基于深度学习技术在CT引导下经皮肺穿刺活检术中降低辐射剂量的临床应用  

Clinical application of deep learning-based technique for radiation dose reduction in CT-guided percutaneous transthoracic needle biopsy

作　　者：徐龙 贾永军 于楠 于勇 韩冬 马光明 申利 段海峰 XU Long;JIA Yongjun;YU Nan;YU Yong;HAN Dong;MA Guangming;SHEN Li;DUAN Haifeng(School of Medical Technology,Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi Province 712046,China;Department of Radiology,the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi Province 712000,China)

机构地区：[1]陕西中医药大学医学技术学院,陕西咸阳712046 [2]陕西中医药大学附属医院影像科,陕西咸阳712000

出　　处：《实用放射学杂志》2024年第7期1146-1150,共5页Journal of Practical Radiology

基　　金：陕西省自然科学基础研究计划项目(2022JM-453)。

摘　　要：目的基于深度学习图像重建(DLIR)技术探讨不同噪声指数(NI)在CT引导下经皮肺穿刺活检术(PTNB)中降低辐射剂量的临床应用价值。方法选取32例行PTNB患者,在调整穿刺针后采用小范围(40 mm),管电压100 kV,自动管电流调节(ATCM),NI依次为15、30、45扫描获得3组图像。A组为NI 15自适应统计迭代重建-V(ASIR-V)50%重建图像,B、C组分别为NI 30、NI 45 DLIR高强度算法重建图像,分别测量穿刺点中心及其上、下10 mm层面脊柱旁肌肉、皮下脂肪及主动脉血管CT值和标准差(SD)值,计算信噪比(SNR)和对比噪声比(CNR),并由2名医师对图像进行主观评分,同时比较3组有效剂量(ED)。结果经主观评价A、B、C 3组图像质量均能满足临床穿刺需求。B组图像SD及SNR均优于A、C组,A、B组及B、C组图像在脊柱旁肌肉、皮下脂肪处SD和SNR差异有统计学意义(P<0.05);A、C组图像在脊柱旁肌肉、皮下脂肪处的SD和SNR差异无统计学意义。3组间ED的差异均有统计学意义(P<0.05)。B、C组较A组的ED分别降低了82.86%和93.90%;C组较B组的ED降低了64.44%。结论提高NI结合DLIR技术可以显著减少CT引导下PTNB过程中患者辐射剂量。Objective To explore the clinical application value of deep learning image reconstruction(DLIR)-based technique for radiation dose reduction with different noise index(NI)in CT-guided percutaneous transthoracic needle biopsy(PTNB).Methods Thirty-two patients undergoing PTNB were selected,and three sets of CT images with NI of 15,30,and 45 sequentially were obtained after adjusting the puncture needle using the scanning parameters of a small range(40 mm),tube voltage 100 kV,and automatic tube current modulation(ATCM).Group A was 50%weight of adaptive statistical iterative reconstruction-Veo(ASIR-V)scanned with NI 15,and group B and C were the DLIR-high reconstructed images with NI 30 and NI 45 respectively.The CT value and standard deviation(SD)value of paraspinal muscles,subcutaneous fat,and arterial vessels were measured at the puncture center point and its upper and lower 10 mm sclices,respectively,and the signal-to-noise ratio(SNR)and the contrast-to-noise ratio(CNR)were also calculated.Then the images were subjectively scored by two physicians,meanwhile the effective dose(ED)among the three groups was compared.Results According to the subjective evaluation,the image quality of group A,B,and C all met the clinical requirement for puncture.The SD and SNR of the images in group B were better than those in groups A and C.The SD and SNR of paraspinal muscles and sudcutaneous fat were significantly different between groups A and B,and between groups B and C(P<0.05),however those of paraspinal muscles and subcutaneous fat between groups A and C were not significant.The differences in ED among the three groups were all statistically significant(P<0.05).Compared with group A,the ED in groups B and C were reduced by 82.86%and 93.90% respectively,and the ED in group C was reduced by 64.44% compared with group B.Conclusion Increasing the NI combined with the DLIR technique can significantly reduce the radiation dose during CT-guided PTNB.

关 键 词：肺 穿刺活检 噪声指数 深度学习算法 辐射剂量 

分 类 号：R322.35[医药卫生—人体解剖和组织胚胎学] R815[医药卫生—基础医学]