Visual and Quantitative Evaluation of Low-Concentration Bismuth in Dual-Contrast Imaging of Iodine and Bismuth Using Clinical Photon-Counting CT.

Simultaneous dual-contrast imaging of iodine and bismuth has shown promise in prior phantom and animal studies utilizing spectral CT. However, it is noted that in previous studies, Pepto-Bismol has frequently been employed as the source of bismuth, exceeding the recommended levels for human subjects. This investigation sought to assess the feasibility of visually differentiating and precisely quantifying low-concentration bismuth using clinical dual-source photon-counting CT (PCCT) in a scenario involving both iodinated and bismuth-based contrast materials. Four bismuth samples (0.6, 1.3, 2.5, and 5.1 mg/mL) were prepared using Pepto-Bismol, alongside three iodine rods (1, 2, and 5 mg/mL), inserted into multi-energy CT phantoms with three different sizes, and scanned on a PCCT system at three tube potentials (120, 140, and Sn140 kV). A generic image-based three-material decomposition method generated iodine and bismuth maps, with mean mass concentrations and noise levels measured. The root-mean-square errors for iodine and bismuth determined the optimal tube potential. The tube potential of 140 kV demonstrated optimal quantification performance when both iodine and bismuth were considered. Distinct differentiation of iodine rods with all three concentrations and bismuth samples with mass concentrations ≥ 1.3 mg/mL was observed across all phantom sizes at the optimal kV setting.

Improving spatial resolution with an edge-enhancement model for low-dose propagation-based X-ray phase-contrast computed tomography.

Propagation-based X-ray phase-contrast computed tomography (PB-PCCT) has been increasingly popular for distinguishing low contrast tissues. Phase retrieval is an important step to quantitatively obtain the phase information before the tomographic reconstructions, while typical phase retrieval methods in PB-PCCT, such as homogenous transport of intensity equation (TIE-Hom), are essentially low-pass filters and thus improve the signal to noise ratio at the expense of the reduced spatial resolution of the reconstructed image. To improve the reconstructed spatial resolution, measured phase contrast projections with high edge enhancement and the phase projections retrieved by TIE-Hom were weighted summed and fed into an iterative tomographic algorithm within the framework of the adaptive steepest descent projections onto convex sets (ASD-POCS), which was employed for suppressing the image noise in low dose reconstructions because of the sparse-view scanning strategy or low exposure time for single phase contrast projection. The merging strategy decreases the accuracy of the linear model of PB-PCCT and would finally lead to the reconstruction failure in iterative reconstructions. Therefore, the additive median root prior is also introduced in the algorithm to partly increase the model accuracy. The reconstructed spatial resolution and noise performance can be flexibly balanced by a pair of antagonistic hyper-parameters. Validations were performed by the established phase-contrast Feldkamp-Davis-Kress, phase-retrieved Feldkamp-Davis-Kress, conventional ASD-POCS and the proposed enhanced ASD-POCS with a numerical phantom dataset and experimental biomaterial dataset. Simulation results show that the proposed algorithm outperforms the conventional ASD-POCS in spatial evaluation assessments such as root mean square error (a ratio of 9.78%), contrast to noise ratio (CNR) (a ratio of 7.46%), and also frequency evaluation assessments such as modulation transfer function (a ratio of 66.48% of MTF50% (50% MTF value)), noise power spectrum (a ratio of 35.25% of f50% (50% value of the Nyquist frequency)) and noise equivalent quanta (1-2 orders of magnitude at high frequencies). Experimental results again confirm the superiority of proposed strategy relative to the conventional one in terms of edge sharpness and CNR (an average increase of 67.35%).

Prediction and classification of sleep quality based on phase synchronization related whole-brain dynamic connectivity using resting state fMRI.

