Abstract
BACKGROUND: Denoising low dose computed tomography (CT) images can have great advantages for the aim of minimizing the radiation risk of the patients, as it can help lower the effective dose to the patient while providing constant image quality. In recent years, deep denoising methods became a popular way to accomplish this task. Conventional deep denoising algorithms, however, cannot handle the correlation between neighboring pixels or voxels very well, because the noise structure in CT is a resultant of the global attenuation properties of the patient and because the receptive field of most denoising approaches is rather small. PURPOSE: The purpose of this study is to improve existing denoising networks, by providing them additional information about the image noise. METHODS: We here propose to generate N additional noise realizations by simulation, reconstruct them, and use these noise images as additional input into existing denoising networks. This noise augmentation is intended to guide the denoising process. The additional noise realizations are not only required during training, but also during inference. The rationale behind this noise-augmented deep denoising (NADD) is that CT image noise is strongly patient-specific and it is non-local since it depends on the attenuation of X-ray beams. NADD is architecture-agnostic and can thus be used to improve any previously proposed method. We demonstrate NADD using existing denoising networks that we slightly modified in their input layer in order to take the CT image that is to be denoised plus additional noise images as input. To do so, we modified three popular denoising networks, the CNN10, the ResNet, and the WGAN-VGG and apply them to clinical cases with 90% dose reduction. RESULTS: In all cases tested, the denoising networks strongly benefit from the noise augmentation. Noise artifacts that are being misinterpreted by the original networks as being anatomical structures, are correctly removed by the NADD version of the same networks. The more noise images are provided, the better the performance. CONCLUSIONS: Providing additional simulated noise realizations helps to significantly improve the performance of CT image denoising networks.