Artifact correction in low‐dose dental CT imaging using Wasserstein generative adversarial networks

The Impact of AI on Metal Artifacts in CBCT Oral Cavity Imaging

OBJECTIVE

This study aimed to assess the impact of artificial intelligence (AI)-driven noise reduction algorithms on metal artifacts and image quality parameters in cone-beam computed tomography (CBCT) images of the oral cavity.

MATERIALS AND METHODS

This retrospective study included 70 patients, 61 of whom were analyzed after excluding those with severe motion artifacts. CBCT scans, performed using a Hyperion X9 PRO 13 × 10 CBCT machine, included images with dental implants, amalgam fillings, orthodontic appliances, root canal fillings, and crowns. Images were processed with the ClariCT.AI deep learning model (DLM) for noise reduction. Objective image quality was assessed using metrics such as the differentiation between voxel values (ΔVVs), the artifact index (AIx), and the contrast-to-noise ratio (CNR). Subjective assessments were performed by two experienced readers, who rated overall image quality and artifact intensity on predefined scales.

RESULTS

Compared with native images, DLM reconstructions significantly reduced the AIx and increased the CNR (p < 0.001), indicating improved image clarity and artifact reduction. Subjective assessments also favored DLM images, with higher ratings for overall image quality and lower artifact intensity (p < 0.001). However, the ΔVV values were similar between the native and DLM images, indicating that while the DLM reduced noise, it maintained the overall density distribution. Orthodontic appliances produced the most pronounced artifacts, while implants generated the least.

CONCLUSIONS

AI-based noise reduction using ClariCT.AI significantly enhances CBCT image quality by reducing noise and metal artifacts, thereby improving diagnostic accuracy and treatment planning. Further research with larger, multicenter cohorts is recommended to validate these findings.

Generative adversarial networks in dental imaging: a systematic review

OBJECTIVES

This systematic review on generative adversarial network (GAN) architectures for dental image analysis provides a comprehensive overview to readers regarding current GAN trends in dental imagery and potential future applications.

METHODS

Electronic databases (PubMed/MEDLINE, Scopus, Embase, and Cochrane Library) were searched to identify studies involving GANs for dental image analysis. Eighteen full-text articles describing the applications of GANs in dental imagery were reviewed. Risk of bias and applicability concerns were assessed using the QUADAS-2 tool.

RESULTS

GANs were used for various imaging modalities, including two-dimensional and three-dimensional images. In dental imaging, GANs were utilized for tasks such as artifact reduction, denoising, and super-resolution, domain transfer, image generation for augmentation, outcome prediction, and identification. The generated images were incorporated into tasks such as landmark detection, object detection and classification. Because of heterogeneity among the studies, a meta-analysis could not be conducted. Most studies (72%) had a low risk of bias in all four domains. However, only three (17%) studies had a low risk of applicability concerns.

CONCLUSIONS

This extensive analysis of GANs in dental imaging highlighted their broad application potential within the dental field. Future studies should address limitations related to the stability, repeatability, and overall interpretability of GAN architectures. By overcoming these challenges, the applicability of GANs in dentistry can be enhanced, ultimately benefiting the dental field in its use of GANs and artificial intelligence.

Noise-Optimized CBCT Imaging of Temporomandibular Joints-The Impact of AI on Image Quality

Background: Temporomandibular joint disorder (TMD) is a common medical condition. Cone beam computed tomography (CBCT) is effective in assessing TMD-related bone changes, but image noise may impair diagnosis. Emerging deep learning reconstruction algorithms (DLRs) could minimize noise and improve CBCT image clarity. This study compares standard and deep learning-enhanced CBCT images for image quality in detecting osteoarthritis-related degeneration in TMJs (temporomandibular joints). This study analyzed CBCT images of patients with suspected temporomandibular joint degenerative joint disease (TMJ DJD). Methods: The DLM reconstructions were performed with ClariCT.AI software. Image quality was evaluated objectively via CNR in target areas and subjectively by two experts using a five-point scale. Both readers also assessed TMJ DJD lesions. The study involved 50 patients with a mean age of 28.29 years. Results: Objective analysis revealed a significantly better image quality in DLM reconstructions (CNR levels; p < 0.001). Subjective assessment showed high inter-reader agreement (κ = 0.805) but no significant difference in image quality between the reconstruction types (p = 0.055). Lesion counts were not significantly correlated with the reconstruction type (p > 0.05). Conclusions: The analyzed DLM reconstruction notably enhanced the objective image quality in TMJ CBCT images but did not significantly alter the subjective quality or DJD lesion diagnosis. However, the readers favored DLM images, indicating the potential for better TMD diagnosis with CBCT, meriting more study.

A Review of deep learning methods for denoising of medical low-dose CT images

To prevent patients from being exposed to excess of radiation in CT imaging, the most common solution is to decrease the radiation dose by reducing the X-ray, and thus the quality of the resulting low-dose CT images (LDCT) is degraded, as evidenced by more noise and streaking artifacts. Therefore, it is important to maintain high quality CT image while effectively reducing radiation dose. In recent years, with the rapid development of deep learning technology, deep learning-based LDCT denoising methods have become quite popular because of their data-driven and high-performance features to achieve excellent denoising results. However, to our knowledge, no relevant article has so far comprehensively introduced and reviewed advanced deep learning denoising methods such as Transformer structures in LDCT denoising tasks. Therefore, based on the literatures related to LDCT image denoising published from year 2016-2023, and in particular from 2020 to 2023, this study presents a systematic survey of current situation, and challenges and future research directions in LDCT image denoising field. Four types of denoising networks are classified according to the network structure: CNN-based, Encoder-Decoder-based, GAN-based, and Transformer-based denoising networks, and each type of denoising network is described and summarized from the perspectives of structural features and denoising performances. Representative deep-learning denoising methods for LDCT are experimentally compared and analyzed. The study results show that CNN-based denoising methods capture image details efficiently through multi-level convolution operation, demonstrating superior denoising effects and adaptivity. Encoder-decoder networks with MSE loss, achieve outstanding results in objective metrics. GANs based methods, employing innovative generators and discriminators, obtain denoised images that exhibit perceptually a closeness to NDCT. Transformer-based methods have potential for improving denoising performances due to their powerful capability in capturing global information. Challenges and opportunities for deep learning based LDCT denoising are analyzed, and future directions are also presented.

Deep learning-based tooth segmentation methods in medical imaging: A review

Deep learning approaches for tooth segmentation employ convolutional neural networks (CNNs) or Transformers to derive tooth feature maps from extensive training datasets. Tooth segmentation serves as a critical prerequisite for clinical dental analysis and surgical procedures, enabling dentists to comprehensively assess oral conditions and subsequently diagnose pathologies. Over the past decade, deep learning has experienced significant advancements, with researchers introducing efficient models such as U-Net, Mask R-CNN, and Segmentation Transformer (SETR). Building upon these frameworks, scholars have proposed numerous enhancement and optimization modules to attain superior tooth segmentation performance. This paper discusses the deep learning methods of tooth segmentation on dental panoramic radiographs (DPRs), cone-beam computed tomography (CBCT) images, intro oral scan (IOS) models, and others. Finally, we outline performance-enhancing techniques and suggest potential avenues for ongoing research. Numerous challenges remain, including data annotation and model generalization limitations. This paper offers insights for future tooth segmentation studies, potentially facilitating broader clinical adoption.

