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Objective. The aim of this study was to reconstruct volumetric computed tomography (CT) images in real-time from ultra-sparse two-dimensional x-ray projections, facilitating easier navigation and positioning during image-guided radiation therapy. Approach. Our approach leverages a voxel-sapce-searching Transformer model to overcome the limitations of conventional CT reconstruction techniques, which require extensive x-ray projections and lead to high radiation doses and equipment constraints. Main results. The proposed XTransCT algorithm demonstrated superior performance in terms of image quality, structural accuracy, and generalizability across different datasets, including a hospital set of 50 patients, the large-scale public LIDC-IDRI dataset, and the LNDb dataset for cross-validation. Notably, the algorithm achieved an approximately 300% improvement in reconstruction speed, with a rate of 44 ms per 3D image reconstruction compared to former 3D convolution-based methods. Significance. The XTransCT architecture has the potential to impact clinical practice by providing high-quality CT images faster and with substantially reduced radiation exposure for patients. The model's generalizability suggests it has the potential applicable in various healthcare settings. [ABSTRACT FROM AUTHOR]

Purpose. Although deep learning (DL) technique has been successfully used for computed tomography (CT) reconstruction, its implementation on cone-beam CT (CBCT) reconstruction is extremely challenging due to memory limitations. In this study, a novel DL technique is developed to resolve the memory issue, and its feasibility is demonstrated for CBCT reconstruction from sparsely sampled projection data. Methods. The novel geometry-guided deep learning (GDL) technique is composed of a GDL reconstruction module and a post-processing module. The GDL reconstruction module learns and performs projection-to-image domain transformation by replacing the traditional single fully connected layer with an array of small fully connected layers in the network architecture based on the projection geometry. The DL post-processing module further improves image quality after reconstruction. We demonstrated the feasibility and advantage of the model by comparing ground truth CBCT with CBCT images reconstructed using (1) GDL reconstruction module only, (2) GDL reconstruction module with DL post-processing module, (3) Feldkamp, Davis, and Kress (FDK) only, (4) FDK with DL post-processing module, (5) ray-tracing only, and (6) ray-tracing with DL post-processing module. The differences are quantified by peak-signal-to-noise ratio (PSNR), structural similarity index measure (SSIM), and root-mean-square error (RMSE). Results. CBCT images reconstructed with GDL show improvements in quantitative scores of PSNR, SSIM, and RMSE. Reconstruction time per image for all reconstruction methods are comparable. Compared to current DL methods using large fully connected layers, the estimated memory requirement using GDL is four orders of magnitude less, making DL CBCT reconstruction feasible. Conclusion. With much lower memory requirement compared to other existing networks, the GDL technique is demonstrated to be the first DL technique that can rapidly and accurately reconstruct CBCT images from sparsely sampled data. [ABSTRACT FROM AUTHOR]

Patient movement affects image quality in oral and maxillofacial cone-beam computed tomography imaging. While many efforts are made to minimize the possibility of motion during a scan, relatively little attention has been given to motion correction after acquisition. We propose a novel method which can improve the image quality after an oral and maxillofacial scan. The proposed method is based on our previous work and is a retrospective motion estimation and motion compensation (ME/MC) approach that iteratively estimates and compensates for rigid pose change over time. During motion estimation, image update and motion update are performed alternately in a multi-resolution scheme to obtain the motion. We propose use of a feature-based motion update and patch-based image update in the iterative estimation process, to alleviate the effect of limited scan field of view on estimation. During motion compensation, a fine-resolution image reconstruction was performed with compensation for the estimated motion. The proposed ME/MC method was evaluated with simulations, phantom and patient studies. Two experts in dentomaxillofacial radiology assessed the diagnostic importance of the resulting motion artifact suppression. The quality of the reconstructed images was improved after motion compensation, and most of the image artifacts were eliminated. Quantitative analysis by comparison to a reference image and by calculation of a sharpness metric agreed with the qualitative observation. The results are promising, and further evaluation is required to assess the clinical value of the proposed method. [ABSTRACT FROM AUTHOR]

This study introduces and evaluates respiratory-correlated four-dimensional (4D) inverse geometry computed tomography (IGCT). The projection data of the IGCT were acquired in a single gantry rotation over 120 s. Three virtual phantoms—static Defrise, 4D Shepp–Logan, and 4D extended cardiac-torso (XCAT)—were used to obtain projection data for the IGCT and cone-beam computed tomography (CBCT). The projection acquisition parameters were determined to eliminate vacancies in the Radon space for an accurate rebinning process. Phase-based sorting was conducted within 10 phase bins, and the sorted projection data were binned into a cone beam geometry. Finally, Feldkamp–Davis–Kress reconstruction was conducted independently at each phase. The reconstructed images were compared using the structural similarity index measure (SSIM) and root mean square error (RMSE). The vertical profile of the Defrise reconstruction image was uniform, and the cone beam artefact was reduced in the IGCT image. Under an ideal projection acquisition condition, the mean coronal plane SSIMs of the Shepp–Logan and 4D XCAT phantoms were 0.899 and 0.706, respectively, which were higher than those of the CBCT (0.784 and 0.623, respectively). Similarly, the mean RMSEs of the coronal plane IGCT (0.036 and 0.158) exhibited an improvement over those of the CBCT (0.165 and 0.261, respectively). The mean standard deviations of the SSIM and RMSE were lower for IGCT than for CBCT. In particular, the SSIM and RMSE of the sagittal and coronal planes of the Shepp–Logan IGCT images were stable in all phase bins; however, those of the CBCT changed depending on the phase bins. Poor image quality was observed for IGCT under inappropriate conditions. This was caused by a vacancy in the Radon space, owing to an inappropriate scan setting. Overall, the proposed 4D IGCT exhibited better image quality than conventional CBCT. [ABSTRACT FROM AUTHOR]

Beam hardening in x-ray computed tomography (CT) is inevitable because of the polychromatic x-ray spectrum and energy-dependent attenuation coefficients of materials, leading to the underestimation of artifacts arising from projection data, especially on metal regions. State-of-the-art research on beam-hardening artifacts is based on a numerical method that recursively performs CT reconstruction, which leads to a heavy computational burden. To address this computational issue, we propose a constrained beam-hardening estimator that provides an efficient numerical solution via a linear combination of two images reconstructed only once during the entire process. The proposed estimator reflects the geometry of metal objects and physical characteristics of beam hardening during the transmission of polychromatic x-rays through a material. Most of the associated parameters are numerically obtained from an initial uncorrected CT image and forward projection transformation without additional optimization procedures. Only the unknown parameter related to beam-hardening artifacts is fine-tuned by linear optimization, which is performed only in the reconstruction image domain. The proposed approach was systematically assessed using numerical simulations and phantom data for qualitative and quantitative comparisons. Compared with existing sinogram inpainting-based and model-based approaches, the proposed scheme in conjunction with the constrained beam-hardening estimator not only provided improved image quality in areas surrounding the metal but also achieved fast beam-hardening correction owing to the analytical reconstruction structure. This work may have significant implications in improving dose calculation accuracy or target volume delineation for treatment planning in radiotherapy. [ABSTRACT FROM AUTHOR]

Model-based iterative reconstruction (MBIR) for cone-beam CT (CBCT) offers better noise-resolution tradeoff and image quality than analytical methods for acquisition protocols with low x-ray dose or limited data, but with increased computational burden that poses a drawback to routine application in clinical scenarios. This work develops a comprehensive framework for acceleration of MBIR in the form of penalized weighted least squares optimized with ordered subsets separable quadratic surrogates. The optimization was scheduled on a set of stages forming a morphological pyramid varying in voxel size. Transition between stages was controlled with a convergence criterion based on the deviation between the mid-band noise power spectrum (NPS) measured on a homogeneous region of the evolving reconstruction and that expected for the converged image, computed with an analytical model that used projection data and the reconstruction parameters. A stochastic backprojector was developed by introducing a random perturbation to the sampling position of each voxel for each ray in the reconstruction within a voxel-based backprojector, breaking the deterministic pattern of sampling artifacts when combined with an unmatched Siddon forward projector. This fast, forward and backprojector pair were included into a multi-resolution reconstruction strategy to provide support for objects partially outside of the field of view. Acceleration from ordered subsets was combined with momentum accumulation stabilized with an adaptive technique that automatically resets the accumulated momentum when it diverges noticeably from the current iteration update. The framework was evaluated with CBCT data of a realistic abdomen phantom acquired on an imaging x-ray bench and with clinical CBCT data from an angiography robotic C-arm (Artis Zeego, Siemens Healthineers, Forchheim, Germany) acquired during a liver embolization procedure. Image fidelity was assessed with the structural similarity index (SSIM) computed with a converged reconstruction. The accelerated framework provided accurate reconstructions in 60 s (SSIM = 0.97) and as little as 27 s (SSIM = 0.94) for soft-tissue evaluation. The use of simple forward and backprojectors resulted in 9.3× acceleration. Accumulation of momentum provided extra ∼3.5× acceleration with stable convergence for 6–30 subsets. The NPS-driven morphological pyramid resulted in initial faster convergence, achieving similar SSIM with 1.5× lower runtime than the single-stage optimization. Acceleration of MBIR to provide reconstruction time compatible with clinical applications is feasible via architectures that integrate algorithmic acceleration with approaches to provide stable convergence, and optimization schedules that maximize convergence speed. [ABSTRACT FROM AUTHOR]

