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Metal artifacts caused by the presence of metallic implants tremendously degrade the reconstructed computed tomography (CT) image quality, affecting clinical diagnosis or reducing the accuracy of organ delineation and dose calculation in radiotherapy. Recently, deep learning methods in sinogram and image domains have been rapidly applied on metal artifact reduction (MAR) task. The supervised dual-domain methods perform well on synthesized data, while unsupervised methods with unpaired data are more generalized on clinical data. However, most existing methods intend to restore the corrupted sinogram within metal trace, which essentially remove beam hardening artifacts but ignore other components of metal artifacts, such as scatter, non-linear partial volume effect and noise. In this paper, we mathematically derive a physical property of metal artifacts which is verified via Monte Carlo (MC) simulation and propose a novel physics based non-local dual-domain network (PND-Net) for MAR in CT imaging. Specifically, we design a novel non-local sinogram decomposition network (NSD-Net) to acquire the weighted artifact component, and an image restoration network (IR-Net) is proposed to reduce the residual and secondary artifacts in the image domain. To facilitate the generalization and robustness of our method on clinical CT images, we employ a trainable fusion network (F-Net) in the artifact synthesis path to achieve unpaired learning. Furthermore, we design an internal consistency loss to ensure the integrity of anatomical structures in the image domain, and introduce the linear interpolation sinogram as prior knowledge to guide sinogram decomposition. Extensive experiments on simulation and clinical data demonstrate that our method outperforms the state-of-the-art MAR methods., Comment: 19 pages, 8 figures

Purpose: Radiation therapy treatment planning is a trial-and-error, often time-consuming process. An optimal dose distribution based on a specific anatomy can be predicted by pre-trained deep learning (DL) models. However, dose distributions are often optimized based on not only patient-specific anatomy but also physician preferred trade-offs between planning target volume (PTV) coverage and organ at risk (OAR) sparing. Therefore, it is desirable to allow physicians to fine-tune the dose distribution predicted based on patient anatomy. In this work, we developed a DL model to predict the individualized 3D dose distributions by using not only the anatomy but also the desired PTV/OAR trade-offs, as represented by a dose volume histogram (DVH), as inputs. Methods: The desired DVH, fine-tuned by physicians from the initially predicted DVH, is first projected onto the Pareto surface, then converted into a vector, and then concatenated with mask feature maps. The network output for training is the dose distribution corresponding to the Pareto optimal DVH. The training/validation datasets contain 77 prostate cancer patients, and the testing dataset has 20 patients. Results: The trained model can predict a 3D dose distribution that is approximately Pareto optimal. We calculated the difference between the predicted and the optimized dose distribution for the PTV and all OARs as a quantitative evaluation. The largest average error in mean dose was about 1.6% of the prescription dose, and the largest average error in the maximum dose was about 1.8%. Conclusions: In this feasibility study, we have developed a 3D U-Net model with the anatomy and desired DVH as inputs to predict an individualized 3D dose distribution. The predicted dose distributions can be used as references for dosimetrists and physicians to rapidly develop a clinically acceptable treatment plan.

In this paper, we present a new method to generate an instantaneous volumetric image using a single x-ray projection. To fully extract motion information hidden in projection images, we partitioned a projection image into small patches. We utilized a sparse learning method to automatically select patches that have a high correlation with principal component analysis (PCA) coefficients of a lung motion model. A model that maps the patch intensity to the PCA coefficients is built along with the patch selection process. Based on this model, a measured projection can be used to predict the PCA coefficients, which are further used to generate a motion vector field and hence a volumetric image. We have also proposed an intensity baseline correction method based on the partitioned projection, where the first and the second moments of pixel intensities at a patch in a simulated image are matched with those in a measured image via a linear transformation. The proposed method has been valid in simulated data and real phantom data. The algorithm is able to identify patches that contain relevant motion information, e.g. diaphragm region. It is found that intensity correction step is important to remove the systematic error in the motion prediction. For the simulation case, the sparse learning model reduced prediction error for the first PCA coefficient to 5%, compared to the 10% error when sparse learning is not used. 95th percentile error for the predicted motion vector is reduced from 2.40 mm to 0.92mm. In the phantom case, the predicted tumor motion trajectory is successfully reconstructed with 0.82 mm mean vector field error compared to 1.66 mm error without using the sparse learning method. The algorithm robustness with respect to sparse level, patch size, and existence of diaphragm, as well as computation time, has also been studied., Comment: 20 pages, 9 figures

Computed tomography (CT) to cone-beam computed tomography (CBCT) deformable image registration (DIR) is a crucial step in adaptive radiation therapy. Current intensity-based registration algorithms, such as demons, may fail in the context of CT-CBCT DIR because of inconsistent intensities between the two modalities. In this paper, we propose a variant of demons, called Deformation with Intensity Simultaneously Corrected (DISC), to deal with CT-CBCT DIR. DISC distinguishes itself from the original demons algorithm by performing an adaptive intensity correction step on the CBCT image at every iteration step of the demons registration. Specifically, the intensity correction of a voxel in CBCT is achieved by matching the first and the second moments of the voxel intensities inside a patch around the voxel with those on the CT image. It is expected that such a strategy can remove artifacts in the CBCT image, as well as ensuring the intensity consistency between the two modalities. DISC is implemented on computer graphics processing units (GPUs) in compute unified device architecture (CUDA) programming environment. The performance of DISC is evaluated on a simulated patient case and six clinical head-and-neck cancer patient data. It is found that DISC is robust against the CBCT artifacts and intensity inconsistency and significantly improves the registration accuracy when compared with the original demons., Comment: 22 pages, 9 figures, and 3 tables