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

Unsupervised Polychromatic Neural Representation for CT Metal Artifact Reduction

Emerging neural reconstruction techniques based on tomography (e.g., NeRF, NeAT, and NeRP) have started showing unique capabilities in medical imaging. In this work, we present a novel Polychromatic neural representation (Polyner) to tackle the challenging problem of CT imaging when metallic implants exist within the human body. The artifacts arise from the drastic variation of metal's attenuation coefficients at various energy levels of the X-ray spectrum, leading to a nonlinear metal effect in CT measurements. Reconstructing CT images from metal-affected measurements hence poses a complicated nonlinear inverse problem where empirical models adopted in previous metal artifact reduction (MAR) approaches lead to signal loss and strongly aliased reconstructions. Polyner instead models the MAR problem from a nonlinear inverse problem perspective. Specifically, we first derive a polychromatic forward model to accurately simulate the nonlinear CT acquisition process. Then, we incorporate our forward model into the implicit neural representation to accomplish reconstruction. Lastly, we adopt a regularizer to preserve the physical properties of the CT images across different energy levels while effectively constraining the solution space. Our Polyner is an unsupervised method and does not require any external training data. Experimenting with multiple datasets shows that our Polyner achieves comparable or better performance than supervised methods on in-domain datasets while demonstrating significant performance improvements on out-of-domain datasets. To the best of our knowledge, our Polyner is the first unsupervised MAR method that outperforms its supervised counterparts.Comment: 19 page

The Estimation and Correction of Rigid Motion in Helical Computed Tomography

X-ray CT is a tomographic imaging tool used in medicine and industry. Although technological developments have significantly improved the performance of CT systems, the accuracy of images produced by state-of-the-art scanners is still often limited by artefacts due to object motion. To tackle this problem, a number of motion estimation and compensation methods have been proposed. However, no methods with the demonstrated ability to correct for rigid motion in helical CT scans appear to exist. The primary aims of this thesis were to develop and evaluate effective methods for the estimation and correction of arbitrary six degree-of-freedom rigid motion in helical CT. As a first step, a method was developed to accurately estimate object motion during CT scanning with an optical tracking system, which provided sub-millimetre positional accuracy. Subsequently a motion correction method, which is analogous to a method previously developed for SPECT, was adapted to CT. The principle is to restore projection consistency by modifying the source-detector orbit in response to the measured object motion and reconstruct from the modified orbit with an iterative reconstruction algorithm. The feasibility of this method was demonstrated with a rapidly moving brain phantom, and the efficacy of correcting for a range of human head motions acquired from healthy volunteers was evaluated in simulations. The methods developed were found to provide accurate and artefact-free motion corrected images with most types of head motion likely to be encountered in clinical CT imaging, provided that the motion was accurately known. The method was also applied to CT data acquired on a hybrid PET/CT scanner demonstrating its versatility. Its clinical value may be significant by reducing the need for repeat scans (and repeat radiation doses), anesthesia and sedation in patient groups prone to motion, including young children

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

Model-Based Iterative Reconstruction in Cone-Beam Computed Tomography: Advanced Models of Imaging Physics and Prior Information

