Metal artifacts in computed tomography (CT) images can significantly degrade image quality and impede accurate diagnosis. Supervised metal artifact reduction (MAR) methods, trained using simulated datasets, often struggle to perform well on real clinical CT images due to a substantial domain gap. Although state-of-the-art semi-supervised methods use pseudo ground-truths generated by a prior network to mitigate this issue, their reliance on a fixed prior limits both the quality and quantity of these pseudo ground-truths, introducing confirmation bias and reducing clinical applicability. To address these limitations, we propose a novel Radiologist-In-the-loop SElf-training framework for MAR, termed RISE-MAR, which can integrate radiologists' feedback into the semi-supervised learning process, progressively improving the quality and quantity of pseudo ground-truths for enhanced generalization on real clinical CT images. For quality assurance, we introduce a clinical quality assessor model that emulates radiologist evaluations, effectively selecting high-quality pseudo ground-truths for semi-supervised training. For quantity assurance, our self-training framework iteratively generates additional high-quality pseudo ground-truths, expanding the clinical dataset and further improving model generalization. Extensive experimental results on multiple clinical datasets demonstrate the superior generalization performance of our RISE-MAR over state-of-the-art methods, advancing the development of MAR models for practical application. Code is available at https://github.com/Masaaki-75/rise-mar.
Emerging neural reconstruction techniques based on tomography (e.g., NeRF, NeAT, and NeRP) have started showing unique capabilities in medical imaging. In this work, we present a novel Polychromatic neural representation (Polyner) to tackle the challenging problem of CT imaging when metallic implants exist within the human body. CT metal artifacts arise from the drastic variation of metal's attenuation coefficients at various energy levels of the X-ray spectrum, leading to a nonlinear metal effect in CT measurements. Recovering CT images from metal-affected measurements hence poses a complicated nonlinear inverse problem where empirical models adopted in previous metal artifact reduction (MAR) approaches lead to signal loss and strongly aliased reconstructions. Polyner instead models the MAR problem from a nonlinear inverse problem perspective. Specifically, we first derive a polychromatic forward model to accurately simulate the nonlinear CT acquisition process. Then, we incorporate our forward model into the implicit neural representation to accomplish reconstruction. Lastly, we adopt a regularizer to preserve the physical properties of the CT images across different energy levels while effectively constraining the solution space. Our Polyner is an unsupervised method and does not require any external training data. Experimenting with multiple datasets shows that our Polyner achieves comparable or better performance than supervised methods on in-domain datasets while demonstrating significant performance improvements on out-of-domain datasets. To the best of our knowledge, our Polyner is the first unsupervised MAR method that outperforms its supervised counterparts. The code for this work is available at: https://github.com/iwuqing/Polyner.
During the process of computed tomography (CT), metallic implants often cause disruptive artifacts in the reconstructed images, impeding accurate diagnosis. Several supervised deep learning-based approaches have been proposed for reducing metal artifacts (MAR). However, these methods heavily rely on training with simulated data, as obtaining paired metal artifact CT and clean CT data in clinical settings is challenging. This limitation can lead to decreased performance when applying these methods in clinical practice. Existing unsupervised MAR methods, whether based on learning or not, typically operate within a single domain, either in the image domain or the sinogram domain. In this paper, we propose an unsupervised MAR method based on the diffusion model, a generative model with a high capacity to represent data distributions. Specifically, we first train a diffusion model using CT images without metal artifacts. Subsequently, we iteratively utilize the priors embedded within the pre-trained diffusion model in both the sinogram and image domains to restore the degraded portions caused by metal artifacts. This dual-domain processing empowers our approach to outperform existing unsupervised MAR methods, including another MAR method based on the diffusion model, which we have qualitatively and quantitatively validated using synthetic datasets. Moreover, our method demonstrates superior visual results compared to both supervised and unsupervised methods on clinical datasets.
Sparse-view computed tomography (CT) has been adopted as an important technique for speeding up data acquisition and decreasing radiation dose. However, due to the lack of sufficient projection data, the reconstructed CT images often present severe artifacts, which will be further amplified when patients carry metallic implants. For this joint sparse-view reconstruction and metal artifact reduction task, most of the existing methods are generally confronted with two main limitations: 1) They are almost built based on common network modules without fully embedding the physical imaging geometry constraint of this specific task into the dual-domain learning; 2) Some important prior knowledge is not deeply explored and sufficiently utilized. Against these issues, we specifically construct a dual-domain reconstruction model and propose a model-driven equivariant proximal network, called MEPNet. The main characteristics of MEPNet are: 1) It is optimization-inspired and has a clear working mechanism; 2) The involved proximal operator is modeled via a rotation equivariant convolutional neural network, which finely represents the inherent rotational prior underlying the CT scanning that the same organ can be imaged at different angles. Extensive experiments conducted on several datasets comprehensively substantiate that compared with the conventional convolution-based proximal network, such a rotation equivariance mechanism enables our proposed method to achieve better reconstruction performance with fewer network parameters. We will release the code at \url{https://github.com/hongwang01/MEPNet}.
