Purpose: The three-dimensional digital subtraction angiography (3D DSA) technique is the current standard and is based on both mask and fill runs to enable the subtraction technique. Artificial intelligence (AI)-based 3D angiography (3DA) was developed to reduce radiation dosage because only one contrast-enhanced run of the C‑arm system is required for reconstruction of DSA-like 3D volumes. The aim was the evaluation of this algorithm regarding its diagnostic information.
Methods: 3D DSA datasets without pathologic findings were reconstructed both with subtraction technique and with the AI-based algorithm. Corresponding reconstructions were evaluated by 2 neuroradiologists with respect to image quality (IQ), visualization of major segments of the circle of Willis (ICA = C4-C7; OphA; ACA = A1-A2, MCA = M1-M2; VA = V4; BA; AICA; SUCA; PCA = P1-P2), identifiability of perforators (lenticulostriate/thalamoperforating arteries) and vessel diameters (ICA = C4; MCA = M1; BA; PCA = P1).
Results: In total 15 datasets were successfully reconstructed as 3D DSA and 3DA with diagnostic image quality. All major segments of the circle of Willis and perforators were comparably visualized with 3DA. Quantitative analysis of vessel diameters in 3D DSA and 3DA datasets was equivalent and did not show relevant differences (rICA = 0.901, p = 0.001; rM1 = 0.951, p = 0.001; rBA = 0.906, p = 0.001; rP1 = 0.991, p = 0.001).
Conclusions: The use of 3DA demonstrated reliable visualization of cerebral vasculature with respect to quantitative and qualitative parameters. Therefore, 3DA is a promising method that might help to reduce patient radiation.
Keywords: 3D angiography; Artificial intelligence; Deep learning; Dose reduction; Flat-detector computed tomography.