Preliminary results of DSA denoising based on a weighted low-rank approach using an advanced neurovascular replication system

  • Sai Gokul HariharanEmail author
  • Christian Kaethner
  • Norbert Strobel
  • Markus Kowarschik
  • Julie DiNitto
  • Shadi Albarqouni
  • Rebecca Fahrig
  • Nassir Navab
Original Article



2D digital subtraction angiography (DSA) has become an important technique for interventional neuroradiology tasks, such as detection and subsequent treatment of aneurysms. In order to provide high-quality DSA images, usually undiluted contrast agent and a high X-ray dose are used. The iodinated contrast agent puts a burden on the patients’ kidneys while the use of high-dose X-rays expose both patients and medical staff to a considerable amount of radiation. Unfortunately, reducing either the X-ray dose or the contrast agent concentration usually results in a sacrifice of image quality.

Materials and methods

To denoise a frame, the proposed spatiotemporal denoising method utilizes the low-rank nature of a spatially aligned temporal sequence where variation is introduced by the flow of contrast agent through a vessel tree of interest. That is, a constrained weighted rank-1 approximation of the stack comprising the frame to be denoised and its temporal neighbors is computed where the weights are used to prevent the contribution of non-similar pixels toward the low-rank approximation. The method has been evaluated using a vascular flow phantom emulating cranial arteries into which contrast agent can be manually injected (Vascular Simulations Replicator, Vascular Simulations, Stony Brook NY, USA). For the evaluation, image sequences acquired at different dose levels as well as different contrast agent concentrations have been used.


Qualitative and quantitative analyses have shown that with the proposed approach, the dose and the concentration of the contrast agent could both be reduced by about 75%, while maintaining the required image quality. Most importantly, it has been observed that the DSA images obtained using the proposed method have the closest resemblance to typical DSA images, i.e., they preserve the typical image characteristics best.


Using the proposed denoising approach, it is possible to improve the image quality of low-dose DSA images. This improvement could enable both a reduction in contrast agent and radiation dose when acquiring DSA images, thereby benefiting patients as well as clinicians. Since the resulting images are free from artifacts and as the inherent characteristics of the images are also preserved, the proposed method seems to be well suited for clinical images as well.


Spatiotemporal denoising Low-dose X-ray sequences Weighted low-rank approximation Digital subtraction angiography 



This work was supported by Siemens Healthineers AG.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© CARS 2019

Authors and Affiliations

  1. 1.Computer Aided Medical ProceduresTechnische Universität MünchenMunichGermany
  2. 2.Siemens Healthineers AG, Advanced TherapiesForchheimGermany
  3. 3.Fakultät für ElektrotechnikHochschule für angewandte Wissenschaften Würzburg-SchweinfurtSchweinfurtGermany
  4. 4.Siemens Medical SolutionsHoffman EstatesUSA
  5. 5.Pattern Recognition LabFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
  6. 6.Whiting School of EngineeringJohns Hopkins UniversityBaltimoreUSA

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