Unpaired low-dose computed tomography image denoising using a progressive cyclical convolutional neural network

BACKGROUND

Reducing the radiation dose from computed tomography (CT) can significantly reduce the radiation risk to patients. However, low-dose CT (LDCT) suffers from severe and complex noise interference that affects subsequent diagnosis and analysis. Recently, deep learning-based methods have shown superior performance in LDCT image-denoising tasks. However, most methods require many normal-dose and low-dose CT image pairs, which are difficult to obtain in clinical applications. Unsupervised methods, on the other hand, are more general.

PURPOSE

Deep learning methods based on GAN networks have been widely used for unsupervised LDCT denoising, but the additional memory requirements of the model also hinder its further clinical application. To this end, we propose a simpler multi-stage denoising framework trained using unpaired data, the progressive cyclical convolutional neural network (PCCNN), which can remove the noise from CT images in latent space.

METHODS

Our proposed PCCNN introduces a noise transfer model that transfers noise from LDCT to normal-dose CT (NDCT), denoised CT images generated from unpaired CT images, and noisy CT images. The denoising framework also contains a progressive module that effectively removes noise through multi-stage wavelet transforms without sacrificing high-frequency components such as edges and details.

RESULTS

Compared with seven LDCT denoising algorithms, we perform a quantitative and qualitative evaluation of the experimental results and perform ablation experiments on each network module and loss function. On the AAPM dataset, compared with the contrasted unsupervised methods, our denoising framework has excellent denoising performance increasing the peak signal-to-noise ratio (PSNR) from 29.622 to 30.671, and the structural similarity index (SSIM) was increased from 0.8544 to 0.9199. The PCCNN denoising results were relatively optimal and statistically significant. In the qualitative result comparison, PCCNN without introducing additional blurring and artifacts, the resulting image has higher resolution and complete detail preservation, and the overall structural texture of the image is closer to NDCT. In visual assessments, PCCNN achieves a relatively balanced result in noise suppression, contrast retention, and lesion discrimination.

CONCLUSIONS

Extensive experimental validation shows that our scheme achieves reconstruction results comparable to supervised learning methods and has performed well in image quality and medical diagnostic acceptability.

Deep learning and artificial intelligence in dental diagnostic imaging

The application of artificial intelligence (AI) based on deep learning in dental diagnostic imaging is increasing. Several popular deep learning tasks have been applied to dental diagnostic images. Classification tasks are used to classify images with and without positive abnormal findings or to evaluate the progress of a lesion based on imaging findings. Region (object) detection and segmentation tasks have been used for tooth identification in panoramic radiographs. This technique is useful for automatically creating a patient's dental chart. Deep learning methods can also be used for detecting and evaluating anatomical structures of interest from images. Furthermore, generative AI based on natural language processing can automatically create written reports from the findings of diagnostic imaging.

Evaluating the performance of generative adversarial network-synthesized periapical images in classifying C-shaped root canals

This study evaluated the performance of generative adversarial network (GAN)-synthesized periapical images for classifying C-shaped root canals, which are challenging to diagnose because of their complex morphology. GANs have emerged as a promising technique for generating realistic images, offering a potential solution for data augmentation in scenarios with limited training datasets. Periapical images were synthesized using the StyleGAN2-ADA framework, and their quality was evaluated based on the average Frechet inception distance (FID) and the visual Turing test. The average FID was found to be 35.353 (± 4.386) for synthesized C-shaped canal images and 25.471 (± 2.779) for non C-shaped canal images. The visual Turing test conducted by two radiologists on 100 randomly selected images revealed that distinguishing between real and synthetic images was difficult. These results indicate that GAN-synthesized images exhibit satisfactory visual quality. The classification performance of the neural network, when augmented with GAN data, showed improvements compared with using real data alone, and could be advantageous in addressing data conditions with class imbalance. GAN-generated images have proven to be an effective data augmentation method, addressing the limitations of limited training data and computational resources in diagnosing dental anomalies.

MLNAN: Multi-level noise-aware network for low-dose CT imaging implemented with constrained cycle Wasserstein generative adversarial networks

Low-dose CT techniques attempt to minimize the radiation exposure of patients by estimating the high-resolution normal-dose CT images to reduce the risk of radiation-induced cancer. In recent years, many deep learning methods have been proposed to solve this problem by building a mapping function between low-dose CT images and their high-dose counterparts. However, most of these methods ignore the effect of different radiation doses on the final CT images, which results in large differences in the intensity of the noise observable in CT images. What'more, the noise intensity of low-dose CT images exists significantly differences under different medical devices manufacturers. In this paper, we propose a multi-level noise-aware network (MLNAN) implemented with constrained cycle Wasserstein generative adversarial networks to recovery the low-dose CT images under uncertain noise levels. Particularly, the noise-level classification is predicted and reused as a prior pattern in generator networks. Moreover, the discriminator network introduces noise-level determination. Under two dose-reduction strategies, experiments to evaluate the performance of proposed method are conducted on two datasets, including the simulated clinical AAPM challenge datasets and commercial CT datasets from United Imaging Healthcare (UIH). The experimental results illustrate the effectiveness of our proposed method in terms of noise suppression and structural detail preservation compared with several other deep-learning based methods. Ablation studies validate the effectiveness of the individual components regarding the afforded performance improvement. Further research for practical clinical applications and other medical modalities is required in future works.

Self-adaption and texture generation: A hybrid loss function for low-dose CT denoising

BACKGROUND

Deep learning has been successfully applied to low-dose CT (LDCT) denoising. But the training of the model is very dependent on an appropriate loss function. Existing denoising models often use per-pixel loss, including mean abs error (MAE) and mean square error (MSE). This ignores the difference in denoising difficulty between different regions of the CT images and leads to the loss of large texture information in the generated image.

PURPOSE

In this paper, we propose a new hybrid loss function that adapts to the noise in different regions of CT images to balance the denoising difficulty and preserve texture details, thus acquiring CT images with high-quality diagnostic value using LDCT images, providing strong support for condition diagnosis.

METHODS

We propose a hybrid loss function consisting of weighted patch loss (WPLoss) and high-frequency information loss (HFLoss). To enhance the model's denoising ability of the local areas which are difficult to denoise, we improve the MAE to obtain WPLoss. After the generated image and the target image are divided into several patches, the loss weight of each patch is adaptively and dynamically adjusted according to its loss ratio. In addition, considering that texture details are contained in the high-frequency information of the image, we use HFLoss to calculate the difference between CT images in the high-frequency information part.

RESULTS

Our hybrid loss function improves the denoising performance of several models in the experiment, and obtains a higher peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM). Moreover, through visual inspection of the generated results of the comparison experiment, the proposed hybrid function can effectively suppress noise and retain image details.

CONCLUSIONS

We propose a hybrid loss function for LDCT image denoising, which has good interpretation properties and can improve the denoising performance of existing models. And the validation results of multiple models using different datasets show that it has good generalization ability. By using this loss function, high-quality CT images with low radiation are achieved, which can avoid the hazards caused by radiation and ensure the disease diagnosis for patients.

