A Guided Refinement Network Model With Joint Denoising and Segmentation for Low-Dose Coronary CTA Subtle Structure Enhancement

Coronary CT angiography (CCTA) is an essential technique for clinical coronary assessment. However, the risks associated with ionizing radiation cannot be ignored, especially its stochastic effects, which increase the risk of cancer. Although it can effectively alleviate radiation problems, low-dose CCTA can reduce imaging quality and interfere with the diagnosis of the radiologist. Existing deep learning methods based on image restoration suffer from subtle structure degradation after noise suppression, leading to unclear coronary boundaries. Furthermore, in the absence of prior guidance on coronary location, subtle coronary branches will be lost after aggressive noise suppression and are difficult to restore successfully. To address the above issues, this paper proposes a novel Guided Refinement Network (GRN) model based on joint learning for restoring high-quality images from low-dose CCTA. GRN integrates coronary segmentation, which provides coronary location, into the denoising, and the two leverage mutual guidance for effective interaction and collaborative optimization. On the one hand, denoising provides images with lower noise levels for segmentation to assist in generating coronary masks. Furthermore, segmentation provides a prior coronary location for denoising, aiming to preserve and restore subtle coronary branches. GRN achieves noise suppression and subtle structure enhancement for low-dose CCTA imaging through joint denoising and segmentation, while also generating segmentation results with reference value. Quantitative and qualitative results show that GRN outperforms existing methods in noise suppression, subtle structure restoration, and visual perception improvement, and generates coronary masks that can serve as a reference for radiologists to assist in diagnosing coronary disease.