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A Machine-learning Based Initialization for Joint Statistical Iterative Dual-energy CT with Application to Proton Therapy

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 Added by Tao Ge
 Publication date 2021
and research's language is English




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Dual-energy CT (DECT) has been widely investigated to generate more informative and more accurate images in the past decades. For example, Dual-Energy Alternating Minimization (DEAM) algorithm achieves sub-percentage uncertainty in estimating proton stopping-power mappings from experimental 3-mm collimated phantom data. However, elapsed time of iterative DECT algorithms is not clinically acceptable, due to their low convergence rate and the tremendous geometry of modern helical CT scanners. A CNN-based initialization method is introduced to reduce the computational time of iterative DECT algorithms. DEAM is used as an example of iterative DECT algorithms in this work. The simulation results show that our method generates denoised images with greatly improved estimation accuracy for adipose, tonsils, and muscle tissue. Also, it reduces elapsed time by approximately 5-fold for DEAM to reach the same objective function value for both simulated and real data.



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Purpose: Dual-energy CT (DECT) has been used to derive relative stopping power (RSP) map by obtaining the energy dependence of photon interactions. The DECT-derived RSP maps could potentially be compromised by image noise levels and the severity of artifacts when using physics-based mapping techniques, which would affect subsequent clinical applications. This work presents a noise-robust learning-based method to predict RSP maps from DECT for proton radiation therapy. Methods: The proposed method uses a residual attention cycle-consistent generative adversarial (CycleGAN) network. CycleGAN were used to let the DECT-to-RSP mapping be close to a one-to-one mapping by introducing an inverse RSP-to-DECT mapping. We retrospectively investigated 20 head-and-neck cancer patients with DECT scans in proton radiation therapy simulation. Ground truth RSP values were assigned by calculation based on chemical compositions, and acted as learning targets in the training process for DECT datasets, and were evaluated against results from the proposed method using a leave-one-out cross-validation strategy. Results: The predicted RSP maps showed an average normalized mean square error (NMSE) of 2.83% across the whole body volume, and average mean error (ME) less than 3% in all volumes of interest (VOIs). With additional simulated noise added in DECT datasets, the proposed method still maintained a comparable performance, while the physics-based stoichiometric method suffered degraded inaccuracy from increased noise level. The average differences in DVH metrics for clinical target volumes (CTVs) were less than 0.2 Gy for D95% and Dmax with no statistical significance. Conclusion: These results strongly indicate the high accuracy of RSP maps predicted by our machine-learning-based method and show its potential feasibility for proton treatment planning and dose calculation.
Purpose: Dual-energy CT (DECT) has been shown to derive stopping power ratio (SPR) map with higher accuracy than conventional single energy CT (SECT) by obtaining the energy dependence of photon interactions. However, DECT is not as widely implemented as SECT in proton radiation therapy simulation. This work presents a learning-based method to synthetize DECT images from SECT for proton radiation therapy. Methods: The proposed method uses a residual attention generative adversarial network. Residual blocks with attention gates were used to force the model focus on the difference between DECT maps and SECT images. To evaluate the accuracy of the method, we retrospectively investigated 20 head-and-neck cancer patients with both DECT and SECT scans available. The high and low energy CT images acquired from DECT acted as learning targets in the training process for SECT datasets and were evaluated against results from the proposed method using a leave-one-out cross-validation strategy. To evaluate our method in the context of a practical application, we generated SPR maps from sDECT using physics-based dual-energy stoichiometric method and compared the maps to those generated from DECT. Results: The synthesized DECT images showed an average mean absolute error around 30 Hounsfield Unit (HU) across the whole-body volume. The corresponding SPR maps generated from synthetic DECT showed an average normalized mean square error of about 1% with reduced noise level and artifacts than those from original DECT. Conclusions: The accuracy of the synthesized DECT image by our machine-learning-based method was evaluated on head and neck patient, and potential feasibility for proton treatment planning and dose calculation was shown by generating SPR map using the synthesized DECT.
LDCT has drawn major attention in the medical imaging field due to the potential health risks of CT-associated X-ray radiation to patients. Reducing the radiation dose, however, decreases the quality of the reconstructed images, which consequently compromises the diagnostic performance. Various deep learning techniques have been introduced to improve the image quality of LDCT images through denoising. GANs-based denoising methods usually leverage an additional classification network, i.e. discriminator, to learn the most discriminate difference between the denoised and normal-dose images and, hence, regularize the denoising model accordingly; it often focuses either on the global structure or local details. To better regularize the LDCT denoising model, this paper proposes a novel method, termed DU-GAN, which leverages U-Net based discriminators in the GANs framework to learn both global and local difference between the denoised and normal-dose images in both image and gradient domains. The merit of such a U-Net based discriminator is that it can not only provide the per-pixel feedback to the denoising network through the outputs of the U-Net but also focus on the global structure in a semantic level through the middle layer of the U-Net. In addition to the adversarial training in the image domain, we also apply another U-Net based discriminator in the image gradient domain to alleviate the artifacts caused by photon starvation and enhance the edge of the denoised CT images. Furthermore, the CutMix technique enables the per-pixel outputs of the U-Net based discriminator to provide radiologists with a confidence map to visualize the uncertainty of the denoised results, facilitating the LDCT-based screening and diagnosis. Extensive experiments on the simulated and real-world datasets demonstrate superior performance over recently published methods both qualitatively and quantitatively.
Markov random fields (MRFs) have been widely used as prior models in various inverse problems such as tomographic reconstruction. While MRFs provide a simple and often effective way to model the spatial dependencies in images, they suffer from the fact that parameter estimation is difficult. In practice, this means that MRFs typically have very simple structure that cannot completely capture the subtle characteristics of complex images. In this paper, we present a novel Gaussian mixture Markov random field model (GM-MRF) that can be used as a very expressive prior model for inverse problems such as denoising and reconstruction. The GM-MRF forms a global image model by merging together individual Gaussian-mixture models (GMMs) for image patches. In addition, we present a novel analytical framework for computing MAP estimates using the GM-MRF prior model through the construction of surrogate functions that result in a sequence of quadratic optimizations. We also introduce a simple but effective method to adjust the GM-MRF so as to control the sharpness in low- and high-contrast regions of the reconstruction separately. We demonstrate the value of the model with experiments including image denoising and low-dose CT reconstruction.
Proton beam therapy can potentially offer improved treatment for cancers of the head and neck and in paediatric patients. There has been a sharp uptake of proton beam therapy in recent years as improved delivery techniques and patient benefits are observed. However, treatments are currently planned using conventional x-ray CT images due to the absence of devices able to perform high quality proton computed tomography (pCT) under realistic clinical conditions. A new plastic-scintillator-based range telescope concept, named ASTRA, is proposed here as the energy tagging detector of a pCT system. Simulations conducted using Geant4 yield an expected energy resolution of 0.7% and have demonstrated the ability of ASTRA to track multiple protons simultaneously. If calorimetric information is used the energy resolution could be further improved to about 0.5%. Assuming clinical beam parameters the system is expected to be able to efficiently reconstruct at least, 10$^8$ protons/s. The performance of ASTRA has been tested by imaging phantoms to evaluate the image contrast and relative stopping power reconstruction.

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