Classifications

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  • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
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  • G06T2211/444—Low dose acquisition or reduction of radiation dose

Definitions

• the present disclosure generally relates to systems and methods for simulating conventional X-ray images from CT data.
• the present disclosure relates to presenting ultra-low-dose CT data to users as a two-dimensional image simulating an X-ray image.
• Computed tomography (CT) imaging provides advantages over conventional planar X-ray (CXR) imaging. Accordingly, CT imaging has replaced X-ray imaging in various clinical settings and is increasingly adopted in additional clinical settings in place of such X-ray imaging.
• CT imaging provides additional information and, in particular, three-dimensional spatial information. Also, CXR has a relatively low sensitivity and high false negative rate in many clinical scenarios. CT imaging, because of the additional information associated with it, is also more amenable to various image processing and Al based diagnosis techniques.
• CXR has a higher spatial resolution and suffers less from noise than conventional CT imaging and, in particular, ULCT imaging.
• CT imaging has not been more widely adopted in routine clinical settings is that reading time of CT imaging is substantially higher than CXR. This is partially because radiologists are more familiar with CXR images and are, therefore, more comfortable reading and basing diagnoses on such conventional planar X-ray images.
• Systems and methods for transforming three-dimensional computed tomography (CT) data into two dimensional images are provided. Such a method is provided including retrieving three-dimensional CT imaging data, where the three- dimensional CT imaging data comprises projection data acquired from a plurality of angles about a central axis.
• the imaging data is processed as a three-dimensional image and the method proceeds to generate a two- dimensional image by tracing rays from a simulated radiation source outside of a subject of the three-dimensional image.
• the two-dimensional image is then presented to a user as a simulated X- ray.
• the processing of the three-dimensional CT imaging data includes reconstructing the three-dimensional image using filtered back projection.
• the thee-dimensional CT imaging data comprises ultra-low-dose CT imaging data
• processing the three-dimensional CT imaging data further comprises denoising the imaging data.
• processing the three-dimensional CT imaging data further includes performing an Artificial Intelligence (Al) based super-resolution process.
• Al Artificial Intelligence
• Such a super-resolution process may include a deblurring process.
• denoising the imaging data may comprise applying a trained convolutional neural network (CNN) to the three-dimensional CT imaging data.
• CNN convolutional neural network
• a denoising process is applied to the three- dimensional CT imaging data prior to reconstructing the three-dimensional image.
• the method further includes processing the two- dimensional image prior to presenting the image to the user by applying a style to the two-dimensional image.
• a style may be derived from a plurality of X-ray images, and the style may then modify the appearance of the two-dimensional image, but not the morphological contents of the two-dimensional image.
• the plurality of X-ray images are conventional planar X-ray images.
• the processing of the three-dimensional CT imaging data includes identifying at least one physical element in the three-dimensional image and removing or masking out the at least one physical element from the three- dimensional image prior to generating the two-dimensional image.
• the physical element is an anatomical element, such as ribs or a heart.
• the physical element is a table or an implant.
• the two-dimensional image is presented to the user with the three-dimensional image, and an indicator is incorporated into the three- dimensional image indicating a segment of the three-dimensional image represented in the two-dimensional image.
• the method further includes processing the two- dimensional image prior to presenting the image to the user.
• processing may include applying a denoising or super-resolution process to the image.
• Al based denoising or super-resolution processes are applied in 2D planes in the three-dimensional CT imaging data.
• the three-dimensional CT imaging data comprises spectral data or photon- counting data
• the simulated X-ray is a simulated spectral X- ray or photon- counting X-ray.
• the generation of the two-dimensional image is performed by a neural network.
• neural network is a trained convolutional neural network.
• Figure 1 is a schematic diagram of a system according to one embodiment of the present disclosure.
• Figure 2 illustrates an exemplary imaging device according to one embodiment of the present disclosure.
• Figure 3 illustrates a schematic workflow for implementing a method according to one embodiment of the present disclosure.
• Figure 4 is a flow chart illustrating a method according to one embodiment of the present disclosure.
• Figure 5 schematically shows a ray tracing process applied to a three- dimensional image usable in the context of one embodiment of the present disclosure.
• Figures 6A-C illustrate an implementation of a style transfer for use in the method according to one embodiment of the present disclosure.
• CT computed tomography
• CXR planar X-ray
• UFDCT ultra-low-dose CT imaging
• ULDCT imaging provides three-dimensional spatial information, which allows for sophisticated analytical techniques. Further, ULDCT avoids the relatively low sensitivity and high false negative rates associated with CXR in many clinical scenarios.
