A Metal Artifact Reduction Method Using a Fully Convolutional Network in the Sinogram and Image Domains for Dental Computed Tomography.

The reconstruction quality of dental computed tomography (DCT) is vulnerable to metal implants because the presence of dense metallic objects causes beam hardening and streak artifacts in the reconstructed images. These metal artifacts degrade the images and decrease the clinical usefulness of DCT. Although interpolation-based metal artifact reduction (MAR) methods have been introduced, they may not be efficient in DCT because teeth as well as metallic objects have high X-ray attenuation. In this study, we investigated an effective MAR method based on a fully convolutional network (FCN) in both sinogram and image domains. The method consisted of three main steps: (1) segmentation of the metal trace, (2) FCN-based restoration in the sinogram domain, and (3) FCN-based restoration in image domain followed by metal insertion. We performed a computational simulation and an experiment to investigate the image quality and evaluated the effectiveness of the proposed method. The results of the proposed method were compared with those obtained by the normalized MAR method and the deep learning-based MAR algorithm in the sinogram domain with respect to the root-mean-square error and the structural similarity. Our results indicate that the proposed MAR method significantly reduced the presence of metal artifacts in DCT images and demonstrated better image performance than those of the other algorithms in reducing the streak artifacts without introducing any contrast anomaly.

A Compressed-Sensing Based Blind Deconvolution Method for Image Deblurring in Dental Cone-Beam Computed Tomography.

In cone-beam computed tomography (CBCT), reconstructed images are inherently degraded, restricting its image performance, due mainly to imperfections in the imaging process resulting from detector resolution, noise, X-ray tube's focal spot, and reconstruction procedure as well. Thus, the recovery of CBCT images from their degraded version is essential for improving image quality. In this study, we investigated a compressed-sensing (CS)-based blind deconvolution method to solve the blurring problem in CBCT where both the image to be recovered and the blur kernel (or point-spread function) of the imaging system are simultaneously recursively identified. We implemented the proposed algorithm and performed a systematic simulation and experiment to demonstrate the feasibility of using the algorithm for image deblurring in dental CBCT. In the experiment, we used a commercially available dental CBCT system that consisted of an X-ray tube, which was operated at 90 kVp and 5 mA, and a CMOS flat-panel detector with a 200-µm pixel size. The image characteristics were quantitatively investigated in terms of the image intensity, the root-mean-square error, the contrast-to-noise ratio, and the noise power spectrum. The results indicate that our proposed method effectively reduced the image blur in dental CBCT, excluding repetitious measurement of the system's blur kernel.

Framework for dual-energy-like chest radiography image synthesis from single-energy computed tomography based on cycle-consistent generative adversarial network.

BACKGROUND: Dual-energy (DE) chest radiography (CXR) enables the selective imaging of two relevant materials, namely, soft tissue and bone structures, to better characterize various chest pathologies (i.e., lung nodule, bony lesions, etc.) and potentially improve CXR-based diagnosis. Recently, deep-learning-based image synthesis techniques have attracted considerable attention as alternatives to existing DE methods (i.e., dual-exposure-based and sandwich-detector-based methods) because software-based bone-only and bone-suppression images in CXR could be useful. PURPOSE: The objective of this study was to develop a new framework for DE-like CXR image synthesis from single-energy computed tomography (CT) based on a cycle-consistent generative adversarial network. METHODS: The core techniques of the proposed framework are divided into three categories: (1) data configuration from the generation of pseudo CXR from single energy CT, (2) learning of the developed network architecture using pseudo CXR and pseudo-DE imaging using a single-energy CT, and (3) inference of the trained network on real single-energy CXR. We performed a visual inspection and comparative evaluation using various metrics and introduced a figure of image quality (FIQ) to consider the effects of our framework on the spatial resolution and noise in terms of a single index through various test cases. RESULTS: Our results indicate that the proposed framework is effective and exhibits potential synthetic imaging ability for two relevant materials: soft tissue and bone structures. Its effectiveness was validated, and its ability to overcome the limitations associated with DE imaging techniques (e.g., increase in exposure dose owing to the requirement of two acquisitions, and emphasis on noise characteristics) via an artificial intelligence technique was presented. CONCLUSIONS: The developed framework addresses X-ray dose issues in the field of radiation imaging and enables pseudo-DE imaging with single exposure.

