Low-dimensional Manifold Constrained Disentanglement Network for Metal Artifact Reduction

Semi-supervised spatial-frequency transformer for metal artifact reduction in maxillofacial CT and evaluation with intraoral scan

PURPOSE

To develop a semi-supervised domain adaptation technique for metal artifact reduction with a spatial-frequency transformer (SFTrans) model (Semi-SFTrans), and to quantitatively compare its performance with supervised models (Sup-SFTrans and ResUNet) and traditional linear interpolation MAR method (LI) in oral and maxillofacial CT.

METHODS

Supervised models, including Sup-SFTrans and a state-of-the-art model termed ResUNet, were trained with paired simulated CT images, while semi-supervised model, Semi-SFTrans, was trained with both paired simulated and unpaired clinical CT images. For evaluation on the simulated data, we calculated Peak Signal-to-Noise Ratio (PSNR) and Structural Similarity Index Measure (SSIM) on the images corrected by four methods: LI, ResUNet, Sup-SFTrans, and Semi-SFTrans. For evaluation on the clinical data, we collected twenty-two clinical cases with real metal artifacts, and the corresponding intraoral scan data. Three radiologists visually assessed the severity of artifacts using Likert scales on the original, Sup-SFTrans-corrected, and Semi-SFTrans-corrected images. Quantitative MAR evaluation was conducted by measuring Mean Hounsfield Unit (HU) values, standard deviations, and Signal-to-Noise Ratios (SNRs) across Regions of Interest (ROIs) such as the tongue, bilateral buccal, lips, and bilateral masseter muscles, using paired t-tests and Wilcoxon signed-rank tests. Further, teeth integrity in the corrected images was assessed by comparing teeth segmentation results from the corrected images against the ground-truth segmentation derived from registered intraoral scan data, using Dice Score and Hausdorff Distance.

RESULTS

Sup-SFTrans outperformed LI, ResUNet and Semi-SFTrans on the simulated dataset. Visual assessments from the radiologists showed that average scores were (2.02 ± 0.91) for original CT, (4.46 ± 0.51) for Semi-SFTrans CT, and (3.64 ± 0.90) for Sup-SFTrans CT, with intra correlation coefficients (ICCs)＞0.8 of all groups and p < 0.001 between groups. On soft tissue, both Semi-SFTrans and Sup-SFTrans significantly reduced metal artifacts in tongue (p < 0.001), lips, bilateral buccal regions, and masseter muscle areas (p < 0.05). Semi-SFTrans achieved superior metal artifact reduction than Sup-SFTrans in all ROIs (p < 0.001). SNR results indicated significant differences between Semi-SFTrans and Sup-SFTrans in tongue (p = 0.0391), bilateral buccal (p = 0.0067), lips (p = 0.0208), and bilateral masseter muscle areas (p = 0.0031). Notably, Semi-SFTrans demonstrated better teeth integrity preservation than Sup-SFTrans (Dice Score: p < 0.001; Hausdorff Distance: p = 0.0022).

CONCLUSION

The semi-supervised MAR model, Semi-SFTrans, demonstrated superior metal artifact reduction performance over supervised counterparts in real dental CT images.

CT metal artefact reduction for hip and shoulder implants using novel algorithms and machine learning: A systematic review with pairwise and network meta-analyses

INTRODUCTION

Many tools have been developed to reduce metal artefacts in computed tomography (CT) images resulting from metallic prosthesis; however, their relative effectiveness in preserving image quality is poorly understood. This paper reviews the literature on novel metal artefact reduction (MAR) methods targeting large metal artefacts in fan-beam CT to examine their effectiveness in reducing metal artefacts and effect on image quality.

METHODS

The PRISMA checklist was used to search for articles in five electronic databases (MEDLINE, Scopus, Web of Science, IEEE, EMBASE). Studies that assessed the effectiveness of recently developed MAR method on fan-beam CT images of hip and shoulder implants were reviewed. Study quality was assessed using the National Institute of Health (NIH) tool. Meta-analyses were conducted in R, and results that could not be meta-analysed were synthesised narratively.

