An Interpretable X-ray Style Transfer via Trainable Local Laplacian Filter

Radiologists have preferred visual impressions or 'styles' of X-ray images that are manually adjusted to their needs to support their diagnostic performance. In this work, we propose an automatic and interpretable X-ray style transfer by introducing a trainable version of the Local Laplacian Filter (LLF). From the shape of the LLF's optimized remap function, the characteristics of the style transfer can be inferred and reliability of the algorithm can be ensured. Moreover, we enable the LLF to capture complex X-ray style features by replacing the remap function with a Multi-Layer Perceptron (MLP) and adding a trainable normalization layer. We demonstrate the effectiveness of the proposed method by transforming unprocessed mammographic X-ray images into images that match the style of target mammograms and achieve a Structural Similarity Index (SSIM) of 0.94 compared to 0.82 of the baseline LLF style transfer method from Aubry et al.

Metal-conscious Embedding for CBCT Projection Inpainting

The existence of metallic implants in projection images for cone-beam computed tomography (CBCT) introduces undesired artifacts which degrade the quality of reconstructed images. In order to reduce metal artifacts, projection inpainting is an essential step in many metal artifact reduction algorithms. In this work, a hybrid network combining the shift window (Swin) vision transformer (ViT) and a convolutional neural network is proposed as a baseline network for the inpainting task. To incorporate metal information for the Swin ViT-based encoder, metal-conscious self-embedding and neighborhood-embedding methods are investigated. Both methods have improved the performance of the baseline network. Furthermore, by choosing appropriate window size, the model with neighborhood-embedding could achieve the lowest mean absolute error of 0.079 in metal regions and the highest peak signal-to-noise ratio of 42.346 in CBCT projections. At the end, the efficiency of metal-conscious embedding on both simulated and real cadaver CBCT data has been demonstrated, where the inpainting capability of the baseline network has been enhanced.

Simulation-Driven Training of Vision Transformers Enabling Metal Segmentation in X-Ray Images

In several image acquisition and processing steps of X-ray radiography, knowledge of the existence of metal implants and their exact position is highly beneficial (e.g. dose regulation, image contrast adjustment). Another application which would benefit from an accurate metal segmentation is cone beam computed tomography (CBCT) which is based on 2D X-ray projections. Due to the high attenuation of metals, severe artifacts occur in the 3D X-ray acquisitions. The metal segmentation in CBCT projections usually serves as a prerequisite for metal artifact avoidance and reduction algorithms. Since the generation of high quality clinical training is a constant challenge, this study proposes to generate simulated X-ray images based on CT data sets combined with self-designed computer aided design (CAD) implants and make use of convolutional neural network (CNN) and vision transformer (ViT) for metal segmentation. Model test is performed on accurately labeled X-ray test datasets obtained from specimen scans. The CNN encoder-based network like U-Net has limited performance on cadaver test data with an average dice score below 0.30, while the metal segmentation transformer with dual decoder (MST-DD) shows high robustness and generalization on the segmentation task, with an average dice score of 0.90. Our study indicates that the CAD model-based data generation has high flexibility and could be a way to overcome the problem of shortage in clinical data sampling and labelling. Furthermore, the MST-DD approach generates a more reliable neural network in case of training on simulated data.