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Learning to Avoid Poor Images: Towards Task-aware C-arm Cone-beam CT Trajectories

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 Added by Jan-Nico Zaech
 Publication date 2019
and research's language is English




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Metal artifacts in computed tomography (CT) arise from a mismatch between physics of image formation and idealized assumptions during tomographic reconstruction. These artifacts are particularly strong around metal implants, inhibiting widespread adoption of 3D cone-beam CT (CBCT) despite clear opportunity for intra-operative verification of implant positioning, e.g. in spinal fusion surgery. On synthetic and real data, we demonstrate that much of the artifact can be avoided by acquiring better data for reconstruction in a task-aware and patient-specific manner, and describe the first step towards the envisioned task-aware CBCT protocol. The traditional short-scan CBCT trajectory is planar, with little room for scene-specific adjustment. We extend this trajectory by autonomously adjusting out-of-plane angulation. This enables C-arm source trajectories that are scene-specific in that they avoid acquiring poor images, characterized by beam hardening, photon starvation, and noise. The recommendation of ideal out-of-plane angulation is performed on-the-fly using a deep convolutional neural network that regresses a detectability-rank derived from imaging physics.



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Despite the widespread availability of in-treatment room cone beam computed tomography (CBCT) imaging, due to the lack of reliable segmentation methods, CBCT is only used for gross set up corrections in lung radiotherapies. Accurate and reliable auto-segmentation tools could potentiate volumetric response assessment and geometry-guided adaptive radiation therapies. Therefore, we developed a new deep learning CBCT lung tumor segmentation method. Methods: The key idea of our approach called cross modality educed distillation (CMEDL) is to use magnetic resonance imaging (MRI) to guide a CBCT segmentation network training to extract more informative features during training. We accomplish this by training an end-to-end network comprised of unpaired domain adaptation (UDA) and cross-domain segmentation distillation networks (SDN) using unpaired CBCT and MRI datasets. Feature distillation regularizes the student network to extract CBCT features that match the statistical distribution of MRI features extracted by the teacher network and obtain better differentiation of tumor from background.} We also compared against an alternative framework that used UDA with MR segmentation network, whereby segmentation was done on the synthesized pseudo MRI representation. All networks were trained with 216 weekly CBCTs and 82 T2-weighted turbo spin echo MRI acquired from different patient cohorts. Validation was done on 20 weekly CBCTs from patients not used in training. Independent testing was done on 38 weekly CBCTs from patients not used in training or validation. Segmentation accuracy was measured using surface Dice similarity coefficient (SDSC) and Hausdroff distance at 95th percentile (HD95) metrics.
Since the breakout of coronavirus disease (COVID-19), the computer-aided diagnosis has become a necessity to prevent the spread of the virus. Detecting COVID-19 at an early stage is essential to reduce the mortality risk of the patients. In this study, a cascaded system is proposed to segment the lung, detect, localize, and quantify COVID-19 infections from computed tomography (CT) images Furthermore, the system classifies the severity of COVID-19 as mild, moderate, severe, or critical based on the percentage of infected lungs. An extensive set of experiments were performed using state-of-the-art deep Encoder-Decoder Convolutional Neural Networks (ED-CNNs), UNet, and Feature Pyramid Network (FPN), with different backbone (encoder) structures using the variants of DenseNet and ResNet. The conducted experiments showed the best performance for lung region segmentation with Dice Similarity Coefficient (DSC) of 97.19% and Intersection over Union (IoU) of 95.10% using U-Net model with the DenseNet 161 encoder. Furthermore, the proposed system achieved an elegant performance for COVID-19 infection segmentation with a DSC of 94.13% and IoU of 91.85% using the FPN model with the DenseNet201 encoder. The achieved performance is significantly superior to previous methods for COVID-19 lesion localization. Besides, the proposed system can reliably localize infection of various shapes and sizes, especially small infection regions, which are rarely considered in recent studies. Moreover, the proposed system achieved high COVID-19 detection performance with 99.64% sensitivity and 98.72% specificity. Finally, the system was able to discriminate between different severity levels of COVID-19 infection over a dataset of 1,110 subjects with sensitivity values of 98.3%, 71.2%, 77.8%, and 100% for mild, moderate, severe, and critical infections, respectively.
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