Purpose: Task-based image quality assessment using model observers (MOs) is an effective approach to radiation dose and scanning protocol optimization in computed tomography (CT) imaging, once the correlation between MOs and radiologists can be established in well-defined clinically relevant tasks. Conventional MO studies were typically simplified to detection, classification, or localization tasks using tissue-mimicking phantoms, as traditional MOs cannot be readily used in complex anatomical background. However, anatomical variability can affect human diagnostic performance.

Approach: To address this challenge, we developed a deep-learning-based MO (DL-MO) for localization tasks and validated in a lung nodule detection task, using previously validated projection-based lesion-/noise-insertion techniques. The DL-MO performance was compared with 4 radiologist readers over 12 experimental conditions, involving varying radiation dose levels, nodule sizes, nodule types, and reconstruction types. Each condition consisted of 100 trials (i.e., 30 images per trial) generated from a patient cohort of 50 cases. DL-MO was trained using small image volume-of-interests extracted across the entire volume of training cases. For each testing trial, the nodule searching of DL-MO was confined to a 3-mm thick volume to improve computational efficiency, and radiologist readers were tasked to review the entire volume.

Results: A strong correlation between DL-MO and human readers was observed (Pearson’s correlation coefficient: 0.980 with a 95% confidence interval of [0.924, 0.994]). The averaged performance bias between DL-MO and human readers was 0.57%.

Conclusion: The experimental results indicated the potential of using the proposed DL-MO for diagnostic image quality assessment in realistic chest CT tasks.