Medical image super-resolution reconstruction algorithms based on deep learning: A survey

BACKGROUND AND OBJECTIVE

With the high-resolution (HR) requirements of medical images in clinical practice, super-resolution (SR) reconstruction algorithms based on low-resolution (LR) medical images have become a research hotspot. This type of method can significantly improve image SR without improving hardware equipment, so it is of great significance to review it.

METHODS

Aiming at the unique SR reconstruction algorithms in the field of medical images, based on subdivided medical fields such as magnetic resonance (MR) images, computed tomography (CT) images, and ultrasound images. Firstly, we deeply analyzed the research progress of SR reconstruction algorithms, and summarized and compared the different types of algorithms. Secondly, we introduced the evaluation indicators corresponding to the SR reconstruction algorithms. Finally, we prospected the development trend of SR reconstruction technology in the medical field.

RESULTS

The medical image SR reconstruction technology based on deep learning can provide more abundant lesion information, relieve the expert's diagnosis pressure, and improve the diagnosis efficiency and accuracy.

CONCLUSION

The medical image SR reconstruction technology based on deep learning helps to improve the quality of medicine, provides help for the diagnosis of experts, and lays a solid foundation for the subsequent analysis and identification tasks of the computer, which is of great significance for improving the diagnosis efficiency of experts and realizing intelligent medical care.

Machine Learning in Dentistry: A Scoping Review

Machine learning (ML) is being increasingly employed in dental research and application. We aimed to systematically compile studies using ML in dentistry and assess their methodological quality, including the risk of bias and reporting standards. We evaluated studies employing ML in dentistry published from 1 January 2015 to 31 May 2021 on MEDLINE, IEEE Xplore, and arXiv. We assessed publication trends and the distribution of ML tasks (classification, object detection, semantic segmentation, instance segmentation, and generation) in different clinical fields. We appraised the risk of bias and adherence to reporting standards, using the QUADAS-2 and TRIPOD checklists, respectively. Out of 183 identified studies, 168 were included, focusing on various ML tasks and employing a broad range of ML models, input data, data sources, strategies to generate reference tests, and performance metrics. Classification tasks were most common. Forty-two different metrics were used to evaluate model performances, with accuracy, sensitivity, precision, and intersection-over-union being the most common. We observed considerable risk of bias and moderate adherence to reporting standards which hampers replication of results. A minimum (core) set of outcome and outcome metrics is necessary to facilitate comparisons across studies.

Personalized dental medicine, artificial intelligence, and their relevance for dentomaxillofacial imaging

Personalized medicine refers to the tailoring of diagnostics and therapeutics to individuals based on one's biological, social, and behavioral characteristics. While personalized dental medicine is still far from being a reality, advanced artificial intelligence (AI) technologies with improved data analytic approaches are expected to integrate diverse data from the individual, setting, and system levels, which may facilitate a deeper understanding of the interaction of these multilevel data and therefore bring us closer to more personalized, predictive, preventive, and participatory dentistry, also known as P4 dentistry. In the field of dentomaxillofacial imaging, a wide range of AI applications, including several commercially available software options, have been proposed to assist dentists in the diagnosis and treatment planning of various dentomaxillofacial diseases, with performance similar or even superior to that of specialists. Notably, the impact of these dental AI applications on treatment decision, clinical and patient-reported outcomes, and cost-effectiveness has so far been assessed sparsely. Such information should be further investigated in future studies to provide patients, providers, and healthcare organizers a clearer picture of the true usefulness of AI in daily dental practice.

Segmentation-guided Denoising Network for Low-dose CT Imaging

BACKGROUND

To reduce radiation exposure and improve diagnosis in low-dose computed tomography, several deep learning (DL)-based image denoising methods have been proposed to suppress noise and artifacts over the past few years. However, most of them seek an objective data distribution approximating the gold standard and neglect structural semantic preservation. Moreover, the numerical response in CT images presents substantial regional anatomical differences among tissues in terms of X-ray absorbency.

METHODS

In this paper, we introduce structural semantic information for low-dose CT imaging. First, the regional segmentation prior to low-dose CT can guide the denoising process. Second the structural semantical results can be considered as evaluation metrics on the estimated normal-dose CT images. Then, a semantic feature transform is engaged to combine the semantic and image features on a semantic fusion module. In addition, the structural semantic loss function is introduced to measure the segmentation difference.

RESULTS

Experiments are conducted on clinical abdomen data obtained from a clinical hospital, and the semantic labels consist of subcutaneous fat, muscle and visceral fat associated with body physical evaluation. Compared with other DL-based methods, the proposed method achieves better performance on quantitative metrics and better semantic evaluation.

CONCLUSIONS

The quantitative experimental results demonstrate the promising performance of the proposed methods in noise reduction and structural semantic preservation. While, the proposed method may suffer from several limitations on abnormalities, unknown noise and different manufacturers. In the future, the proposed method will be further explored, and wider applications in PET/CT and PET/MR will be sought.

Improving image quality and lung nodule detection for low-dose chest CT by using generative adversarial network reconstruction

OBJECTIVES

To investigate the improvement of two denoising models with different learning targets (Dir and Res) of generative adversarial network (GAN) on image quality and lung nodule detectability in chest low-dose CT (LDCT).

METHODS

In training phase, by using LDCT images simulated from standard dose CT (SDCT) of 200 participants, Dir model was trained targeting SDCT images, while Res model targeting the residual between SDCT and LDCT images. In testing phase, a phantom and 95 chest LDCT, exclusively with training data, were included for evaluation of imaging quality and pulmonary nodules detectability.

RESULTS

For phantom images, structural similarity, peak signal-to-noise ratio of both Res and Dir models were higher than that of LDCT. Standard deviation of Res model was the lowest. For patient images, image noise and quality of both two models, were better than that of LDCT. Artifacts of Res model was less than that of LDCT. The diagnostic sensitivity of lung nodule by two readers for LDCT, Res and Dir model, were 72/77%, 79/83% and 72/79% respectively.

CONCLUSION

Two GAN denoising models, including Res and Dir trained with different targets, could effectively reduce image noise of chest LDCT. The image quality evaluation scoring and nodule detectability of Res denoising model was better than that of Dir denoising model and that of hybrid IR images.

ADVANCES IN KNOWLEDGE

The GAN-trained model, which learned the residual between SDCT and LDCT images, reduced image noise and increased the lung nodule detectability by radiologists on chest LDCT. This demonstrates the potential for clinical benefit.

The use of deep learning methods in low-dose computed tomography image reconstruction: a systematic review

Conventional reconstruction techniques, such as filtered back projection (FBP) and iterative reconstruction (IR), which have been utilised widely in the image reconstruction process of computed tomography (CT) are not suitable in the case of low-dose CT applications, because of the unsatisfying quality of the reconstructed image and inefficient reconstruction time. Therefore, as the demand for CT radiation dose reduction continues to increase, the use of artificial intelligence (AI) in image reconstruction has become a trend that attracts more and more attention. This systematic review examined various deep learning methods to determine their characteristics, availability, intended use and expected outputs concerning low-dose CT image reconstruction. Utilising the methodology of Kitchenham and Charter, we performed a systematic search of the literature from 2016 to 2021 in Springer, Science Direct, arXiv, PubMed, ACM, IEEE, and Scopus. This review showed that algorithms using deep learning technology are superior to traditional IR methods in noise suppression, artifact reduction and structure preservation, in terms of improving the image quality of low-dose reconstructed images. In conclusion, we provided an overview of the use of deep learning approaches in low-dose CT image reconstruction together with their benefits, limitations, and opportunities for improvement.

