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Register a new userA comprehensive study on the relationship between image quality and imaging dose in low-dose cone beam CT
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While compressed sensing (CS) based reconstructions have been developed for low-dose CBCT, a clear understanding on the relationship between the image quality and imaging dose at low dose levels is needed. In this paper, we qualitatively investigate this subject in a comprehensive manner with extensive experimental and simulation studies. The basic idea is to plot image quality and imaging dose together as functions of number of projections and mAs per projection over the whole clinically relevant range. A clear understanding on the tradeoff between image quality and dose can be achieved and optimal low-dose CBCT scan protocols can be developed for various imaging tasks in IGRT. Main findings of this work include: 1) Under the CS framework, image quality has little degradation over a large dose range, and the degradation becomes evident when the dose < 100 total mAs. A dose < 40 total mAs leads to a dramatic image degradation. Optimal low-dose CBCT scan protocols likely fall in the dose range of 40-100 total mAs, depending on the specific IGRT applications. 2) Among different scan protocols at a constant low-dose level, the super sparse-view reconstruction with projection number less than 50 is the most challenging case, even with strong regularization. Better image quality can be acquired with other low mAs protocols. 3) The optimal scan protocol is the combination of a medium number of projections and a medium level of mAs/view. This is more evident when the dose is around 72.8 total mAs or below and when the ROI is a low-contrast or high-resolution object. Based on our results, the optimal number of projections is around 90 to 120. 4) The clinically acceptable lowest dose level is task dependent. In our study, 72.8mAs is a safe dose level for visualizing low-contrast objects, while 12.2 total mAs is sufficient for detecting high-contrast objects of diameter greater than 3 mm.
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Cone beam CT (CBCT) has been widely used for patient setup in image guided radiation therapy (IGRT). Radiation dose from CBCT scans has become a clinical concern. The purposes of this study are 1) to commission a GPU-based Monte Carlo (MC) dose calculation package gCTD for Varian On-Board Imaging (OBI) system and test the calculation accuracy, and 2) to quantitatively evaluate CBCT dose from the OBI system in typical IGRT scan protocols. We first conducted dose measurements in a water phantom. X-ray source model parameters used in gCTD are obtained through a commissioning process. gCTD accuracy is demonstrated by comparing calculations with measurements in water and in CTDI phantoms. 25 brain cancer patients are used to study dose in a standard-dose head protocol, and 25 prostate cancer patients are used to study dose in pelvis protocol and pelvis spotlight protocol. Mean dose to each organ is calculated. Mean dose to 2% voxels that have the highest dose is also computed to quantify the maximum dose. It is found that the mean dose value to an organ varies largely among patients. Moreover, dose distribution is highly non-homogeneous inside an organ. The maximum dose is found to be 1~3 times higher than the mean dose depending on the organ, and is up to 8 times higher for the entire body due to the very high dose region in bony structures. High computational efficiency has also been observed in our studies, such that MC dose calculation time is less than 5 min for a typical case.
X-ray Computed Tomography (CT) is an important tool in medical imaging to obtain a direct visualization of patient anatomy. However, the x-ray radiation exposure leads to the concern of lifetime cancer risk. Low-dose CT scan can reduce the radiation exposure to patient while the image quality is usually degraded due to the appearance of noise and artifacts. Numerous studies have been conducted to regularize CT image for better image quality. Yet, exploring the underlying manifold where real CT images residing on is still an open problem. In this paper, we propose a fully data-driven manifold learning approach by incorporating the emerging deep-learning technology. An encoder-decoder convolutional neural network has been established to map a CT image to the inherent low-dimensional manifold, as well as to restore the CT image from its corresponding manifold representation. A novel reconstruction algorithm assisted by the leant manifold prior has been developed to achieve high quality low-dose CT reconstruction. In order to demonstrate the effectiveness of the proposed framework, network training, testing, and comprehensive simulation study have been performed using patient abdomen CT images. The trained encoder-decoder CNN is capable of restoring high-quality CT images with average error of ~20 HU. Furthermore, the proposed manifold prior assisted reconstruction scheme achieves high-quality low-dose CT reconstruction, with average reconstruction error of < 30 HU, more than five times and two times lower than that of filtered back projection method and total-variation based iterative reconstruction method, respectively.
The extensive use of medical CT has raised a public concern over the radiation dose to the patient. Reducing the radiation dose leads to increased CT image noise and artifacts, which can adversely affect not only the radiologists judgement but also the performance of downstream medical image analysis tasks. Various low-dose CT denoising methods, especially the recent deep learning based approaches, have produced impressive results. However, the existing denoising methods are all downstream-task-agnostic and neglect the diverse needs of the downstream applications. In this paper, we introduce a novel Task-Oriented Denoising Network (TOD-Net) with a task-oriented loss leveraging knowledge from the downstream tasks. Comprehensive empirical analysis shows that the task-oriented loss complements other task agnostic losses by steering the denoiser to enhance the image quality in the task related regions of interest. Such enhancement in turn brings general boosts on the performance of various methods for the downstream task. The presented work may shed light on the future development of context-aware image denoising methods.
A computer-aided detection (CAD) system for the identification of pulmonary nodules in low-dose multi-detector helical CT images with 1.25 mm slice thickness is being developed in the framework of the INFN-supported MAGIC-5 Italian project. The basic modules of our lung-CAD system, a dot enhancement filter for nodule candidate selection and a voxel-based neural classifier for false-positive finding reduction, are described. Preliminary results obtained on the so-far collected database of lung CT scans are discussed.
This paper applies the recent fast iterative neural network framework, Momentum-Net, using appropriate models to low-dose X-ray computed tomography (LDCT) image reconstruction. At each layer of the proposed Momentum-Net, the model-based image reconstruction module solves the majorized penalized weighted least-square problem, and the image refining module uses a four-layer convolutional neural network (CNN). Experimental results with the NIH AAPM-Mayo Clinic Low Dose CT Grand Challenge dataset show that the proposed Momentum-Net architecture significantly improves image reconstruction accuracy, compared to a state-of-the-art noniterative image denoising deep neural network (NN), WavResNet (in LDCT). We also investigated the spectral normalization technique that applies to image refining NN learning to satisfy the nonexpansive NN property; however, experimental results show that this does not improve the image reconstruction performance of Momentum-Net.
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