Recently, functional network connectivity (FNC) has been extended from static to dynamic analysis to explore the time-varying functional organization of brain networks. Nowadays, a majority of dynamic FNC (dFNC) analysis frameworks identified recurring FNC patterns with linear correlations based on the amplitude of fMRI time series. However, the brain is a complex dynamical system and phase synchronization provides more informative measures. This paper proposes a novel framework for the prediction/classification of behaviors and cognitions based on the dFNCs derived from phase locking value. When applying to the analysis of fMRI data from Human Connectome Project (HCP), four dFNC states are identified for the study of sleep quality. State 1 exhibits most intense phase synchronization across the whole brain. States 2 and 3 have low and weak connections, respectively. State 4 exhibits strong phase synchronization in intra and inter-connections of somatomotor, visual and cognitive control networks. Through the two-sample t-test, we reveal that for the group with bad sleep quality, state 4 shows decreased phase synchronization within and between networks such as subcortical, auditory, somatomotor and visual, but increased phase synchronization within cognitive control network, and between this network and somatomotor/visual/default-mode/cerebellar networks. The networks with increased phase synchronization in state 4 behave oppositely in state 2. Group differences are absent in state 3, and weak in state 1. We establish a prediction model by linear regression of FNC against sleep quality, and adopt a support vector machine approach for the classification. We compare the performance between conventional FNC and PLV-based dFNC with cross-validation. Results show that the PLV-based dFNC significantly outperforms the conventional FNC in terms of both predictive power and classification accuracy. We also observe that combining static and dynamic features does not significantly improve the classification over using dFNC features alone. Overall, the proposed approach provides a novel means to assess dFNC, which can be used as brain fingerprints to facilitate prediction and classification.

Multi-wavelength spatial frequency domain diffuse optical tomography using single-pixel imaging based on lock-in photon counting.

We present a spatial frequency domain (SFD) diffuse optical tomography for simultaneous acquisition of multi-wavelength tomographic images of turbid media. We propose a highly sensitive single-pixel SFD imaging system for simultaneously collecting multi-wavelength spatially modulated reflectance images, instead of using the expensive electron-multiplying charge-coupled device camera that requires switching between the multi-wavelength collections. The single-pixel SFD imaging system using three low-power light sources (455, 532 and 660 nm) that were intensity-modulated by square waves with three different frequencies for frequency encoding, and all the light sources were focused onto one digital micromirror device (DMD) for generating wide-field sinusoidal illumination patterns. Reflected light from the surface of the turbid media was modulated by the other DMD with many sampling patterns before being spatially integrated. Spatially integrated light signals were frequency decoded with a novel highly sensitive lock-in photon counting detection, then multi-wavelength spatially modulated reflectance images were recovered with the single-pixel imaging (SPI) method. We incorporated the two-dimensional discrete cosine transform (DCT) into the SPI method to reduce the number of sampling patterns, and, thereby, the proposed DCT-SPI scheme achieved a fast acquisition of SFD reflectance images that is desired for a dynamic SFD imaging application. Direct current (DC) and alternating current (AC) amplitudes at all the locations on the media surface were extracted from the recovered images. Multi-wavelength tomographic images were reconstructed with an inversion algorithm based on the first-order Rytov approximation of the diffusion equation, using both the extracted DC and AC amplitudes. We performed experiments using a series of tissue simulating phantoms to verify the performances of the proposed approach and compared the experimental results with those using a conventional camera-based SFD imaging system. The results demonstrate that our DCT-SPI based SFD-DOT approach is well suited for simultaneous reconstruction of multi-wavelength tomographic images to pave the way for many SFD imaging applications.

Investigation on the Dependency of Phase Retrieval Accuracy Versus Edge Enhancement to the Noise Ratio of X-ray Propagation-Based Phase-Contrast Imaging.

Phase retrieval is necessary for propagation-based phase-contrast imaging (PB-PCI). Arhatari established a model for predicting the impact of the sample-to-detector distance and the system noise on the phase retrieval performance. We have extended Arhatari's model to account for the parameters of excessive source size, finite detector resolution, and geometrical magnification for more practical cases. However, there exist interaction effects among these parameters resulting in difficulty of predicting the phase retrieval performance. In this study, we found that optimizing the trade-off among these parameters for phase retrieval is consistent with the improvement of edge enhancement to noise ratio (EE/N) in the "forward problem" of the PB-PCI. Hence, we engaged in establishing a relationship between EE/N and phase retrieval performance in terms of the "forward problem" and "inverse problem" of the PB-PCI, respectively. Our results showed that, at fixed detector resolution, phase retrieval from the phase-contrast projections at the same EE/N level resulted in the consistent phase retrieval performance. Therefore, the performance of phase retrieval can be predicted based on the EE/N level and be quantitatively optimized by increasing EE/N.