During X-ray computed tomography (CT) scanning, metallic implants carrying with patients often lead to adverse artifacts in the captured CT images and then impair the clinical treatment. Against this metal artifact reduction (MAR) task, the existing deep-learning-based methods have gained promising reconstruction performance. Nevertheless, there is still some room for further improvement of MAR performance and generalization ability, since some important prior knowledge underlying this specific task has not been fully exploited. Hereby, in this paper, we carefully analyze the characteristics of metal artifacts and propose an orientation-shared convolution representation strategy to adapt the physical prior structures of artifacts, i.e., rotationally symmetrical streaking patterns. The proposed method rationally adopts Fourier-series-expansion-based filter parametrization in artifact modeling, which can better separate artifacts from anatomical tissues and boost the model generalizability. Comprehensive experiments executed on synthesized and clinical datasets show the superiority of our method in detail preservation beyond the current representative MAR methods. Code will be available at \url{https://github.com/hongwang01/OSCNet}
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.
Inspired by the great success of deep neural networks, learning-based methods have gained promising performances for metal artifact reduction (MAR) in computed tomography (CT) images. However, most of the existing approaches put less emphasis on modelling and embedding the intrinsic prior knowledge underlying this specific MAR task into their network designs. Against this issue, we propose an adaptive convolutional dictionary network (ACDNet), which leverages both model-based and learning-based methods. Specifically, we explore the prior structures of metal artifacts, e.g., non-local repetitive streaking patterns, and encode them as an explicit weighted convolutional dictionary model. Then, a simple-yet-effective algorithm is carefully designed to solve the model. By unfolding every iterative substep of the proposed algorithm into a network module, we explicitly embed the prior structure into a deep network, \emph{i.e.,} a clear interpretability for the MAR task. Furthermore, our ACDNet can automatically learn the prior for artifact-free CT images via training data and adaptively adjust the representation kernels for each input CT image based on its content. Hence, our method inherits the clear interpretability of model-based methods and maintains the powerful representation ability of learning-based methods. Comprehensive experiments executed on synthetic and clinical datasets show the superiority of our ACDNet in terms of effectiveness and model generalization. {\color{blue}{{\textit{Code is available at {\url{https://github.com/hongwang01/ACDNet}}.}}}}
During the computed tomography (CT) imaging process, metallic implants within patients often cause harmful artifacts, which adversely degrade the visual quality of reconstructed CT images and negatively affect the subsequent clinical diagnosis. For the metal artifact reduction (MAR) task, current deep learning based methods have achieved promising performance. However, most of them share two main common limitations: 1) the CT physical imaging geometry constraint is not comprehensively incorporated into deep network structures; 2) the entire framework has weak interpretability for the specific MAR task; hence, the role of each network module is difficult to be evaluated. To alleviate these issues, in the paper, we construct a novel deep unfolding dual domain network, termed InDuDoNet+, into which CT imaging process is finely embedded. Concretely, we derive a joint spatial and Radon domain reconstruction model and propose an optimization algorithm with only simple operators for solving it. By unfolding the iterative steps involved in the proposed algorithm into the corresponding network modules, we easily build the InDuDoNet+ with clear interpretability. Furthermore, we analyze the CT values among different tissues, and merge the prior observations into a prior network for our InDuDoNet+, which significantly improve its generalization performance.Comprehensive experiments on synthesized data and clinical data substantiate the superiority of the proposed methods as well as the superior generalization performance beyond the current state-of-the-art (SOTA) MAR methods. . Code is available at \url{https://github.com/hongwang01/InDuDoNet_plus}.
For the task of metal artifact reduction (MAR), although deep learning (DL)-based methods have achieved promising performances, most of them suffer from two problems: 1) the CT imaging geometry constraint is not fully embedded into the network during training, leaving room for further performance improvement; 2) the model interpretability is lack of sufficient consideration. Against these issues, we propose a novel interpretable dual domain network, termed as InDuDoNet, which combines the advantages of model-driven and data-driven methodologies. Specifically, we build a joint spatial and Radon domain reconstruction model and utilize the proximal gradient technique to design an iterative algorithm for solving it. The optimization algorithm only consists of simple computational operators, which facilitate us to correspondingly unfold iterative steps into network modules and thus improve the interpretablility of the framework. Extensive experiments on synthesized and clinical data show the superiority of our InDuDoNet. Code is available in \url{https://github.com/hongwang01/InDuDoNet}.%method on the tasks of MAR and downstream multi-class pelvic fracture segmentation.