Image-guided therapies in the abdomen and pelvis are often hindered by motion artifacts in cone-beam CT (CBCT) arising from complex, non-periodic, deformable organ motion during long scan times (5–30 s). We propose a deformable image-based motion compensation method to address these challenges and improve CBCT guidance. Motion compensation is achieved by selecting a set of small regions of interest in the uncompensated image to minimize a cost function consisting of an autofocus objective and spatiotemporal regularization penalties. Motion trajectories are estimated using an iterative optimization algorithm (CMA-ES) and used to interpolate a 4D spatiotemporal motion vector field. The motion-compensated image is reconstructed using a modified filtered backprojection approach. Being image-based, the method does not require additional input besides the raw CBCT projection data and system geometry that are used for image reconstruction. Experimental studies investigated: (1) various autofocus objective functions, analyzed using a digital phantom with a range of sinusoidal motion magnitude (4, 8, 12, 16, 20 mm); (2) spatiotemporal regularization, studied using a CT dataset from The Cancer Imaging Archive with deformable sinusoidal motion of variable magnitude (10, 15, 20, 25 mm); and (3) performance in complex anatomy, evaluated in cadavers undergoing simple and complex motion imaged on a CBCT-capable mobile C-arm system (Cios Spin 3D, Siemens Healthineers, Forchheim, Germany). Gradient entropy was found to be the best autofocus objective for soft-tissue CBCT, increasing structural similarity (SSIM) by 42%–92% over the range of motion magnitudes investigated. The optimal temporal regularization strength was found to vary widely (0.5–5 mm−2) over the range of motion magnitudes investigated, whereas optimal spatial regularization strength was relatively constant (0.1). In cadaver studies, deformable motion compensation was shown to improve local SSIM by ∼17% for simple motion and ∼21% for complex motion and provided strong visual improvement of motion artifacts (reduction of blurring and streaks and improved visibility of soft-tissue edges). The studies demonstrate the robustness of deformable motion compensation to a range of motion magnitudes, frequencies, and other factors (e.g. truncation and scatter). [ABSTRACT FROM AUTHOR]

Four-dimensional (4D) cone-beam CT (CBCT) reconstructs temporally-resolved phases of 3D volumes often with the same amount of projection data that are meant for reconstructing a single 3D volume. 4D CBCT is a sparse-data problem that is very challenging for high-quality 4D CBCT image reconstruction. Here we develop a new method, namely 4D-AirNet, that synergizes analytical and iterative method with deep learning for high-quality temporally-resolved CBCT slice reconstruction. 4D-AirNet is an unrolling method using the optimization framework of fused analytical and iterative reconstruction (AIR), which is based on proximal forward-backward splitting (PFBS). Three different strategies are developed for 4D-AirNet: random-phase (RP), prior-guided (PG), and all-phase (AP). RP-AirNet and PG-AirNet utilize phase-by-phase training and reconstruction, while PG-AirNet also uses a prior image reconstructed with all-phase projection data. Dense connectivity is built into 4D-AirNet networks for improved reconstruction quality. In contrast, AP-AirNet trains and reconstructs all phases simultaneously. In addition, the joint regularization method of DL and conventional spatiotemporal total variation (TV) is investigated. 4D-AirNet methods were evaluated in comparison with conventional iterative (TV) and deep learning (LEARN) methods, using simulated 2D-t CBCT scans from a lung dataset with various sparse-data levels. The reconstruction results suggest 4D-AirNet methods outperform TV and LEARN, and AP-AirNet provides the best reconstruction quality overall. [ABSTRACT FROM AUTHOR]

Metal artifacts present a challenge to cone-beam CT (CBCT) image-guided surgery, obscuring visualization of metal instruments and adjacent anatomy—often in the very region of interest pertinent to the imaging/surgical tasks. We present a method to reduce the influence of metal artifacts by prospectively defining an image acquisition protocol—viz., the C-arm source-detector orbit—that mitigates metal-induced biases in the projection data. The metal artifact avoidance (MAA) method is compatible with simple mobile C-arms, does not require exact prior information on the patient or metal implants, and is consistent with 3D filtered backprojection (FBP), more advanced (e.g. polyenergetic) model-based image reconstruction (MBIR), and metal artifact reduction (MAR) post-processing methods. The MAA method consists of: (i) coarse localization of metal objects in the field-of-view (FOV) via two or more low-dose scout projection views and segmentation (e.g. a simple U-Net) in coarse backprojection; (ii) model-based prediction of metal-induced x-ray spectral shift for all source-detector vertices accessible by the imaging system (e.g. gantry rotation and tilt angles); and (iii) identification of a circular or non-circular orbit that reduces the variation in spectral shift. The method was developed, tested, and evaluated in a series of studies presenting increasing levels of complexity and realism, including digital simulations, phantom experiment, and cadaver experiment in the context of image-guided spine surgery (pedicle screw implants). The MAA method accurately predicted tilted circular and non-circular orbits that reduced the magnitude of metal artifacts in CBCT reconstructions. Realistic distributions of metal instrumentation were successfully localized (0.71 median Dice coefficient) from 2–6 low-dose scout views even in complex anatomical scenes. The MAA-predicted tilted circular orbits reduced root-mean-square error (RMSE) in 3D image reconstructions by 46%–70% and 'blooming' artifacts (apparent width of the screw shaft) by 20–45%. Non-circular orbits defined by MAA achieved a further ∼46% reduction in RMSE compared to the best (tilted) circular orbit. The MAA method presents a practical means to predict C-arm orbits that minimize spectral bias from metal instrumentation. Resulting orbits—either simple tilted circular orbits or more complex non-circular orbits that can be executed with a motorized multi-axis C-arm—exhibited substantial reduction of metal artifacts in raw CBCT reconstructions by virtue of higher fidelity projection data, which are in turn compatible with subsequent MAR post-processing and/or polyenergetic MBIR to further reduce artifacts. [ABSTRACT FROM AUTHOR]

The primary cone-beam computed tomography (CBCT) imaging beam scatters inside the patient and produces a contaminating photon fluence that is registered by the detector. Scattered photons cause artifacts in the image reconstruction, and are partially responsible for the inferior image quality compared to diagnostic fan-beam CT. In this work, a deep convolutional autoencoder (DCAE) and projection-based scatter removal algorithm were constructed for the ImagingRingTM system on rails (IRr), which allows for non-isocentric acquisitions around virtual rotation centers with its independently rotatable source and detector arms. A Monte Carlo model was developed to simulate (i) a non-isocentric training dataset of ≈1200 projection pairs (primary + scatter) from 27 digital head-and-neck cancer patients around five different virtual rotation centers (DCAENONISO), and (ii) an isocentric dataset existing of ≈1200 projection pairs around the physical rotation center (DCAEISO). The scatter removal performance of both DCAE networks was investigated in two digital anthropomorphic phantom simulations and due to superior performance only the DCAENONISO was applied on eight real patient acquisitions. Measures for the quantitative error, the signal-to-noise ratio, and the similarity were evaluated for two simulated digital head-and-neck patients, and the contrast-to-noise ratio (CNR) was investigated between muscle and adipose tissue in the real patient image reconstructions. Image quality metrics were compared between the uncorrected data, the currently implemented heuristic scatter correction data, and the DCAE corrected image reconstruction. The DCAENONISO corrected image reconstructions of two digital patient simulations showed superior image quality metrics compared to the uncorrected and corrected image reconstructions using a heuristic scatter removal. The proposed DCAENONISO scatter correction in this study was successfully demonstrated in real non-isocentric patient CBCT acquisitions and achieved statistically significant higher CNRs compared to the uncorrected or the heuristic corrected image data. This paper presents for the first time a projection-based scatter removal algorithm for isocentric and non-isocentric CBCT imaging using a deep convolutional autoencoder trained on Monte Carlo composed datasets. The algorithm was successfully applied to real patient data. [ABSTRACT FROM AUTHOR]