• ULDCT has a slower read time than CXR, and radiologists are less familiar and less comfortable with ULDCT. As such, radiologists prefer to be presented with and make diagnoses based on more familiar CXR images.
• the methods described herein therefore provide a workflow for generating artificial CXR images, or images stylized to have the appearance of CXR images, from ULDCT data.
• Such methods may be implemented or enhanced using artificial intelligence (Al) techniques, including the use of learning algorithms in the form of neural networks, such as convolutional neural networks (CNN).
• Al artificial intelligence
• CXR style images may be generated from ULDCT data and presented to radiologists.
• Such presentation may follow the implementation of analytical techniques to the underlying ULDCT data in either raw or three-dimensional image formats, and may be presented to radiologists either as a proxy for a CXR image or in the context of a corresponding ULDCT based image interface.
• ULDCT imaging data may be generated as three- dimensional CT imaging data using a system such as that illustrated in Figure 1 and by way of an imaging device such as that illustrated in Figure 2.
• the retrieved data may then be processed using the processing device of the system of Figure 1.
• Figure 1 is a schematic diagram of a system 100 according to one embodiment of the present disclosure. As shown, the system 100 typically includes a processing device 110 and an imaging device 120.
• the processing device 110 may apply processing routines to images or measured data, such as projection data, received from the image device 120.
• the processing device 110 may include a memory 113 and processor circuitry 111.
• the memory 113 may store a plurality of instructions.
• the processor circuitry 111 may couple to the memory 113 and may be configured to execute the instructions.
• the instructions stored in the memory 113 may comprise processing routines, as well as data associated with processing routines, such as machine learning algorithms, and various filters for processing images.
• the processing device 110 may further include an input 115 and an output 117.
• the input 115 may receive information, such as three-dimensional images or measured data, such as three-dimensional CT imaging data, from the imaging device 120.
• the output 117 may output information, such as filtered images, or converted two- dimensional images, to a user or a user interface device.
• the output may include a monitor or display.
• the processing device 110 may relate to the imaging device 120 directly. In alternate embodiments, the processing device 110 may be distinct from the imaging device 120, such that the processing device 110 receives images or measured data for processing by way of a network or other interface at the input 115.
• the imaging device 120 may include an image data processing device, and a spectral or conventional CT scanning unit for generating CT projection data when scanning an object (e.g., a patient).
• the imaging device 120 may be a conventional CT scanning unit configured for generating helical scans.
• Figure 2 illustrates an exemplary imaging device 200 according to one embodiment of the present disclosure. It will be understood that while a CT imaging device 200 is shown, and the following discussion is generally in the context of CT images, similar methods may be applied in the context of other imaging devices, and images to which these methods may be applied may be acquired in a wide variety of ways.
• the CT scanning unit may be adapted for performing one or multiple axial scans and/or a helical scan of an object in order to generate the CT projection data.
• the CT scanning unit may comprise an energy-resolving photon counting or spectral dual-layer image detector. Spectral content may be acquired using other detector setups as well.
• the CT scanning unit may include a radiation source that emits radiation for traversing the object when acquiring the projection data.
• the CT scanning unit 200 may include a stationary gantry 202 and a rotating gantry 204, which may be rotatably supported by the stationary gantry 202.
• the rotating gantry 204 may rotate about a longitudinal axis around an examination region 206 for the object when acquiring the projection data.
• the CT scanning unit 200 may include a support 207 to support the patient in the examination region 206 and configured to pass the patient through the examination region during the imaging process.
• the CT scanning unit 200 may include a radiation source 208, such as an X-ray tube, which may be supported by and configured to rotate with the rotating gantry 204.
• the radiation source 208 may include an anode and a cathode.
• a source voltage applied across the anode and the cathode may accelerate electrons from the cathode to the anode.
• the electron flow may provide a current flow from the cathode to the anode, such as to produce radiation for traversing the examination region 206.
• the CT scanning unit 200 may comprise a detector 210.
• the detector 210 may subtend an angular arc opposite the examination region 206 relative to the radiation source 208.
• the detector 210 may include a one- or two-dimensional array of pixels, such as direct conversion detector pixels.
• the detector 210 may be adapted for detecting radiation traversing the examination region 206 and for generating a signal indicative of an energy thereof.
• the CT scanning unit 200 may include generators 211 and 213.
• the generator 211 may generate tomographic projection data 209 based on the signal from the detector 210.
• the generator 213 may receive the tomographic projection data 209 and, in some embodiments, generate three-dimensional CT imaging data 311 of the object based on the tomographic projection data 209.
