Impact of deep learning reconstruction on radiation dose reduction and cancer risk in CT examinations: a real-world clinical analysis

The purpose of this study is to estimate the extent to which the implementation of deep learning reconstruction (DLR) may reduce the risk of radiation-induced cancer from CT examinations, utilizing real-world clinical data.

We retrospectively analyzed scan data of adult patients who underwent body CT during two periods relative to DLR implementation at our facility: a 12-month pre-DLR phase (n = 5553) using hybrid iterative reconstruction and a 12-month post-DLR phase (n = 5494) with routine CT reconstruction transitioning to DLR. To ensure comparability between two groups, we employed propensity score matching 1:1 based on age, sex, and body mass index. Dose data were collected to estimate organ-specific equivalent doses and total effective doses. We assessed the average dose reduction post-DLR implementation and estimated the Lifetime Attributable Risk (LAR) for cancer per CT exam pre- and post-DLR implementation. The number of radiation-induced cancers before and after the implementation of DLR was also estimated.

After propensity score matching, 5247 cases from each group were included in the final analysis. Post-DLR, the total effective body CT dose significantly decreased to 15.5 ± 10.3 mSv from 28.1 ± 14.0 mSv pre-DLR (p < 0.001), a 45% reduction. This dose reduction significantly lowered the radiation-induced cancer risk, especially among younger women, with the estimated annual cancer incidence from 0.247% pre-DLR to 0.130% post-DLR.

The implementation of DLR has the possibility to reduce radiation dose by 45% and the risk of radiation-induced cancer from 0.247 to 0.130% as compared with the iterative reconstruction.

Question Can implementing deep learning reconstruction (DLR) in routine CT scans significantly reduce radiation dose and the risk of radiation-induced cancer compared to hybrid iterative reconstruction?

Findings DLR reduced the total effective body CT dose by 45% (from 28.1 ± 14.0 mSv to 15.5 ± 10.3 mSv) and decreased estimated cancer incidence from 0.247 to 0.130%.

Clinical relevance Adopting DLR in clinical practice substantially lowers radiation exposure and cancer risk from CT exams, enhancing patient safety, especially for younger women, and underscores the importance of advanced imaging techniques.