Methods to overcome metal artifacts in computed tomography (CT) images have been researched and developed for nearly 40 years. When X-rays pass through a metal object, depending on its size and density, different physical effects will negatively affect the measurements, most notably beam hardening, scatter, noise, and the non-linear partial volume effect. These phenomena severely degrade image quality and hinder the diagnostic power and treatment outcomes in many clinical applications. In this paper, we first review the fundamental causes of metal artifacts, categorize metal object types, and present recent trends in the CT metal artifact reduction (MAR) literature. To improve image quality and recover information about underlying structures, many methods and correction algorithms have been proposed and tested. We comprehensively review and categorize these methods into six different classes of MAR: metal implant optimization, improvements to the data acquisition process, data correction based on physics models, modifications to the reconstruction algorithm (projection completion and iterative reconstruction), and image-based post-processing. The primary goals of this paper are to identify the strengths and limitations of individual MAR methods and overall classes, and establish a relationship between types of metal objects and the classes that most effectively overcome their artifacts. The main challenges for the field of MAR continue to be cases with large, dense metal implants, as well as cases with multiple metal objects in the field of view. Severe photon starvation is difficult to compensate for with only software corrections. Hence, the future of MAR seems to be headed toward a combined approach of improving the acquisition process with dual-energy CT, higher energy X-rays, or photon-counting detectors, along with advanced reconstruction approaches. Additional outlooks are addressed, including the need for a standardized evaluation system to compare MAR methods.

Computed tomography (CT) is a popular medical imaging modality and enjoys wide clinical applications. At the same time, the X-ray radiation dose associated with CT scannings raises a public concern due to its potential risks to the patients. Over the past years, major efforts have been dedicated to the development of low-dose CT (LDCT) methods. However, the radiation dose reduction compromises the signal-to-noise ratio, leading to strong noise and artifacts that down-grade the CT image quality. In this paper, we propose a novel 3-D noise reduction method, called structurally sensitive multi-scale generative adversarial net, to improve the LDCT image quality. Specifically, we incorporate 3-D volumetric information to improve the image quality. Also, different loss functions for training denoising models are investigated. Experiments show that the proposed method can effectively preserve the structural and textural information in reference to the normal-dose CT images and significantly suppress noise and artifacts. Qualitative visual assessments by three experienced radiologists demonstrate that the proposed method retrieves more information and outperforms competing methods.

Understanding cellular architectures and their connectivity is essential for interrogating system function and dysfunction. However, we lack technologies for mapping the multiscale details of individual cells and their connectivity in the human organ–scale system. We developed a platform that simultaneously extracts spatial, molecular, morphological, and connectivity information of individual cells from the same human brain. The platform includes three core elements: a vibrating microtome for ultraprecision slicing of large-scale tissues without losing cellular connectivity (MEGAtome), a polymer hydrogel–based tissue processing technology for multiplexed multiscale imaging of human organ–scale tissues (mELAST), and a computational pipeline for reconstructing three-dimensional connectivity across multiple brain slabs (UNSLICE). We applied this platform for analyzing human Alzheimer’s disease pathology at multiple scales and demonstrating scalable neural connectivity mapping in the human brain.

Hemorrhage is a leading cause of trauma death, particularly in prehospital environments when evacuation is delayed. Obtaining central vascular access to a deep artery or vein is important for administration of emergency drugs and analgesics, and rapid replacement of blood volume, as well as invasive sensing and emerging life-saving interventions. However, central access is normally performed by highly experienced critical care physicians in a hospital setting. We developed a handheld AI-enabled interventional device, AI-GUIDE (Artificial Intelligence Guided Ultrasound Interventional Device), capable of directing users with no ultrasound or interventional expertise to catheterize a deep blood vessel, with an initial focus on the femoral vein. AI-GUIDE integrates with widely available commercial portable ultrasound systems and guides a user in ultrasound probe localization, venous puncture-point localization, and needle insertion. The system performs vascular puncture robotically and incorporates a preloaded guidewire to facilitate the Seldinger technique of catheter insertion. Results from tissue-mimicking phantom and porcine studies under normotensive and hypotensive conditions provide evidence of the technique’s robustness, with key performance metrics in a live porcine model including: a mean time to acquire femoral vein insertion point of 53 ± 36 s (5 users with varying experience, in 20 trials), a total time to insert catheter of 80 ± 30 s (1 user, in 6 trials), and a mean number of 1.1 (normotensive, 39 trials) and 1.3 (hypotensive, 55 trials) needle insertion attempts (1 user). These performance metrics in a porcine model are consistent with those for experienced medical providers performing central vascular access on humans in a hospital.

Machine learning and deep learning are rapidly finding applications in the medical imaging field. In this paper, we address the long-standing problem of metal artifacts in computed tomography (CT) images by training a dual-stream deep convolutional neural network for streak removal. While many metal artifact reduction methods exist, even state-of-the-art algorithms fall short in some clinical applications. Specifically, proton therapy planning requires high image quality with accurate tumor volumes to ensure treatment success. We explore a dual-stream deep network structure with residual learning to correct metal streak artifacts after a first-pass by a state-of-the-art interpolation-based algorithm, NMAR. We provide the network with a mask of the streaks in order to focus attention on those areas. Our experiments compare a mean squared error loss function with a perceptual loss function to emphasize preservation of image features and texture. Both visual and quantitative metrics are used to assess the resulting image quality for metal implant cases. Success may be due to the duality of information processing, with one network stream performing local structure correction, while the other stream provides an attention mechanism to destreak effectively. This study shows that image-domain deep learning can be highly effective for metal artifact reduction (MAR), and highlights the benefits and drawbacks of different loss functions for solving a major CT reconstruction challenge.