CT: Technology and PhysicsImage Quality Evaluation in Dual-Energy CT of the Chest, Abdomen, and Pelvis in Obese Patients With Deep Learning Image ReconstructionFair, Eric MD∗; Profio, Mark BSEE/MBA∗; Kulkarni, Naveen MD∗; Laviolette, Peter S. PhD∗; Barnes, Bret RT∗; Bobholz, Samuel BS†; Levenhagen, Maureen RT∗; Ausman, Robin BSC∗; Griffin, Michael O. MD, PhD∗; Duvnjak, Petar MD∗; Zorn, Adam P. MD∗; Foley, W. Dennis MD∗ Author Information From the Departments of ∗Radiology †Biophysics, Medical College of Wisconsin, Milwaukee, WI. Received for publication May 24, 2021; accepted September 28, 2021. Correspondence to: Eric Fair, MD, Department of Radiology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI 53226 (e-mail: [email protected]). The authors declare no conflict of interest. General support for this study and report provided to the Department of Radiology, Medical College of Wisconsin by GE Healthcare. There is no direct author affiliation or employment with GE Healthcare at the time of data acquisition or manuscript preparation. Journal of Computer Assisted Tomography: 7/8 2022 - Volume 46 - Issue 4 - p 604-611 doi: 10.1097/RCT.0000000000001316 Buy Metrics Abstract Objective The aim of this study was to evaluate image quality in vascular and oncologic dual-energy computed tomography (CT) imaging studies performed with a deep learning (DL)–based image reconstruction algorithm in patients with body mass index of ≥30. Methods Vascular and multiphase oncologic staging dual-energy CT examinations were evaluated. Two image reconstruction algorithms were applied to the dual-energy CT data sets: standard of care Adaptive Statistical Iterative Reconstruction (ASiR-V) and TrueFidelity DL image reconstruction at 2 levels (medium and high). Subjective quality criteria were independently evaluated by 4 abdominal radiologists, and interreader agreement was assessed. Signal-to-noise ratio (SNR) and contrast-to-noise ratio were compared between image reconstruction methods. Results Forty-eight patients were included in this study, and the mean patient body mass index was 39.5 (SD, 7.36). TrueFidelity-High (DL-High) and TrueFidelity-Medium (DL-Med) image reconstructions showed statistically significant higher Likert scores compared with ASiR-V across all subjective image quality criteria (P < 0.001 for DL-High vs ASiR-V; P < 0.05 for DL-Med vs ASiR-V), and SNRs for aorta and liver were significantly higher for DL-High versus ASiR-V (P < 0.001). Contrast-to-noise ratio for aorta and SNR for aorta and liver were significantly higher for DL-Med versus ASiR-V (P < 0.05). Conclusions TrueFidelity DL image reconstruction provides improved image quality compared with ASiR-V in dual-energy CTs obtained in obese patients. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.