Improving Image Quality of Sparse-view Lung Cancer CT Images with a Convolutional Neural Network

Purpose: To improve the image quality of sparse-view computed tomography (CT) images with a U-Net for lung cancer detection and to determine the best trade-off between number of views, image quality, and diagnostic confidence. Methods: CT images from 41 subjects (34 with lung cancer, seven healthy) were retrospectively selected (01.2016-12.2018) and forward projected onto 2048-view sinograms. Six corresponding sparse-view CT data subsets at varying levels of undersampling were reconstructed from sinograms using filtered backprojection with 16, 32, 64, 128, 256, and 512 views, respectively. A dual-frame U-Net was trained and evaluated for each subsampling level on 8,658 images from 22 diseased subjects. A representative image per scan was selected from 19 subjects (12 diseased, seven healthy) for a single-blinded reader study. The selected slices, for all levels of subsampling, with and without post-processing by the U-Net model, were presented to three readers. Image quality and diagnostic confidence were ranked using pre-defined scales. Subjective nodule segmentation was evaluated utilizing sensitivity (Se) and Dice Similarity Coefficient (DSC) with 95% confidence intervals (CI). Results: The 64-projection sparse-view images resulted in Se = 0.89 and DSC = 0.81 [0.75,0.86] while their counterparts, post-processed with the U-Net, had improved metrics (Se = 0.94, DSC = 0.85 [0.82,0.87]). Fewer views lead to insufficient quality for diagnostic purposes. For increased views, no substantial discrepancies were noted between the sparse-view and post-processed images. Conclusion: Projection views can be reduced from 2048 to 64 while maintaining image quality and the confidence of the radiologists on a satisfactory level.