An Lp (0 ≤ p ≤ 1)-norm regularized image reconstruction scheme for breast DOT with non-negative-constraint.

BACKGROUND: In diffuse optical tomography (DOT), the image reconstruction is often an ill-posed inverse problem, which is even more severe for breast DOT since there are considerably increasing unknowns to reconstruct with regard to the achievable number of measurements. One common way to address this ill-posedness is to introduce various regularization methods. There has been extensive research regarding constructing and optimizing objective functions. However, although these algorithms dramatically improved reconstruction images, few of them have designed an essentially differentiable objective function whose full gradient is easy to obtain to accelerate the optimization process. METHODS: This paper introduces a new kind of non-negative prior information, designing differentiable objective functions for cases of L1-norm, Lp (0 < p < 1)-norm and L0-norm. Incorporating this non-negative prior information, it is easy to obtain the gradient of these differentiable objective functions, which is useful to guide the optimization process. RESULTS: Performance analyses are conducted using both numerical and phantom experiments. In terms of spatial resolution, quantitativeness, gray resolution and execution time, the proposed methods perform better than the conventional regularization methods without this non-negative prior information. CONCLUSIONS: The proposed methods improves the reconstruction images using the introduced non-negative prior information. Furthermore, the non-negative constraint facilitates the gradient computation, accelerating the minimization of the objective functions.

Combined diffuse optical tomography and photoacoustic tomography for enhanced functional imaging of small animals: a methodological study on phantoms.

Hybrid imaging methods combining diffuse optical tomography (DOT) and other anatomical or nonoptical functional modalities have been widely investigated to improve imaging performance degraded by the strong optical scattering of biological tissues, through constraining the reconstruction process by prior structures. However, these modalities with different contrast mechanisms may be ineffective in revealing early-staged lesions with high optical contrast but no morphological changes. Photoacoustic tomography (PAT) is particularly useful for visualizing light-absorbing structures embedded in soft tissues with high spatial resolution. Although it is still challenging for PAT to quantitatively disclose the absorption distribution, the modality does provide reliable and specific a priori information differentiating light-absorbing structures of soft tissues and might be more appropriate to guide DOT in lesion diagnosis, as compared with other anatomical or nonoptical functional modalities. In this study, a PAT-guided DOT approach is introduced with both soft- and hard-prior regularizations. The methodology is experimentally validated on small-animal-sized phantoms using a computed-tomography-analogous (CT-analogous) PAT/DOT dual-modality system, focusing on future whole-body applications. The results show that the proposed scheme is capable of effectively improving the quantitative accuracy and spatial resolution of DOT reconstruction.

Improving the accuracy of MTF measurement at low frequencies based on oversampled edge spread function deconvolution.

The modulation transfer function (MTF) of a radiographic system is often evaluated by measuring the system's edge spread function (ESF) using edge device. However, the numerical differentiation procedure of the traditional slanted edge method amplifies noises in the line spread function (LSF) and limits the accuracy of the MTF measurement at low frequencies. The purpose of this study is to improve the accuracy of low-frequency MTF measurement for digital x-ray imaging systems. An edge spread function (ESF) deconvolution technique was developed for MTF measurement based on the degradation model of slanted edge images. Specifically, symmetric oversampled ESFs were constructed by subtracting a shifted version of the ESF from the original one. For validation, the proposed MTF technique was compared with conventional slanted edge method through computer simulations as well as experiments on two digital radiography systems. The simulation results show that the average errors of the proposed ESF deconvolution technique were 0.11% ± 0.09% and 0.23% ± 0.14%, and they outperformed the conventional edge method (0.64% ± 0.57% and 1.04% ± 0.82% respectively) at low-frequencies. On the experimental edge images, the proposed technique achieved better uncertainty performance than the conventional method. As a result, both computer simulation and experiments have demonstrated that the accuracy of MTF measurement at low frequencies can be improved by using the proposed ESF deconvolution technique.

