Reconstructing Quantitative Cerebral Perfusion Images Directly From Measured Sinogram Data Acquired Using C-arm Cone-Beam CT

To shorten the door-to-puncture time for better treating patients with acute ischemic stroke, it is highly desired to obtain quantitative cerebral perfusion images using C-arm cone-beam computed tomography (CBCT) equipped in the interventional suite. However, limited by the slow gantry rotation speed, the temporal resolution and temporal sampling density of typical C-arm CBCT are much poorer than those of multi-detector-row CT in the diagnostic imaging suite. The current quantitative perfusion imaging includes two cascaded steps: time-resolved image reconstruction and perfusion parametric estimation. For time-resolved image reconstruction, the technical challenge imposed by poor temporal resolution and poor sampling density causes inaccurate quantification of the temporal variation of cerebral artery and tissue attenuation values. For perfusion parametric estimation, it remains a technical challenge to appropriately design the handcrafted regularization for better solving the associated deconvolution problem. These two challenges together prevent obtaining quantitatively accurate perfusion images using C-arm CBCT. The purpose of this work is to simultaneously address these two challenges by combining the two cascaded steps into a single joint optimization problem and reconstructing quantitative perfusion images directly from the measured sinogram data. In the developed direct cerebral perfusion parametric image reconstruction technique, TRAINER in short, the quantitative perfusion images have been represented as a subject-specific conditional generative model trained under the constraint of the time-resolved CT forward model, perfusion convolutional model, and the subject's own measured sinogram data. Results shown in this paper demonstrated that using TRAINER, quantitative cerebral perfusion images can be accurately obtained using C-arm CBCT in the interventional suite.

Sequential-Scanning Dual-Energy CT Imaging Using High Temporal Resolution Image Reconstruction and Error-Compensated Material Basis Image Generation

Dual-energy computed tomography (DECT) has been widely used to obtain quantitative elemental composition of imaged subjects for personalized and precise medical diagnosis. Compared with DECT leveraging advanced X-ray source and/or detector technologies, the use of the sequential-scanning data acquisition scheme to implement DECT may make a broader impact on clinical practice because this scheme requires no specialized hardware designs and can be directly implemented into conventional CT systems. However, since the concentration of iodinated contrast agent in the imaged subject varies over time, sequentially scanned data sets acquired at two tube potentials are temporally inconsistent. As existing material basis image reconstruction approaches assume that the data sets acquired at two tube potentials are temporally consistent, the violation of this assumption results in inaccurate quantification of material concentration. In this work, we developed sequential-scanning DECT imaging using high temporal resolution image reconstruction and error-compensated material basis image generation, ACCELERATION in short, to address the technical challenge induced by temporal inconsistency of sequentially scanned data sets and improve quantification accuracy of material concentration in sequential-scanning DECT. ACCELERATION has been validated and evaluated using numerical simulation data sets generated from clinical human subject exams and experimental human subject studies. Results demonstrated the improvement of quantification accuracy and image quality using ACCELERATION.

ACCELERATION: Sequentially-scanning DECT Imaging Using High Temporal Resolution Image Reconstruction And Temporal Extrapolation

Dual-energy computed tomography (DECT) has been widely used to obtain quantitative elemental composition of imaged subjects for personalized and precise medical diagnosis. Compared with existing high-end DECT leveraging advanced X-ray source and/or detector technologies, the use of the sequentially-scanning data acquisition scheme to implement DECT may make broader impact on clinical practice because this scheme requires no specialized hardware designs. However, since the concentration of iodinated contrast agent in the imaged subject varies over time, sequentially-scanned data sets acquired at two tube potentials are temporally inconsistent. As existing material decomposition approaches for DECT assume that the data sets acquired at two tube potentials are temporally consistent, the violation of this assumption results in inaccurate quantification accuracy of iodine concentration. In this work, we developed a technique to achieve sequentially-scanning DECT imaging using high temporal resolution image reconstruction and temporal extrapolation, ACCELERATION in short, to address the technical challenge induced by temporal inconsistency of sequentially-scanned data sets and improve iodine quantification accuracy in sequentially-scanning DECT. ACCELERATION has been validated and evaluated using numerical simulation data sets generated from clinical human subject exams. Results demonstrated the improvement of iodine quantification accuracy using ACCELERATION.

RetinexFlow for CT metal artifact reduction

Metal artifacts is a major challenge in computed tomography (CT) imaging, significantly degrading image quality and making accurate diagnosis difficult. However, previous methods either require prior knowledge of the location of metal implants, or have modeling deviations with the mechanism of artifact formation, which limits the ability to obtain high-quality CT images. In this work, we formulate metal artifacts reduction problem as a combination of decomposition and completion tasks. And we propose RetinexFlow, which is a novel end-to-end image domain model based on Retinex theory and conditional normalizing flow, to solve it. Specifically, we first design a feature decomposition encoder for decomposing the metal implant component and inherent component, and extracting the inherent feature. Then, it uses a feature-to-image flow module to complete the metal artifact-free CT image step by step through a series of invertible transformations. These designs are incorporated in our model with a coarse-to-fine strategy, enabling it to achieve superior performance. The experimental results on on simulation and clinical datasets show our method achieves better quantitative and qualitative results, exhibiting better visual performance in artifact removal and image fidelity

Deep Learning Angiography (DLA): Three-dimensional C-arm Cone Beam CT Angiography Using Deep Learning

Background and Purpose: Our purpose was to develop a deep learning angiography (DLA) method to generate 3D cerebral angiograms from a single contrast-enhanced acquisition. Material and Methods: Under an approved IRB protocol 105 3D-DSA exams were randomly selected from an internal database. All were acquired using a clinical system (Axiom Artis zee, Siemens Healthineers) in conjunction with a standard injection protocol. More than 150 million labeled voxels from 35 subjects were used for training. A deep convolutional neural network was trained to classify each image voxel into three tissue types (vasculature, bone and soft tissue). The trained DLA model was then applied for tissue classification in a validation cohort of 8 subjects and a final testing cohort consisting of the remaining 62 subjects. The final vasculature tissue class was used to generate the 3D-DLA images. To quantify the generalization error of the trained model, accuracy, sensitivity, precision and F1-scores were calculated for vasculature classification in relevant anatomy. The 3D-DLA and clinical 3D-DSA images were subject to a qualitative assessment for the presence of inter-sweep motion artifacts. Results: Vasculature classification accuracy and 95% CI in the testing dataset was 98.7% ([98.3, 99.1] %). No residual signal from osseous structures was observed for all 3D-DLA testing cases except for small regions in the otic capsule and nasal cavity compared to 37% (23/62) of the 3D-DSAs. Conclusion: DLA accurately recreated the vascular anatomy of the 3D-DSA reconstructions without mask. DLA reduced mis-registration artifacts induced by inter-sweep motion. DLA reduces radiation exposure required to obtain clinically useful 3D-DSA