Synthetic contrast enhancement in cardiac CT with Deep Learning

In Europe the 20% of the CT scans cover the thoracic region. The acquired images contain information about the cardiovascular system that often remains latent due to the lack of contrast in the cardiac area. On the other hand, the contrast enhanced computed tomography (CECT) represents an imaging technique that allows to easily assess the cardiac chambers volumes and the contrast dynamics. With this work we aim to face the problem of extraction and presentation of these latent information, using a deep learning approach with convolutional neural networks. Starting from the extraction of relevant features from the image without contrast medium, we try to re-map them on features typical of CECT, to synthesize an image characterized by an attenuation in the cardiac chambers as if a virtually iodine contrast medium was injected. The purposes are to guarantee an estimation of the left cardiac chambers volume and to perform an evaluation of the contrast dynamics. Our approach is based on a deconvolutional network trained on a set of 120 patients who underwent both CT acquisitions in the same contrastographic arterial phase and the same cardiac phase. To ensure a reliable predicted CECT image, in terms of values and morphology, a custom loss function is defined by combining an error function to find a pixel-wise correspondence, which takes into account the similarity in term of Hounsfield units between the input and output images and by a cross-entropy computed on the binarized versions of the synthesized and of the real CECT image. The proposed method is finally tested on 20 subjects.

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