Metal implants can heavily attenuate X-rays in computed tomography (CT) scans, leading to severe artifacts in reconstructed images, which significantly jeopardize image quality and negatively impact subsequent diagnoses and treatment planning. With the rapid development of deep learning in the field of medical imaging, several network models have been proposed for metal artifact reduction (MAR) in CT. Despite the encouraging results achieved by these methods, there is still much room to further improve performance. In this paper, a novel Dual-domain Adaptive-scaling Non-local network (DAN-Net) for MAR. We correct the corrupted sinogram using adaptive scaling first to preserve more tissue and bone details as a more informative input. Then, an end-to-end dual-domain network is adopted to successively process the sinogram and its corresponding reconstructed image generated by the analytical reconstruction layer. In addition, to better suppress the existing artifacts and restrain the potential secondary artifacts caused by inaccurate results of the sinogram-domain network, a novel residual sinogram learning strategy and nonlocal module are leveraged in the proposed network model. In the experiments, the proposed DAN-Net demonstrates performance competitive with several state-of-the-art MAR methods in both qualitative and quantitative aspects.
Current deep neural network based approaches to computed tomography (CT) metal artifact reduction (MAR) are supervised methods that rely on synthesized metal artifacts for training. However, as synthesized data may not accurately simulate the underlying physical mechanisms of CT imaging, the supervised methods often generalize poorly to clinical applications. To address this problem, we propose, to the best of our knowledge, the first unsupervised learning approach to MAR. Specifically, we introduce a novel artifact disentanglement network that disentangles the metal artifacts from CT images in the latent space. It supports different forms of generations (artifact reduction, artifact transfer, and self-reconstruction, etc.) with specialized loss functions to obviate the need for supervision with synthesized data. Extensive experiments show that when applied to a synthesized dataset, our method addresses metal artifacts significantly better than the existing unsupervised models designed for natural image-to-image translation problems, and achieves comparable performance to existing supervised models for MAR. When applied to clinical datasets, our method demonstrates better generalization ability over the supervised models. The source code of this paper is publicly available at https://github.com/liaohaofu/adn.
Current deep neural network based approaches to computed tomography (CT) metal artifact reduction (MAR) are supervised methods which rely heavily on synthesized data for training. However, as synthesized data may not perfectly simulate the underlying physical mechanisms of CT imaging, the supervised methods often generalize poorly to clinical applications. To address this problem, we propose, to the best of our knowledge, the first unsupervised learning approach to MAR. Specifically, we introduce a novel artifact disentanglement network that enables different forms of generations and regularizations between the artifact-affected and artifact-free image domains to support unsupervised learning. Extensive experiments show that our method significantly outperforms the existing unsupervised models for image-to-image translation problems, and achieves comparable performance to existing supervised models on a synthesized dataset. When applied to clinical datasets, our method achieves considerable improvements over the supervised models. The source code of this paper is publicly available at https://github.com/liaohaofu/adn.
Filtered back projection (FBP) is the most widely used method for image reconstruction in X-ray computed tomography (CT) scanners. The presence of hyper-dense materials in a scene, such as metals, can strongly attenuate X-rays, producing severe streaking artifacts in the reconstruction. These metal artifacts can greatly limit subsequent object delineation and information extraction from the images, restricting their diagnostic value. This problem is particularly acute in the security domain, where there is great heterogeneity in the objects that can appear in a scene, highly accurate decisions must be made quickly. The standard practical approaches to reducing metal artifacts in CT imagery are either simplistic non-adaptive interpolation-based projection data completion methods or direct image post-processing methods. These standard approaches have had limited success. Motivated primarily by security applications, we present a new deep-learning-based metal artifact reduction (MAR) approach that tackles the problem in the projection data domain. We treat the projection data corresponding to metal objects as missing data and train an adversarial deep network to complete the missing data in the projection domain. The subsequent complete projection data is then used with FBP to reconstruct image intended to be free of artifacts. This new approach results in an end-to-end MAR algorithm that is computationally efficient so practical and fits well into existing CT workflows allowing easy adoption in existing scanners. Training deep networks can be challenging, and another contribution of our work is to demonstrate that training data generated using an accurate X-ray simulation can be used to successfully train the deep network when combined with transfer learning using limited real data sets. We demonstrate the effectiveness and potential of our algorithm on simulated and real examples.