Role of gut-derived bacterial lipopolysaccharide and peripheral TLR4 in immobilization stress-induced itch aggravation in a mouse model of atopic dermatitis.

Psychological stress and intestinal leakage are key factors in atopic dermatitis (AD) recurrence and exacerbation. Here, we demonstrate the mechanism underlying bacterial translocation across intestinal epithelial barrier damaged due to stress and further aggravation of trimellitic anhydride (TMA)-induced itch, which remain unclear, in AD mice. Immobilization (IMO) stress exacerbated scratching bouts and colon histological damage, and increased serum corticosterone and lipopolysaccharide (LPS). Orally administered fluorescein isothiocyanate (FITC)-dextran and surgically injected (into the colon) Cy5.5-conjugated LPS were detected in the serum and skin after IMO stress, respectively. The relative abundance of aerobic or facultative anaerobic bacteria was increased in the colon mucus layer, and Lactobacillus murinus, E. coli, Staphylococcus nepalensis, and several strains of Bacillus sp. were isolated from the spleens and mesenteric lymph nodes. Oral antibiotics or intestinal permeability blockers, such as lubiprostone (Lu), 2,4,6-triaminopyrimidine (TAP) and ML-7, inhibited IMO stress-associated itch; however, it was reinduced through intradermal or i.p. injection of LPS without IMO stress. I.p. injection of TAK-242 (resatorvid), a TLR4 inhibitor, abrogated IMO stress-associated itch, which was also confirmed in TLR4-KO mice. IMO stress alone did not cause itch in naïve mice. IMO stress-induced itch aggravation in TMA-treated AD mice might be attributed to the translocation of gut-derived bacterial cells and LPS, which activates peripheral TLR4 signaling.

Feasibility of artificial intelligence-driven interfractional monitoring of organ changes by mega-voltage computed tomography in intensity-modulated radiotherapy of prostate cancer.

PURPOSE: High-dose radiotherapy (RT) for localized prostate cancer requires careful consideration of target position changes and adjacent organs-at-risk (OARs), such as the rectum and bladder. Therefore, daily monitoring of target position and OAR changes is crucial in minimizing interfractional dosimetric uncertainties. For efficient monitoring of the internal condition of patients, we assessed the feasibility of an auto-segmentation of OARs on the daily acquired images, such as megavoltage computed tomography (MVCT), via a commercial artificial intelligence (AI)-based solution in this study. MATERIALS AND METHODS: We collected MVCT images weekly during the entire course of RT for 100 prostate cancer patients treated with the helical TomoTherapy system. Based on the manually contoured body outline, the bladder including prostate area, and rectal balloon regions for the 100 MVCT images, we trained the commercially available fully convolutional (FC)-DenseNet model and tested its auto-contouring performance. RESULTS: Based on the optimally determined hyperparameters, the FC-DenseNet model successfully auto-contoured all regions of interest showing high dice similarity coefficient (DSC) over 0.8 and a small mean surface distance (MSD) within 1.43 mm in reference to the manually contoured data. With this well-trained AI model, we have efficiently monitored the patient's internal condition through six MVCT scans, analyzing DSC, MSD, centroid, and volume differences. CONCLUSION: We have verified the feasibility of utilizing a commercial AI-based model for auto-segmentation with low-quality daily MVCT images. In the future, we will establish a fast and accurate auto-segmentation and internal organ monitoring system for efficiently determining the time for adaptive replanning.

Feasibility study of deep-learning-based bone suppression incorporated with single-energy material decomposition technique in chest X-rays.

