Improving Image Quality of Sparse-view Lung Cancer CT Images with a Convolutional Neural Network

Purpose: To improve the image quality of sparse-view computed tomography (CT) images with a U-Net for lung cancer detection and to determine the best trade-off between number of views, image quality, and diagnostic confidence. Methods: CT images from 41 subjects (34 with lung cancer, seven healthy) were retrospectively selected (01.2016-12.2018) and forward projected onto 2048-view sinograms. Six corresponding sparse-view CT data subsets at varying levels of undersampling were reconstructed from sinograms using filtered backprojection with 16, 32, 64, 128, 256, and 512 views, respectively. A dual-frame U-Net was trained and evaluated for each subsampling level on 8,658 images from 22 diseased subjects. A representative image per scan was selected from 19 subjects (12 diseased, seven healthy) for a single-blinded reader study. The selected slices, for all levels of subsampling, with and without post-processing by the U-Net model, were presented to three readers. Image quality and diagnostic confidence were ranked using pre-defined scales. Subjective nodule segmentation was evaluated utilizing sensitivity (Se) and Dice Similarity Coefficient (DSC) with 95% confidence intervals (CI). Results: The 64-projection sparse-view images resulted in Se = 0.89 and DSC = 0.81 [0.75,0.86] while their counterparts, post-processed with the U-Net, had improved metrics (Se = 0.94, DSC = 0.85 [0.82,0.87]). Fewer views lead to insufficient quality for diagnostic purposes. For increased views, no substantial discrepancies were noted between the sparse-view and post-processed images. Conclusion: Projection views can be reduced from 2048 to 64 while maintaining image quality and the confidence of the radiologists on a satisfactory level.

Improving Automated Hemorrhage Detection in Sparse-view Computed Tomography via Deep Convolutional Neural Network based Artifact Reduction

Intracranial hemorrhage poses a serious health problem requiring rapid and often intensive medical treatment. For diagnosis, a Cranial Computed Tomography (CCT) scan is usually performed. However, the increased health risk caused by radiation is a concern. The most important strategy to reduce this potential risk is to keep the radiation dose as low as possible and consistent with the diagnostic task. Sparse-view CT can be an effective strategy to reduce dose by reducing the total number of views acquired, albeit at the expense of image quality. In this work, we use a U-Net architecture to reduce artifacts from sparse-view CCTs, predicting fully sampled reconstructions from sparse-view ones. We evaluate the hemorrhage detectability in the predicted CCTs with a hemorrhage classification convolutional neural network, trained on fully sampled CCTs to detect and classify different sub-types of hemorrhages. Our results suggest that the automated classification and detection accuracy of hemorrhages in sparse-view CCTs can be improved substantially by the U-Net. This demonstrates the feasibility of rapid automated hemorrhage detection on low-dose CT data to assist radiologists in routine clinical practice.

Optimizing Convolutional Neural Networks for Chronic Obstructive Pulmonary Disease Detection in Clinical Computed Tomography Imaging

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of death worldwide, yet early detection and treatment can prevent the progression of the disease. In contrast to the conventional method of detecting COPD with spirometry tests, X-ray Computed Tomography (CT) scans of the chest provide a measure of morphological changes in the lung. It has been shown that automated detection of COPD can be performed with deep learning models. However, the potential of incorporating optimal window setting selection, typically carried out by clinicians during examination of CT scans for COPD, is generally overlooked in deep learning approaches. We aim to optimize the binary classification of COPD with densely connected convolutional neural networks (DenseNets) through implementation of manual and automated Window-Setting Optimization (WSO) steps. Our dataset consisted of 78 CT scans from the Klinikum rechts der Isar research hospital. Repeated inference on the test set showed that without WSO, the plain DenseNet resulted in a mean slice-level AUC of 0.80$\pm$0.05. With input images manually adjusted to the emphysema window setting, the plain DenseNet model predicted COPD with a mean AUC of 0.86$\pm$0.04. By automating the WSO through addition of a customized layer to the DenseNet, an optimal window setting in the proximity of the emphysema window setting was learned and a mean AUC of 0.82$\pm$0.04 was achieved. Detection of COPD with DenseNet models was optimized by WSO of CT data to the emphysema window setting range, demonstrating the importance of implementing optimal window setting selection in the deep learning pipeline.