ArticleQuantitative imaging in medicine and surgery2026
Evaluation of optimal ClearInfinity artificial intelligence deep learning reconstruction algorithm weights with a 70-kVp tube voltage combined with "dual-low" abdominal computed tomography angiography.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Abdominal computed tomography angiography (CTA) often requires a high tube voltage and relatively large contrast volume to ensure adequate vascular enhancement, which increases radiation exposure and contrast-related risks. Deep learning reconstruction techniques have demonstrated potential to improve image quality under low-dose acquisition conditions. This study evaluated a 70-kVp abdominal CTA protocol using low tube voltage and low contrast medium volume ("dual-low"), reconstructed with ClearInfinity (Neusoft Medical) at different weighting levels. Methods: A prospective study was conducted on 100 patients undergoing abdominal CTA who were divided into two groups: group A (70 kVp, 40-45 mL of contrast medium, and a flow rate of 2.0-2.5 mL/s) and group B (conventional 100-kVp protocol, 60-70 mL of contrast medium, and a flow rate of 3.0-3.5 mL/s). Group B served as standard-dose reference, and its images were reconstructed using the vendor-recommended ClearView iterative reconstruction. Images in Group A were reconstructed with ClearInfinity at four weighting levels-30%, 50%, 70%, and 90%-which corresponded to groups A1 to A4, respectively. Radiation dose parameters, including computed tomography dose index volume (CTDIvol), dose-length product (DLP), and effective dose (ED) were recorded and analyzed for both groups. Objective evaluation included CT attenuation, image noise (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Subjective image quality was independently evaluated by two radiologists. Results: The CTDIvol, DLP, and ED in group A were significantly lower than those in group B (P<0.001). Mean vascular attenuation did not differ significantly between the groups (P>0.05). As the ClearInfinity weighting increased from 30% to 90%, image noise progressively decreased, whereas both the SNR and CNR progressively increased. Compared with the iterative reconstruction group (group B), group A4 exhibited a lower SD and higher SNR and CNR across major abdominal vessels (all P values <0.05). Subjective image quality increased from A1 to A2 and then remained stable at higher ClearInfinity weights, with no significant differences across groups A2-A4. Interobserver agreement for subjective scoring was excellent (κ>0.81). Conclusions: A 70-kVp abdominal CTA protocol reconstructed with 90% ClearInfinity weighting provides substantial radiation dose reduction while preserving diagnostic vascular image quality despite reduced contrast volume.
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