Method for determining the modulation transfer function of X-ray fluorescence mapping system.

A method for determining the modulation transfer function (MTF) in direct X-ray fluorescence mapping (XFM) system is reported. With a standard container filled with homogeneous gold nanoparticle (GNP) solution (1% by weight), sharp edges are made and utilized to acquire the data for edge spread function (ESF). Through necessary data processing such as signal extraction, attenuation correction and curve fitting and proper calculations of differentiating and Fourier transform, MTF can be determined. Influencing factors of MTF determination in XFM system are thoroughly discussed in theory and validated by experiments. The results show that different mapping steps do not noticeably affect the measured MTF, while MTF is greatly degraded as the collimator-to-object distance increases. The theoretical analyses and experimental validations of the MTF determination are useful and helpful for imaging performance evaluation, system design and optimal operations. The presented methodology could be applied in other XRF based systems with modified imaging trajectories.

Monotone spline regression for accurate MTF measurement at low frequencies.

The modulation transfer function (MTF) of radiographic systems is frequently evaluated by the system's line spread function (LSF) using narrow slits. The conventional slit method requires LSF tail approximation, which is achieved by exponentially extrapolating the LSF tails beyond 1% of peak value. However, the estimated MTF at low frequencies from extrapolation may not reflect the true performance of the system. In this study, a monotone spline regression technique for LSF tail approximation is developed to improve the accuracy of MTF estimation at low frequencies. This technique is based on the underlying physical principles of the system response. The advantages of this technique are demonstrated with simulated examples of which the true MTFs are known. The application of this measurement technique is also demonstrated.

Sparse CT reconstruction based on multi-direction anisotropic total variation (MDATV).

BACKGROUND: The sparse CT (Computed Tomography), inspired by compressed sensing, means to introduce a prior information of image sparsity into CT reconstruction to reduce the input projections so as to reduce the potential threat of incremental X-ray dose to patients' health. Recently, many remarkable works were concentrated on the sparse CT reconstruction from sparse (limited-angle or few-view style) projections. In this paper we would like to incorporate more prior information into the sparse CT reconstruction for improvement of performance. It is known decades ago that the given projection directions can provide information about the directions of edges in the restored CT image. ATV (Anisotropic Total Variation), a TV (Total Variation) norm based regularization, could use the prior information of image sparsity and edge direction simultaneously. But ATV can only represent the edge information in few directions and lose much prior information of image edges in other directions. METHODS: To sufficiently use the prior information of edge directions, a novel MDATV (Multi-Direction Anisotropic Total Variation) is proposed. In this paper we introduce the 2D-IGS (Two Dimensional Image Gradient Space), and combined the coordinate rotation transform with 2D-IGS to represent edge information in multiple directions. Then by incorporating this multi-direction representation into ATV norm we get the MDATV regularization. To solve the optimization problem based on the MDATV regularization, a novel ART (algebraic reconstruction technique) + MDATV scheme is outlined. And NESTA (NESTerov's Algorithm) is proposed to replace GD (Gradient Descent) for minimizing the TV-based regularization. RESULTS: The numerical and real data experiments demonstrate that MDATV based iterative reconstruction improved the quality of restored image. NESTA is more suitable than GD for minimization of TV-based regularization. CONCLUSIONS: MDATV regularization can sufficiently use the prior information of image sparsity and edge information simultaneously. By incorporating more prior information, MDATV based approach could reconstruct the image more exactly.

Channelized hotelling observer-based low-contrast detectability on the ACR CT accreditation phantom: Part II. Repeatability study.

