ABSTRACT
Electrocardiogram (ECG)-gated multi-phase computed tomography angiography (MP-CTA) is frequently used for diagnosis of coronary artery disease. Radiation dose may become a potential concern as the scan needs to cover a wide range of cardiac phases during a heart cycle. A common method to reduce radiation is to limit the full-dose acquisition to a predefined range of phases while reducing the radiation dose for the rest. Our goal in this study is to develop a spatiotemporal deep learning method to enhance the quality of low-dose CTA images at phases acquired at reduced radiation dose. Recently, we demonstrated that a deep learning method, Cycle-Consistent generative adversarial networks (CycleGAN), could effectively denoise low-dose CT images through spatial image translation without labeled image pairs in both low-dose and full-dose image domains. As CycleGAN does not utilize the temporal information in its denoising mechanism, we propose to use RecycleGAN, which could translate a series of images ordered in time from the low-dose domain to the full-dose domain through an additional recurrent network. To evaluate RecycleGAN, we use the XCAT phantom program, a highly realistic simulation tool based on real patient data, to generate MP-CTA image sequences for 18 patients (14 for training, 2 for validation and 2 for test). Our simulation results show that RecycleGAN can achieve better denoising performance than CycleGAN based on both visual inspection and quantitative metrics. We further demonstrate the superior denoising performance of RecycleGAN using clinical MP-CTA images from 50 patients.