Deep-learning lesion and noise insertion for virtual clinical trial in chest ct

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Accurate and objective image quality assessment is essential for the task of radiation dose optimization in clinical CT. Standard method relies on multi-reader multi-case (MRMC) studies in which radiologists are tasked to interpret diagnostic image quality of many carefully-collected positive and negative cases. The efficiency of such MRMC studies is frequently challenged by the lengthy and expensive procedure of case collection and the establishment of clinical reference standard. To address this challenge, multiple methods of virtual clinical trial to synthesize patient cases at different conditions have been proposed. Projection-domain lesion- / noise-insertion methods require the access to patient raw data and vendor-specific proprietary tools which are frequently not accessible to most users. The conventional image-domain noise-insertion methods are often challenged by the over-simplified lesion models and CT system models which may not represent conditions in real scans. In this work, we developed deep-learning lesion and noise insertion techniques that can synthesize chest CT images at different dose levels with and without lung nodules using existing patient cases. The proposed method involved a nodule-insertion convolutional neural network (CNN) and a noise-insertion CNN. Both CNNs demonstrated comparable quality to our previously-validated projection domain lesion- / noise-insertion techniques: mean structural similarity index (SSIM) of inserted nodules 0.94 (routine dose), and mean percent noise difference ∼5% (50% of routine dose). The proposed deep-learning techniques for chest CT virtual clinical trial operate directly on image domain, which is more widely applicable than projection-domain techniques.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2021
Subtitle of host publicationPhysics of Medical Imaging
EditorsHilde Bosmans, Wei Zhao, Lifeng Yu
ISBN (Electronic)9781510640191
StatePublished - 2021
EventMedical Imaging 2021: Physics of Medical Imaging - Virtual, Online, United States
Duration: Feb 15 2021Feb 19 2021

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


ConferenceMedical Imaging 2021: Physics of Medical Imaging
Country/TerritoryUnited States
CityVirtual, Online


  • Chest ct
  • Deep learning
  • Image domain
  • Lesion insertion
  • Noise insertion
  • Virtual clinical trial

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging


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