Cone-Beam Angle Dependency of 3D Models Computed from Cone-Beam CT Images

Cone-beam dental CT can provide high-precision 3D images of the teeth and surrounding bones. From the 3D CT images, 3D models, also called digital impressions, can be computed for CAD/CAM-based fabrication of dental restorations or orthodontic devices. However, the cone-beam angle-dependent artifacts, mostly caused by the incompleteness of the projection data acquired in the circular cone-beam scan geometry, can induce significant errors in the 3D models. Using a micro-CT, we acquired CT projection data of plaster cast models at several different cone-beam angles, and we investigated the dependency of the model errors on the cone-beam angle in comparison with the reference models obtained from the optical scanning of the plaster models. For the 3D CT image reconstruction, we used the conventional Feldkamp algorithm and the combined half-scan image reconstruction algorithm to investigate the dependency of the model errors on the image reconstruction algorithm. We analyzed the mean of positive deviations and the mean of negative deviations of the surface points on the CT-image-derived 3D models from the reference model, and we compared them between the two image reconstruction algorithms. It has been found that the model error increases as the cone-beam angle increases in both algorithms. However, the model errors are smaller in the combined half-scan image reconstruction when the cone-beam angle is as large as 10 degrees.

Application of generative adversarial networks (GAN) for ophthalmology image domains: a survey

BACKGROUND

Recent advances in deep learning techniques have led to improved diagnostic abilities in ophthalmology. A generative adversarial network (GAN), which consists of two competing types of deep neural networks, including a generator and a discriminator, has demonstrated remarkable performance in image synthesis and image-to-image translation. The adoption of GAN for medical imaging is increasing for image generation and translation, but it is not familiar to researchers in the field of ophthalmology. In this work, we present a literature review on the application of GAN in ophthalmology image domains to discuss important contributions and to identify potential future research directions.

METHODS

We performed a survey on studies using GAN published before June 2021 only, and we introduced various applications of GAN in ophthalmology image domains. The search identified 48 peer-reviewed papers in the final review. The type of GAN used in the analysis, task, imaging domain, and the outcome were collected to verify the usefulness of the GAN.

RESULTS

In ophthalmology image domains, GAN can perform segmentation, data augmentation, denoising, domain transfer, super-resolution, post-intervention prediction, and feature extraction. GAN techniques have established an extension of datasets and modalities in ophthalmology. GAN has several limitations, such as mode collapse, spatial deformities, unintended changes, and the generation of high-frequency noises and artifacts of checkerboard patterns.

CONCLUSIONS

The use of GAN has benefited the various tasks in ophthalmology image domains. Based on our observations, the adoption of GAN in ophthalmology is still in a very early stage of clinical validation compared with deep learning classification techniques because several problems need to be overcome for practical use. However, the proper selection of the GAN technique and statistical modeling of ocular imaging will greatly improve the performance of each image analysis. Finally, this survey would enable researchers to access the appropriate GAN technique to maximize the potential of ophthalmology datasets for deep learning research.

Postoperative Curative Effect of Cardiac Surgery Diagnosed by Compressed Sensing Algorithm-Based E-Health CT Image Information and Effect of Baduanjin Exercise on Cardiac Autonomic Nerve Function of Patients

This research was aimed at exploring the effect of CT images reconstructed by optimized compressed sensing algorithm on postoperative diagnosis of patients with hypertensive heart disease and the influence of Baduanjin on cardiac autonomic nerve function. Based on the compressed sensing algorithm, the maximum likelihood expectation maximization algorithm was introduced to optimize it, and the optimization algorithm was established. The optimized algorithm and filtered back projection algorithm (FBP) were compared regarding the root mean squared error (RMSE), peak signal-to-noise ratio (PSNR), and structural similar image metric (SSIM). A total of 126 patients with hypertensive heart disease who underwent CT examination in the hospital were selected as study subjects. According to whether Baduanjin intervention was adopted, patients were divided into observation group (conventional treatment +Baduanjin) and control group (conventional treatment), with 63 patients in each group. The effect of CT examination on postoperative diagnosis was analyzed. Systolic blood pressure (SBP), diastolic blood pressure (DBP), differential pressure (DP), respiratory rate and heart rate (HR), very low-frequency (VLF) power, low-frequency (LF) power, high-frequency (HF) power, total power (TP) of HR variability, and changes in LF/HF of patients before and after treatment were compared. The RMSE of the compressed sensing optimization algorithm (3.28 ± 0.36) was significantly lower than that of the FBP algorithm (9.25 ± 1.03) (P < 0.05). The SSIM and PNSR of the compressed sensing optimization algorithm were (0.87 ± 0.10) and (21.22 ± 1.60) dB, respectively. The SSIM was significantly higher than the FBP algorithm (P < 0.01), and the PNSR was also higher than the FBP algorithm (P < 0.05). The detection rate of CT for pleural effusion was 16 cases (25.40%) higher than 5 cases (7.94%) with TTE (P < 0.01). After treatment, SBP, DBP, HR, LF, VLF, LF/HF, and DP values in the observation group were lower than those in the control group (P < 0.05), and TP and HF were higher than those in the control group (P < 0.05). It suggested that a novel algorithm was established based on compressed sensing algorithm to improve image quality. CT image had important guiding significance for postoperative diagnosis of heart. Baduanjin intervention could improve the integrated function of patient's autonomic nervous system and the regulation ability of the vagus nerve.

The synthesis of high-energy CT images from low-energy CT images using an improved cycle generative adversarial network

Background

The dose of radiation a patient receives when undergoing dual-energy computed tomography (CT) is of significant concern to the medical community, and balancing the tradeoffs between the level of radiation used and the quality of CT images is challenging. This paper proposes a method of synthesizing high-energy CT (HECT) images from low-energy CT (LECT) images using a neural network that achieves an alternative to HECT scanning by employing an LECT scan, which greatly reduces the radiation dose a patient receives.

Methods

In the training phase, the proposed structure cyclically generates HECT and LECT images to improve the accuracy of extracting edge and texture features. Specifically, we combine multiple connection methods with channel attention (CA) and pixel attention (PA) mechanisms to improve the network's mapping ability of image features. In the prediction phase, we use a model consisting of only the network component that synthesizes HECT images from LECT images.

Results

Our proposed method was conducted on clinical hip CT image data sets from Guizhou Provincial People's Hospital. In a comparison with other available methods [a generative adversarial network (GAN), a residual encoder-to-decoder network with a visual geometry group (VGG) pretrained model (RED-VGG), a Wasserstein GAN (WGAN), and CycleGAN] in terms of metrics of peak signal-to-noise ratio (PSNR), structural similarity index measure (SSIM), normalized mean square error (NMSE), and a visual effect evaluation, the proposed method was found to perform better on each of these evaluation criteria. Compared with the results produced by CycleGAN, the proposed method improved the PSNR by 2.44%, the SSIM by 1.71%, and the NMSE by 15.2%. Furthermore, the differences in the statistical indicators are statistically significant, proving the strength of the proposed method.

