Deep learning and iterative image reconstruction for head CT: Impact on image quality and radiation dose reduction—Comparative study

<b>Background and purpose:</b> This study focuses on an objective evaluation of a novel reconstruction algorithm-Deep Learning Image Reconstruction (DLIR)-ability to improve image quality and reduce radiation dose compared to the established standard of Adaptive Statistical Iterative Reconstruction-V (ASIR-V), in unenhanced head computed tomography (CT). <b>Materials and methods:</b> A retrospective analysis of 163 consecutive unenhanced head CTs was conducted. Image quality assessment was computed on the objective parameters of Signal-to-Noise Ratio (SNR) and Contrast-to-Noise Ratio (CNR), derived from 5 regions of interest (ROI). The evaluation of DLIR dose reduction abilities was based on the analysis of the PACS derived parameters of dose length product and computed tomography dose index volume (CTDIvol). <b>Results:</b> Following the application of rigorous criteria, the study comprised 35 patients. Significant image quality improvement was achieved with the implementation of DLIR, as evidenced by up to a 145% and 160% increase in SNR in supra- and infratentorial regions, respectively. CNR measurements further confirmed the superiority of DLIR over ASIR-V, with an increase of 171.5% in the supratentorial region and a 59.3% increase in the infratentorial region. Despite the signal improvement and noise reduction DLIR facilitated radiation dose reduction of up to 44% in CTDIvol. <b>Conclusion:</b> Implementation of DLIR in head CT scans enables significant image quality improvement and dose reduction abilities compared to standard ASIR-V. However, the dose reduction feature was proven insufficient to counteract the lack of gantry angulation in wide-detector scanners.