BACKGROUND: Objective and quantitative evaluation for low-contrast detectability that correlates with human observer performance is lacking for routine CT quality control testing. Channelized Hotelling observer (CHO) is considered a strong candidate to fill the need but has long been deemed impractical to implement due to its requirement of a large number of repeated scans in order to provide accurate and precise estimates of index of detectability (d'). In our previous work, we optimized a CHO model observer on the American College of Radiology (ACR) CT accreditation phantom and achieved accurate measurement of d' with only 1-3 repeat scans. PURPOSE: In this work, we aim to validate the repeatability of the proposed CHO-based low-contrast evaluation on four scanner models using the ACR CT accreditation phantom. METHODS: The repeatability test was performed on four different scanners from two major CT manufacturers: Siemens Force and Alpha; Canon Prism and Prime SP. An ACR CT phantom was scanned 10 times, each time after repositioning of the phantom. For each repositioning, 3 repeated scans were acquired at 24, 12, and 6 mGy on all four scanner models. CHO was applied at the measured dose levels for different low-contrast object sizes (4-6 mm). The CHO was also applied to images created using deep learning-based reconstructions on Canon Prism and to four different scan/reconstruction modes on the Siemens Alpha, a photon-counting-detector (PCD)-CT. The repeatability was evaluated by the probability that a measurement would fall within the ±15% tolerance (P<15% ). RESULTS: With the CHO setting optimized for the ACR phantom and the use of 3 repeated scans and 9 non-overlapping slices per scan, the CHO measurement could provide high repeatability with P<15% of 98.8%-99.9% at 12 mGy with IR reconstruction on all four scanners. On scanner A, P<15% were 91.5%-99.9% at the three dose levels and for all three object sizes while the numbers were 93.6%-99.998% on scanner B. P<15% were 96.5%-97.2% for the two deep learning reconstructions and 97.0%-99.97% for the four scan/reconstruction modes on the PCD-CT. CONCLUSION: The CHO provided highly repeatable measurements with over 95% probability that a CHO measurement would lie within the ±15% tolerance for most of the dose levels and object sizes on the ACR phantom. The repeatability was maintained when the CHO was applied to images created with a commercial deep learning-based reconstruction and various scan/reconstruction modes on a PCD-CT. This study demonstrates that practical implementation of CHO for routine quality control and performance evaluation is feasible.

Evaluation of data uncertainty for deep-learning-based CT noise reduction using ensemble patient data and a virtual imaging trial framework.

Deep learning-based image reconstruction and noise reduction (DLIR) methods have been increasingly deployed in clinical CT. Accurate assessment of their data uncertainty properties is essential to understand the stability of DLIR in response to noise. In this work, we aim to evaluate the data uncertainty of a DLIR method using real patient data and a virtual imaging trial framework and compare it with filtered-backprojection (FBP) and iterative reconstruction (IR). The ensemble of noise realizations was generated by using a realistic projection domain noise insertion technique. The impact of varying dose levels and denoising strengths were investigated for a ResNet-based deep convolutional neural network (DCNN) model trained using patient images. On the uncertainty maps, DCNN shows more detailed structures than IR although its bias map has less structural dependency, which implies that DCNN is more sensitive to small changes in the input. Both visual examples and histogram analysis demonstrated that hotspots of uncertainty in DCNN may be associated with a higher chance of distortion from the truth than IR, but it may also correspond to a better detection performance for some of the small structures.

Low-contrast detectability of photon-counting-detector CT at different scan modes and image types in comparison with energy-integrating-detector CT.

