Ultra-Dense Denoising Network: Application to Cardiac Catheter-Based X-Ray Procedures

Reducing radiation dose in cardiac catheter-based X-ray procedures increases safety but also image noise and artifacts. Excessive noise and artifacts can compromise vital image information, which can affect clinical decision-making. Developing more effective X-ray denoising methodologies will be beneficial to both patients and healthcare professionals by allowing imaging at lower radiation dose without compromising image information. This paper proposes a framework based on a convolutional neural network (CNN), namely Ultra-Dense Denoising Network (UDDN), for low-dose X-ray image denoising. To promote feature extraction, we designed a novel residual block which establishes a solid correlation among multiple-path neural units via abundant cross connections in its representation enhancement section. Experiments on synthetic additive noise X-ray data show that the UDDN achieves statistically significant higher peak signal-to-noise ratio (PSNR) and structural similarity index measure (SSIM) than other comparative methods. We enhanced the clinical adaptability of our framework by training using normally-distributed noise and tested on clinical data taken from procedures at St. Thomas' hospital in London. The performance was assessed by using local SNR and by clinical voting using ten cardiologists. The results show that the UDDN outperforms the other comparative methods and is a promising solution to this challenging but clinically impactful task.