OBJECTIVE: To improve the detection of lung abnormalities in chest X-rays by accurately suppressing overlapping bone structures in the lung area. According to literature on missed lung cancer in chest X-rays, such structures are a significant cause of chest-related diagnostic errors. METHODS: This study presents a deep-learning-based bone suppression method where a residual U-Net model is trained for chest X-rays using data set generated from the single-energy material decomposition (SEMD) technique on CT. Synthetic projection images and soft-tissue selective images were obtained from the CT data set via the SEMD, which were then used as the input and label data of the U-Net network. The trained network was tested on synthetic chest X-rays and two real chest radiographs. RESULTS: Bone-suppressed images of the real chest radiographs obtained by the proposed method were similar to the results from the American Association of Physicists in Medicine lung CT data; pulmonary nodules in the soft-tissue selective images appeared more clearly than in the synthetic projection images. The peak signal-to-noise ratio and structural similarity values measured between the output and the corresponding label images were approximately 17.85 and 0.90, respectively. CONCLUSION: The proposed method effectively yielded bone-suppressed chest X-ray images, indicating its clinical usefulness, and it can improve the detection of lung abnormalities in chest X-rays. ADVANCES IN KNOWLEDGE: The idea of using SEMD to obtain large amounts of paired images for deep-learning-based bone suppression algorithms is novel.

An X-ray spectrum estimation method from transmission measurement combined with scatter correction.

PURPOSE: Conventional x-ray spectrum estimation methods from transmission measurement often lead to inaccurate results when extensive x-ray scatter is present in the measured projection. This study aims to apply the weighted L1-norm scatter correction algorithm in spectrum estimation for reducing residual differences between the estimated and true spectrum. METHOD: The scatter correction algorithm is based on a simple radiographic scattering model where the intensity of scattered x-ray is directly estimated from a transmission measurement. Then, the scatter-corrected measurement is used for the spectrum estimation method that consists of deciding the weights of predefined spectra and representing the spectrum as a linear combination of the predefined spectra with the weights. The performances of the estimation method combined with scatter correction are evaluated on both simulated and experimental data. RESULTS: The results show that the estimated spectra using the scatter-corrected projection nearly match the true spectra. The normalized-root-mean-square-error and the mean energy difference between the estimated spectra and corresponding true spectra are reduced from 5.8% and 1.33 keV without the scatter correction to 3.2% and 0.73 keV with the scatter correction for both simulation and experimental data, respectively. CONCLUSIONS: The proposed method is more accurate for the acquisition of x-ray spectrum than the estimation method without scatter correction and the spectrum can be successfully estimated even the materials of the filters and their thicknesses are unknown. The proposed method has the potential to be used in several diagnostic x-ray imaging applications.

Improvement of megavoltage computed tomography image quality for adaptive helical tomotherapy using cycleGAN-based image synthesis with small datasets.

PURPOSE: Megavoltage computed tomography (MVCT) offers an opportunity for adaptive helical tomotherapy. However, high noise and reduced contrast in the MVCT images due to a decrease in the imaging dose to patients limits its usability. Therefore, we propose an algorithm to improve the image quality of MVCT. METHODS: The proposed algorithm generates kilovoltage CT (kVCT)-like images from MVCT images using a cycle-consistency generative adversarial network (cycleGAN)-based image synthesis model. Data augmentation using an affine transformation was applied to the training data to overcome the lack of data diversity in the network training. The mean absolute error (MAE), root-mean-square error (RMSE), peak signal-to-noise ratio (PSNR), and structural similarity index measure (SSIM) were used to quantify the correction accuracy of the images generated by the proposed algorithm. The proposed method was validated by comparing the images generated with those obtained from conventional and deep learning-based image processing method through non-augmented datasets. RESULTS: The average MAE, RMSE, PSNR, and SSIM values were 18.91 HU, 69.35 HU, 32.73 dB, and 95.48 using the proposed method, respectively, whereas cycleGAN with non-augmented data showed inferior results (19.88 HU, 70.55 HU, 32.62 dB, 95.19, respectively). The voxel values of the image obtained by the proposed method also indicated similar distributions to those of the kVCT image. The dose-volume histogram of the proposed method was also similar to that of electron density corrected MVCT. CONCLUSIONS: The proposed algorithm generates synthetic kVCT images from MVCT images using cycleGAN with small patient datasets. The image quality achieved by the proposed method was correspondingly improved to the level of a kVCT image while maintaining the anatomical structure of an MVCT image. The evaluation of dosimetric effectiveness of the proposed method indicates the applicability of accurate treatment planning in adaptive radiation therapy.

