The reconstruction of computed tomography (CT) images is an active area of research. Following the rise of deep learning methods, many data-driven models have been proposed in recent years. In this work, we present the results of a data challenge that we organized, bringing together algorithm experts from different institutes to jointly work on quantitative evaluation of several data-driven methods on two large, public datasets during a ten day sprint. We focus on two applications of CT, namely, low-dose CT and sparse-angle CT. This enables us to fairly compare different methods using standardized settings. As a general result, we observe that the deep learning-based methods are able to improve the reconstruction quality metrics in both CT applications while the top performing methods show only minor differences in terms of peak signal-to-noise ratio (PSNR) and structural similarity (SSIM). We further discuss a number of other important criteria that should be taken into account when selecting a method, such as the availability of training data, the knowledge of the physical measurement model and the reconstruction speed.

Purpose: Sparsity of annotated data is a major limitation in medical image processing tasks such as registration. Registered multimodal image data are essential for the diagnosis of medical conditions and the success of interventional medical procedures. To overcome the shortage of data, we present a method that allows the generation of annotated multimodal 4D datasets. Methods: We use a CycleGAN network architecture to generate multimodal synthetic data from the 4D extended cardiac–torso (XCAT) phantom and real patient data. Organ masks are provided by the XCAT phantom; therefore, the generated dataset can serve as ground truth for image segmentation and registration. Realistic simulation of respiration and heartbeat is possible within the XCAT framework. To underline the usability as a registration ground truth, a proof of principle registration is performed. Results: Compared to real patient data, the synthetic data showed good agreement regarding the image voxel intensity distribution and the noise characteristics. The generated T1-weighted magnetic resonance imaging, computed tomography (CT), and cone beam CT images are inherently co-registered. Thus, the synthetic dataset allowed us to optimize registration parameters of a multimodal non-rigid registration, utilizing liver organ masks for evaluation. Conclusion: Our proposed framework provides not only annotated but also multimodal synthetic data which can serve as a ground truth for various tasks in medical imaging processing. We demonstrated the applicability of synthetic data for the development of multimodal medical image registration algorithms.

Abdominal aortic aneurysms (AAA) may remain clinically silent until they enlarge and patients present with a potentially lethal rupture. This necessitates early detection and elective treatment. The goal of this study was to develop an easy-to-train algorithm which is capable of automated AAA screening in CT scans and can be applied to an intra-hospital environment. Three deep convolutional neural networks (ResNet, VGG-16 and AlexNet) were adapted for 3D classification and applied to a dataset consisting of 187 heterogenous CT scans. The 3D ResNet outperformed both other networks. Across the five folds of the first training dataset it achieved an accuracy of 0.856 and an area under the curve (AUC) of 0.926. Subsequently, the algorithms performance was verified on a second data set containing 106 scans, where it ran fully automated and resulted in an accuracy of 0.953 and an AUC of 0.971. A layer-wise relevance propagation (LRP) made the decision process interpretable and showed that the network correctly focused on the aortic lumen. In conclusion, the deep learning-based screening proved to be robust and showed high performance even on a heterogeneous multi-center data set. Integration into hospital workflow and its effect on aneurysm management would be an exciting topic of future research.

Objective: Three-dimensional (3D) blood vessel structure information is important for diagnosis and treatment in various clinical scenarios. We present a fully automatic method for the extraction and differentiation of the arterial and venous vessel trees from abdominal contrast enhanced computed tomography (CE-CT) volumes using convolutional neural networks (CNNs). Methods: We used a novel ratio-based sampling method to train 2D and 3D versions of the U-Net, the V-Net and the DeepVesselNet. Networks were trained with a combination of the Dice and cross entropy loss. Performance was evaluated on 20 IR-CAD subjects. Best performing networks were combined into an ensemble. We investigated seven different weight-ing schemes. Trained networks were additionally applied to 26 BTCV cases to validate the generalizability. Results: Based on our experiments, the optimal configuration is an equally weighted ensemble of 2D and 3D U-and V-Nets. Our method achieved Dice similarity coefficients of 0.758 ± 0.050 (veins) and 0.838 ± 0.074 (arteries) on the IRCAD data set. Application to the BTCV data set showed a high transfer ability. Conclusion: Abdominal vascular structures can be segmented more accurately using ensembles than individual CNNs. 2D and 3D networks have complementary strengths and weaknesses. Our ensemble of 2D and 3D U-Nets and V-Nets in combination with ratio-based sampling achieves a high agreement with manual annotations for both artery and vein segmentation. Our results surpass other state-of-the-art methods. Significance: Our segmen-tation pipeline can provide valuable information for the planning of living donor organ transplantations.

Metal artifacts are common in CT-guided interventions due to the presence of metallic instruments. These artifacts often obscure clinically relevant structures, which can complicate the intervention. In this work, we present a deep learning CT reconstruction called iCTU-Net for the reduction of metal artifacts. The network emulates the filtering and back projection steps of the classical filtered back projection (FBP). A U-Net is used as post-processing to refine the back projected image. The reconstruction is trained end-to-end, i.e., the inputs of the iCTU-Net are sinograms and the outputs are reconstructed images. The network does not require a predefined back projection operator or the exact X-ray beam geometry. Supervised training is performed on simulated interventional data of the abdomen. For projection data exhibiting severe artifacts, the iCTU-Net achieved reconstructions with SSIM = $0.970\pm 0.009$ and PSNR = $40.7\pm 1.6$. The best reference method, an image based post-processing network, only achieved SSIM = $0.944\pm 0.024$ and PSNR = $39.8\pm 1.9$. Since the whole reconstruction process is learned, the network was able to fully utilize the raw data, which benefited from the removal of metal artifacts. The proposed method was the only studied method that could eliminate the metal streak artifacts.

Accurate quantification of perfusion is crucial for diagnosis and monitoring of kidney function. Arterial spin labeling (ASL), a completely non-invasive magnetic resonance imaging technique, is a promising method for this application. However, differences in acquisition (e.g., ASL parameters, readout) and processing (e.g., registration, segmentation) between studies impede the comparison of results. To alleviate challenges arising solely from differences in processing pipelines, synthetic data are of great value. In this work, synthetic renal ASL data were generated using body models from the XCAT phantom and perfusion was added using the general kinetic model. Our in-house developed processing pipeline was then evaluated in terms of registration, quantification, and segmentation using the synthetic data. Registration performance was evaluated qualitatively with line profiles and quantitatively with mean structural similarity index measures (MSSIMs). Perfusion values obtained from the pipeline were compared to the values assumed when generating the synthetic data. Segmentation masks obtained by semi-automated procedure of the processing pipeline were compared to the original XCAT organ masks using the Dice index. Overall, the pipeline evaluation yielded good results. After registration, line profiles were smoother and, on average, MSSIMs increased by 25%. Mean perfusion values for cortex and medulla were close to the assumed perfusion of 250 mL/100 g/min and 50 mL/100 g/min, respectively. Dice indices ranged 0.80–0.93, 0.78–0.89, and 0.64–0.84 for whole kidney, cortex, and medulla, respectively. The generation of synthetic ASL data allows flexible choice of parameters and the generated data are well suited for evaluation of processing pipelines.