Noise reduction in CT image using prior knowledge aware iterative denoising

The clinical demand for low image noise often limits the slice thickness used in many CT applications. However, a thick-slice image is more susceptible to longitudinal partial volume effects, which can blur key anatomic structures and pathologies of interest. In this work, we develop a prior knowledge aware iterative denoising (PKAID) framework that utilizes spatial data redundancy in the slice increment direction to generate low-noise, thin-slice images, and demonstrate its application in non-contrast head CT exams. The proposed technique takes advantage of the low noise of thicker images and exploits the structural similarity between the thick- and thin-slice images to reduce noise in the thin-slice image. Phantom data and patient cases (n = 3) of head CT were used to assess performance of this method. Images were reconstructed at clinically utilized slice thickness (5 mm) and thinner slice thickness (2 mm). PKAID was used to reduce image noise in 2 mm images using the 5 mm images as low-noise prior. Noise amplitude, noise power spectra (NPS), modulation transfer function (MTF), and slice sensitivity profiles (SSPs) of images before/after denoising were analyzed. The NPS and MTF analysis showed that PKAID preserved noise texture and resolution of the original thin-slice image, while reducing noise to the level of thick-slice image. The SSP analysis showed that the slice thickness of the original thin-slice image was retained. Patient examples demonstrated that PKAID-processed, thin-slice images better delineated brain structures and key pathologies such as subdural hematoma compared to the clinical 5 mm images, while additionally reducing image noise. To test an alternative PKAID utilization for dose reduction, a head exam with 40% dose reduction was simulated using projection-domain noise insertion. The image of 5 mm slice thickness was then denoised using PKAID. The results showed that the PKAID-processed reduced-dose images maintained similar noise and image quality compared to the full-dose images.