Cone-beam CT (CBCT) has become the standard image guidance tool for patient setup in image-guided radiation therapy. However, due to its large illumination field, scattered photons severely degrade its image quality. While kernel-based scatter correction methods have been used routinely in the clinic, it is still desirable to develop Monte Carlo (MC) simulation-based methods due to their accuracy. However, the high computational burden of the MC method has prevented routine clinical application. This paper reports our recent development of a practical method of MC-based scatter estimation and removal for CBCT. In contrast with conventional MC approaches that estimate scatter signals using a scatter-contaminated CBCT image, our method used a planning CT image for MC simulation, which has the advantages of accurate image intensity and absence of image truncation. In our method, the planning CT was first rigidly registered with the CBCT. Scatter signals were then estimated via MC simulation. After scatter signals were removed from the raw CBCT projections, a corrected CBCT image was reconstructed. The entire workflow was implemented on a GPU platform for high computational efficiency. Strategies such as projection denoising, CT image downsampling, and interpolation along the angular direction were employed to further enhance the calculation speed. We studied the impact of key parameters in the workflow on the resulting accuracy and efficiency, based on which the optimal parameter values were determined. Our method was evaluated in numerical simulation, phantom, and real patient cases. In the simulation cases, our method reduced mean HU errors from 44 HU to 3 HU and from 78 HU to 9 HU in the full-fan and the half-fan cases, respectively. In both the phantom and the patient cases, image artifacts caused by scatter, such as ring artifacts around the bowtie area, were reduced. With all the techniques employed, we achieved computation time of less than 30 sec including the time for both the scatter estimation and CBCT reconstruction steps. The efficacy of our method and its high computational efficiency make our method attractive for clinical use.
Purpose: Compressed sensing (CS)-based iterative reconstruction (IR) techniques are able to reconstruct cone-beam CT (CBCT) images from undersampled noisy data, allowing for imaging dose reduction. However, there are a few practical concerns preventing the clinical implementation of these techniques. On the image quality side, data truncation along the superior-inferior direction under the cone-beam geometry produces severe cone artifacts in the reconstructed images. Ring artifacts are also seen in the half-fan scan mode. On the reconstruction efficiency side, the long computation time hinders clinical use in image-guided radiation therapy (IGRT). Methods: Image quality improvement methods are proposed to mitigate the cone and ring image artifacts in IR. The basic idea is to use weighting factors in the IR data fidelity term to improve projection data consistency with the reconstructed volume. In order to improve the computational efficiency, a multiple graphics processing units (GPUs)-based CS-IR system was developed. The parallelization scheme, detailed analyses of computation time at each step, their relationship with image resolution, and the acceleration factors were studied. The whole system was evaluated in various phantom and patient cases. Results: Ring artifacts can be mitigated by properly designing a weighting factor as a function of the spatial location on the detector. As for the cone artifact, without applying a correction method, it contaminated 13 out of 80 slices in a head-neck case (full-fan). Contamination was even more severe in a pelvis case under half-fan mode, where 36 out of 80 slices were affected, leading to poorer soft tissue delineation and reduced superior-inferior coverage. The proposed method effectively corrects those contaminated slices with mean intensity differences compared to FDK results decreasing from ∼497 and ∼293 HU to ∼39 and ∼27 HU for the full-fan and half-fan cases, respectively. In terms of efficiency boost, an overall 3.1× speedup factor has been achieved with four GPU cards compared to a single GPU-based reconstruction. The total computation time is ∼30 s for typical clinical cases. Conclusions: The authors have developed a low-dose CBCT IR system for IGRT. By incorporating data consistency-based weighting factors in the IR model, cone/ring artifacts can be mitigated. A boost in computational efficiency is achieved by multi-GPU implementation. C 2014 American Association of Physicists in Medicine. [http://dx
Purpose: Despite the indispensable role of x-ray computed tomography (CT) in diagnostic medicine, the associated harmful ionizing radiation dose is a major concern, as it may cause genetic diseases and cancer. Decreasing patients' exposure can reduce the radiation dose and hence the related risks, but it would inevitably induce higher quantum noise. Supervised deep learning techniques have been used to train deep neural networks for denoising low-dose CT (LDCT) images, but the success of such strategies requires massive sets of pixel-level paired LDCT and normal-dose CT (NDCT) images, which are rarely available in real clinical practice. Our purpose is to mitigate the data scarcity problem for deep learning-based LDCT denoising. Methods: To solve this problem, we devised a shift-invariant property-based neural network that uses only the LDCT images to characterize both the inherent pixel correlations and the noise distribution, shaping into our probabilistic self-learning (PSL) framework. The AAPM Low-dose CT Challenge dataset was used to train the network. Both simulated datasets and real dataset were employed to test the denoising performance as well as the model generalizability. The performance was compared to a conventional method (total variation (TV)-based), a popular self-learning method (noise2void (N2V)), and a well-known unsupervised learning method (CycleGAN) by using both qualitative visual inspection and quantitative metrics including peak signal-noise-ratio (PSNR), structural similarity index (SSIM) and contrast-to-noise-ratio (CNR). The standard deviations (STD) of selected flat regions were also calculated for comparison. Results: The PSL method can improve the averaged PSNR/SSIM values from 27.61/0.5939 (LDCT) to 30.50/0.6797. By contrast, the averaged PSNR/SSIM values were 31.49/0.7284 (TV), 29.43/ 0.6699 (N2V), and 29.79/0.6992 (CycleGAN). The averaged STDs of selected flat regions were calculated to be 132.3 HU (LDCT), 25.77 HU (TV), 19.95 HU (N2V), 75.06 HU (CycleGAN), 60.62 HU (PSL) and 57.28 HU (NDCT). As for the low-contrast lesion detectability quantification, the CNR were calculated to be 0.202 (LDCT), 0.356 (TV), 0.372 (N2V), 0.383 (CycleGAN), 0.399 (PSL), and 0.359 (NDCT). By visual inspection, we observed that the proposed PSL method can deliver a noise-suppressed and detail-preserved image, while the TV-based method would lead to the blocky artifact, the N2V method would produce over-smoothed structures and CT value biased effect, and the CycleGAN method would generate slightly noisy results with inaccurate CT values. We also verified the generalizability of the PSL method, which exhibited superior denoising performance among various testing datasets with different data distribution shifts. Conclusions: A deep learning-based convolutional neural network can be trained without paired datasets. Qualitatively visual inspection showed the proposed PSL method can achieve superior denoising performance than all the competitors, despite that the employed quantitative metrics in terms of PS...
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