A gradient-based approach to fast and accurate head motion compensation in cone-beam CT

Cone-beam computed tomography (CBCT) systems, with their portability, present a promising avenue for direct point-of-care medical imaging, particularly in critical scenarios such as acute stroke assessment. However, the integration of CBCT into clinical workflows faces challenges, primarily linked to long scan duration resulting in patient motion during scanning and leading to image quality degradation in the reconstructed volumes. This paper introduces a novel approach to CBCT motion estimation using a gradient-based optimization algorithm, which leverages generalized derivatives of the backprojection operator for cone-beam CT geometries. Building on that, a fully differentiable target function is formulated which grades the quality of the current motion estimate in reconstruction space. We drastically accelerate motion estimation yielding a 19-fold speed-up compared to existing methods. Additionally, we investigate the architecture of networks used for quality metric regression and propose predicting voxel-wise quality maps, favoring autoencoder-like architectures over contracting ones. This modification improves gradient flow, leading to more accurate motion estimation. The presented method is evaluated through realistic experiments on head anatomy. It achieves a reduction in reprojection error from an initial average of 3mm to 0.61mm after motion compensation and consistently demonstrates superior performance compared to existing approaches. The analytic Jacobian for the backprojection operation, which is at the core of the proposed method, is made publicly available. In summary, this paper contributes to the advancement of CBCT integration into clinical workflows by proposing a robust motion estimation approach that enhances efficiency and accuracy, addressing critical challenges in time-sensitive scenarios.Comment: This work has been submitted to the IEEE for possible publication. Copyright may be transferred without notice, after which this version may no longer be accessibl

IMPROVED IMAGE QUALITY IN CONE-BEAM COMPUTED TOMOGRAPHY FOR IMAGE-GUIDED INTERVENTIONS

In the past few decades, cone-beam computed tomography (CBCT) emerged as a rapidly developing imaging modality that provides single rotation 3D volumetric reconstruction with sub-millimeter spatial resolution. Compared to the conventional multi-detector CT (MDCT), CBCT exhibited a number of characteristics that are well suited to applications in image-guided interventions, including improved mechanical simplicity, higher portability, and lower cost. Although the current generation of CBCT has shown strong promise for high-resolution and high-contrast imaging (e.g., visualization of bone structures and surgical instrumentation), it is often believed that CBCT yields inferior contrast resolution compared to MDCT and is not suitable for soft-tissue imaging. Aiming at expanding the utility of CBCT in image-guided interventions, this dissertation concerns the development of advanced imaging systems and algorithms to tackle the challenges of soft-tissue contrast resolution. The presented material includes work encompassing: (i) a comprehensive simulation platform to generate realistic CBCT projections (e.g., as training data for deep learning approaches); (ii) a new projection domain statistical noise model to improve the noise-resolution tradeoff in model-based iterative reconstruction (MBIR); (iii) a novel method to avoid CBCT metal artifacts by optimization of the source-detector orbit; (iv) an integrated software pipeline to correct various forms of CBCT artifacts (i.e., lag, glare, scatter, beam hardening, patient motion, and truncation); (v) a new 3D reconstruction method that only reconstructs the difference image from the image prior for use in CBCT neuro-angiography; and (vi) a novel method for 3D image reconstruction (DL-Recon) that combines deep learning (DL)-based image synthesis network with physics-based models based on Bayesian estimation of the statical uncertainty of the neural network. Specific clinical challenges were investigated in monitoring patients in the neurological critical care unit (NCCU) and advancing intraoperative soft-tissue imaging capability in image-guided spinal and intracranial neurosurgery. The results show that the methods proposed in this work substantially improved soft-tissue contrast in CBCT. The thesis demonstrates that advanced imaging approaches based on accurate system models, novel artifact reduction methods, and emerging 3D image reconstruction algorithms can effectively tackle current challenges in soft-tissue contrast resolution and expand the application of CBCT in image-guided interventions