Conclusions

The proposed method synthesizes high-energy CT images from low-energy CT images, which significantly reduces both the cost of treatment and the radiation dose received by patients. Based on both image quality score metrics and visual effects comparisons, the results of the proposed method are superior to those obtained by other methods.

How Machine Learning is Powering Neuroimaging to Improve Brain Health

This report presents an overview of how machine learning is rapidly advancing clinical translational imaging in ways that will aid in the early detection, prediction, and treatment of diseases that threaten brain health. Towards this goal, we aresharing the information presented at a symposium, "Neuroimaging Indicators of Brain Structure and Function - Closing the Gap Between Research and Clinical Application", co-hosted by the McCance Center for Brain Health at Mass General Hospital and the MIT HST Neuroimaging Training Program on February 12, 2021. The symposium focused on the potential for machine learning approaches, applied to increasingly large-scale neuroimaging datasets, to transform healthcare delivery and change the trajectory of brain health by addressing brain care earlier in the lifespan. While not exhaustive, this overview uniquely addresses many of the technical challenges from image formation, to analysis and visualization, to synthesis and incorporation into the clinical workflow. Some of the ethical challenges inherent to this work are also explored, as are some of the regulatory requirements for implementation. We seek to educate, motivate, and inspire graduate students, postdoctoral fellows, and early career investigators to contribute to a future where neuroimaging meaningfully contributes to the maintenance of brain health.

Applications of artificial intelligence in dentistry: A comprehensive review

OBJECTIVE

To perform a comprehensive review of the use of artificial intelligence (AI) and machine learning (ML) in dentistry, providing the community with a broad insight on the different advances that these technologies and tools have produced, paying special attention to the area of esthetic dentistry and color research.

MATERIALS AND METHODS

The comprehensive review was conducted in MEDLINE/PubMed, Web of Science, and Scopus databases, for papers published in English language in the last 20 years.

RESULTS

Out of 3871 eligible papers, 120 were included for final appraisal. Study methodologies included deep learning (DL; n = 76), fuzzy logic (FL; n = 12), and other ML techniques (n = 32), which were mainly applied to disease identification, image segmentation, image correction, and biomimetic color analysis and modeling.

CONCLUSIONS

The insight provided by the present work has reported outstanding results in the design of high-performance decision support systems for the aforementioned areas. The future of digital dentistry goes through the design of integrated approaches providing personalized treatments to patients. In addition, esthetic dentistry can benefit from those advances by developing models allowing a complete characterization of tooth color, enhancing the accuracy of dental restorations.

CLINICAL SIGNIFICANCE

The use of AI and ML has an increasing impact on the dental profession and is complementing the development of digital technologies and tools, with a wide application in treatment planning and esthetic dentistry procedures.

InNetGAN: Inception Network-Based Generative Adversarial Network for Denoising Low-Dose Computed Tomography

Low-dose Computed Tomography (LDCT) has gained a great deal of attention in clinical procedures due to its ability to reduce the patient's risk of exposure to the X-ray radiation. However, reducing the X-ray dose increases the quantum noise and artifacts in the acquired LDCT images. As a result, it produces visually low-quality LDCT images that adversely affect the disease diagnosing and treatment planning in clinical procedures. Deep Learning (DL) has recently become the cutting-edge technology of LDCT denoising due to its high performance and data-driven execution compared to conventional denoising approaches. Although the DL-based models perform fairly well in LDCT noise reduction, some noise components are still retained in denoised LDCT images. One reason for this noise retention is the direct transmission of feature maps through the skip connections of contraction and extraction path-based DL modes. Therefore, in this study, we propose a Generative Adversarial Network with Inception network modules (InNetGAN) as a solution for filtering the noise transmission through skip connections and preserving the texture and fine structure of LDCT images. The proposed Generator is modeled based on the U-net architecture. The skip connections in the U-net architecture are modified with three different inception network modules to filter out the noise in the feature maps passing over them. The quantitative and qualitative experimental results have shown the performance of the InNetGAN model in reducing noise and preserving the subtle structures and texture details in LDCT images compared to the other state-of-the-art denoising algorithms.

Learning a Deep CNN Denoising Approach Using Anatomical Prior Information Implemented With Attention Mechanism for Low-Dose CT Imaging on Clinical Patient Data From Multiple Anatomical Sites

Dose reduction in computed tomography (CT) has gained considerable attention in clinical applications because it decreases radiation risks. However, a lower dose generates noise in low-dose computed tomography (LDCT) images. Previous deep learning (DL)-based works have investigated ways to improve diagnostic performance to address this ill-posed problem. However, most of them disregard the anatomical differences among different human body sites in constructing the mapping function between LDCT images and their high-resolution normal-dose CT (NDCT) counterparts. In this article, we propose a novel deep convolutional neural network (CNN) denoising approach by introducing information of the anatomical prior. Instead of designing multiple networks for each independent human body anatomical site, a unified network framework is employed to process anatomical information. The anatomical prior is represented as a pattern of weights of the features extracted from the corresponding LDCT image in an anatomical prior fusion module. To promote diversity in the contextual information, a spatial attention fusion mechanism is introduced to capture many local regions of interest in the attention fusion module. Although many network parameters are saved, the experimental results demonstrate that our method, which incorporates anatomical prior information, is effective in denoising LDCT images. Furthermore, the anatomical prior fusion module could be conveniently integrated into other DL-based methods and avails the performance improvement on multiple anatomical data.

Contrast-enhanced to noncontrast CT transformation via an adjacency content-transfer-based deep subtraction residual neural network

To reduce overall patient radiation exposure in some clinical scenarios (since cancer patients need frequent follow-ups), noncontrast CT is not used in some institutions. However, although less desirable, noncontrast CT could provide additional important information. In this article, we propose a deep subtraction residual network based on adjacency content transfer to reconstruct noncontrast CT from contrast CT and maintain image quality comparable to that of a CT scan originally acquired without contrast. To address the slight structural dissimilarity of the paired CT images (noncontrast CT and contrast CT) due to involuntary physiological motion, we introduce a contrastive loss network derived from the adjacency content-transfer strategy. We evaluate the results of various similarity metrics (MSE, SSIM, NRMSE, PSNR, MAE) and the fitting curve (HU distribution) of the output mapping to estimate the reconstruction performance of the algorithm. To build the model, we randomly select a total of 15,405 CT paired images (noncontrast CT and contrast-enhanced CT) for training and 10,270 CT paired images for testing. The proposed algorithm preserves the robust structures from the contrast-enhanced CT scans and learns the noncontrast attenuation pattern from the noncontrast CT scans. During the evaluation, the deep subtraction residual network achieves higher MSE, MAE, NRMSE, and PSNR scores (by 30%) than those of the baseline models (BEGAN, CycleGAN, Pixel2Pixel) and better simulates the HU curve of noncontrast CT attenuation. After validation based on an analysis of the experimental results, we can report that the noncontrast CT images reconstructed by our proposed algorithm not only preserve the high-quality structures from the contrast-enhanced CT images, but also mimic the CT attenuation of the originally acquired noncontrast CT images.

