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Diffusion Posterior Sampling (DPS) can be used in Computed Tomography (CT) reconstruction by leveraging diffusion-based generative models for unconditional image synthesis while matching the observations (data) of a CT scan. Of particular interest is its application in scenarios involving sparse or limited angular sampling, where conventional reconstruction algorithms are often insufficient. We developed a DPS algorithm for 3D reconstruction from a stationary CT (sCT) portable brain stroke imaging unit based on a multi-x-ray source array (MXA) of 31 x-ray tubes and a curved area detector. In this configuration, conventional reconstruction e.g., Penalized Weighted Least Squares (PWLS) with a Huber edge-preserving penalty, suffers from severe directional undersampling artifacts. The proposed DPS integrates a two-dimensional diffusion model, acting on image slices, coupled to sCT data consistency and volumetric regularization terms to enable 3D reconstruction robust to noise and incomplete sampling. To reduce the computational burden of DPS, stochastic contraction with PWLS initialization was used to decrease the number of diffusion steps. The validation studies involved simulations of anthropomorphic brain phantoms with synthetic bleeds and experimental data from an sCT bench. In simulations, DPS achieved ~130% reduction of directional artifacts compared to PWLS and 30% better recovery of lesion shape (DICE coefficient). Benchtop studies demonstrated enhanced visualization of brain features in a Kyoto Kagaku head phantom. The proposed DPS achieved improved visualization of intracranial hemorrhage and brain morphology compared to conventional model-based reconstruction for the highly undersampled sCT system.

Contrast resolution beyond the limits of conventional cone-beam CT (CBCT) systems is essential to high-quality imaging of the brain. We present a deep learning reconstruction method (dubbed DL-Recon) that integrates physically principled reconstruction models with DL-based image synthesis based on the statistical uncertainty in the synthesis image. A synthesis network was developed to generate a synthesized CBCT image (DL-Synthesis) from an uncorrected filtered back-projection (FBP) image. To improve generalizability (including accurate representation of lesions not seen in training), voxel-wise epistemic uncertainty of DL-Synthesis was computed using a Bayesian inference technique (Monte-Carlo dropout). In regions of high uncertainty, the DL-Recon method incorporates information from a physics-based reconstruction model and artifact-corrected projection data. Two forms of the DL-Recon method are proposed: (i) image-domain fusion of DL-Synthesis and FBP (DL-FBP) weighted by DL uncertainty; and (ii) a model-based iterative image reconstruction (MBIR) optimization using DL-Synthesis to compute a spatially varying regularization term based on DL uncertainty (DL-MBIR). The error in DL-Synthesis images was correlated with the uncertainty in the synthesis estimate. Compared to FBP and PWLS, the DL-Recon methods (both DL-FBP and DL-MBIR) showed ~50% reduction in noise (at matched spatial resolution) and ~40-70% improvement in image uniformity. Conventional DL-Synthesis alone exhibited ~10-60% under-estimation of lesion contrast and ~5-40% reduction in lesion segmentation accuracy (Dice coefficient) in simulated and real brain lesions, suggesting a lack of reliability / generalizability for structures unseen in the training data. DL-FBP and DL-MBIR improved the accuracy of reconstruction by directly incorporating information from the measurements in regions of high uncertainty., Comment: This work was presented at the 16th International Meeting on Fully Three-Dimensional Image Reconstruction in Radiology and Nuclear Medicine (Fully3D), July 19-23, 2021, Leuven, Belgium

