DuDoUFNet: Dual-Domain Under-to-Fully-Complete Progressive Restoration Network for Simultaneous Metal Artifact Reduction and Low-Dose CT Reconstruction

DuDoCFNet: Dual-Domain Coarse-to-Fine Progressive Network for Simultaneous Denoising, Limited-View Reconstruction, and Attenuation Correction of Cardiac SPECT

Single-Photon Emission Computed Tomography (SPECT) is widely applied for the diagnosis of coronary artery diseases. Low-dose (LD) SPECT aims to minimize radiation exposure but leads to increased image noise. Limited-view (LV) SPECT, such as the latest GE MyoSPECT ES system, enables accelerated scanning and reduces hardware expenses but degrades reconstruction accuracy. Additionally, Computed Tomography (CT) is commonly used to derive attenuation maps ( μ -maps) for attenuation correction (AC) of cardiac SPECT, but it will introduce additional radiation exposure and SPECT-CT misalignments. Although various methods have been developed to solely focus on LD denoising, LV reconstruction, or CT-free AC in SPECT, the solution for simultaneously addressing these tasks remains challenging and under-explored. Furthermore, it is essential to explore the potential of fusing cross-domain and cross-modality information across these interrelated tasks to further enhance the accuracy of each task. Thus, we propose a Dual-Domain Coarse-to-Fine Progressive Network (DuDoCFNet), a multi-task learning method for simultaneous LD denoising, LV reconstruction, and CT-free μ -map generation of cardiac SPECT. Paired dual-domain networks in DuDoCFNet are cascaded using a multi-layer fusion mechanism for cross-domain and cross-modality feature fusion. Two-stage progressive learning strategies are applied in both projection and image domains to achieve coarse-to-fine estimations of SPECT projections and CT-derived μ -maps. Our experiments demonstrate DuDoCFNet's superior accuracy in estimating projections, generating μ -maps, and AC reconstructions compared to existing single- or multi-task learning methods, under various iterations and LD levels. The source code of this work is available at https://github.com/XiongchaoChen/DuDoCFNet-MultiTask.

Cascaded Multi-path Shortcut Diffusion Model for Medical Image Translation

Image-to-image translation is a vital component in medical imaging processing, with many uses in a wide range of imaging modalities and clinical scenarios. Previous methods include Generative Adversarial Networks (GANs) and Diffusion Models (DMs), which offer realism but suffer from instability and lack uncertainty estimation. Even though both GAN and DM methods have individually exhibited their capability in medical image translation tasks, the potential of combining a GAN and DM to further improve translation performance and to enable uncertainty estimation remains largely unexplored. In this work, we address these challenges by proposing a Cascade Multi-path Shortcut Diffusion Model (CMDM) for high-quality medical image translation and uncertainty estimation. To reduce the required number of iterations and ensure robust performance, our method first obtains a conditional GAN-generated prior image that will be used for the efficient reverse translation with a DM in the subsequent step. Additionally, a multi-path shortcut diffusion strategy is employed to refine translation results and estimate uncertainty. A cascaded pipeline further enhances translation quality, incorporating residual averaging between cascades. We collected three different medical image datasets with two sub-tasks for each dataset to test the generalizability of our approach. Our experimental results found that CMDM can produce high-quality translations comparable to state-of-the-art methods while providing reasonable uncertainty estimations that correlate well with the translation error.

Semi-supervised iterative adaptive network for low-dose CT sinogram recovery

Background.Concern has been expressed regarding the risk of carcinogenesis from medical computed tomography (CT) radiation. Lowering radiation in CT without appropriate modifications often leads to severe noise-induced artifacts in the images. The utilization of deep learning (DL) techniques has achieved promising reconstruction performance in low-dose CT (LDCT) imaging. However, most DL-based algorithms require the pre-collection of a large set of image pairs (low-dose/standard-dose) and the training of networks in an end-to-end supervised manner. Meanwhile, securing such a large volume of paired, well-registered training data in clinical practice is challenging. Moreover, these algorithms often overlook the potential to utilize the abundant information in a large collection of LDCT-only images/sinograms.Methods.In this paper, we introduce a semi-supervised iterative adaptive network (SIA-Net) for LDCT imaging, utilizing both labeled and unlabeled sinograms in a cohesive network framework, integrating supervised and unsupervised learning processes. Specifically, the supervised process captures critical features (i.e. noise distribution and tissue characteristics) latent in the paired sinograms, while the unsupervised process effectively learns these features in the unlabeled low-dose sinograms, employing a conventional weighted least-squares model with a regularization term. Furthermore, the SIA-Net method is designed to adaptively transfer the learned feature distribution from the supervised to the unsupervised process, thereby obtaining a high-fidelity sinogram through iterative adaptive learning. Finally, high-quality CT images can be reconstructed from the refined sinogram using the filtered back-projection algorithm.Results.Experimental results on two clinical datasets indicate that the proposed SIA-Net method achieves competitive performance in terms of noise reduction and structure preservation in LDCT imaging, when compared to traditional supervised learning methods.