Deep Convolutional Neural Network With Adversarial Training for Denoising Digital Breast Tomosynthesis Images

Digital breast tomosynthesis (DBT) is a quasi-three-dimensional imaging modality that can reduce false negatives and false positives in mass lesion detection caused by overlapping breast tissue in conventional two-dimensional (2D) mammography. The patient dose of a DBT scan is similar to that of a single 2D mammogram, while acquisition of each projection view adds detector readout noise. The noise is propagated to the reconstructed DBT volume, possibly obscuring subtle signs of breast cancer such as microcalcifications (MCs). This study developed a deep convolutional neural network (DCNN) framework for denoising DBT images with a focus on improving the conspicuity of MCs as well as preserving the ill-defined margins of spiculated masses and normal tissue textures. We trained the DCNN using a weighted combination of mean squared error (MSE) loss and adversarial loss. We configured a dedicated x-ray imaging simulator in combination with digital breast phantoms to generate realistic in silico DBT data for training. We compared the DCNN training between using digital phantoms and using real physical phantoms. The proposed denoising method improved the contrast-to-noise ratio (CNR) and detectability index (d') of the simulated MCs in the validation phantom DBTs. These performance measures improved with increasing training target dose and training sample size. Promising denoising results were observed on the transferability of the digital-phantom-trained denoiser to DBT reconstructed with different techniques and on a small independent test set of human subject DBT images.

Synthesizing PET/MR (T1-weighted) images from non-attenuation-corrected PET images

Positron emission tomography (PET) imaging can be used for early detection, diagnosis and postoperative patient monitoring of many diseases. Traditional PET imaging requires not only additional computed tomography (CT) imaging or magnetic resonance imaging (MR) to provide anatomical information but also attenuation correction (AC) map calculation based on CT images or MR images for accurate quantitative estimation. During a patient's treatment, PET/CT or PET/MR scans are inevitably repeated many times, leading to additional doses of ionizing radiation (CT scans) and additional economic and time costs (MR scans). To reduce adverse effects while obtaining high-quality PET/MR images in the course of a patient's treatment, especially in the stage of evaluating the effect of postoperative treatment, in this work, we propose a new method based on deep learning, which can directly obtain synthetic attenuation-corrected PET (sAC PET) and synthetic T1-weighted MR (sMR) images based only on non-attenuation-corrected PET (NAC PET) images. Our model, based on the Wasserstein generative adversarial network, first removes noise and artifacts from the NAC PET images to generate sAC PET images and then generates sMR images from the obtained sAC PET images. To evaluate the performance of this generative model, we evaluated it on paired PET/MR images from a total of eighty clinical patients. Based on qualitative and quantitative analysis, the generated sAC PET and sMR images showed a high degree of similarity to the real AC PET and real MR images. These results indicated that our proposed method can reduce the frequency of additional anatomical imaging scans during PET imaging and has great potential in improving doctors' clinical diagnosis efficiency, saving patients' economic expenditure and reducing the radiation risk brought by CT scanning.

PWLS-PR: low-dose computed tomography image reconstruction using a patch-based regularization method based on the penalized weighted least squares total variation approach

BACKGROUND

Radiation exposure computed tomography (CT) scans and the associated risk of cancer in patients have been major clinical concerns. Existing research can achieve low-dose CT imaging by reducing the X-ray current and the number of projections per rotation of the human body. However, this method may produce excessive noise and fringe artifacts in the traditional filtered back projection (FBP)-reconstructed image.

METHODS

To solve this problem, iterative image reconstruction is a promising option to obtain high-quality images from low-dose scans. This paper proposes a patch-based regularization method based on penalized weighted least squares total variation (PWLS-PR) for iterative image reconstruction. This method uses neighborhood patches instead of single pixels to calculate the nonquadratic penalty. The proposed regularization method is more robust than the conventional regularization method in identifying random fluctuations caused by sharp edges and noise. Each iteration of the proposed algorithm can be described in the following three steps: image updating via the total variation based on penalized weighted least squares (PWLS-TV), image smoothing, and pixel-by-pixel image fusion.

RESULTS

Simulation and real-world projection experiments show that the proposed PWLS-PR algorithm achieves a higher image reconstruction performance than similar algorithms. Through the qualitative and quantitative evaluation of simulation experiments, the effectiveness of the method is also verified.

CONCLUSIONS

Furthermore, this study shows that the PWLS-PR method reduces the amount of projection data required for repeated CT scans and has the useful potential to reduce the radiation dose in clinical medical applications.

A review on Deep Learning approaches for low-dose Computed Tomography restoration

Computed Tomography (CT) is a widely use medical image modality in clinical medicine, because it produces excellent visualizations of fine structural details of the human body. In clinical procedures, it is desirable to acquire CT scans by minimizing the X-ray flux to prevent patients from being exposed to high radiation. However, these Low-Dose CT (LDCT) scanning protocols compromise the signal-to-noise ratio of the CT images because of noise and artifacts over the image space. Thus, various restoration methods have been published over the past 3 decades to produce high-quality CT images from these LDCT images. More recently, as opposed to conventional LDCT restoration methods, Deep Learning (DL)-based LDCT restoration approaches have been rather common due to their characteristics of being data-driven, high-performance, and fast execution. Thus, this study aims to elaborate on the role of DL techniques in LDCT restoration and critically review the applications of DL-based approaches for LDCT restoration. To achieve this aim, different aspects of DL-based LDCT restoration applications were analyzed. These include DL architectures, performance gains, functional requirements, and the diversity of objective functions. The outcome of the study highlights the existing limitations and future directions for DL-based LDCT restoration. To the best of our knowledge, there have been no previous reviews, which specifically address this topic.

Half-scan artifact correction using generative adversarial network for dental CT

Half-scan image reconstruction with Parker weighting can correct motion artifacts in dental CT images taken with a slow scan-based dental CT. Since the residual half-scan artifacts in the dental CT images appear much stronger than those in medical CT images, the artifacts often persist to the extent that they compromise the surface-rendered bone and tooth images computed from the dental CT images. We used a variation of generative adversarial network (GAN), so-called U-WGAN, to correct half-scan artifacts in dental CT images. For the generative network of GAN, we used a U-net structure of five stages to take advantage of its high computational efficiency. We trained the network using the Wasserstein loss function on the dental CT images of 40 patients. We tested the network with comparing its output images to the half-scan images corrected with other methods; Parker weighting and the other two popular GANs, that is, SRGAN and m-WGAN. For the quantitative comparison, we used the image quality metrics measuring the similarity of the corrected images to the full-scan images (reference images) and the noise level on the corrected images. We also compared the visual quality of the surface-rendered bone and tooth images. We observed that the proposed network outperformed Parker weighting and other GANs in all the image quality metrics. The computation time for the proposed network to process 336×336×336 3D images on a GPU-equipped personal computer was about 3 s, which was much shorter than those of SRGAN and m-WGAN, 50 s and 54 s, respectively.

