Objective . High-resolution magnetic resonance imaging (MRI) can enhance lesion diagnosis, prognosis, and delineation. However, gradient power and hardware limitations prohibit recording thin slices or sub-1 mm resolution. Furthermore, long scan time is not clinically acceptable. Conventional high-resolution images generated using statistical or analytical methods include the limitation of capturing complex, high-dimensional image data with intricate patterns and structures. This study aims to harness cutting-edge diffusion probabilistic deep learning techniques to create a framework for generating high-resolution MRI from low-resolution counterparts, improving the uncertainty of denoising diffusion probabilistic models (DDPM). Approach . DDPM includes two processes. The forward process employs a Markov chain to systematically introduce Gaussian noise to low-resolution MRI images. In the reverse process, a U-Net model is trained to denoise the forward process images and produce high-resolution images conditioned on the features of their low-resolution counterparts. The proposed framework was demonstrated using T2-weighted MRI images from institutional prostate patients and brain patients collected in the Brain Tumor Segmentation Challenge 2020 (BraTS2020). Main results . For the prostate dataset, the bicubic interpolation model (Bicubic), conditional generative-adversarial network (CGAN), and our proposed DDPM framework improved the noise quality measure from low-resolution images by 4.4%, 5.7%, and 12.8%, respectively. Our method enhanced the signal-to-noise ratios by 11.7%, surpassing Bicubic (9.8%) and CGAN (8.1%). In the BraTS2020 dataset, the proposed framework and Bicubic enhanced peak signal-to-noise ratio from resolution-degraded images by 9.1% and 5.8%. The multi-scale structural similarity indexes were 0.970 ± 0.019, 0.968 ± 0.022, and 0.967 ± 0.023 for the proposed method, CGAN, and Bicubic, respectively. Significance . This study explores a deep learning-based diffusion probabilistic framework for improving MR image resolution. Such a framework can be used to improve clinical workflow by obtaining high-resolution images without penalty of the long scan time. Future investigation will likely focus on prospectively testing the efficacy of this framework with different clinical indications.

Purpose: For pencil‐beam scanning proton therapy systems, in‐air non‐Gaussian halo can significantly impact output at small field sizes and low energies. Since the low‐intensity tail of spot profile (halo) is not necessarily modeled in treatment planning systems (TPSs), this can potentially lead to significant differences in patient dose distribution. In this work, we report such impact for a Varian ProBeam system.Methods: We use a pair magnification technique to measure two‐dimensional (2D) spot profiles of protons from 70 to 242 MeV at the treatment isocenter and 30 cm upstream of the isocenter. Measurements are made with both Gafchromic film and a scintillator detector coupled to a CCD camera (IBA Lynx). Spot profiles are measured down to 0.01% of their maximum intensity. Field size factors (FSFs) are compared among calculation using measured 2D profiles, calculation using a clinical treatment planning algorithm (Raystation 8A clinical Monte Carlo), and a CC04 small‐volume ion chamber. FSFs were measured for square fields of proton energies ranging from 70 to 242 MeV.Results: All film and Lynx measurements agree within 1 mm for full width at half maximum beam intensity. The measured radial spot profiles disagree with simple Gaussian approximations, which are used for modeling in the TPS. FSF measurements show the magnitude of disagreements between beam output in reality and in the TPS without modeling halo. We found that the clinical TPS overestimated output by as much as 6% for small field sizes of 2 cm at the lowest energy of 70 MeV while the film and Lynx measurements agreed within 4% and 1%, respectively, for this FSF.Conclusions: If the in‐air halo for low‐energy proton beams is not fully modeled by the TPS, this could potentially lead to under‐dosing small, shallow treatment volumes in PBS treatment plans.

