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Dose Reduction in 4-Dimensional Computed Tomography Imaging: Breathing Signal-Guided Deep Learning-Driven Data Acquisition.

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Title: Dose Reduction in 4-Dimensional Computed Tomography Imaging: Breathing Signal-Guided Deep Learning-Driven Data Acquisition.
Authors: Wimmert, Lukas1,2,3 (AUTHOR), Gauer, Tobias4 (AUTHOR), Dickmann, Jannis5 (AUTHOR), Hofmann, Christian5 (AUTHOR), Sentker, Thilo1,2,3 (AUTHOR), Werner, Rene1,2,3 (AUTHOR) r.werner@uke.de
Source: International Journal of Radiation Oncology, Biology, Physics. Feb2026, Vol. 124 Issue 2, p512-521. 10p.
Subjects: Radiation exposure, Four-dimensional imaging, Tumor diagnosis, Acquisition of data, Radiation protection, Deep learning, Radiotherapy
Abstract: Four-dimensional computed tomography (4D CT) imaging is essential for radiation therapy planning in thoracic tumors. However, current protocols tend to acquire more projection data than is strictly necessary for reconstructing the 4D CT, potentially leading to unnecessary radiation exposure and a misalignment with the ALARA (As Low As Reasonably Achievable) principle. We propose a deep learning (DL)-driven approach that uses the patient's breathing signal to guide data acquisition, aiming to acquire only necessary projection data. This retrospective study analyzed 1415 breathing signals from 294 patients, with a 75/25 training/validation split at the patient level. On the basis of the signals, a DL model was trained to predict optimal beam-on events for projection data acquisition. Model testing was performed on 104 independent clinical 4D CT scans. The performance of the model was assessed by measuring temporal alignment between predicted and optimal beam-on events. To assess the impact on the reconstructed images, each 4D CT data set was reconstructed twice: using all clinically acquired projections (reference) and using only the model-selected projections (dose-reduced). Reference and dose-reduced images were compared using Dice coefficients for organ segmentations, deformable image registration-based displacement fields, artifact frequency, and tumor segmentation agreement, the latter evaluated in terms of Hausdorff distance and tumor motion ranges. The proposed approach reduced beam-on time and imaging dose by a median of 29% (IQR, 24%-35%), corresponding to 11.6 mGy dose reduction for a standard 4D CT CTDIvol of 40 mGy. Temporal alignment between predicted and optimal beam-on events showed marginal differences. Similarly, reconstructed dose-reduced images showed only minimal differences to the reference images, demonstrated by high lung and liver segmentation Dice values, small-magnitude (deformable image registration) displacement fields, and unchanged artifact frequency. Minor deviations of tumor segmentation and motion ranges compared with the reference suggest only minimal impact of the proposed approach on treatment planning. The proposed DL-driven data acquisition approach has the ability to reduce radiation exposure during 4D CT imaging while preserving diagnostic quality, offering a clinically viable, ALARA-adhering solution for 4D CT imaging. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Four-dimensional computed tomography (4D CT) imaging is essential for radiation therapy planning in thoracic tumors. However, current protocols tend to acquire more projection data than is strictly necessary for reconstructing the 4D CT, potentially leading to unnecessary radiation exposure and a misalignment with the ALARA (As Low As Reasonably Achievable) principle. We propose a deep learning (DL)-driven approach that uses the patient's breathing signal to guide data acquisition, aiming to acquire only necessary projection data. This retrospective study analyzed 1415 breathing signals from 294 patients, with a 75/25 training/validation split at the patient level. On the basis of the signals, a DL model was trained to predict optimal beam-on events for projection data acquisition. Model testing was performed on 104 independent clinical 4D CT scans. The performance of the model was assessed by measuring temporal alignment between predicted and optimal beam-on events. To assess the impact on the reconstructed images, each 4D CT data set was reconstructed twice: using all clinically acquired projections (reference) and using only the model-selected projections (dose-reduced). Reference and dose-reduced images were compared using Dice coefficients for organ segmentations, deformable image registration-based displacement fields, artifact frequency, and tumor segmentation agreement, the latter evaluated in terms of Hausdorff distance and tumor motion ranges. The proposed approach reduced beam-on time and imaging dose by a median of 29% (IQR, 24%-35%), corresponding to 11.6 mGy dose reduction for a standard 4D CT CTDIvol of 40 mGy. Temporal alignment between predicted and optimal beam-on events showed marginal differences. Similarly, reconstructed dose-reduced images showed only minimal differences to the reference images, demonstrated by high lung and liver segmentation Dice values, small-magnitude (deformable image registration) displacement fields, and unchanged artifact frequency. Minor deviations of tumor segmentation and motion ranges compared with the reference suggest only minimal impact of the proposed approach on treatment planning. The proposed DL-driven data acquisition approach has the ability to reduce radiation exposure during 4D CT imaging while preserving diagnostic quality, offering a clinically viable, ALARA-adhering solution for 4D CT imaging. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1016/j.ijrobp.2025.08.047
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      – Code: eng
        Text: English
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        PageCount: 10
        StartPage: 512
    Subjects:
      – SubjectFull: Radiation exposure
        Type: general
      – SubjectFull: Four-dimensional imaging
        Type: general
      – SubjectFull: Tumor diagnosis
        Type: general
      – SubjectFull: Acquisition of data
        Type: general
      – SubjectFull: Radiation protection
        Type: general
      – SubjectFull: Deep learning
        Type: general
      – SubjectFull: Radiotherapy
        Type: general
    Titles:
      – TitleFull: Dose Reduction in 4-Dimensional Computed Tomography Imaging: Breathing Signal-Guided Deep Learning-Driven Data Acquisition.
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            NameFull: Gauer, Tobias
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            NameFull: Hofmann, Christian
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              M: 02
              Text: Feb2026
              Type: published
              Y: 2026
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