Intraoperative cone-beam CT (CBCT) is increasingly used for surgical navigation and validation of device placement. In spinal deformity correction, CBCT provides visualization of pedicle screws and fixation rods in relation to adjacent anatomy. This work reports and evaluates a method that uses prior information regarding such surgical instrumentation for improved metal artifact reduction (MAR). The known-component MAR (KC-MAR) approach achieves precise localization of instrumentation in projection images using rigid or deformable 3D–2D registration of component models, thereby overcoming residual errors associated with segmentation-based methods. Projection data containing metal components are processed via 2D inpainting of the detector signal, followed by 3D filtered back-projection (FBP). Phantom studies were performed to identify nominal algorithm parameters and quantitatively investigate performance over a range of component material composition and size. A cadaver study emulating screw and rod placement in spinal deformity correction was conducted to evaluate performance under realistic clinical imaging conditions. KC-MAR demonstrated reduction in artifacts (standard deviation in voxel values) across a range of component types and dose levels, reducing the artifact to 5–10 HU. Accurate component delineation was demonstrated for rigid (screw) and deformable (rod) models with sub-mm registration errors, and a single-pixel dilation of the projected components was found to compensate for partial-volume effects. Artifacts associated with spine screws and rods were reduced by 40%–80% in cadaver studies, and the resulting images demonstrated markedly improved visualization of instrumentation (e.g. screw threads) within cortical margins. The KC-MAR algorithm combines knowledge of surgical instrumentation with 3D image reconstruction in a manner that overcomes potential pitfalls of segmentation. The approach is compatible with FBP—thereby maintaining simplicity in a manner that is consistent with surgical workflow—or more sophisticated model-based reconstruction methods that could further improve image quality and/or help reduce radiation dose. [ABSTRACT FROM AUTHOR]

The potential for statistical image reconstruction methods such as penalized-likelihood (PL) to improve C-arm cone-beam CT (CBCT) soft-tissue visualization for intraoperative imaging over conventional filtered backprojection (FBP) is assessed in this work by making a fair comparison in relation to soft-tissue performance. A prototype mobile C-arm was used to scan anthropomorphic head and abdomen phantoms as well as a cadaveric torso at doses substantially lower than typical values in diagnostic CT, and the effects of dose reduction via tube current reduction and sparse sampling were also compared. Matched spatial resolution between PL and FBP was determined by the edge spread function of low-contrast (∼40–80 HU) spheres in the phantoms, which were representative of soft-tissue imaging tasks. PL using the non-quadratic Huber penalty was found to substantially reduce noise relative to FBP, especially at lower spatial resolution where PL provides a contrast-to-noise ratio increase up to 1.4–2.2× over FBP at 50% dose reduction across all objects. Comparison of sampling strategies indicates that soft-tissue imaging benefits from fully sampled acquisitions at dose above ∼1.7 mGy and benefits from 50% sparsity at dose below ∼1.0 mGy. Therefore, an appropriate sampling strategy along with the improved low-contrast visualization offered by statistical reconstruction demonstrates the potential for extending intraoperative C-arm CBCT to applications in soft-tissue interventions in neurosurgery as well as thoracic and abdominal surgeries by overcoming conventional tradeoffs in noise, spatial resolution, and dose. [ABSTRACT FROM AUTHOR]

Cone-beam consistency conditions (also known as range conditions) are mathematical relationships between different cone-beam projections, and they therefore describe the redundancy or overlap of information between projections. These redundancies have often been exploited for applications in image reconstruction. In this work we describe new consistency conditions for cone-beam projections whose source positions lie on a plane. A further restriction is that the target object must not intersect this plane. The conditions require that moments of the cone-beam projections be polynomial functions of the source positions, with some additional constraints on the coefficients of the polynomials. A precise description of the consistency conditions is that the four parameters of the cone-beam projections (two for the detector, two for the source position) can be expressed with just three variables, using a certain formulation involving homogeneous polynomials. The main contribution of this work is our demonstration that these conditions are not only necessary, but also sufficient. Thus the consistency conditions completely characterize all redundancies, so no other independent conditions are possible and in this sense the conditions are full. The idea of the proof is to use the known consistency conditions for 3D parallel projections, and to then apply a 1996 theorem of Edholm and Danielsson that links parallel to cone-beam projections. The consistency conditions are illustrated with a simulation example. [ABSTRACT FROM AUTHOR]

Non-coplanar beams are important for treatment of both cranial and noncranial tumors. Treatment verification of such beams with couch rotation/kicks, however, is challenging, particularly for the application of cone beam CT (CBCT). In this situation, only limited and unconventional imaging angles are feasible to avoid collision between the gantry, couch, patient, and on-board imaging system. The purpose of this work is to develop a CBCT verification strategy for patients undergoing non-coplanar radiation therapy. We propose an image reconstruction scheme that integrates a prior image constrained compressed sensing (PICCS) technique with image registration. Planning CT or CBCT acquired at the neutral position is rotated and translated according to the nominal couch rotation/translation to serve as the initial prior image. Here, the nominal couch movement is chosen to have a rotational error of 5° and translational error of 8 mm from the ground truth in one or more axes or directions. The proposed reconstruction scheme alternates between two major steps. First, an image is reconstructed using the PICCS technique implemented with total-variation minimization and simultaneous algebraic reconstruction. Second, the rotational/translational setup errors are corrected and the prior image is updated by applying rigid image registration between the reconstructed image and the previous prior image. The PICCS algorithm and rigid image registration are alternated iteratively until the registration results fall below a predetermined threshold. The proposed reconstruction algorithm is evaluated with an anthropomorphic digital phantom and physical head phantom. The proposed algorithm provides useful volumetric images for patient setup using projections with an angular range as small as 60°. It reduced the translational setup errors from 8 mm to generally <1 mm and the rotational setup errors from 5° to <1°. Compared with the PICCS algorithm alone, the integration of rigid registration significantly improved the reconstructed image quality, with a reduction of mostly 2–3 folds (up to 100) in root mean square image error. The proposed algorithm provides a remedy for solving the problem of non-coplanar CBCT reconstruction from limited angle of projections by combining the PICCS technique and rigid image registration in an iterative framework. In this proof of concept study, non-coplanar beams with couch rotations of 45° can be effectively verified with the CBCT technique. [ABSTRACT FROM AUTHOR]

The mechanical motion of the gantry in conventional cone beam CT scanners restricts the speed of data acquisition in applications with near real time requirements. A possible resolution of this problem is to replace the moving source detector assembly with static parts that are electronically activated. An example of such a system is the Rapiscan Systems RTT80 real time tomography scanner, with a static ring of sources and axially offset static cylinder of detectors. A consequence of such a design is asymmetrical axial truncation of the cone beam projections resulting, in the sense of integral geometry, in severely incomplete data. In particular we collect data only in a fraction of the Tam–Danielsson window, hence the standard cone beam reconstruction techniques do not apply. In this work we propose a family of multi-sheet surface rebinning methods for reconstruction from such truncated projections. The proposed methods combine analytical and numerical ideas utilizing linearity of the ray transform to reconstruct data on multi-sheet surfaces, from which the volumetric image is obtained through deconvolution. In this first paper in the series, we discuss the rebinning to multi-sheet surfaces. In particular we concentrate on the underlying transforms on multi-sheet surfaces and their approximation with data collected by offset multi-source scanning geometries like the RTT. The optimal multi-sheet surface and the corresponding rebinning function are found as a solution of a variational problem. In the case of the quadratic objective, the variational problem for the optimal rebinning pair can be solved by a globally convergent iteration. Examples of optimal rebinning pairs are computed for different trajectories. We formulate the axial deconvolution problem for the recovery of the volumetric image from the reconstructions on multi-sheet surfaces. Efficient and stable solution of the deconvolution problem is the subject of the second paper in this series (Betcke and Lionheart 2013 Inverse Problems29 115004). [ABSTRACT FROM AUTHOR]

