Skeletal Muscle Segmentation at the Level of the Third Lumbar Vertebra (L3) in Low-Dose Computed Tomography: A Lightweight Algorithm.

BACKGROUND: The cross-sectional area of skeletal muscles at the level of the third lumbar vertebra (L3) measured from computed tomography (CT) images is an established imaging biomarker used to assess patients' nutritional status. With the increasing prevalence of low-dose CT scans in clinical practice, accurate and automated skeletal muscle segmentation at the L3 level in low-dose CT images has become an issue to address. This study proposed a lightweight algorithm for automated segmentation of skeletal muscles at the L3 level in low-dose CT images. METHODS: This study included 57 patients with rectal cancer, with both low-dose plain and contrast-enhanced pelvic CT image series acquired using a radiotherapy CT scanner. A training set of 30 randomly selected patients was used to develop a lightweight segmentation algorithm, and the other 27 patients were used as the test set. A radiologist selected the most representative axial CT image at the L3 level for both the image series for all the patients, and three groups of observers manually annotated the skeletal muscles in the 54 CT images of the test set as the gold standard. The performance of the proposed algorithm was evaluated in terms of the Dice similarity coefficient (DSC), precision, recall, 95th percentile of the Hausdorff distance (HD95), and average surface distance (ASD). The running time of the proposed algorithm was recorded. An open source deep learning-based AutoMATICA algorithm was compared with the proposed algorithm. The inter-observer variations were also used as the reference. RESULTS: The DSC, precision, recall, HD95, ASD, and running time were 93.2 ± 1.9% (mean ± standard deviation), 96.7 ± 2.9%, 90.0 ± 2.9%, 4.8 ± 1.3 mm, 0.8 ± 0.2 mm, and 303 ± 43 ms (on CPU) for the proposed algorithm, and 94.1 ± 4.1%, 92.7 ± 5.5%, 95.7 ± 4.0%, 7.4 ± 5.7 mm, 0.9 ± 0.6 mm, and 448 ± 40 ms (on GPU) for AutoMATICA, respectively. The differences between the proposed algorithm and the inter-observer reference were 4.7%, 1.2%, 7.9%, 3.2 mm, and 0.6 mm, respectively, for the averaged DSC, precision, recall, HD95, and ASD. CONCLUSION: The proposed algorithm can be used to segment skeletal muscles at the L3 level in either the plain or enhanced low-dose CT images.

Deep learning-based projection synthesis for low-dose cone-beam computed tomography imaging in image-guided radiotherapy.

Background: The imaging dose of cone-beam computed tomography (CBCT) in image-guided radiotherapy (IGRT) poses adverse effects on patient health. To improve the quality of sparse-view low-dose CBCT images, a projection synthesis convolutional neural network (SynCNN) model is proposed. Methods: Included in this retrospective, single-center study were 223 patients diagnosed with brain tumours from Beijing Cancer Hospital. The proposed SynCNN model estimated two pairs of orthogonally direction-separable spatial kernels to synthesize the missing projection in between the input neighboring sparse-view projections via local convolution operations. The SynCNN model was trained on 150 real patients to learn patterns for inter-view projection synthesis. CBCT data from 30 real patients were used to validate the SynCNN, while data from a phantom and 43 real patients were used to test the SynCNN externally. Sparse-view projection datasets with 1/2, 1/4, and 1/8 of the original sampling rate were simulated, and the corresponding full-view projection datasets were restored using the SynCNN model. The tomographic images were then reconstructed with the Feldkamp-Davis-Kress algorithm. The root-mean-square error (RMSE), peak signal-to-noise ratio (PSNR), and structural similarity (SSIM) metrics were measured in both the projection and image domains. Five experts were invited to grade the image quality blindly for 40 randomly selected evaluation groups with a four-level rubric, where a score greater than or equal to 2 was considered acceptable image quality. The running time of the SynCNN model was recorded. The SynCNN model was directly compared with the three other methods on 1/4 sparse-view reconstructions. Results: The phantom and patient studies showed that the missing projections were accurately synthesized. In the image domain, for the phantom study, compared with images reconstructed from sparse-view projections, images with SynCNN synthesis exhibited significantly improved qualities with decreased values in RMSE and increased values in PSNR and SSIM. For the patient study, between the results with and without the SynCNN synthesis, the averaged RMSE decreased by 3.4×10-4, 10.3×10-4, and 21.7×10-4, the averaged PSNR increased by 3.4, 6.6, and 9.4 dB, and the averaged SSIM increased by 5.2×10-2, 18.9×10-2 and 33.9×10-2, for the 1/2, 1/4, and 1/8 sparse-view reconstructions, respectively. In expert subjective evaluation, both the median scores and acceptance rates of the images with SynCNN synthesis were higher than those reconstructed from sparse-view projections. It took the model less than 0.01 s to synthesize an inter-view projection. Compared with the three other methods, the SynCNN model obtained the best scores in terms of the three metrics in both domains. Conclusions: The proposed SynCNN model effectively improves the quality of sparse-view CBCT images at a low time cost. With the SynCNN model, the CBCT imaging dose in IGRT could be reduced potentially.

TIGRE-VarianCBCT for on-board cone-beam computed tomography, an open-source toolkit for imaging, dosimetry and clinical research.

We presented TIGRE-VarianCBCT, an open-source toolkit Matlab-GPU for Varian on-board cone-beam CT with particular emphasis to address challenges in raw data preprocessing, artifacts correction, tomographic reconstruction and image post-processing. The aim of this project is to provide not only a tool to bridge the gap between clinical usage of CBCT scan data and research algorithms but also a framework that breaks down the imaging chain into individual processes so that research effort can be focused on a specific part. The entire imaging chain, module-based architecture, data flow and techniques used in the creation of the toolkit are presented. Raw scan data are first decoded to extract X-ray fluoro image series and set up the imaging geometry. Data conditioning operations including scatter correction, normalization, beam-hardening correction, ring removal are performed sequentially. Reconstruction is supported by TIGRE with FDK as well as a variety of iterative algorithms. Pixel-to-HU mapping is calibrated by a CatphanTM 504 phantom. Imaging dose in CTDIw is calculated in an empirical formula. The performance was validated on real patient scans with good agreement with respect to vendor-designed program. Case studies in scan protocol optimization, low dose imaging and iterative algorithm comparison demonstrated its substantial potential in performing scan data based clinical studies. The toolkit is released under the BSD license, imposing minimal restrictions on its use and distribution. The toolkit is accessible as a module at https://github.com/CERN/TIGRE.

Spatial Uniformity Assessment of Particles Distributed in a Spherical Fuel Element Using a Non-Destructive Approach.

In many manufacturing procedures, a large number of identical particles need to be disseminated uniformly into a given space. The uniformity of the spatial distribution of the particles can be critical to the properties of the final products. We proposed an image processing-based non-destructive technique to evaluate the particles' spatial uniformity in a spherical space imaged with computed tomography. Both graphic (qualitative) and numerical (quantitative) methods were developed to demonstrate the (non-) uniformity of the particles. Simulation results indicated that the technique helped detecting the non-uniformity in the particles' spatial distribution accurately. We conclude that the proposed technique can be used to test whether a number of particles in a sphere are uniformly distributed statistically and graphically.