Self-supervised dual-domain balanced dropblock-network for low-dose CT denoising

Objective.Self-supervised learning methods have been successfully applied for low-dose computed tomography (LDCT) denoising, with the advantage of not requiring labeled data. Conventional self-supervised methods operate only in the image domain, ignoring valuable priors in the sinogram domain. Recently proposed dual-domain methods address this limitation but encounter issues with blurring artifacts in the reconstructed image due to the inhomogeneous distribution of noise levels in low-dose sinograms.Approach.To tackle this challenge, this paper proposes SDBDNet, an end-to-end dual-domain self-supervised method for LDCT denoising. With the network designed based on the properties of inhomogeneous noise in low-dose sinograms and the principle of moderate sinogram-domain denoising, SDBDNet achieves effective denoising in dual domains without introducing blurring artifacts. Specifically, we split the sinogram into two subsets based on the positions of detector cells to generate paired training data with high similarity and independent noise. These sub-sinograms are then restored to their original size using 1D interpolation and learning-based correction. To achieve adaptive and moderate smoothing in the sinogram domain, we integrate Dropblock, a type of convolution layer with regularization, into SDBDNet, and set a weighted average between the denoised sinograms and their noisy counterparts, leading to a well-balanced dual-domain approach.Main results.Numerical experiments show that our method outperforms popular non-learning and self-supervised learning methods, demonstrating its effectiveness and superior performance.Significance.While introducing a novel high-performance dual-domain self-supervised LDCT denoising method, this paper also emphasizes and verifies the importance of appropriate sinogram-domain denoising in dual-domain methods, which might inspire future work.

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.

Proj2Proj: self-supervised low-dose CT reconstruction

In Computed Tomography (CT) imaging, one of the most serious concerns has always been ionizing radiation. Several approaches have been proposed to reduce the dose level without compromising the image quality. With the emergence of deep learning, thanks to the increasing availability of computational power and huge datasets, data-driven methods have recently received a lot of attention. Deep learning based methods have also been applied in various ways to address the low-dose CT reconstruction problem. However, the success of these methods largely depends on the availability of labeled data. On the other hand, recent studies showed that training can be done successfully without the need for labeled datasets. In this study, a training scheme was defined to use low-dose projections as their own training targets. The self-supervision principle was applied in the projection domain. The parameters of a denoiser neural network were optimized through self-supervised training. It was shown that our method outperformed both traditional and compressed sensing-based iterative methods, and deep learning based unsupervised methods, in the reconstruction of analytic CT phantoms and human CT images in low-dose CT imaging. Our method's reconstruction quality is also comparable to a well-known supervised method.

CT image denoising methods for image quality improvement and radiation dose reduction

With the ever-increasing use of computed tomography (CT), concerns about its radiation dose have become a significant public issue. To address the need for radiation dose reduction, CT denoising methods have been widely investigated and applied in low-dose CT images. Numerous noise reduction algorithms have emerged, such as iterative reconstruction and most recently, deep learning (DL)-based approaches. Given the rapid advancements in Artificial Intelligence techniques, we recognize the need for a comprehensive review that emphasizes the most recently developed methods. Hence, we have performed a thorough analysis of existing literature to provide such a review. Beyond directly comparing the performance, we focus on pivotal aspects, including model training, validation, testing, generalizability, vulnerability, and evaluation methods. This review is expected to raise awareness of the various facets involved in CT image denoising and the specific challenges in developing DL-based models.

Advances in metal artifact reduction in CT images: A review of traditional and novel metal artifact reduction techniques

Metal artifacts degrade CT image quality, hampering clinical assessment. Numerous metal artifact reduction methods are available to improve the image quality of CT images with metal implants. In this review, an overview of traditional methods is provided including the modification of acquisition and reconstruction parameters, projection-based metal artifact reduction techniques (MAR), dual energy CT (DECT) and the combination of these techniques. Furthermore, the additional value and challenges of novel metal artifact reduction techniques that have been introduced over the past years are discussed such as photon counting CT (PCCT) and deep learning based metal artifact reduction techniques.

FedFTN: Personalized federated learning with deep feature transformation network for multi-institutional low-count PET denoising

Low-count PET is an efficient way to reduce radiation exposure and acquisition time, but the reconstructed images often suffer from low signal-to-noise ratio (SNR), thus affecting diagnosis and other downstream tasks. Recent advances in deep learning have shown great potential in improving low-count PET image quality, but acquiring a large, centralized, and diverse dataset from multiple institutions for training a robust model is difficult due to privacy and security concerns of patient data. Moreover, low-count PET data at different institutions may have different data distribution, thus requiring personalized models. While previous federated learning (FL) algorithms enable multi-institution collaborative training without the need of aggregating local data, addressing the large domain shift in the application of multi-institutional low-count PET denoising remains a challenge and is still highly under-explored. In this work, we propose FedFTN, a personalized federated learning strategy that addresses these challenges. FedFTN uses a local deep feature transformation network (FTN) to modulate the feature outputs of a globally shared denoising network, enabling personalized low-count PET denoising for each institution. During the federated learning process, only the denoising network's weights are communicated and aggregated, while the FTN remains at the local institutions for feature transformation. We evaluated our method using a large-scale dataset of multi-institutional low-count PET imaging data from three medical centers located across three continents, and showed that FedFTN provides high-quality low-count PET images, outperforming previous baseline FL reconstruction methods across all low-count levels at all three institutions.