In airport baggage scanning it is desirable to have a system that can scan baggage moving at standard conveyor belt speeds. One way to achieve this is to use multiple electronically switched sources rather than a single source on a mechanically rotated gantry. In such a system placing the detectors opposite the sources would obstruct the beam, so they have to be offset (hence offset multi-source geometry). This results in asymmetrical axial truncation of the cone beam projections. As such projections do not constitute complete data in the sense of integral geometry, the standard cone beam reconstruction algorithms do not apply. In this series of papers we introduce a new family of rebinning methods for reconstruction from axially asymmetrically truncated cone beam projections. In the first paper we discussed the approximation of the data on the multi-sheet surface with the truncated projection data obtained from offset multi-source geometries. In this second paper we focus on the recovery of the volumetric image from the reconstruction of data rebinned to multi-sheet surfaces. Multi-sheet rebinning effects an implicit relation between the fan beam transforms on the individual sheets and the rebinned data. This relation in conjunction with the linearity of the ray transform allows us to formulate the deconvolution problem for the recovery of the volume from a stack of reconstructed images on multi-sheet surfaces. We discuss the errors in the right-hand side of the deconvolution problem (reconstruction on multi-sheet surfaces) resulting from rebinning approximation. We introduce convolution matrix models based on the distribution of the distances of the rays from the multi-sheet surface, which considerably improve the data model fit and in turn lead to a superior solution. Multiple strategies for solution of the deconvolution problem are discussed and an efficient and robust implementation is presented, which makes the method capable of real time reconstruction. We conclude with some reconstruction results from simulated as well as real data collected with a Rapiscan RTT80 scanner. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate whether quality assurance (QA) for cone-beam computed tomography (CBCT) image rotation is necessary in order to ensure the accuracy of CBCT based image-guided radiation therapy (IGRT) and adaptive radiotherapy (ART). Misregistration of angular coordinates duringCBCTacquisitionmay lead to a rotated reconstructed image. If target localization is performed based on this image, an under- or over-dosage of the target volume (TV) and organs at risk (OARs) may occur. Therefore, patient CT image sets were rotated by 1° up to 3° and the treatment plans were recalculated to quantify changes in dose-volume histograms. A computer code in C++ was written to model the TV displacement and overlap area of an ellipse shape at the target and dose prescription levels corresponding to the image rotation. We investigated clinical scenarios in IGRT and ART in order to study the implications of image rotation on dose distributions for: (1) lateral TV and isocenter (SBRT), (2) central TV and isocenter (IMRT), (3) lateral TV and isocenter (IMRT). Mathematical analysis showed the dose coverage of TV depends on its shape, size, location, and orientation relative to the isocenter. Evaluation of three first scenario for θ = 1° showed variations in TV D95 in the context of IGRT and ART when compared to the original plan were within 2.7 ± 2.6% and 7.7 ± 6.9% respectively while variations in the second and third scenarios were less significant (<0.5%) for the angular range evaluated. However a larger degree of variation was found in terms of minimum and maximum doses for target and OARs. The rotation of CBCT image data sets may have significant dosimetric consequences in IGRT and ART. The TV's location relative to isocenter and shape determine the extent of alterations in dose indicators. Our findings suggest that a CBCT QA criterion of 1? would be a reasonable action level to ensure accurate dose delivery. [ABSTRACT FROM AUTHOR]

Due to a limited number of projections at each phase, severe view aliasing artifacts are present in four-dimensional cone beam computed tomography (4D-CBCT) when reconstruction is performed using conventional algorithms. In this work, we aim to obtain high-quality 4D-CBCT of lung cancer patients in radiation therapy by deforming the planning CT. The deformation vector fields (DVF) to deform the planning CT are estimated through matching the forward projection of the deformed prior image and measured on-treatment CBCT projection. The estimation of the DVF is formulated as an unconstrained optimization problem, where the objective function to be minimized is the sum of the squared difference between the forward projection of the deformed planning CT and the measured 4D-CBCT projection. A nonlinear conjugate gradient method is used to solve the DVF. As the number of the variables in the DVF is much greater than the number of measurements, the solution to such a highly ill-posed problem is very sensitive to the initials during the optimization process. To improve the estimation accuracy of DVF, we proposed a new strategy to obtain better initials for the optimization. In this strategy, 4D-CBCT is first reconstructed by total variation minimization. Demons deformable registration is performed to register the planning CT and the 4D-CBCT reconstructed by total variation minimization. The resulted DVF from demons registration is then used as the initial parameters in the optimization process.A4Dnonuniform rotational B-spline-based cardiac-torso (NCAT) phantom and a patient 4D-CBCT are used to evaluate the algorithm. Image quality of 4D-CBCT is substantially improved by using the proposed strategy in both NCAT phantom and patient studies. The proposed method has the potential to improve the temporal resolution of 4D-CBCT. Improved 4DCBCT can better characterize the motion of lung tumors and will be a valuable tool for image-guided adaptive radiation therapy. [ABSTRACT FROM AUTHOR]

The field of view (FOV) of a cone-beam computed tomography (CBCT) unit in a single-photon emission computed tomography (SPECT)/CBCT system can be increased by offsetting the CBCT detector. Analytic-based algorithms have been developed for image reconstruction from data collected at a large number of densely sampled views in offset-detector CBCT. However, the radiation dose involved in a large number of projections can be of a health concern to the imaged subject. CBCT-imaging dose can be reduced by lowering the number of projections. As analytic-based algorithms are unlikely to reconstruct accurate images from sparse-view data, we investigate and characterize in the work optimization-based algorithms, including an adaptive steepest descentweighted projection onto convex sets (ASD-WPOCS) algorithms, for image reconstruction from sparse-view data collected in offset-detector CBCT. Using simulated data and real data collected from a physical pelvis phantom and patient, we verify and characterize properties of the algorithms under study. Results of our study suggest that optimization-based algorithms such as ASDWPOCS may be developed for yielding images of potential utility from a number of projections substantially smaller than those used currently in clinical SPECT/CBCT imaging, thus leading to a dose reduction in CBCT imaging. [ABSTRACT FROM AUTHOR]

C-arm cone-beam CT (CBCT) can provide intraoperative 3D imaging capability for surgical guidance, but workflow and radiation dose are the significant barriers to broad utilization. One main reason is that each 3D image acquisition requires a complete scan with a full radiation dose to present a completely new 3D image every time. In this paper, we propose to utilize patient-specific CT or CBCT as prior knowledge to accurately reconstruct the aspects of the region that have changed by the surgical procedure from only a sparse set of x-rays. The proposed methods consist of a 3D-2D registration between the prior volume and a sparse set of intraoperative x-rays, creating digitally reconstructed radiographs (DRRs) from the registered prior volume, computing difference images by subtracting DRRs from the intraoperative x-rays, a penalized likelihood reconstruction of the volume of change (VOC) from the difference images, and finally a fusion of VOC reconstruction with the prior volume to visualize the entire surgical field. When the surgical changes are local and relatively small, the VOC reconstruction involves only a small volume size and a small number of projections, allowing less computation and lower radiation dose than is needed to reconstruct the entire surgical field. We applied this approach to sacroplasty phantom data obtained from a CBCT test bench and vertebroplasty data with a fresh cadaver acquired from a C-arm CBCT system with a flat-panel detector. The VOCs were reconstructed from a varying number of images (10-66 images) and compared to the CBCT ground truth using four different metrics (mean squared error, correlation coefficient, structural similarity index and perceptual difference model). The results show promising reconstruction quality with structural similarity to the ground truth close to 1 even when only 15-20 images were used, allowing dose reduction by the factor of 10-20. [ABSTRACT FROM AUTHOR]

We present a stored system matrix (SM) approach for iterative x-ray CT image reconstruction with helical cone-beam geometry. Because of the symmetry of a helical source trajectory, it is sufficient to calculate and store the SM entries for one transaxial slice only and for all source positions illuminating the slice. This is made possible by (1) selecting the reconstruction slice thickness to be an integer multiple of the source translation per projection view, and (2) discretizing the 3D reconstruction volume on a rotated stack of slices. Using the proposed method, thememory requirement for reconstructing a full field-ofview of clinical scanners is manageable on current computing platforms. The same storage principle can be generalized and applied to volume-of-interest (VOI) image reconstruction for helical cone-beam CT. In this case, the stored SM entries correspond to a partial- or full-ring region on one transaxial slice, and for all source positions illuminating the ring. The size and location of the ring depend on the size and the location of the VOI and the scan geometry. We demonstrate by both computer simulations and clinical patient data the speed and efficacy of iterative image reconstruction using the stored SM approach. [ABSTRACT FROM AUTHOR]

The Kodak Image Station In-Vivo FX has an x-ray module with conebeam configuration for radiographic imaging but lacks the functionality of tomography. To introduce x-ray tomography into the system, we choose the two-circles-plus-one-line trajectory by mounting one translation motor and one rotation motor. We establish a reconstruction algorithm by applying the M-line reconstruction method. Numerical studies and preliminary physical phantom experiment demonstrate the feasibility of the proposed design and reconstruction algorithm. [ABSTRACT FROM AUTHOR]