Metal artifacts present a frequent challenge to cone-beam CT (CBCT) in image-guided surgery, obscuring visualization of metal instruments and adjacent anatomy. Recent advances in mobile C-arm systems have enabled 3D imaging capacity with non-circular orbits. We extend a previously proposed metal artifacts avoidance (MAA) method to reduce the influence of metal artifacts by prospectively defining a non-circular orbit that avoids metal-induced biases in projection domain. Accurate geometric calibration is an important challenge to accurate 3D image reconstruction for such orbits. We investigate the performance of interpolation-based calibration from a library of circular orbits for any non-circular orbit. We apply the method to non-circular scans acquired for MAA, which involves: (i) coarse 3D localization of metal objects via only two scout views using an end-to-end trained neural network; (ii) calculation of the metal-induced x-ray spectral shift for all possible views; and (iii) identification of the non-circular orbit that minimizes the variations in spectral shift. Non-circular orbits with interpolation-based geometric calibration yielded reasonably accurate 3D image reconstruction. The end-to-end neural network accurately localized metal implants with just two scout views even in complex anatomical scenes, improving Dice coefficient by ~42% compared to a more conventional cascade of separately trained U-nets. In a spine phantom with pedicle screw instrumentation, non-circular orbits identified by the MAA method reduced the magnitude of metal "blomming" artifacts (apparent width of the screw shaft) in CBCT reconstructions by ~70%. The proposed imaging and calibration methods present a practical means to improve image quality in mobile C-arm CBCT by identifying non-circular scan protocols that improve sampling and reduce metal-induced biases in the projection data., Comment: This work was presented at the 6th International Conference on Image Formation in X-Ray Computed Tomography, August, 2020, Regensburg, Germany

Detector lag and gantry motion during x-ray exposure and integration both result in azimuthal blurring in CT reconstructions. These effects can degrade image quality both for high-resolution features as well as low-contrast details. In this work we consider a forward model for model-based iterative reconstruction (MBIR) that is sufficiently general to accommodate both of these physical effects. We integrate this forward model in a penalized, weighted, nonlinear least-square style objective function for joint reconstruction and correction of these blur effects. We show that modeling detector lag can reduce/remove the characteristic lag artifacts in head imaging in both a simulation study and physical experiments. Similarly, we show that azimuthal blur ordinarily introduced by gantry motion can be mitigated with proper reconstruction models. In particular, we find the largest image quality improvement at the periphery of the field-of-view where gantry motion artifacts are most pronounced. These experiments illustrate the generality of the underlying forward model, suggesting the potential application in modeling a number of physical effects that are traditionally ignored or mitigated through pre-corrections to measurement data., Comment: Published in the conference proceedings of the 5th International Conference on Image Formation in X-Ray Computed Tomography

We present a novel reconstruction algorithm based on a general cone-beam CT forward model which is capable of incorporating the blur and noise correlations that are exhibited in flat-panel CBCT measurement data. Specifically, the proposed model may include scintillator blur, focal-spot blur, and noise correlations due to light spread in the scintillator. The proposed algorithm (GPL-BC) uses a Gaussian Penalized-Likelihood objective function which incorporates models of Blur and Correlated noise. In a simulation study, GPL-BC was able to achieve lower bias as compared to deblurring followed by FDK as well as a model-based reconstruction method without integration of measurement blur. In the same study, GPL-BC was able to achieve better line-pair reconstructions (in terms of segmented-image accuracy) as compared to deblurring followed by FDK, a model based method without blur, and a model based method with blur but not noise correlations. A prototype extremities quantitative cone-beam CT test bench was used to image a physical sample of human trabecular bone. These data were used to compare reconstructions using the proposed method and model based methods without blur and/or correlation to a registered {\mu}CT image of the same bone sample. The GPL-BC reconstructions resulted in more accurate trabecular bone segmentation. Multiple trabecular bone metrics, including Trabecular Thickness (Tb.Th.) were computed for each reconstruction approach as well as the {\mu}CT volume. The GPL-BC reconstruction provided the most accurate Tb.Th. measurement, 0.255 mm, as compared to the {\mu}CT derived value of 0.193 mm, followed by the GPL-B reconstruction, the GPL-I reconstruction, and then the FDK reconstruction (0.271 mm, 0.309 mm, and 0.335 mm, respectively).