CT-based synthetic contrast-enhanced dual-energy CT generation using conditional denoising diffusion probabilistic model

Objective. The study aimed to generate synthetic contrast-enhanced Dual-energy CT (CE-DECT) images from non-contrast single-energy CT (SECT) scans, addressing the limitations posed by the scarcity of DECT scanners and the health risks associated with iodinated contrast agents, particularly for high-risk patients. Approach. A conditional denoising diffusion probabilistic model (C-DDPM) was utilized to create synthetic images. Imaging data were collected from 130 head-and-neck (HN) cancer patients who had undergone both non-contrast SECT and CE-DECT scans. Main Results. The performance of the C-DDPM was evaluated using Mean Absolute Error (MAE), Structural Similarity Index (SSIM), and Peak Signal-to-Noise Ratio (PSNR). The results showed MAE values of 27.37 +/- 3.35 Hounsfield Units (HU) for high-energy CT (H-CT) and 24.57 +/- 3.35HU for low-energy CT (L-CT), SSIM values of 0.74 +/- 0.22 for H-CT and 0.78 +/- 0.22 for L-CT, and PSNR values of 18.51 +/- 4.55 decibels (dB) for H-CT and 18.91 +/- 4.55 dB for L-CT. Significance. The study demonstrates the efficacy of the deep learning model in producing high-quality synthetic CE-DECT images, which significantly benefits radiation therapy planning. This approach provides a valuable alternative imaging solution for facilities lacking DECT scanners and for patients who are unsuitable for iodine contrast imaging, thereby enhancing the reach and effectiveness of advanced imaging in cancer treatment planning.