C-arm cone-beam CT could replace preoperative multi-detector CT scans in the cardiac interventional setting. However, cardiac gating results in view angle undersampling and the small size of the detector results in projection data truncation. These problems are incompatible with conventional tomographic reconstruction algorithms. In this paper, the prior image constrained compressed sensing (PICCS) reconstruction method was adapted to solve these issues. The performance of the proposed method was compared to that of FDK, FDK with extrapolated projection data (E-FDK), and total variation-based compressed sensing. A canine projection dataset acquired using a clinical C-arm imaging system supplied realistic cardiac motion and anatomy for this evaluation. Three different levels of truncationwere simulated. The relative root mean squared error and the universal image quality index were used to quantify the reconstruction accuracy. Three main conclusions were reached. (1) The adapted version of the PICCS algorithm offered the highest image quality and reconstruction accuracy. (2) Nomeaningful variation in performance was observed when the amount of truncation was changed. (3) This study showed evidence that accurate interior tomography with an undersampled acquisition is possible for realistic objects if a prior image with minimal artifacts is available. [ABSTRACT FROM AUTHOR]

Volumetric cone-beam CT (CBCT) images are acquired repeatedly during a course of radiation therapy and a natural question to ask is whether CBCT images obtained earlier in the process can be utilized as prior knowledge to reduce patient imaging dose in subsequent scans. The purpose of this work is to develop an adaptive prior image constrained compressed sensing (APICCS) method to solve this problem. Reconstructed images using full projections are taken on the first day of radiation therapy treatment and are used as prior images. The subsequent scans are acquired using a protocol of sparse projections. In the proposed APICCS algorithm, the prior images are utilized as an initial guess and are incorporated into the objective function in the compressed sensing (CS)-based iterative reconstruction process. Furthermore, the prior information is employed to detect any possible mismatched regions between the prior and current images for improved reconstruction. For this purpose, the prior images and the reconstructed images are classified into three anatomical regions: air, soft tissue and bone. Mismatched regions are identified by local differences of the corresponding groups in the two classified sets of images. A distance transformation is then introduced to convert the information into an adaptive voxel-dependent relaxation map. In constructing the relaxation map, the matched regions (unchanged anatomy) between the prior and current images are assigned with smaller weight values, which are translated into less influence on the CS iterative reconstruction process. On the other hand, the mismatched regions (changed anatomy) are associated with larger values and the regions are updated more by the new projection data, thus avoiding any possible adverse effects of prior images. The APICCS approach was systematically assessed by using patient data acquired under standard and low-dose protocols for qualitative and quantitative comparisons. The APICCS method provides an effective way for us to enhance the image quality at the matched regions between the prior and current images compared to the existing PICCS algorithm. Compared to the current CBCT imaging protocols, the APICCS algorithm allows an imaging dose reduction of 10-40 times due to the greatly reduced number of projections and lower x-ray tube current level coming from the low-dose protocol. [ABSTRACT FROM AUTHOR]

Differential phase-contrast computed tomography (DPC-CT) is a novel x-ray inspection method. Currently, DPC-CT reconstruction problems are solved by using parallel-beam, fan-beam and cone-beam algorithms. The above algorithms cannot show the internal structures of rod-shaped objects well enough for only reconstructing a few slices. The helical cone-beam algorithms have significant advantages for rod-shaped objects over other algorithms. Along with our numerical evaluation and verification, we report a PI-line-based approximate algorithm for helical cone-beam DPC-CT, which can be applied to reconstruct the refractive index decrement distribution of the samples directly from phase-contrast projection images. Simulations using a 3D Shepp-Logan phantom are carried out to verify the proposed algorithm. Reconstruction results show that the proposed algorithm can provide higher quality performance compared with the existing interpolation-based reconstruction algorithm. [ABSTRACT FROM AUTHOR]

4D cone beam computed tomography (CBCT) images of the thorax and abdomen can have reduced quality due to the limited number of projections per respiratory bin used in gated image reconstruction. In this work, we present a new algorithm to reconstruct high quality CBCT images by simultaneously reconstructing images and generating an associated respiratory motion model. This is done by updating model parameters to compensate for motion during the iterative image reconstruction process. CBCT image acquisition was simulated using the digital eXternal CArdiac Torso (XCAT) phantom, simulating breathing motion using four patient breathing traces. 4DCBCT images were reconstructed using the simultaneous algebraic reconstruction technique (SART), and compared to the proposed motion-compensated SART (McSART) algorithm. McSART used a motion model that describes tissue position as a function of diaphragm amplitude and velocity. The McSART algorithm alternately updated the motion model and image reconstruction, increasing the number of projections used for image reconstruction with every iteration. The model was able to interpolate and extrapolate deformations according to the magnitude of the surrogate signal. Without noise, the final iteration McSART images had HU errors at 31%, 34%, and 44% of their SART-reconstructed counterparts compared to ground truth XCAT images, with corresponding root-mean-square (RMS) motion model errors of 0.75 mm, 1.08 mm, and 1.17 mm respectively. With added image noise, McSART’s HU error was 31% of the SART-reconstructed 4DCBCT error, with a 1.43 mm RMS motion model error. Qualitatively, blurring and streaking artifacts were reduced in all the reconstructed images compared to 3D or SART-reconstructed 4DCBCT. The output of the algorithm was a high quality reference image and a corresponding motion model, that could be used to deform the reference image to any other point in a breathing cycle. [ABSTRACT FROM AUTHOR]

Respiratory-correlated cone-beam CT (CBCT) not only inhibits rapid scanning due to the slow speed of the LINAC head gantry rotation, but its implementation for routine patient imaging is impractical because of the high radiation dose delivered during the process. Digital tomosynthesis (DTS) is a potentially faster technique that delivers a much lower radiation dose by reducing the number of projections in a limited angular range. Unfortunately, 4D-DTS introduces strong aliasing artifacts in the reconstructed images due to the sparsely sampled projections in each respiratory phase bin. The authors hereby suggest a novel low-dose 4D-DTS image reconstruction method that achieves a compromise between the occurrence of aliasing artifacts and image smoothing using a brute force-based adaptive weighting parameter searching technique. We used a prototype LINAC system mounted with a flat-panel detector to acquire tomosynthesis projections of respiratory motion in a phantom in the anterior–posterior (AP) and lateral views. Three different 4D-DTS image reconstruction schemes that included conventional filtered back-projection (FBP), adaptive steepest descent projection onto convex sets (ASD-POCS), and the proposed brute force-based adaptive total variation (BF-ATV) were implemented in four different respiratory phase bins for both AP and lateral views. All reconstructions were accelerated using a single GPU card to reduce the computation time. To study the performance of the algorithm under various sparse conditions, we operated the prototype system in three different gantry sweep modes. The results indicate that the proposed BF-ATV method yields the largest structural similarities in the differenced image between the ground-truth dataset acquired using the slow gantry sweep mode and the sparse dataset from both moderate and fast sweep modes. In addition, the proposed method maintained the object sharpness with less streaking lines and small loss of sharpness compared to the conventional FBP and ASD-POCS methods. In conclusion, the proposed low-dose 4D-DTS reconstruction scheme may provide better performance due in part to its rapid scanning. Therefore, it is potentially applicable to practical 4D imaging for radiotherapy. [ABSTRACT FROM AUTHOR]

Recent advances in total variation (TV) technology enable accurate CT image reconstruction from highly under-sampled and noisy projection data. The standard iterative reconstruction algorithms, which work well in conventional CT imaging, fail to perform as expected in cone beam CT (CBCT) applications, wherein the non-ideal physics issues, including scatter and beam hardening, are more severe. These physics issues result in large areas of shading artifacts and cause deterioration to the piecewise constant property assumed in reconstructed images. To overcome this obstacle, we incorporate a shading correction scheme into low-dose CBCT reconstruction and propose a clinically acceptable and stable three-dimensional iterative reconstruction method that is referred to as the shading correction assisted iterative reconstruction. In the proposed method, we modify the TV regularization term by adding a shading compensation image to the reconstructed image to compensate for the shading artifacts while leaving the data fidelity term intact. This compensation image is generated empirically, using image segmentation and low-pass filtering, and updated in the iterative process whenever necessary. When the compensation image is determined, the objective function is minimized using the fast iterative shrinkage-thresholding algorithm accelerated on a graphic processing unit. The proposed method is evaluated using CBCT projection data of the Catphan© 600 phantom and two pelvis patients. Compared with the iterative reconstruction without shading correction, the proposed method reduces the overall CT number error from around 200 HU to be around 25 HU and increases the spatial uniformity by a factor of 20 percent, given the same number of sparsely sampled projections. A clinically acceptable and stable iterative reconstruction algorithm for CBCT is proposed in this paper. Differing from the existing algorithms, this algorithm incorporates a shading correction scheme into the low-dose CBCT reconstruction and achieves more stable optimization path and more clinically acceptable reconstructed image. The method proposed by us does not rely on prior information and thus is practically attractive to the applications of low-dose CBCT imaging in the clinic. [ABSTRACT FROM AUTHOR]