A new dental CBCT metal artifact reduction method based on a dual-domain processing framework

Objective.Cone beam computed tomography (CBCT) has been wildly used in clinical treatment of dental diseases. However, patients often have metallic implants in mouth, which will lead to severe metal artifacts in the reconstructed images. To reduce metal artifacts in dental CBCT images, which have a larger amount of data and a limited field of view compared to computed tomography images, a new dental CBCT metal artifact reduction method based on a projection correction and a convolutional neural network (CNN) based image post-processing model is proposed in this paper. Approach.The proposed method consists of three stages: (1) volume reconstruction and metal segmentation in the image domain, using the forward projection to get the metal masks in the projection domain; (2) linear interpolation in the projection domain and reconstruction to build a linear interpolation (LI) corrected volume; (3) take the LI corrected volume as prior and perform the prior based beam hardening correction in the projection domain, and (4) combine the constructed projection corrected volume and LI-volume slice-by-slice in the image domain by two concatenated U-Net based models (CNN1 and CNN2). Simulated and clinical dental CBCT cases are used to evaluate the proposed method. The normalized root means square difference (NRMSD) and the structural similarity index (SSIM) are used for the quantitative evaluation of the method.Main results.The proposed method outperforms the frequency domain fusion method (FS-MAR) and a state-of-art CNN based method on the simulated dataset and yields the best NRMSD and SSIM of 4.0196 and 0.9924, respectively. Visual results on both simulated and clinical images also illustrate that the proposed method can effectively reduce metal artifacts.Significance. This study demonstrated that the proposed dual-domain processing framework is suitable for metal artifact reduction in dental CBCT 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.

CGP-Uformer: A low-dose CT image denoising Uformer based on channel graph perception

BACKGROUND

An effective method for achieving low-dose CT is to keep the number of projection angles constant while reducing radiation dose at each angle. However, this leads to high-intensity noise in the reconstructed image, adversely affecting subsequent image processing, analysis, and diagnosis.

OBJECTIVE

This paper proposes a novel Channel Graph Perception based U-shaped Transformer (CGP-Uformer) network, aiming to achieve high-performance denoising of low-dose CT images.

METHODS

The network consists of convolutional feed-forward Transformer (ConvF-Transformer) blocks, a channel graph perception block (CGPB), and spatial cross-attention (SC-Attention) blocks. The ConvF-Transformer blocks enhance the ability of feature representation and information transmission through the CNN-based feed-forward network. The CGPB introduces Graph Convolutional Network (GCN) for Channel-to-Channel feature extraction, promoting the propagation of information across distinct channels and enabling inter-channel information interchange. The SC-Attention blocks reduce the semantic difference in feature fusion between the encoder and decoder by computing spatial cross-attention.

RESULTS

By applying CGP-Uformer to process the 2016 NIH AAPM-Mayo LDCT challenge dataset, experiments show that the peak signal-to-noise ratio value is 35.56 and the structural similarity value is 0.9221.

CONCLUSIONS

Compared to the other four representative denoising networks currently, this new network demonstrates superior denoising performance and better preservation of image details.

Structure-preserved meta-learning uniting network for improving low-dose CT quality

Objective.Deep neural network (DNN) based methods have shown promising performances for low-dose computed tomography (LDCT) imaging. However, most of the DNN-based methods are trained on simulated labeled datasets, and the low-dose simulation algorithms are usually designed based on simple statistical models which deviate from the real clinical scenarios, which could lead to issues of overfitting, instability and poor robustness. To address these issues, in this work, we present a structure-preserved meta-learning uniting network (shorten as 'SMU-Net') to suppress noise-induced artifacts and preserve structure details in the unlabeled LDCT imaging task in real scenarios.Approach.Specifically, the presented SMU-Net contains two networks, i.e., teacher network and student network. The teacher network is trained on simulated labeled dataset and then helps the student network train with the unlabeled LDCT images via the meta-learning strategy. The student network is trained on real LDCT dataset with the pseudo-labels generated by the teacher network. Moreover, the student network adopts the Co-teaching strategy to improve the robustness of the presented SMU-Net.Main results.We validate the proposed SMU-Net method on three public datasets and one real low-dose dataset. The visual image results indicate that the proposed SMU-Net has superior performance on reducing noise-induced artifacts and preserving structure details. And the quantitative results exhibit that the presented SMU-Net method generally obtains the highest signal-to-noise ratio (PSNR), the highest structural similarity index measurement (SSIM), and the lowest root-mean-square error (RMSE) values or the lowest natural image quality evaluator (NIQE) scores.Significance.We propose a meta learning strategy to obtain high-quality CT images in the LDCT imaging task, which is designed to take advantage of unlabeled CT images to promote the reconstruction performance in the LDCT environments.