Temporal feature prior-aided separated reconstruction method for low-dose dynamic myocardial perfusion computed tomography

Dynamic myocardial perfusion computed tomography (DMP-CT) is an effective medical imaging technique for coronary artery disease diagnosis and therapy guidance. However, the radiation dose received by the patient during repeated CT scans is a widespread concern of radiologists because of the increased risk of cancer. The sparse few-view CT scanning protocol can be a feasible approach to reduce the radiation dose of DMP-CT imaging; however, an advanced reconstruction algorithm is needed. In this paper, a temporal feature prior-aided separated reconstruction method (TFP-SR) for low-dose DMP-CT images reconstruction from sparse few-view sinograms is proposed. To implement the proposed method, the objective perfusion image is divided into the baseline fraction and the enhancement fraction introduced by the arrival of the contrast agent. The core of the proposed TFP-SR method is the utilization of the temporal evolution information that naturally exists in the DMP-CT image sequence to aid the enhancement image reconstruction from limited data. The temporal feature vector of an image pixel is defined by the intensities of this pixel in the pre-reconstructed enhancement sequence, and the connection between two related features is calculated via a zero-mean Gaussian function. A prior matrix is constructed based on the connections between the extracted temporal features and used in the iterative reconstruction of the enhancement images. To evaluate the proposed method, the conventional filtered back-projection algorithm, the total variation regularized PWLS (PWLS-TV) and the prior image constrained compressed sensing are compared in this paper based on studies on a digital extended cardiac-torso (XCAT) thoracic phantom and a preclinical porcine DMP-CT data set that take image misregistration into account. The experimental results demonstrate that the proposed TFP-SR method has superior performance in sparse DMP-CT images reconstruction in terms of image quality and the analyses of the time attenuation curve and hemodynamic parameters.

LCPR-Net: low-count PET image reconstruction using the domain transform and cycle-consistent generative adversarial networks

BACKGROUND

Reducing the radiation tracer dose and scanning time during positron emission tomography (PET) imaging can reduce the cost of the tracer, reduce motion artifacts, and increase the efficiency of the scanner. However, the reconstructed images to be noisy. It is very important to reconstruct high-quality images with low-count (LC) data. Therefore, we propose a deep learning method called LCPR-Net, which is used for directly reconstructing full-count (FC) PET images from corresponding LC sinogram data.

METHODS

Based on the framework of a generative adversarial network (GAN), we enforce a cyclic consistency constraint on the least-squares loss to establish a nonlinear end-to-end mapping process from LC sinograms to FC images. In this process, we merge a convolutional neural network (CNN) and a residual network for feature extraction and image reconstruction. In addition, the domain transform (DT) operation sends a priori information to the cycle-consistent GAN (CycleGAN) network, avoiding the need for a large amount of computational resources to learn this transformation.

RESULTS

The main advantages of this method are as follows. First, the network can use LC sinogram data as input to directly reconstruct an FC PET image. The reconstruction speed is faster than that provided by model-based iterative reconstruction. Second, reconstruction based on the CycleGAN framework improves the quality of the reconstructed image.

CONCLUSIONS

Compared with other state-of-the-art methods, the quantitative and qualitative evaluation results show that the proposed method is accurate and effective for FC PET image reconstruction.

DaNet: dose-aware network embedded with dose-level estimation for low-dose CT imaging

Many deep learning (DL)-based image restoration methods for low-dose CT (LDCT) problems directly employ the end-to-end networks on low-dose training data without considering dose differences. However, the radiation dose difference has a great impact on the ultimate results, and lower doses increase the difficulty of restoration. Moreover, there is increasing demand to design and estimate acceptable scanning doses for patients in clinical practice, necessitating dose-aware networks embedded with adaptive dose estimation. In this paper, we consider these dose differences of input LDCT images and propose an adaptive dose-aware network. First, considering a large dose distribution range for simulation convenience, we coarsely define five dose levels in advance as lowest, lower, mild, higher and highest radiation dose levels. Instead of directly building the end-to-end mapping function between LDCT images and high-dose CT counterparts, the dose level is primarily estimated in the first stage. In the second stage, the adaptively learned low-dose level is used to guide the image restoration process as the pattern of prior information through the channel feature transform. We conduct experiments on a simulated dataset based on original high dose parts of American Association of Physicists in Medicine challenge datasets from the Mayo Clinic. Ablation studies validate the effectiveness of the dose-level estimation, and the experimental results show that our method is superior to several other DL-based methods. Specifically, our method provides obviously better performance in terms of the peak signal-to-noise ratio and visual quality reflected in subjective scores. Due to the dual-stage process, our method may suffer limitations under more parameters and coarse dose-level definitions, and thus, further improvements in clinical practical applications with different CT equipment vendors are planned in future work.

A brief introduction to concepts and applications of artificial intelligence in dental imaging

This report aims to summarize the fundamental concepts of Artificial Intelligence (AI), and to provide a non-exhaustive overview of AI applications in dental imaging, comprising diagnostics, forensics, image processing and image reconstruction. AI has arguably become the hottest topic in radiology in recent years owing to the increased computational power available to researchers, the continuing collection of digital data, as well as the development of highly efficient algorithms for machine learning and deep learning. It is now feasible to develop highly robust AI applications that make use of the vast amount of data available to us, and that keep learning and improving over time.

Emerging methods in radiology

Imaging modalities have developed rapidly in recent decades. In addition to improved resolution as well as whole-body and faster image acquisition, the possibilities of functional and molecular examination of tissue pathophysiology have had a decisive influence on imaging diagnostics and provided ground-breaking knowledge. Many promising approaches are currently being pursued to increase the application area of devices and contrast media and to improve their sensitivity and quantitative informative value. These are complemented by new methods of data processing, multiparametric data analysis, and integrated diagnostics. The aim of this article is to provide an overview of technological innovations that will enrich clinical imaging in the future, and to highlight the resultant diagnostic options. These relate to the established imaging methods such as CT, MRI, ultrasound, PET, and SPECT but also to new methods such as magnetic particle imaging (MPI), optical imaging, and photoacoustics. In addition, approaches to radiomic image evaluation are explained and the chances and difficulties for their broad clinical introduction are discussed. The potential of imaging to describe pathophysiological relationships in ever increasing detail, both at whole-body and tissue level, can in future be used to better understand the mechanistic effect of drugs, to preselect patients to therapies, and to improve monitoring of therapy success. Consequently, the use of interdisciplinary integrated diagnostics will greatly change and enrich the profession of radiologists.