Task-based analysis of medical imaging performance underlies many ongoing efforts in the development of new imaging systems. In statistical image reconstruction, regularization is often formulated in terms to encourage smoothness and/or sharpness (e.g. a linear, quadratic, or Huber penalty) but without explicit formulation of the task. We propose an alternative regularization approach in which a spatially varying penalty is determined that maximizes task-based imaging performance at every location in a 3D image. We apply the method to model-based image reconstruction (MBIR—viz., penalized weighted least-squares, PWLS) in cone-beam CT (CBCT) of the head, focusing on the task of detecting a small, low-contrast intracranial hemorrhage (ICH), and we test the performance of the algorithm in the context of a recently developed CBCT prototype for point-of-care imaging of brain injury. Theoretical predictions of local spatial resolution and noise are computed via an optimization by which regularization (specifically, the quadratic penalty strength) is allowed to vary throughout the image to maximize local task-based detectability index (). Simulation studies and test-bench experiments were performed using an anthropomorphic head phantom. Three PWLS implementations were tested: conventional (constant) penalty; a certainty-based penalty derived to enforce constant point-spread function, PSF; and the task-based penalty derived to maximize local detectability at each location. Conventional (constant) regularization exhibited a fairly strong degree of spatial variation in , and the certainty-based method achieved uniform PSF, but each exhibited a reduction in detectability compared to the task-based method, which improved detectability up to ~15%. The improvement was strongest in areas of high attenuation (skull base), where the conventional and certainty-based methods tended to over-smooth the data. The task-driven reconstruction method presents a promising regularization method in MBIR by explicitly incorporating task-based imaging performance as the objective. The results demonstrate improved ICH conspicuity and support the development of high-quality CBCT systems. [ABSTRACT FROM AUTHOR]

In cone-beam CT, involuntary patient motion and inaccurate or irreproducible scanner motion substantially degrades image quality. To avoid artifacts this motion needs to be estimated and compensated during image reconstruction. In previous work we showed that Fourier consistency conditions (FCC) can be used in fan-beam CT to estimate motion in the sinogram domain. This work extends the FCC to cone-beam CT. We derive an efficient cost function to compensate for motion using detector translations. The extended FCC method have been tested with five translational motion patterns, using a challenging numerical phantom. We evaluated the root-mean-square-error and the structural-similarity-index between motion corrected and motion-free reconstructions. Additionally, we computed the mean-absolute-difference (MAD) between the estimated and the ground-truth motion. The practical applicability of the method is demonstrated by application to respiratory motion estimation in rotational angiography, but also to motion correction for weight-bearing imaging of knees. Where the latter makes use of a specifically modified FCC version which is robust to axial truncation. The results show a great reduction of motion artifacts. Accurate estimation results were achieved with a maximum MAD value of 708 μm and 1184 μm for motion along the vertical and horizontal detector direction, respectively. The image quality of reconstructions obtained with the proposed method is close to that of motion corrected reconstructions based on the ground-truth motion. Simulations using noise-free and noisy data demonstrate that FCC are robust to noise. Even high-frequency motion was accurately estimated leading to a considerable reduction of streaking artifacts. The method is purely image-based and therefore independent of any auxiliary data. [ABSTRACT FROM AUTHOR]

Excessive radiation exposure is still a major concern in 4D cone-beam computed tomography (4D-CBCT) due to its prolonged scanning duration. Radiation dose can be effectively reduced by either under-sampling the x-ray projections or reducing the x-ray flux. However, 4D-CBCT reconstruction under such low-dose protocols is prone to image artifacts and noise. In this work, we propose a novel joint regularization-based iterative reconstruction method for low-dose 4D-CBCT. To tackle the under-sampling problem, we employ spatiotemporal tensor framelet (STF) regularization to take advantage of the spatiotemporal coherence of the patient anatomy in 4D images. To simultaneously suppress the image noise caused by photon starvation, we also incorporate spatiotemporal nonlocal total variation (SNTV) regularization to make use of the nonlocal self-recursiveness of anatomical structures in the spatial and temporal domains. Under the joint STF–SNTV regularization, the proposed iterative reconstruction approach is evaluated first using two digital phantoms and then using physical experiment data in the low-dose context of both under-sampled and noisy projections. Compared with existing approaches via either STF or SNTV regularization alone, the presented hybrid approach achieves improved image quality, and is particularly effective for the reconstruction of low-dose 4D-CBCT data that are not only sparse but noisy. [ABSTRACT FROM AUTHOR]

Accurate reconstruction from a reduced data set is highly essential for computed tomography in fast and/or low dose imaging applications. Conventional total variation (TV)-based algorithms apply the L1 norm-based penalties, which are not as efficient as Lp () quasi-norm-based penalties. TV with a p-th power-based norm can serve as a feasible alternative of the conventional TV, which is referred to as total p-variation (TpV). This paper proposes a TpV-based reconstruction model and develops an efficient algorithm. The total p-variation and Kullback–Leibler (KL) data divergence, which has better noise suppression capability compared with the often-used quadratic term, are combined to build the reconstruction model. The proposed algorithm is derived by the alternating direction method (ADM) which offers a stable, efficient, and easily coded implementation. We apply the proposed method in the reconstructions from very few views of projections (7 views evenly acquired within 180°). The images reconstructed by the new method show clearer edges and higher numerical accuracy than the conventional TV method. Both the simulations and real CT data experiments indicate that the proposed method may be promising for practical applications. [ABSTRACT FROM AUTHOR]

Application of model-based iterative reconstruction (MBIR) to high resolution cone-beam CT (CBCT) is computationally challenging because of the very fine discretization (voxel size  <100 µm) of the reconstructed volume. Moreover, standard MBIR techniques require that the complete transaxial support for the acquired projections is reconstructed, thus precluding acceleration by restricting the reconstruction to a region-of-interest. To reduce the computational burden of high resolution MBIR, we propose a multiresolution penalized-weighted least squares (PWLS) algorithm, where the volume is parameterized as a union of fine and coarse voxel grids as well as selective binning of detector pixels. We introduce a penalty function designed to regularize across the boundaries between the two grids. The algorithm was evaluated in simulation studies emulating an extremity CBCT system and in a physical study on a test-bench. Artifacts arising from the mismatched discretization of the fine and coarse sub-volumes were investigated. The fine grid region was parameterized using 0.15 mm voxels and the voxel size in the coarse grid region was varied by changing a downsampling factor. No significant artifacts were found in either of the regions for downsampling factors of up to 4×. For a typical extremities CBCT volume size, this downsampling corresponds to an acceleration of the reconstruction that is more than five times faster than a brute force solution that applies fine voxel parameterization to the entire volume. For certain configurations of the coarse and fine grid regions, in particular when the boundary between the regions does not cross high attenuation gradients, downsampling factors as high as 10×  can be used without introducing artifacts, yielding a ~50×  speedup in PWLS. The proposed multiresolution algorithm significantly reduces the computational burden of high resolution iterative CBCT reconstruction and can be extended to other applications of MBIR where computationally expensive, high-fidelity forward models are applied only to a sub-region of the field-of-view. [ABSTRACT FROM AUTHOR]

We investigate an optimization-based reconstruction, with an emphasis on image-artifact reduction, from data collected in C-arm cone-beam computed tomography (CBCT) employed in image-guided interventional procedures. In the study, an image to be reconstructed is formulated as a solution to a convex optimization program in which a weighted data divergence is minimized subject to a constraint on the image total variation (TV); a data-derivative fidelity is introduced in the program specifically for effectively suppressing dominant, low-frequency data artifact caused by, e.g. data truncation; and the Chambolle–Pock (CP) algorithm is tailored to reconstruct an image through solving the program. Like any other reconstructions, the optimization-based reconstruction considered depends upon numerous parameters. We elucidate the parameters, illustrate their determination, and demonstrate their impact on the reconstruction. The optimization-based reconstruction, when applied to data collected from swine and patient subjects, yields images with visibly reduced artifacts in contrast to the reference reconstruction, and it also appears to exhibit a high degree of robustness against distinctively different anatomies of imaged subjects and scanning conditions of clinical significance. Knowledge and insights gained in the study may be exploited for aiding in the design of practical reconstructions of truly clinical-application utility. [ABSTRACT FROM AUTHOR]

