Abstract

Conventional non-local total variation (NLTV) approaches use the weight of a non-local means (NLM) filter, which degrades performance in low-dose cone-beam computed tomography (CBCT) images generated with a low milliampere-seconds (mAs) parameter value because a local patch used to determine the pixel weights comprises noisy-damaged pixels that reduce the similarity between corresponding patches. In this paper, we propose a novel type of NLTV based on a combination of mutual information (MI): MI-NLTV. It is based on a statistical measure for a similarity calculation between the corresponding bins of non-local patches vs. a reference patch. The weight is determined in terms of a statistical measure comprising the MI value between corresponding non-local patches and the reference-patch entropy. The MI-NLTV denoising process is applied to CBCT images generated by the analytical reconstruction algorithm using a ray-driven backprojector (RDB). The MI-NLTV objective function is minimized based on the steepest gradient descent optimization to augment the difference between a real structure and noise, cleaning noisy pixels without significant loss of the fine structure and details that remain in the reconstructed images. The proposed method was evaluated using patient data and actual phantom measurement data acquired with lower mAs. The results show that integrating the RDB further enhances the MI-NLTV denoising-based analytical reconstruction algorithm to achieve a higher CBCT image quality when compared with those generated by NLTV denoising-based approach, with an average of 15.97% higher contrast-to-noise ratio, 2.67% lower root mean square error, 0.12% lower spatial non-uniformity, 1.14% higher correlation, and an average of 18.11% higher detectability index. These quantitative results indicate that the incorporation of MI makes the NLTV more stable and robust than the conventional NLM filter for low-dose CBCT imaging. In addition, achieving clinically acceptable CBCT image quality despite low-mAs projection acquisition can reduce the burden on common online CBCT imaging, improving patient safety throughout the course of radiotherapy.

Highlights

  • Cone-beam computed tomography (CBCT) is used as an image guidance system in many radiotherapy institutions [1]

  • The mutual information (MI)-non-local total variation (NLTV) denoiser was applied to cone-beam computed tomography (CBCT) generated by analytical reconstruction algorithms using pixel-driven backprojector (PDB) or ray-driven backprojector (RDB) based on the Catphan®503 phantom

  • The artifacts were significantly suppressed in the CBCT images processed by the proposed RDB in conjunction with the MI-NLTV denoiser compared with those processed through other approaches

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Summary

Introduction

Cone-beam computed tomography (CBCT) is used as an image guidance system in many radiotherapy institutions [1] It provides a transformation through registration with a reference image that can be used to adjust the patient’s position to align appropriately with the radiation isocenter, ensuring that the planned dose is accurately delivered to the patient during treatment [2,3,4,5]. The material decomposition process is highly sensitive to noise fluctuations owing to the overlap of x-ray spectra at low and high energies. Even this approach comes at the expense of doubling radiation dose. It is necessary to develop an algorithm that can improve the CBCT image quality while appropriately managing the indication-oriented patient dose

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