Purpose: We aim to compare the low-contrast detectability of a clinical whole-body photon-counting-detector (PCD)-CT at different scan modes and image types with an energy-integrating-detector (EID)-CT. Approach: We used a channelized Hotelling observer (CHO) previously optimized for quality control purposes. An American College of Radiology CT accreditation phantom was scanned on both PCD-CT and EID-CT with 10 phantom positionings. For PCD-CT, images were generated using two scan modes, standard resolution (SR) and ultra-high-resolution (UHR); two image types, virtual monochromatic images at 70 keV and low-energy threshold (T3D); both filtered-back-projection (FBP) and iterative reconstruction (IR) reconstruction methods; and three reconstruction kernels. For each positioning, three repeated scans were acquired for each scan mode, image type, and CTDIvol of 6, 12, and 24 mGy. For EID-CT, images acquired from scans (10 positionings × 3 repeats × 3 doses) were reconstructed using the closest counterpart FBP and IR kernels. CHO was applied to calculate the index of detectability (d') on both scanners. Results: With the smooth Br44 kernel, the d' of UHR was mostly comparable with that of the SR mode (difference: -11.4% to 8.3%, p=0.020 to 0.956), and the T3D images had a higher d' (difference: 0.7% to 25.6%) than 70 keV images on PCD-CT. Compared with the EID-CT, UHR-T3D of PCD-CT had non-inferior d' (difference: -2.7% to 12.9%) with IR and non-superior d' (difference: 0.8% to 11.2%) with FBP using the Br44 kernel. PCD-CT produced higher d' than EID-CT by 61.8% to 247.1% with the sharper reconstruction kernels. Conclusions: The comparison between PCD-CT and EID-CT was significantly influenced by the reconstruction method and kernel. With a smooth kernel that is typically used in low-contrast detection tasks, the PCD-CT demonstrated low-contrast detectability that was comparable to EID-CT with IR and showed no superiority when using FBP. With the use of sharper kernels, the PCD-CT significantly outperformed EID-CT in low-contrast detectability.

Image quality evaluation in deep-learning-based CT noise reduction using virtual imaging trial methods: Contrast-dependent spatial resolution.

BACKGROUND: Deep-learning-based image reconstruction and noise reduction methods (DLIR) have been increasingly deployed in clinical CT. Accurate image quality assessment of these methods is challenging as the performance measured using physical phantoms may not represent the true performance of DLIR in patients since DLIR is trained mostly on patient images. PURPOSE: In this work, we aim to develop a patient-data-based virtual imaging trial framework and, as a first application, use it to measure the spatial resolution properties of a DLIR method. METHODS: The patient-data-based virtual imaging trial framework consists of five steps: (1) insertion of lesions into projection domain data using the acquisition geometry of the patient exam to simulate different lesion characteristics; (2) insertion of noise into projection domain data using a realistic photon statistical model of the CT system to simulate different dose levels; (3) creation of DLIR-processed images from projection or image data; (4) creation of ensembles of DLIR-processed patient images from a large number of noise and lesion realizations; and (5) evaluation of image quality using ensemble DLIR images. This framework was applied to measure the spatial resolution of a ResNet based deep convolutional neural network (DCNN) trained on patient images. Lesions in a cylindrical shape and different contrast levels (-500, -100, -50, -20, -10 HU) were inserted to the lower right lobe of the liver in a patient case. Multiple dose levels were simulated (50%, 25%, 12.5%). Each lesion and dose condition had 600 noise realizations. Multiple reconstruction and denoising methods were used on all the noise realizations, including the original filtered-backprojection (FBP), iterative reconstruction (IR), and the DCNN method with three different strength setting (DCNN-weak, DCNN-medium, and DCNN-strong). Mean lesion signal was calculated by performing ensemble averaging of all the noise realizations for each lesion and dose condition and then subtracting the lesion-present images from the lesion absent images. Modulation transfer functions (MTFs) both in-plane and along the z-axis were calculated based on the mean lesion signals. The standard deviations of MTFs at each condition were estimated with bootstrapping: randomly sampling (with replacement) all the DLIR/FBP/IR images from the ensemble data (600 samples) at each condition. The impact of varying lesion contrast, dose levels, and denoising strengths were evaluated. Statistical analysis with paired t-test was used to compare the z-axis and in-plane spatial resolution of five algorithms for five different contrasts and three dose levels. RESULTS: The in-plane and z-axis spatial resolution degradation of DCNN becomes more severe as the contrast or radiation dose decreased, or DCNN denoising strength increased. In comparison with FBP, a 59.5% and 4.1% reduction of in-plane and z-axis MTF (in terms of spatial frequencies at 50% MTF), respectively, was observed at low contrast (-10 HU) for DCNN with the highest denoising strength at 25% routine dose level. When the dose level reduces from 50% to 12.5% of routine dose, the in-plane and z-axis MTFs reduces from 92.1% to 76.3%, and from 98.9% to 95.5%, respectively, at contrast of -100 HU, using FBP as the reference. For most conditions of contrasts and dose levels, significant differences were found among the five algorithms, with the following relationship in both in-plane and cross-plane spatial resolution: FBP > DCNN-Weak > IR > DCNN-Medium > DCNN-Strong. The spatial resolution difference among algorithms decreases at higher contrast or dose levels. CONCLUSIONS: A patient-data-based virtual imaging trial framework was developed and applied to measuring the spatial resolution properties of a DCNN noise reduction method at different contrast and dose levels using real patient data. As with other non-linear image reconstruction and post-processing techniques, the evaluated DCNN method degraded the in-plane and z-axis spatial resolution at lower contrast levels, lower radiation dose, and higher denoising strength.