Feasibility of two-dimensional dose distribution deconvolution using convolution neural networks.

PURPOSE: The purpose of this study was to investigate the feasibility of two-dimensional (2D) dose distribution deconvolution using convolutional neural networks (CNNs) instead of an analytical approach for an in-house scintillation detector that has a detector-interface artifact in the penumbra region. METHODS: Datasets of 2D dose distributions were acquired from a medical linear accelerator of Novalis Tx. The datasets comprise two different sizes of square radiation fields and 13 clinical intensity-modulated radiation treatment (IMRT) plans. These datasets were divided into two datasets (training and test) to train and validate the developed network, called PenumbraNet, which is a shallow linear CNN. The PenumbraNet was trained to transform the measured dose distribution [M(x, y)] to calculated distribution [D(x, y)] by the treatment planning system. After training of the PenumbraNet was completed, the performance was evaluated using test data, which were 10 × 10 cm2 open field and ten clinical IMRT cases. The corrected dose distribution [C(x, y)] was evaluated against D(x, y) with 2%/2 mm and 3%/3 mm criteria of the gamma index for each field. The M(x, y) and deconvolved dose distribution with the analytically obtained kernel using Wiener filtering [A(x, y)] were also evaluated for comparison. In addition, we compared the performance of the shallow depth of linear PenumbraNet with that of nonlinear PenumbraNet and a deep nonlinear PenumbraNet within the same training epoch. RESULTS: The mean gamma passing rates were 84.77% and 95.81% with 3%/3 mm gamma criteria for A(x, y) and C(x, y) of the PenumbraNet, respectively. The mean gamma pass rates of nonlinear PenumbraNet and the deep depth of nonlinear PenumbraNet were 96.62%, 93.42% with 3%/3 mm gamma criteria, respectively. CONCLUSIONS: We demonstrated the feasibility of the PenumbraNets for 2D dose distribution deconvolution. The nonlinear PenumbraNet which has the best performance improved the gamma passing rate by 11.85% from the M(x, y) at 3%/3 mm gamma criteria.

Image reconstruction in region-of-interest (or interior) digital tomosynthesis (DTS) based on compressed-sensing (CS).

BACKGROUND AND OBJECTIVE: Digital tomosynthesis (DTS) based on filtered-backprojection (FBP) reconstruction requires a full field-of-view (FOV) scan and relatively dense projections, which results in high doses for medical imaging purposes. To overcome these difficulties, we investigated region-of-interest (ROI) or interior DTS reconstruction where the x-ray beam span covers only a small ROI containing a target area. METHODS: An iterative method based on compressed-sensing (CS) scheme was compared with the FBP-based algorithm for ROI-DTS reconstruction. We implemented both algorithms and performed a systematic simulation and experiments on body and skull phantoms. The image characteristics were evaluated and compared. RESULTS: The CS-based algorithm yielded much better reconstruction quality in ROI-DTS compared to the FBP-based algorithm, preserving superior image homogeneity, edge sharpening, and in-plane resolution. The image characteristics of the CS-reconstructed images in ROI-DTS were not significantly different from those in full-FOV DTS. The measured CNR value of the CS-reconstructed ROI-DTS image was about 12.3, about 1.9 times larger than that of the FBP-reconstructed ROI-DTS image. CONCLUSIONS: ROI-DTS images of substantially high accuracy were obtained using the CS-based algorithm and at reduced imaging doses and less computational cost, compared to typical full-FOV DTS images. We expect that the proposed method will be useful for the development of new DTS systems.