RESULTS

Thirty-six studies were reviewed. Of these, 20 studies proposed statistical algorithms and 16 used machine learning (ML), and there were 19 novel comparators. Network meta-analysis of 19 studies showed that Recurrent Neural Network MAR (RNN-MAR) is more effective in reducing noise (LogOR 20.7; 95 % CI 12.6-28.9) without compromising image quality (LogOR 4.4; 95 % CI -13.8-22.5). The network meta-analysis and narrative synthesis showed novel MAR methods reduce noise more effectively than baseline algorithms, with five out of 23 ML methods significantly more effective than Filtered Back Projection (FBP) (p < 0.05). Computation time varied, but ML methods were faster than statistical algorithms.

CONCLUSION

ML tools are more effective in reducing metal artefacts without compromising image quality and are computationally faster than statistical algorithms. Overall, novel MAR methods were also more effective in reducing noise than the baseline reconstructions.

IMPLICATIONS FOR PRACTICE

Implementation research is needed to establish the clinical suitability of ML MAR in practice.

b-MAR: bidirectional artifact representations learning framework for metal artifact reduction in dental CBCT

Objective.Metal artifacts in computed tomography (CT) images hinder diagnosis and treatment significantly. Specifically, dental cone-beam computed tomography (Dental CBCT) images are seriously contaminated by metal artifacts due to the widespread use of low tube voltages and the presence of various high-attenuation materials in dental structures. Existing supervised metal artifact reduction (MAR) methods mainly learn the mapping of artifact-affected images to clean images, while ignoring the modeling of the metal artifact generation process. Therefore, we propose the bidirectional artifact representations learning framework to adaptively encode metal artifacts caused by various dental implants and model the generation and elimination of metal artifacts, thereby improving MAR performance.Approach.Specifically, we introduce an efficient artifact encoder to extract multi-scale representations of metal artifacts from artifact-affected images. These extracted metal artifact representations are then bidirectionally embedded into both the metal artifact generator and the metal artifact eliminator, which can simultaneously improve the performance of artifact removal and artifact generation. The artifact eliminator learns artifact removal in a supervised manner, while the artifact generator learns artifact generation in an adversarial manner. To further improve the performance of the bidirectional task networks, we propose artifact consistency loss to align the consistency of images generated by the eliminator and the generator with or without embedding artifact representations.Main results.To validate the effectiveness of our algorithm, experiments are conducted on simulated and clinical datasets containing various dental metal morphologies. Quantitative metrics are calculated to evaluate the results of the simulation tests, which demonstrate b-MAR improvements of >1.4131 dB in PSNR, >0.3473 HU decrements in RMSE, and >0.0025 promotion in structural similarity index measurement over the current state-of-the-art MAR methods. All results indicate that the proposed b-MAR method can remove artifacts caused by various metal morphologies and restore the structural integrity of dental tissues effectively.Significance.The proposed b-MAR method strengthens the joint learning of the artifact removal process and the artifact generation process by bidirectionally embedding artifact representations, thereby improving the model's artifact removal performance. Compared with other comparison methods, b-MAR can robustly and effectively correct metal artifacts in dental CBCT images caused by different dental metals.

Quad-Net: Quad-Domain Network for CT Metal Artifact Reduction

Metal implants and other high-density objects in patients introduce severe streaking artifacts in CT images, compromising image quality and diagnostic performance. Although various methods were developed for CT metal artifact reduction over the past decades, including the latest dual-domain deep networks, remaining metal artifacts are still clinically challenging in many cases. Here we extend the state-of-the-art dual-domain deep network approach into a quad-domain counterpart so that all the features in the sinogram, image, and their corresponding Fourier domains are synergized to eliminate metal artifacts optimally without compromising structural subtleties. Our proposed quad-domain network for MAR, referred to as Quad-Net, takes little additional computational cost since the Fourier transform is highly efficient, and works across the four receptive fields to learn both global and local features as well as their relations. Specifically, we first design a Sinogram-Fourier Restoration Network (SFR-Net) in the sinogram domain and its Fourier space to faithfully inpaint metal-corrupted traces. Then, we couple SFR-Net with an Image-Fourier Refinement Network (IFR-Net) which takes both an image and its Fourier spectrum to improve a CT image reconstructed from the SFR-Net output using cross-domain contextual information. Quad-Net is trained on clinical datasets to minimize a composite loss function. Quad-Net does not require precise metal masks, which is of great importance in clinical practice. Our experimental results demonstrate the superiority of Quad-Net over the state-of-the-art MAR methods quantitatively, visually, and statistically. The Quad-Net code is publicly available at https://github.com/longzilicart/Quad-Net.