Automated Web-based Software for CT Quality Control Testing of Low-contrast Detectability using Model Observers.

The Channelized Hotelling observer (CHO) is well correlated with human observer performance in many CT detection/classification tasks but has not been widely adopted in routine CT quality control and performance evaluation, mainly because of the lack of an easily available, efficient, and validated software tool. We developed a highly automated solution - CT image quality evaluation and Protocol Optimization (CTPro), a web-based software platform that includes CHO and other traditional image quality assessment tools such as modulation transfer function and noise power spectrum. This tool can allow easy access to the CHO for both the research and clinical community and enable efficient, accurate image quality evaluation without the need of installing additional software. Its application was demonstrated by comparing the low-contrast detectability on a clinical photon-counting-detector (PCD)-CT with a traditional energy-integrating-detector (EID)-CT, which showed UHR-T3D had 6.2% higher d' than EID-CT with IR (p = 0.047) and 4.1% lower d' without IR (p = 0.122).

Learned high-resolution cardiac CT imaging from ultra-high-resolution PCD-CT.

Coronary computed tomography angiography (cCTA) is a widely used non-invasive diagnostic exam for patients with coronary artery disease (CAD). However, most clinical CT scanners are limited in spatial resolution from use of energy-integrating detectors (EIDs). Radiological evaluation of CAD is challenging, as coronary arteries are small (3-4 mm diameter) and calcifications within them are highly attenuating, leading to blooming artifacts. As such, this is a task well suited for high spatial resolution. Recently, photon-counting-detector (PCD) CT became commercially available, allowing for ultra-high resolution (UHR) data acquisition. However, PCD-CTs are costly, restricting widespread accessibility. To address this problem, we propose a super resolution convolutional neural network (CNN): ILUMENATE (Improved LUMEN visualization through Artificial super-resoluTion imagEs), creating a high resolution (HR) image simulating UHR PCD-CT. The network was trained and validated using patches extracted from 8 patients with a modified U-Net architecture. Training input and labels consisted of UHR PCD-CT images reconstructed with a smooth kernel degrading resolution (LR input) and sharp kernel (HR label). The network learned the resolution difference and was tested on 5 unseen LR patients. We evaluated network performance quantitatively and qualitatively through visual inspection, line profiles to assess spatial resolution improvements, ROIs for CT number stability and noise assessment, structural similarity index (SSIM), and percent diameter luminal stenosis. Overall, ILUMENATE improved images quantitatively and qualitatively, creating sharper edges more closely resembling reconstructed HR reference images, maintained stable CT numbers with less than 4% difference, reduced noise by 28%, maintained structural similarity (average SSIM = 0.70), and reduced percent diameter stenosis with respect to input images. ILUMENATE demonstrates potential impact for CAD patient management, improving the quality of LR CT images bringing them closer to UHR PCD-CT images.

Self-trained deep convolutional neural network for noise reduction in CT.