This work is to develop a general framework, namely analytical iterative reconstruction (AIR) method, to incorporate analytical reconstruction (AR) method into iterative reconstruction (IR) method, for enhanced CT image quality and reconstruction efficiency. Specifically, AIR is established based on the modified proximal forward–backward splitting (PFBS) algorithm, and its connection to the filtered data fidelity with sparsity regularization is discussed. As a result, AIR decouples data fidelity and image regularization with a two-step iterative scheme, during which an AR-projection step updates the filtered data fidelity term, while a denoising solver updates the sparsity regularization term. During the AR-projection step, the image is projected to the data domain to form the data residual, and then reconstructed by certain AR to a residual image which is then weighted together with previous image iterate to form next image iterate. Intuitively since the eigenvalues of AR-projection operator are close to the unity, PFBS based AIR has a fast convergence. Such an advantage is rigorously established through convergence analysis and numerical computation of convergence rate. The proposed AIR method is validated in the setting of circular cone-beam CT with AR being FDK and total-variation sparsity regularization, and has improved image quality from both AR and IR. For example, AIR has improved visual assessment and quantitative measurement in terms of both contrast and resolution, and reduced axial and half-fan artifacts. [ABSTRACT FROM AUTHOR]

Four-dimensional cone-beam computed tomography (4D-CBCT) of the free-breathing thorax is a valuable tool in image-guided radiation therapy of the thorax and the upper abdomen. It allows the determination of the position of a tumor throughout the breathing cycle, while only its mean position can be extracted from three-dimensional CBCT. The classical approaches are not fully satisfactory: respiration-correlated methods allow one to accurately locate high-contrast structures in any frame, but contain strong streak artifacts unless the acquisition is significantly slowed down. Motion-compensated methods can yield streak-free, but static, reconstructions. This work proposes a 4D-CBCT method that can be seen as a trade-off between respiration-correlated and motion-compensated reconstruction. It builds upon the existing reconstruction using spatial and temporal regularization (ROOSTER) and is called motion-aware ROOSTER (MA-ROOSTER). It performs temporal regularization along curved trajectories, following the motion estimated on a prior 4D CT scan. MA-ROOSTER does not involve motion-compensated forward and back projections: the input motion is used only during temporal regularization. MA-ROOSTER is compared to ROOSTER, motion-compensated Feldkamp–Davis–Kress (MC-FDK), and two respiration-correlated methods, on CBCT acquisitions of one physical phantom and two patients. It yields streak-free reconstructions, visually similar to MC-FDK, and robust information on tumor location throughout the breathing cycle. MA-ROOSTER also allows a variation of the lung tissue density during the breathing cycle, similar to that of planning CT, which is required for quantitative post-processing. [ABSTRACT FROM AUTHOR]

A comprehensive artefact correction method for clinical cone beam CT (CBCT) images acquired for image guided radiation therapy (IGRT) on a commercial system is presented. The method is demonstrated to reduce artefacts and recover CT-like Hounsfield units (HU) in reconstructed CBCT images of five lung cancer patients. Projection image based artefact corrections of image lag, detector scatter, body scatter and beam hardening are described and applied to CBCT images of five lung cancer patients. Image quality is evaluated through visual appearance of the reconstructed images, HU-correspondence with the planning CT images, and total volume HU error. Artefacts are reduced and CT-like HUs are recovered in the artefact corrected CBCT images. Visual inspection confirms that artefacts are indeed suppressed by the proposed method, and the HU root mean square difference between reconstructed CBCTs and the reference CT images are reduced by 31% when using the artefact corrections compared to the standard clinical CBCT reconstruction. A versatile artefact correction method for clinical CBCT images acquired for IGRT has been developed. HU values are recovered in the corrected CBCT images. The proposed method relies on post processing of clinical projection images, and does not require patient specific optimisation. It is thus a powerful tool for image quality improvement of large numbers of CBCT images. [ABSTRACT FROM AUTHOR]

In radiation therapy, fiducial markers are often implanted near tumors and used for patient positioning and respiratory gating purposes. These markers are then used to manually align the patients by matching the markers in the cone beam computed tomography (CBCT) reconstruction to those in the planning CT. This step is time-intensive and user-dependent, and often results in a suboptimal patient setup. We propose a fully automated, robust method based on dynamic programming (DP) for segmenting radiopaque fiducial markers in CBCT projection images, which are then used to automatically optimize the treatment couch position and/or gating window bounds. The mean of the absolute 2D segmentation error of our DP algorithm is mm for 87 markers on 39 patients. Intrafraction images were acquired every 3 s during treatment at two different institutions. For gated patients from Institution A (8 patients, 40 fractions), the DP algorithm increased the delivery accuracy ( versus , p  <  0.01) compared to the manual setup using kV fluoroscopy. For non-gated patients from Institution B (6 patients, 16 fractions), the DP algorithm performed similarly ( mm versus mm, p  =  0.48) compared to the manual setup matching the fiducial markers in the CBCT to the mean position. Our proposed automated patient setup algorithm only takes 1–2 s to run, requires no user intervention, and performs as well as or better than the current clinical setup. [ABSTRACT FROM AUTHOR]

Characterization of anatomical change and other differences is important in sequential computed tomography (CT) imaging, where a high-fidelity patient-specific prior image is typically present, but is not used, in the reconstruction of subsequent anatomical states. Here, we introduce a penalized likelihood (PL) method called reconstruction of difference (RoD) to directly reconstruct a difference image volume using both the current projection data and the (unregistered) prior image integrated into the forward model for the measurement data. The algorithm utilizes an alternating minimization to find both the registration and reconstruction estimates. This formulation allows direct control over the image properties of the difference image, permitting regularization strategies that inhibit noise and structural differences due to inconsistencies between the prior image and the current data. Additionally, if the change is known to be local, RoD allows local acquisition and reconstruction, as opposed to traditional model-based approaches that require a full support field of view (or other modifications). We compared the performance of RoD to a standard PL algorithm, in simulation studies and using test-bench cone-beam CT data. The performances of local and global RoD approaches were similar, with local RoD providing a significant computational speedup. In comparison across a range of data with differing fidelity, the local RoD approach consistently showed lower error (with respect to a truth image) than PL in both noisy data and sparsely sampled projection scenarios. In a study of the prior image registration performance of RoD, a clinically reasonable capture ranges were demonstrated. Lastly, the registration algorithm had a broad capture range and the error for reconstruction of CT data was 35% and 20% less than filtered back-projection for RoD and PL, respectively. The RoD has potential for delivering high-quality difference images in a range of sequential clinical scenarios including image-guided surgeries and treatments where accurate and quantitative assessments of anatomical change is desired. [ABSTRACT FROM AUTHOR]

A simultaneous motion estimation and image reconstruction (SMEIR) strategy was proposed for 4D cone-beam CT (4D-CBCT) reconstruction and showed excellent results in both phantom and lung cancer patient studies. In the original SMEIR algorithm, the deformation vector field (DVF) was defined on voxel grid and estimated by enforcing a global smoothness regularization term on the motion fields. The objective of this work is to improve the computation efficiency and motion estimation accuracy of SMEIR for 4D-CBCT through developing a multi-organ meshing model. Feature-based adaptive meshes were generated to reduce the number of unknowns in the DVF estimation and accurately capture the organ shapes and motion. Additionally, the discontinuity in the motion fields between different organs during respiration was explicitly considered in the multi-organ mesh model. This will help with the accurate visualization and motion estimation of the tumor on the organ boundaries in 4D-CBCT. To further improve the computational efficiency, a GPU-based parallel implementation was designed. The performance of the proposed algorithm was evaluated on a synthetic sliding motion phantom, a 4D NCAT phantom, and four lung cancer patients. The proposed multi-organ mesh based strategy outperformed the conventional Feldkamp–Davis–Kress, iterative total variation minimization, original SMEIR and single meshing method based on both qualitative and quantitative evaluations. [ABSTRACT FROM AUTHOR]