SemiMAR: Semi-Supervised Learning for CT Metal Artifact Reduction

Metal artifacts lead to CT imaging quality degradation. With the success of deep learning (DL) in medical imaging, a number of DL-based supervised methods have been developed for metal artifact reduction (MAR). Nonetheless, fully-supervised MAR methods based on simulated data do not perform well on clinical data due to the domain gap. Although this problem can be avoided in an unsupervised way to a certain degree, severe artifacts cannot be well suppressed in clinical practice. Recently, semi-supervised metal artifact reduction (MAR) methods have gained wide attention due to their ability in narrowing the domain gap and improving MAR performance in clinical data. However, these methods typically require large model sizes, posing challenges for optimization. To address this issue, we propose a novel semi-supervised MAR framework. In our framework, only the artifact-free parts are learned, and the artifacts are inferred by subtracting these clean parts from the metal-corrupted CT images. Our approach leverages a single generator to execute all complex transformations, thereby reducing the model's scale and preventing overlap between clean part and artifacts. To recover more tissue details, we distill the knowledge from the advanced dual-domain MAR network into our model in both image domain and latent feature space. The latent space constraint is achieved via contrastive learning. We also evaluate the impact of different generator architectures by investigating several mainstream deep learning-based MAR backbones. Our experiments demonstrate that the proposed method competes favorably with several state-of-the-art semi-supervised MAR techniques in both qualitative and quantitative aspects.

Low-Dose CT Image Synthesis for Domain Adaptation Imaging Using a Generative Adversarial Network With Noise Encoding Transfer Learning

Deep learning (DL) based image processing methods have been successfully applied to low-dose x-ray images based on the assumption that the feature distribution of the training data is consistent with that of the test data. However, low-dose computed tomography (LDCT) images from different commercial scanners may contain different amounts and types of image noise, violating this assumption. Moreover, in the application of DL based image processing methods to LDCT, the feature distributions of LDCT images from simulation and clinical CT examination can be quite different. Therefore, the network models trained with simulated image data or LDCT images from one specific scanner may not work well for another CT scanner and image processing task. To solve such domain adaptation problem, in this study, a novel generative adversarial network (GAN) with noise encoding transfer learning (NETL), or GAN-NETL, is proposed to generate a paired dataset with a different noise style. Specifically, we proposed a method to perform noise encoding operator and incorporate it into the generator to extract a noise style. Meanwhile, with a transfer learning (TL) approach, the image noise encoding operator transformed the noise type of the source domain to that of the target domain for realistic noise generation. One public and two private datasets are used to evaluate the proposed method. Experiment results demonstrated the feasibility and effectiveness of our proposed GAN-NETL model in LDCT image synthesis. In addition, we conduct additional image denoising study using the synthesized clinical LDCT data, which verified the merit of the proposed synthesis in improving the performance of the DL based LDCT processing method.

Learning disentangled representations in the imaging domain

Disentangled representation learning has been proposed as an approach to learning general representations even in the absence of, or with limited, supervision. A good general representation can be fine-tuned for new target tasks using modest amounts of data, or used directly in unseen domains achieving remarkable performance in the corresponding task. This alleviation of the data and annotation requirements offers tantalising prospects for applications in computer vision and healthcare. In this tutorial paper, we motivate the need for disentangled representations, revisit key concepts, and describe practical building blocks and criteria for learning such representations. We survey applications in medical imaging emphasising choices made in exemplar key works, and then discuss links to computer vision applications. We conclude by presenting limitations, challenges, and opportunities.