PET image reconstruction is challenging due to the ill-poseness of the inverse problem and limited number of detected photons. Recently deep neural networks have been widely and successfully used in computer vision tasks and attracted growing interests in medical imaging. In this work, we trained a deep residual convolutional neural network to improve PET image quality by using the existing inter-patient information. An innovative feature of the proposed method is that we embed the neural network in the iterative reconstruction framework for image representation, rather than using it as a post-processing tool. We formulate the objective function as a constrained optimization problem and solve it using the alternating direction method of multipliers (ADMM) algorithm. Both simulation data and hybrid real data are used to evaluate the proposed method. Quantification results show that our proposed iterative neural network method can outperform the neural network denoising and conventional penalized maximum likelihood methods.

Dose reduction in computed tomography (CT) is essential for decreasing radiation risk in clinical applications. Iterative reconstruction algorithms are one of the most promising way to compensate for the increased noise due to reduction of photon flux. Most iterative reconstruction algorithms incorporate manually designed prior functions of the reconstructed image to suppress noises while maintaining structures of the image. These priors basically rely on smoothness constraints and cannot exploit more complex features of the image. The recent development of artificial neural networks and machine learning enabled learning of more complex features of image, which has the potential to improve reconstruction quality. In this letter, K-sparse auto encoder was used for unsupervised feature learning. A manifold was learned from normal-dose images and the distance between the reconstructed image and the manifold was minimized along with data fidelity during reconstruction. Experiments on 2016 Low-dose CT Grand Challenge were used for the method verification, and results demonstrated the noise reduction and detail preservation abilities of the proposed method.

Motivated by the great potential of deep learning in medical imaging, we propose an iterative positron emission tomography (PET) reconstruction framework using a deep learning-based prior. We utilized the denoising convolutional neural network (DnCNN) method and trained the network using full-dose images as the ground truth and low dose images reconstructed from downsampled data by Poisson thinning as input. Since most published deep networks are trained at a predetermined noise level, the noise level disparity of training and testing data is a major problem for their applicability as a generalized prior. In particular, the noise level significantly changes in each iteration, which can potentially degrade the overall performance of iterative reconstruction. Due to insufficient existing studies, we conducted simulations and evaluated the degradation of performance at various noise conditions. Our findings indicated that DnCNN produces additional bias induced by the disparity of noise levels. To address this issue, we propose a local linear fitting (LLF) function incorporated with the DnCNN prior to improve the image quality by preventing unwanted bias. We demonstrate that the resultant method is robust against noise level disparities despite the network being trained at a predetermined noise level. By means of bias and standard deviation studies via both simulations and clinical experiments, we show that the proposed method outperforms conventional methods based on total variation (TV) and non-local means (NLM) penalties. We thereby confirm that the proposed method improves the reconstruction result both quantitatively and qualitatively.

Early and accurate diagnosis of Coronavirus disease (COVID-19) is essential for patient isolation and contact tracing so that the spread of infection can be limited. Computed tomography (CT) can provide important information in COVID-19, especially for patients with moderate to severe disease as well as those with worsening cardiopulmonary status. As an automatic tool, deep learning methods can be utilized to perform semantic segmentation of affected lung regions, which is important to establish disease severity and prognosis prediction. Both the extent and type of pulmonary opacities help assess disease severity. However, manually pixel-level multi-class labelling is time-consuming, subjective, and non-quantitative. In this work, we proposed a hybrid weak label-based deep learning method that utilize both the manually annotated pulmonary opacities from COVID-19 pneumonia and the patient-level disease-type information available from the clinical report. A UNet was firstly trained with semantic labels to segment the total infected region. It was used to initialize another UNet, which was trained to segment the consolidations with patient-level information using the Expectation-Maximization (EM) algorithm. To demonstrate the performance of the proposed method, multi-institutional CT datasets from Iran, Italy, South Korea, and the United States were utilized. Results show that our proposed method can predict the infected regions as well as the consolidation regions with a good correlation to human annotation.

Objective . Ultrasound is extensively utilized as a convenient and cost-effective method in emergency situations. Unfortunately, the limited availability of skilled clinicians in emergency hinders the wider adoption of point-of-care ultrasound. To overcome this challenge, this paper aims to aid less experienced healthcare providers in emergency lung ultrasound scans. Approach . To assist healthcare providers, it is important to have a comprehensive model that can automatically guide the entire process of lung ultrasound based on the clinician’s workflow. In this paper, we propose a framework for diagnosing pneumothorax using artificial intelligence (AI) assistance. Specifically, the proposed framework for lung ultrasound scan follows the steps taken by skilled physicians. It begins with finding the appropriate transducer position on the chest to locate the pleural line accurately in B-mode. The next step involves acquiring temporal M-mode data to determine the presence of lung sliding, a crucial indicator for pneumothorax. To mimic the sequential process of clinicians, two DL models were developed. The first model focuses on quality assurance (QA) and regression of the pleural line region-of-interest, while the second model classifies lung sliding. To achieve the inference on a mobile device, a size of EfficientNet-Lite0 model was further reduced to have fewer than 3 million parameters. Main results . The results showed that both the QA and lung sliding classification models achieved over 95% in area under the receiver operating characteristic (AUC), while the ROI performance reached 89% in the dice similarity coefficient. The entire stepwise pipeline was simulated using retrospective data, yielding an AUC of 89%. Significance . The step-wise AI framework for the pneumothorax diagnosis with QA offers an intelligible guide for each clinical workflow, which achieved significantly high precision and real-time inferences.

Objective. There are several x-ray computed tomography (CT) scanning strategies used to reduce radiation dose, such as (1) sparse-view CT, (2) low-dose CT and (3) region-of-interest (ROI) CT (called interior tomography). To further reduce the dose, sparse-view and/or low-dose CT settings can be applied together with interior tomography. Interior tomography has various advantages in terms of reducing the number of detectors and decreasing the x-ray radiation dose. However, a large patient or a small field-of-view (FOV) detector can cause truncated projections, and then the reconstructed images suffer from severe cupping artifacts. In addition, although low-dose CT can reduce the radiation exposure dose, analytic reconstruction algorithms produce image noise. Recently, many researchers have utilized image-domain deep learning (DL) approaches to remove each artifact and demonstrated impressive performances, and the theory of deep convolutional framelets supports the reason for the performance improvement. Approach. In this paper, we found that it is difficult to solve coupled artifacts using an image-domain convolutional neural network (CNN) based on deep convolutional framelets. Significance. To address the coupled problem, we decouple it into two sub-problems: (i) image-domain noise reduction inside the truncated projection to solve low-dose CT problem and (ii) extrapolation of the projection outside the truncated projection to solve the ROI CT problem. The decoupled sub-problems are solved directly with a novel proposed end-to-end learning method using dual-domain CNNs. Main results. We demonstrate that the proposed method outperforms the conventional image-domain DL methods, and a projection-domain CNN shows better performance than the image-domain CNNs commonly used by many researchers.