Objective. This study developed an unsupervised motion artifact reduction method for magnetic resonance imaging (MRI) images of patients with brain tumors. The proposed novel design uses multi-parametric multicenter contrast-enhanced T1W (ceT1W) and T2-FLAIR MRI images. Approach. The proposed framework included two generators, two discriminators, and two feature extractor networks. A 3-fold cross-validation was used to train and fine-tune the hyperparameters of the proposed model using 230 brain MRI images with tumors, which were then tested on 148 patients’ in-vivo datasets. An ablation was performed to evaluate the model’s compartments. Our model was compared with Pix2pix and CycleGAN. Six evaluation metrics were reported, including normalized mean squared error (NMSE), structural similarity index (SSIM), multi-scale-SSIM (MS-SSIM), peak signal-to-noise ratio (PSNR), visual information fidelity (VIF), and multi-scale gradient magnitude similarity deviation (MS-GMSD). Artifact reduction and consistency of tumor regions, image contrast, and sharpness were evaluated by three evaluators using Likert scales and compared with ANOVA and Tukey’s HSD tests. Main results. On average, our method outperforms comparative models to remove heavy motion artifacts with the lowest NMSE (18.34±5.07%) and MS-GMSD (0.07 ± 0.03) for heavy motion artifact level. Additionally, our method creates motion-free images with the highest SSIM (0.93 ± 0.04), PSNR (30.63 ± 4.96), and VIF (0.45 ± 0.05) values, along with comparable MS-SSIM (0.96 ± 0.31). Similarly, our method outperformed comparative models in removing in-vivo motion artifacts for different distortion levels except for MS- SSIM and VIF, which have comparable performance with CycleGAN. Moreover, our method had a consistent performance for different artifact levels. For the heavy level of motion artifacts, our method got the highest Likert scores of 2.82 ± 0.52, 1.88 ± 0.71, and 1.02 ± 0.14 (p-values ≪ 0.0001) for our method, CycleGAN, and Pix2pix respectively. Similar trends were also found for other motion artifact levels. Significance. Our proposed unsupervised method was demonstrated to reduce motion artifacts from the ceT1W brain images under a multi-parametric framework.

In the sphere of Cone Beam Computed Tomography (CBCT), acquiring X-ray projections from sufficient angles is indispensable for traditional image reconstruction methods to accurately reconstruct 3D anatomical intricacies. However, this acquisition procedure for the linear accelerator-mounted CBCT systems in radiotherapy takes approximately one minute, impeding its use for ultra-fast intra-fractional motion monitoring during treatment delivery. To address this challenge, we introduce the Patient-specific Cycle-domain Geometric-integrated Denoising Diffusion Probabilistic Model (CG-DDPM). This model aims to leverage patient-specific priors from patient’s CT/4DCT images, which are acquired for treatment planning purposes, to reconstruct 3D CBCT from a single-view 2D CBCT projection of any arbitrary angle during treatment, namely single-view reconstructed CBCT (svCBCT). The CG-DDPM framework encompasses a dual DDPM structure: the Projection-DDPM for synthesizing comprehensive full-view projections and the CBCT-DDPM for creating CBCT images. A key innovation is our Cycle-Domain Geometry-Integrated (CDGI) method, incorporating a Cone Beam X-ray Geometric Transformation Module (GTM) to ensure precise, synergistic operation between the dual DDPMs, thereby enhancing reconstruction accuracy and reducing artifacts. Evaluated in a study involving 37 lung cancer patients, the method demonstrated its ability to reconstruct CBCT not only from simulated X-ray projections but also from real-world data. The CG-DDPM significantly outperforms existing V-shape convolutional neural networks (V-nets), Generative Adversarial Networks (GANs), and DDPM methods in terms of reconstruction fidelity and artifact minimization. This was confirmed through extensive voxel-level, structural, visual, and clinical assessments. The capability of CG-DDPM to generate high-quality reconstructed CBCT from a single-view projection at any arbitrary angle using a single model opens the door for ultra-fast, in-treatment volumetric imaging. This is especially beneficial for radiotherapy at motion-associated cancer sites and image-guided interventional procedures.