Cone-beam computed tomography (CBCT) represents a rapidly developing imaging modality that provides three-dimensional (3D) volumetric images with sub-millimeter spatial resolution and soft-tissue visibility from a single gantry rotation. CBCT tends to have small footprint, mechanical simplicity, open geometry, and low cost compared to conventional diagnostic CT. Because of these features, CBCT has been used in a variety of specialty diagnostic applications, image-guided radiation therapy (on-board CBCT), and surgical guidance (e.g., C-arm based CBCT). However, the current generation of CBCT systems face major challenges in low-contrast, soft-tissue image quality – for example, in the detection of acute intracranial hemorrhage (ICH), which requires a fairly high level of image uniformity, spatial resolution, and contrast resolution. Moreover, conventional approaches in both diagnostic and image-guided interventions that involve a series of imaging studies fail to leverage the wealth of patient-specific anatomical information available from previous scans. Leveraging the knowledge gained from prior images holds the potential for major gains in image quality and dose reduction. Model-based iterative reconstruction (MBIR) attempts to make more efficient use of the measurement data by incorporating a forward model of physical detection processes. Moreover, MBIR allows incorporation of various forms of prior information into image reconstruction, ranging from image smoothness and sharpness to patient-specific anatomical information. By leveraging such advantages, MBIR has demonstrated improved tradeoffs between image quality and radiation dose in multi-detector CT in the past decade and has recently shown similar promise in CBCT. However, the full potential of MBIR in CBCT is yet to be realized. This dissertation explores the capabilities of MBIR in improving image quality (especially low-contrast, soft-tissue image quality) and reducing radiation dose in CBCT. The presented work encompasses new MBIR methods that: i) modify the noise model in MBIR to compensate for noise amplification from artifact correction; ii) design regularization by explicitly incorporating task-based imaging performance as the objective; iii) mitigate truncation effects in a computationally efficient manner; iv) leverage a wealth of patient-specific anatomical information from a previously acquired image; and v) prospectively estimate the optimal amount of prior image information for accurate admission of specific anatomical changes. Specific clinical challenges are investigated in the detection of acute ICH and surveillance of lung nodules. The results show that MBIR can substantially improve low-contrast, soft-tissue image quality in CBCT and enable dose reduction techniques in sequential imaging studies. The thesis demonstrates that novel MBIR methods hold strong potential to overcome conventional barriers to CBCT image quality and open new clinical applications that would benefit from high-quality 3D imaging

A longitudinal four-dimensional computed tomography and cone beam computed tomography dataset for image-guided radiation therapy research in lung cancer.

PURPOSE: To describe in detail a dataset consisting of serial four-dimensional computed tomography (4DCT) and 4D cone beam CT (4DCBCT) images acquired during chemoradiotherapy of 20 locally advanced, nonsmall cell lung cancer patients we have collected at our institution and shared publicly with the research community. ACQUISITION AND VALIDATION METHODS: As part of an NCI-sponsored research study 82 4DCT and 507 4DCBCT images were acquired in a population of 20 locally advanced nonsmall cell lung cancer patients undergoing radiation therapy. All subjects underwent concurrent radiochemotherapy to a total dose of 59.4-70.2 Gy using daily 1.8 or 2 Gy fractions. Audio-visual biofeedback was used to minimize breathing irregularity during all fractions, including acquisition of all 4DCT and 4DCBCT acquisitions in all subjects. Target, organs at risk, and implanted fiducial markers were delineated by a physician in the 4DCT images. Image coordinate system origins between 4DCT and 4DCBCT were manipulated in such a way that the images can be used to simulate initial patient setup in the treatment position. 4DCT images were acquired on a 16-slice helical CT simulator with 10 breathing phases and 3 mm slice thickness during simulation. In 13 of the 20 subjects, 4DCTs were also acquired on the same scanner weekly during therapy. Every day, 4DCBCT images were acquired on a commercial onboard CBCT scanner. An optically tracked external surrogate was synchronized with CBCT acquisition so that each CBCT projection was time stamped with the surrogate respiratory signal through in-house software and hardware tools. Approximately 2500 projections were acquired over a period of 8-10 minutes in half-fan mode with the half bow-tie filter. Using the external surrogate, the CBCT projections were sorted into 10 breathing phases and reconstructed with an in-house FDK reconstruction algorithm. Errors in respiration sorting, reconstruction, and acquisition were carefully identified and corrected. DATA FORMAT AND USAGE NOTES: 4DCT and 4DCBCT images are available in DICOM format and structures through DICOM-RT RTSTRUCT format. All data are stored in the Cancer Imaging Archive (TCIA, http://www.cancerimagingarchive.net/) as collection 4D-Lung and are publicly available. DISCUSSION: Due to high temporal frequency sampling, redundant (4DCT and 4DCBCT) data at similar timepoints, oversampled 4DCBCT, and fiducial markers, this dataset can support studies in image-guided and image-guided adaptive radiotherapy, assessment of 4D voxel trajectory variability, and development and validation of new tools for image registration and motion management