Effect of a novel denoising technique on image quality and diagnostic accuracy in low-dose CT in patients with suspected appendicitis

Manuel Kolb, Corinna Storz, Jong-Hyo Kim, Jakob Weiss, Saif Afat, Konstantin Nikolaou, Fabian Bamberg, Ahmed E. Othman

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives: To determine the effect of a vendor unspecific, DICOM-based denoising technique on image quality and diagnostic performance in low-dose simulated abdominal computed tomography (CT) examinations in patients with suspected appendicitis. Methods and Materials: We included 51 patients who underwent contrast-enhanced abdominal CT with Filtered Back Projection due to suspected appendicitis. Realistic Low-Dose simulation generated low-dose datasets at 25% of the original exposition. QuantaStream Denoising, a novel DICOM-based technique denoised the simulated low-Dose datasets. Original (O100), low-dose (LD25) and denoised (DN25) datasets (n = 153) were evaluated regarding subjective image quality (5-point Likert scale; overall quality/image noise/diagnostic confidence), presence/absence of acute appendicitis, free abdominal air and abscess formation and objective image quality (Signal-to-Noise Ratio (SNR) and noise level) by two independent readers. Results: Subjective image quality was rated highest for O100, followed by DN25 and LD25 with significant differences (p = 0.001). Appendicitis was correctly identified in all datasets (n = 30). Appendicitis specific diagnostic confidence was highest for O100 (p = 0.001), followed by DN25 and LD25 without significant difference. All complications were correctly identified on O100 and DN25. On LD25, diagnostic accuracy decreased for abscess formations (sensitivity:0.714; specificity:1.0) and for free abdominal air (sensitivity:0.750; specificity:0.936). Regarding noise levels DN25 showed non-inferiority to O100. SNRs of O100 and DN25 showed no significant difference (p = 0.06). Conclusion: Our findings indicate that QuantaStream Denoising allows for maintained diagnostic image quality and diagnostic accuracy of low-dose abdominal CT examinations (25% of original exposition) in patients with suspected appendicitis without the need for raw sinogram data.

Original languageEnglish
Pages (from-to)198-204
Number of pages7
JournalEuropean Journal of Radiology
Volume116
DOIs
StatePublished - 1 Jul 2019

Fingerprint

Appendicitis
Tomography
Noise
Air
Abdominal Abscess
Sensitivity and Specificity
Signal-To-Noise Ratio
Abscess
Datasets

Keywords

  • Appendicitis
  • Diagnostic imaging
  • Tomography
  • X-Ray computed

Cite this

Kolb, Manuel ; Storz, Corinna ; Kim, Jong-Hyo ; Weiss, Jakob ; Afat, Saif ; Nikolaou, Konstantin ; Bamberg, Fabian ; Othman, Ahmed E. / Effect of a novel denoising technique on image quality and diagnostic accuracy in low-dose CT in patients with suspected appendicitis. In: European Journal of Radiology. 2019 ; Vol. 116. pp. 198-204.
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abstract = "Objectives: To determine the effect of a vendor unspecific, DICOM-based denoising technique on image quality and diagnostic performance in low-dose simulated abdominal computed tomography (CT) examinations in patients with suspected appendicitis. Methods and Materials: We included 51 patients who underwent contrast-enhanced abdominal CT with Filtered Back Projection due to suspected appendicitis. Realistic Low-Dose simulation generated low-dose datasets at 25{\%} of the original exposition. QuantaStream Denoising, a novel DICOM-based technique denoised the simulated low-Dose datasets. Original (O100), low-dose (LD25) and denoised (DN25) datasets (n = 153) were evaluated regarding subjective image quality (5-point Likert scale; overall quality/image noise/diagnostic confidence), presence/absence of acute appendicitis, free abdominal air and abscess formation and objective image quality (Signal-to-Noise Ratio (SNR) and noise level) by two independent readers. Results: Subjective image quality was rated highest for O100, followed by DN25 and LD25 with significant differences (p = 0.001). Appendicitis was correctly identified in all datasets (n = 30). Appendicitis specific diagnostic confidence was highest for O100 (p = 0.001), followed by DN25 and LD25 without significant difference. All complications were correctly identified on O100 and DN25. On LD25, diagnostic accuracy decreased for abscess formations (sensitivity:0.714; specificity:1.0) and for free abdominal air (sensitivity:0.750; specificity:0.936). Regarding noise levels DN25 showed non-inferiority to O100. SNRs of O100 and DN25 showed no significant difference (p = 0.06). Conclusion: Our findings indicate that QuantaStream Denoising allows for maintained diagnostic image quality and diagnostic accuracy of low-dose abdominal CT examinations (25{\%} of original exposition) in patients with suspected appendicitis without the need for raw sinogram data.",
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Effect of a novel denoising technique on image quality and diagnostic accuracy in low-dose CT in patients with suspected appendicitis. / Kolb, Manuel; Storz, Corinna; Kim, Jong-Hyo; Weiss, Jakob; Afat, Saif; Nikolaou, Konstantin; Bamberg, Fabian; Othman, Ahmed E.

In: European Journal of Radiology, Vol. 116, 01.07.2019, p. 198-204.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Effect of a novel denoising technique on image quality and diagnostic accuracy in low-dose CT in patients with suspected appendicitis

AU - Kolb, Manuel

AU - Storz, Corinna

AU - Kim, Jong-Hyo

AU - Weiss, Jakob

AU - Afat, Saif

AU - Nikolaou, Konstantin

AU - Bamberg, Fabian

AU - Othman, Ahmed E.

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AB - Objectives: To determine the effect of a vendor unspecific, DICOM-based denoising technique on image quality and diagnostic performance in low-dose simulated abdominal computed tomography (CT) examinations in patients with suspected appendicitis. Methods and Materials: We included 51 patients who underwent contrast-enhanced abdominal CT with Filtered Back Projection due to suspected appendicitis. Realistic Low-Dose simulation generated low-dose datasets at 25% of the original exposition. QuantaStream Denoising, a novel DICOM-based technique denoised the simulated low-Dose datasets. Original (O100), low-dose (LD25) and denoised (DN25) datasets (n = 153) were evaluated regarding subjective image quality (5-point Likert scale; overall quality/image noise/diagnostic confidence), presence/absence of acute appendicitis, free abdominal air and abscess formation and objective image quality (Signal-to-Noise Ratio (SNR) and noise level) by two independent readers. Results: Subjective image quality was rated highest for O100, followed by DN25 and LD25 with significant differences (p = 0.001). Appendicitis was correctly identified in all datasets (n = 30). Appendicitis specific diagnostic confidence was highest for O100 (p = 0.001), followed by DN25 and LD25 without significant difference. All complications were correctly identified on O100 and DN25. On LD25, diagnostic accuracy decreased for abscess formations (sensitivity:0.714; specificity:1.0) and for free abdominal air (sensitivity:0.750; specificity:0.936). Regarding noise levels DN25 showed non-inferiority to O100. SNRs of O100 and DN25 showed no significant difference (p = 0.06). Conclusion: Our findings indicate that QuantaStream Denoising allows for maintained diagnostic image quality and diagnostic accuracy of low-dose abdominal CT examinations (25% of original exposition) in patients with suspected appendicitis without the need for raw sinogram data.

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KW - Tomography

KW - X-Ray computed

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