Background Computed tomography angiography (CTA) provides significant information on image quality in vascular imaging, thus offering high-resolution images despite having the disadvantages of increased radiation doses and contrast agent-related side effects. The deep-learning image reconstruction strategies were used to quantitatively evaluate the enhanced contrast-to-noise ratio (CNR) and the dose reduction effect of subtracted images. Objective This study aimed to elucidate a comprehensive understanding of the quantitative image quality features of the conventional filtered back projection (FBP) and the advanced intelligent clear-IQ engine (AiCE), a deep learning reconstruction technique. The comparison was made in subtracted images with variable concentrations of contrast agents at variable tube currents and voltages, enhancing our knowledge of these two techniques. Methods Data were obtained using a state-of-the-art 320-detector CT scanner. Image reconstruction was performed using FBP and AiCE with various intensities. The image quality evaluation was based on eight iodine concentrations in the phantom setup. The efficiency of AiCE relative to FBP was assessed by computing parameters including the root mean square error (RMSE), dose-dependent CNR, and potential dose reduction. Results The results showed that elevated concentrations of iodine and increased tube currents improved AiCE performance regarding CNR enhancement compared to FBP. AiCE also demonstrated a potential dose reduction ranging from 13.7 to 81.9% compared to FBP, suggesting a significant reduction in radiation exposure while maintaining image quality. Conclusions The employment of deep learning image reconstruction with AiCE presented a significant improvement in CNR and potential dose reduction in CT angiography. This study highlights the potential of AiCE to improve vascular image quality and decrease radiation exposure risk, thereby improving diagnostic precision and patient care in vascular imaging practices.
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