To providea methodology that removes the spatial variability of in-plane resolution using different CT reconstructions. The methodology does not require any training, sinogram, or specific reconstructionmethod. The methodology is formulated as a reconstruction problem. The desired sharp image is modeled as an unobservable variable to be estimated from an arbitrary number of observations with spatially variant resolution. The methodology comprises three steps: (1) density harmonization, which removes the density variability across reconstructions; (2) point spread function (PSF) estimation, which estimates a spatially variant PSF with arbitrary shape; (3) deconvolution, which is formulated as a regularized least squares problem. The assessment was performed with CT scans of phantoms acquired with three different Siemens scanners (Definition AS, Definition AS+, Drive). Four low-dose acquisitions reconstructed with backprojection and iterative methods were used for the resolution harmonization. A sharp, high-dose (HD) reconstruction was used as a validation reference. The different factors affecting the in-plane resolution (radial, angular, and longitudinal) were studied with regression analysis of the edge decay (between 10% and 90% of the edge spread function (ESF) amplitude). Results showed that the in-plane resolution improves remarkably and the spatial variability is substantially reduced without compromising the noise characteristics. The modulated transfer function (MTF) also confirmed a pronounced increase in resolution. The resolution improvement was also tested by measuring the wall thickness of tubes simulating airways. In all scanners, the resolution harmonization obtained better performance than the HD, sharp reconstruction used as a reference (up to 50 percentage points). The methodology was also evaluated in clinical scans achieving a noise reduction and a clear improvement in thin-layered structures. The estimated ESF and MTF confirmed the resolution improvement. We propose a versatile methodology to reduce the spatial variability of in-plane resolution in CT scans by leveraging different reconstructions available in clinical studies. The methodology does not require any sinogram, training, or specific reconstruction, and it is not limited to a fixed number of input images. Therefore, it can be easily adopted in multicenter studies and clinical practice. The results obtained with our resolution harmonization methodology evidence its suitability to reduce the spatially variant in-plane resolution in clinical CT scans without compromising the reconstruction's noise characteristics. We believe that the resolution increase achieved by our methodology may contribute in more accurate and reliable measurements of small structures such as vasculature, airways, and wallthickness.
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