Automatic classification of dental artifact status for efficient image veracity checks: effects of image resolution and convolutional neural network depth

Enabling automated pipelines, image analysis and big data methodology in cancer clinics requires thorough understanding of the data. Automated quality assurance steps could improve the efficiency and robustness of these methods by verifying possible data biases. In particular, in head and neck (H&N) computed-tomography (CT) images, dental artifacts (DA) obscure visualization of structures and the accuracy of Hounsfield units; a challenge for image analysis tasks, including radiomics, where poor image quality can lead to systemic biases. In this work we analyze the performance of three-dimensional convolutional neural networks (CNN) trained to classify DA statuses. 1538 patient images were scored by a single observer as DA positive or negative. Stratified five-fold cross validation was performed to train and test CNNs using various isotropic resampling grids (64³, 128³ and 256³), with CNN depths designed to produce 32³, 16³, and 8³ machine generated features. These parameters were selected to determine if more computationally efficient CNNs could be utilized to achieve the same performance. The area under the precision recall curve (PR-AUC) was used to assess CNN performance. The highest PR-AUC (0.92  ±  0.03) was achieved with a CNN depth  =  5, resampling grid  =  256. The CNN performance with 256³ resampling grid size is not significantly better than 64³ and 128³ after 20 epochs, which had PR-AUC  =  0.89  ±  0.03 (p -value  =  0.28) and 0.91  ±  0.02 (p -value  =  0.93) at depths of 3 and 4, respectively. Our experiments demonstrate the potential to automate specific quality assurance tasks required for unbiased and robust automated pipeline and image analysis research. Additionally, we determined that there is an opportunity to simplify CNNs with smaller resampling grids to make the process more amenable to very large datasets that will be available in the future.

Automatic left ventricle segmentation from cardiac magnetic resonance images using a capsule network

PURPOSE

Segmentation of magnetic resonance images (MRI) of the left ventricle (LV) plays a key role in quantifying the volumetric functions of the heart, such as the area, volume, and ejection fraction. Traditionally, LV segmentation is performed manually by experienced experts, which is both time-consuming and prone to subjective bias. This study aims to develop a novel capsule-based automated segmentation method to automatically segment the LV from images obtained by cardiac MRI.

METHOD

The technique applied for segmentation uses Fourier analysis and the circular Hough transform (CHT) to indicate the approximate location of the LV and a network capsule to precisely segment the LV. The neurons of the capsule network output a vector and preserve much of the information about the input by replacing the largest pooling layer with convolutional strides and dynamic routing. Finally, the segmentation result is postprocessed by threshold segmentation and morphological processing to increase the accuracy of LV segmentation.

RESULTS

We fully exploit the capsule network to achieve the segmentation goal and combine LV detection and capsule concepts to complete LV segmentation. In the experiments, the tested methods achieved LV Dice scores of 0.922±0.05 end-diastolic (ED) and 0.898±0.11 end-systolic (ES) on the ACDC 2017 data set. The experimental results confirm that the algorithm can effectively perform LV segmentation from a cardiac magnetic resonance image. To verify the performance of the proposed method, visual and quantitative comparisons are also performed, which show that the proposed method exhibits improved segmentation accuracy compared with the traditional method.

CONCLUSIONS

The evaluation metrics of medical image segmentation indicate that the proposed method in combination with postprocessing and feature detection effectively improves segmentation accuracy for cardiac MRI. To the best of our knowledge, this study is the first to use a deep learning model based on capsule networks to systematically evaluate end-to-end LV segmentation.

Low-dose CT reconstruction method based on prior information of normal-dose image

BACKGROUND

Radiation risk from computed tomography (CT) is always an issue for patients, especially those in clinical conditions in which repeated CT scanning is required. For patients undergoing repeated CT scanning, a low-dose protocol, such as sparse scanning, is often used, and consequently, an advanced reconstruction algorithm is also needed.

OBJECTIVE

To develop a novel algorithm used for sparse-view CT reconstruction associated with the prior image.

METHODS

A low-dose CT reconstruction method based on prior information of normal-dose image (PI-NDI) involving a transformed model for attenuation coefficients of the object to be reconstructed and prior information application in the forward-projection process was used to reconstruct CT images from sparse-view projection data. A digital extended cardiac-torso (XCAT) ventral phantom and a diagnostic head phantom were employed to evaluate the performance of the proposed PI-NDI method. The root-mean-square error (RMSE), peak signal-to-noise ratio (PSNR) and mean percent absolute error (MPAE) of the reconstructed images were measured for quantitative evaluation of the proposed PI-NDI method.

RESULTS

The reconstructed images with sparse-view projection data via the proposed PI-NDI method have higher quality by visual inspection than that via the compared methods. In terms of quantitative evaluations, the RMSE measured on the images reconstructed by the PI-NDI method with sparse projection data is comparable to that by MLEM-TV, PWLS-TV and PWLS-PICCS with fully sampled projection data. When the projection data are very sparse, images reconstructed by the PI-NDI method have higher PSNR values and lower MPAE values than those from the compared algorithms.

CONCLUSIONS

This study presents a new low-dose CT reconstruction method based on prior information of normal-dose image (PI-NDI) for sparse-view CT image reconstruction. The experimental results validate that the new method has superior performance over other state-of-art methods.

Evaluation of reconstruction algorithms for a stationary digital breast tomosynthesis system using a carbon nanotube X-ray source array

Breast cancer is the most frequently diagnosed cancer in women worldwide. Digital breast tomosynthesis (DBT), which is based on limited-angle tomography, was developed to solve tissue overlapping problems associated with traditional breast mammography. However, due to the problems associated with tube movement during the process of data acquisition, stationary DBT (s-DBT) was developed to allow the X-ray source array to stay stationary during the DBT scanning process. In this work, we evaluate four widely used and investigated DBT image reconstruction algorithms, including the commercial Feldkamp-Davis-Kress algorithm (FBP), the simultaneous iterative reconstruction technique (SIRT), the simultaneous algebraic reconstruction technique (SART) and the total variation regularized SART (SART-TV) for an s-DBT imaging system that we set up in our own laboratory for studies using a semi-elliptical digital phantom and a rubber breast phantom to determine the most superior algorithm for s-DBT image reconstruction among the four algorithms. Several quantitative indexes for image quality assessment, including the peak signal-noise ratio (PSNR), the root mean square error (RMSE) and the structural similarity (SSIM), are used to determine the best algorithm for the imaging system that we set up. Image resolutions are measured via the calculation of the contrast-to-noise ratio (CNR) and artefact spread function (ASF). The experimental results show that the SART-TV algorithm gives reconstructed images with the highest PSNR and SSIM values and the lowest RMSE values in terms of image accuracy and similarity, along with the highest CNR values calculated for the selected features and the best ASF curves in terms of image resolution in the horizontal and vertical directions. Thus, the SART-TV algorithm is proven to be the best algorithm for use in s-DBT image reconstruction for the specific imaging task in our study.

Competitive performance of a modularized deep neural network compared to commercial algorithms for low-dose CT image reconstruction

Commercial iterative reconstruction techniques help to reduce CT radiation dose but altered image appearance and artifacts limit their adoptability and potential use. Deep learning has been investigated for low-dose CT (LDCT). Here we design a modularized neural network for LDCT and compared it with commercial iterative reconstruction methods from three leading CT vendors. While popular networks are trained for an end-to-end mapping, our network performs an end-to-process mapping so that intermediate denoised images are obtained with associated noise reduction directions towards a final denoised image. The learned workflow allows radiologists-in-the-loop to optimize the denoising depth in a task-specific fashion. Our network was trained with the Mayo LDCT Dataset, and tested on separate chest and abdominal CT exams from Massachusetts General Hospital. The best deep learning reconstructions were systematically compared to the best iterative reconstructions in a double-blinded reader study. This study confirms that our deep learning approach performed either favorably or comparably in terms of noise suppression and structural fidelity, and is much faster than the commercial iterative reconstruction algorithms.