Novel x-ray medical imaging sensors, such as photon counting detectors (PCDs) and large area CCD and CMOS cameras can involve irregular and/or sparse sampling of the detector plane. Application of such detectors to CT involves undersampling that is markedly different from the commonly considered case of sparse angular sampling. This work investigates volumetric sampling in CT systems incorporating sparsely sampled detectors with axial and helical scan orbits and evaluates performance of model-based image reconstruction (MBIR) with spatially varying regularization in mitigating artifacts due to sparse detector sampling. Volumetric metrics of sampling density and uniformity were introduced. Penalized-likelihood MBIR with a spatially varying penalty that homogenized resolution by accounting for variations in local sampling density (i.e. detector gaps) was evaluated. The proposed methodology was tested in simulations and on an imaging bench based on a Si-strip PCD (total area 5 cm  ×  25 cm) consisting of an arrangement of line sensors separated by gaps of up to 2.5 mm. The bench was equipped with translation/rotation stages allowing a variety of scanning trajectories, ranging from a simple axial acquisition to helical scans with variable pitch. Statistical (spherical clutter) and anthropomorphic (hand) phantoms were considered. Image quality was compared to that obtained with a conventional uniform penalty in terms of structural similarity index (SSIM), image uniformity, spatial resolution, contrast, and noise. Scan trajectories with intermediate helical width (~10 mm longitudinal distance per 360° rotation) demonstrated optimal tradeoff between the average sampling density and the homogeneity of sampling throughout the volume. For a scan trajectory with 10.8 mm helical width, the spatially varying penalty resulted in significant visual reduction of sampling artifacts, confirmed by a 10% reduction in minimum SSIM (from 0.88 to 0.8) and a 40% reduction in the dispersion of SSIM in the volume compared to the constant penalty (both penalties applied at optimal regularization strength). Images of the spherical clutter and wrist phantoms confirmed the advantages of the spatially varying penalty, showing a 25% improvement in image uniformity and 1.8  ×  higher CNR (at matched spatial resolution) compared to the constant penalty. The studies elucidate the relationship between sampling in the detector plane, acquisition orbit, sampling of the reconstructed volume, and the resulting image quality. They also demonstrate the benefit of spatially varying regularization in MBIR for scenarios with irregular sampling patterns. Such findings are important and integral to the incorporation of a sparsely sampled Si-strip PCD in CT imaging. [ABSTRACT FROM AUTHOR]

Recently, the compressed sensing (CS) based iterative reconstruction method has received attention because of its ability to reconstruct cone beam computed tomography (CBCT) images with good quality using sparsely sampled or noisy projections, thus enabling dose reduction. However, some challenges remain. In particular, there is always a tradeoff between image resolution and noise/streak artifact reduction based on the amount of regularization weighting that is applied uniformly across the CBCT volume. The purpose of this study is to develop a novel low-dose CBCT reconstruction algorithm framework called priori mask guided image reconstruction (p-MGIR) that allows reconstruction of high-quality low-dose CBCT images while preserving the image resolution.In p-MGIR, the unknown CBCT volume was mathematically modeled as a combination of two regions: (1) where anatomical structures are complex, and (2) where intensities are relatively uniform. The priori mask, which is the key concept of the p-MGIR algorithm, was defined as the matrix that distinguishes between the two separate CBCT regions where the resolution needs to be preserved and where streak or noise needs to be suppressed. We then alternately updated each part of image by solving two sub-minimization problems iteratively, where one minimization was focused on preserving the edge information of the first part while the other concentrated on the removal of noise/artifacts from the latter part. To evaluate the performance of the p-MGIR algorithm, a numerical head-and-neck phantom, a Catphan 600 physical phantom, and a clinical head-and-neck cancer case were used for analysis. The results were compared with the standard Feldkamp-Davis-Kress as well as conventional CS-based algorithms.Examination of the p-MGIR algorithm showed that high-quality low-dose CBCT images can be reconstructed without compromising the image resolution. For both phantom and the patient cases, the p-MGIR is able to achieve a clinically-reasonable image with 60 projections. Therefore, a clinically-viable, high-resolution head-and-neck CBCT image can be obtained while cutting the dose by 83%. Moreover, the image quality obtained using p-MGIR is better than the quality obtained using other algorithms.In this work, we propose a novel low-dose CBCT reconstruction algorithm called p-MGIR. It can be potentially used as a CBCT reconstruction algorithm with low dose scan requests [ABSTRACT FROM AUTHOR]

Kilo-voltage (KV) cone-beam computed tomography (CBCT) unit mounted onto a linear accelerator treatment system, often referred to as on-board imager (OBI), plays an increasingly important role in image-guided radiation therapy. While the FDK algorithm is currently used for reconstructing images from clinical OBI data, optimization-based reconstruction has also been investigated for OBI CBCT. An optimization-based reconstruction involves numerous parameters, which can significantly impact reconstruction properties (or utility). The success of an optimization-based reconstruction for a particular class of practical applications thus relies strongly on appropriate selection of parameter values. In the work, we focus on tailoring the constrained-TV-minimization-based reconstruction, an optimization-based reconstruction previously shown of some potential for CBCT imaging conditions of practical interest, to OBI imaging through appropriate selection of parameter values. In particular, for given real data of phantoms and patient collected with OBI CBCT, we first devise utility metrics specific to OBI-quality-assurance tasks and then apply them to guiding the selection of parameter values in constrained-TV-minimization-based reconstruction. The study results show that the reconstructions are with improvement, relative to clinical FDK reconstruction, in both visualization and quantitative assessments in terms of the devised utility metrics. [ABSTRACT FROM AUTHOR]

This work introduces a task-driven imaging framework that incorporates a mathematical definition of the imaging task, a model of the imaging system, and a patient-specific anatomical model to prospectively design image acquisition and reconstruction techniques to optimize task performance. The framework is applied to joint optimization of tube current modulation, view-dependent reconstruction kernel, and orbital tilt in cone-beam CT. The system model considers a cone-beam CT system incorporating a flat-panel detector and 3D filtered backprojection and accurately describes the spatially varying noise and resolution over a wide range of imaging parameters in the presence of a realistic anatomical model. Task-based detectability index (d′) is incorporated as the objective function in a task-driven optimization of image acquisition and reconstruction techniques. The orbital tilt was optimized through an exhaustive search across tilt angles ranging ±30°. For each tilt angle, the view-dependent tube current and reconstruction kernel (i.e. the modulation profiles) that maximized detectability were identified via an alternating optimization. The task-driven approach was compared with conventional unmodulated and automatic exposure control (AEC) strategies for a variety of imaging tasks and anthropomorphic phantoms. The task-driven strategy outperformed the unmodulated and AEC cases for all tasks. For example, d′ for a sphere detection task in a head phantom was improved by 30% compared to the unmodulated case by using smoother kernels for noisy views and distributing mAs across less noisy views (at fixed total mAs) in a manner that was beneficial to task performance. Similarly for detection of a line-pair pattern, the task-driven approach increased d′ by 80% compared to no modulation by means of view-dependent mA and kernel selection that yields modulation transfer function and noise-power spectrum optimal to the task. Optimization of orbital tilt identified the tilt angle that reduced quantum noise in the region of the stimulus by avoiding highly attenuating anatomical structures. The task-driven imaging framework offers a potentially valuable paradigm for prospective definition of acquisition and reconstruction protocols that improve task performance without increase in dose. [ABSTRACT FROM AUTHOR]

Onboard cone-beam CT (CBCT) has been widely used in image guided radiation therapy. However, the longitudinal coverage is only 15.5 cm in the pelvis scan mode. As a result, a single CBCT scan cannot cover the planning target volume in the longitudinal direction for over 80% of the patients. The common approach is to use double- or multiple-circular scans and then combine multiple CBCT volumes after reconstruction. However it raises concerns regarding doubled imaging dose at the imaging beam junctions due to beam divergence. In this work, we present a new method, DSCS (Dual Scan with Complementary Shifts), to address the CBCT coverage problem using a pair of complementary circular scans. In DSCS, two circular scans were performed at 39.5 cm apart longitudinally. In the superior scan, the detector panel was offset by 16 cm to the left, 15 cm to the inferior. In the inferior scan, the detector panel was shifted 16 cm to the right and 15 cm to the superior. The effective imaging volume is 39.5 cm longitudinally with a 45 cm lateral field-of-view (FOV). Half beam blocks were used to confine the imaging radiation inside the volume of interest. A new image reconstruction algorithm was developed, based on the Feldkamp–Davis–Kress cone-beam CT reconstruction algorithm, to support the DSCS scanning geometry. Digital phantom simulations were performed to demonstrate the feasibility of DSCS. Physical phantom studies were performed using an anthropomorphic phantom on a commercial onboard CBCT system. With basic scattering corrections, the reconstruction results were acceptable. Other issues, including the discrepancy in couch vertical at different couch longitudinal positions, and the inaccuracy in couch table longitudinal movement, were manually corrected during the reconstruction process. In conclusion, the phantom studies showed that, using DSCS, a 39.5 cm longitudinal coverage with a 45 cm FOV was accomplished. The efficiency of imaging dose usage was near 100%. This proposed method could be potentially useful for image guidance and subsequent treatment plan adaptation. [ABSTRACT FROM AUTHOR]