistical iterative reconstruction-V(50%ASIR-V),and the last whole-lung scan was reconstructed with the three intensities of the deep learning reconstruction algorithm(DLIR-L,DLIR-M,DLIR-H)reconstructed images.The CT and SD values of paraspinal muscles,subcutaneous fat,and aortic vessels were measured,and the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.The baseline characteristics of the patients,the total radiation dose during puncture,the pathological positivity rate,and the complication rate were compared between group A and B.Results The differences in CT values at muscle,subcutaneous fat,and aortic vessels in the reconstructed images under the five different conditions were not statistically significant(P>0.05).The differences in SD,SNR,and CNR values were statistically significant(P<0.05).The two-by-two comparative analyses between the groups showed that there were no statistically significant differences between the DLIR-H images and the 50%ASIR-V images in muscle,fat,and vessel SD and SNR(P>0.05);the differences in CNR values between FBP vs DLIR-H and DLIR-L vs DLIR-H groups were statistically significant(P<0.05).Compared with group A's total radiation dose,group B's total radiation dose was reduced by about 93.6%(P<0.001).The image quality of both groups could meet the needs of clinical puncture,and the differences in baseline characteristics,pathological positivity rate,and complication rate between the two groups were not statistically significant(P>0.05).Conclusion Low-dose CT scanning combined with DLIR reconstruction significantly reduces image noise and improves image quality without compromising the safety of puncture or pathology positivity.