DuDoNet++: Encoding mask projection to reduce CT metal artifacts

CT metal artifact reduction (MAR) is a notoriously challenging task because the artifacts are structured and non-local in the image domain. However, they are inherently local in the sinogram domain. DuDoNet is the state-of-the-art MAR algorithm which exploits the latter characteristic by learning to reduce artifacts in the sinogram and image domain jointly. By design, DuDoNet treats the metal-affected regions in sinogram as missing and replaces them with the surrogate data generated by a neural network. Since fine-grained details within the metal-affected regions are completely ignored, the artifact-reduced CT images by DuDoNet tend to be over-smoothed and distorted. In this work, we investigate the issue by theoretical derivation. We propose to address the problem by (1) retaining the metal-affected regions in sinogram and (2) replacing the binarized metal trace with the metal mask projection such that the geometry information of metal implants is encoded. Extensive experiments on simulated datasets and expert evaluations on clinical images demonstrate that our network called DuDoNet++ yields anatomically more precise artifact-reduced images than DuDoNet, especially when the metallic objects are large.