Conditional Generative Adversarial Networks for low-dose CT image denoising aiming at preservation of critical image content

X-ray Computed Tomography (CT) is an imaging modality where patients are exposed to potentially harmful ionizing radiation. To limit patient risk, reduced-dose protocols are desirable, which inherently lead to an increased noise level in the reconstructed CT scans. Consequently, noise reduction algorithms are indispensable in the reconstruction processing chain. In this paper, we propose to leverage a conditional Generative Adversarial Networks (cGAN) model, to translate CT images from low-to-routine dose. However, when aiming to produce realistic images, such generative models may alter critical image content. Therefore, we propose to employ a frequency-based separation of the input prior to applying the cGAN model, in order to limit the cGAN to high-frequency bands, while leaving low-frequency bands untouched. The results of the proposed method are compared to a state-of-the-art model within the cGAN model as well as in a single-network setting. The proposed method generates visually superior results compared to the single-network model and the cGAN model in terms of quality of texture and preservation of fine structural details. It also appeared that the PSNR, SSIM and TV metrics are less important than a careful visual evaluation of the results. The obtained results demonstrate the relevance of defining and separating the input image into desired and undesired content, rather than blindly denoising entire images. This study shows promising results for further investigation of generative models towards finding a reliable deep learning-based noise reduction algorithm for low-dose CT acquisition.