Purpose: Supervised deep convolutional neural network (CNN)-based methods have been actively used in clinical CT to reduce image noise. The networks of these methods are typically trained using paired high- and low-quality data from a massive number of patients and/or phantom images. This training process is tedious, and the network trained under a given condition may not be generalizable to patient images acquired and reconstructed under different conditions. We propose a self-trained deep CNN (ST_CNN) method for noise reduction in CT that does not rely on pre-existing training datasets. Approach: The ST_CNN training was accomplished using extensive data augmentation in the projection domain, and the inference was applied to the data itself. Specifically, multiple independent noise insertions were applied to the original patient projection data to generate multiple realizations of low-quality projection data. Then, rotation augmentation was adopted for both the original and low-quality projection data by applying the rotation angle directly on the projection data so that images were rotated at arbitrary angles without introducing additional bias. A large number of paired low- and high-quality images from the same patient were reconstructed and paired for training the ST_CNN model. Results: No significant difference was found between the ST_CNN and conventional CNN models in terms of the peak signal-to-noise ratio and structural similarity index measure. The ST_CNN model outperformed the conventional CNN model in terms of noise texture and homogeneity in liver parenchyma as well as better subjective visualization of liver lesions. The ST_CNN may sacrifice the sharpness of vessels slightly compared to the conventional CNN model but without affecting the visibility of peripheral vessels or diagnosis of vascular pathology. Conclusions: The proposed ST_CNN method trained from the data itself may achieve similar image quality in comparison with conventional deep CNN denoising methods pre-trained on external datasets.

Multislice input for 2D and 3D residual convolutional neural network noise reduction in CT.

Purpose: Deep convolutional neural network (CNN)-based methods are increasingly used for reducing image noise in computed tomography (CT). Current attempts at CNN denoising are based on 2D or 3D CNN models with a single- or multiple-slice input. Our work aims to investigate if the multiple-slice input improves the denoising performance compared with the single-slice input and if a 3D network architecture is better than a 2D version at utilizing the multislice input. Approach: Two categories of network architectures can be used for the multislice input. First, multislice images can be stacked channel-wise as the multichannel input to a 2D CNN model. Second, multislice images can be employed as the 3D volumetric input to a 3D CNN model, in which the 3D convolution layers are adopted. We make performance comparisons among 2D CNN models with one, three, and seven input slices and two versions of 3D CNN models with seven input slices and one or three output slices. Evaluation was performed on liver CT images using three quantitative metrics with full-dose images as reference. Visual assessment was made by an experienced radiologist. Results: When the input channels of the 2D CNN model increases from one to three to seven, a trend of improved performance was observed. Comparing the three models with the seven-slice input, the 3D CNN model with a one-slice output outperforms the other models in terms of noise texture and homogeneity in liver parenchyma as well as subjective visualization of vessels. Conclusions: We conclude the that multislice input is an effective strategy for improving performance for 2D deep CNN denoising models. The pure 3D CNN model tends to have a better performance than the other models in terms of continuity across axial slices, but the difference was not significant compared with the 2D CNN model with the same number of slices as the input.

Contrast- and noise-dependent spatial resolution measurement for deep convolutional neural network-based noise reduction in CT using patient data.

Deep convolutional neural network (DCNN)-based noise reduction methods have been increasingly deployed in clinical CT. Accurate assessment of their spatial resolution properties is required. Spatial resolution is typically measured on physical phantoms, which may not represent the true performance of DCNN in patients as it is typically trained and tested with patient images and the generalizability of DNN to physical phantoms is questionable. In this work, we proposed a patient-data-based framework to measure the spatial resolution of DCNN methods, which involves lesion- and noise-insertion in projection domain, lesion ensemble averaging, and modulation transfer function measurement using an oversampled edge spread function from the cylindrical lesion signal. The impact of varying lesion contrast, dose levels, and CNN denoising strengths were investigated for a ResNet-based DCNN model trained using patient images. The spatial resolution degradation of DCNN reconstructions becomes more severe as the contrast or radiation dose decreased, or DCNN denoising strength increased. The measured 50%/10% MTF spatial frequencies of DCNN with highest denoising strength were (-500 HU:0.36/0.72 mm-1; -100 HU:0.32/0.65 mm-1; -50 HU:0.27/0.53 mm-1; -20 HU:0.18/0.36 mm-1; -10 HU:0.15/0.30 mm-1), while the 50%/10% MTF values of FBP were almost kept constant of 0.38/0.76 mm-1.