• the tomographic projection data 209 may be provided to the input 115 of the processing device 110, while in other embodiments the three-dimensional CT imaging data 311 is provided to the input of the processing device.
• Figure 3 illustrates a schematic workflow for implementing a method in accordance with one embodiment of the present disclosure.
• Figure 4 is a flow chart illustrating a method in accordance with one embodiment of the present disclosure. As shown, the method typically includes first retrieving (400) three-dimensional CT imaging data. Such three-dimensional CT imaging data comprises projection data for a subject acquired from a plurality of angles about a central axis.
• the subject may be a patient on the support 207, and the central axis may be an axis passing through the examination region.
• the rotating gantry 204 may then rotate about the central axis of the subject, thereby acquiring the projection data from various angles.
• the three-dimensional CT imaging data 311 is reconstructed (410) as a three-dimensional image 300 in preparation for processing.
• the three-dimensional CT imaging data 311 is then processed (420) as a three-dimensional image 300.
• reconstruction (at 410) and the processing (at 420) are indicated as distinct processes, the reconstruction itself may be the actual processing of the three-dimensional CT imaging data as a three-dimensional image. Similarly, the reconstruction may be part of such processing.
• Such reconstruction (at 410) may be by using standard reconstruction techniques, such as by way of filtered back projection.
• the processing may include denoising 310 which may be, for example, by way of a neural network or other artificial intelligence based learning algorithm.
• the denoising 310 is by way of a convolutional neural network (CNN) previously trained on appropriate images.
• CNN convolutional neural network
• Such denoising processes 310 may be utilized, for example, where the CT imaging is noisy, as in the case of ULDCT images.
• the denoising process may then result in a denoised or partially denoised three- dimensional image 320.
• the denoising process 310 described may be a process that incorporates features that allow it to generalize well to different contrasts, anatomies, reconstruction filters, and noise levels. Such a denoising process 310 may compensate for the high noise levels inherent in ULDCT images.
• the processing of the three-dimensional CT images (at 420) may further include the implementation of a super-resolution process 330.
• the super-resolution process 330 may be by way of Al based learning algorithm, such as a CNN.
• the super-resolution process 330 may include deblurring of the image. The super-resolution process 330 may then result in a higher resolution three-dimensional image 340.
• the super-resolution process 330 typically interpolates the image to smaller voxel sizes while maintaining perceived image sharpness or improving perceived image sharpness.
• Al based super-resolution processes 330 may be trained on either real CT images, including ULDCT images, or more generic image material, such as natural high-resolution photos.
• both denoising processes 310 and superresolution processes 330 are applied in sequence. However, it will be understood that both processes may be incorporated into a single neural network, such as a CNN. Further, while both processes 310, 330 are shown as applied to the three-dimensional image 300, in some embodiments, the processes may be applied directly to the three- dimensional CT imaging data prior to reconstruction (at 410). Further, in some embodiments, one or both processes 310, 330 may be applied on two-dimensional planes in the three-dimensional CT imaging data set perpendicular to the projection direction to be used to generate the two-dimensional image discussed below.
• processing may further comprise identifying (430) at least one physical element in the three-dimensional image. Once identified (at 430), the physical element may be removed or masked out (435) of the three-dimensional image. By removing or masking out (435) an element prior to the generation of a two- dimensional image, such a physical element may be removed from a simulated X-ray to be generated from the CT imaging data.
• the physical element identified may be an anatomical element, such as one or more ribs or a heart.
• anatomical element such as one or more ribs or a heart.
• the physical element identified may be a table 207 or an implant.
• CT imaging data is typically acquired from a patient lying on a table or other support 207, as in the imaging device 200 discussed above.
• conventional planar X-rays are often acquired from standing patients. Accordingly, by removing a support 207, a simulated X-ray may appear more natural to a radiologist viewing the images. Similarly, removing an implant may provide a better view of a patient’s anatomy.
• the physical element may instead be weighted.
• different sections of the three-dimensional image 300 may be weighted differently.
• the method proceeds to generate a two-dimensional image 350 by tracing rays from a simulated radiation source outside of a subject of the three-dimensional image (440).
• a ray tracing process may be, for example, by implementing a Siddons-Jacobs raytracing algorithm.
• Figure 5 illustrates an implementation of a ray tracing process (440) to a three-dimensional image 300 in order to generate a two-dimensional image 350.
• the ray tracing process may then proceed by simulating the process of an X-ray 345 by propagating incident X-ray photons from a simulated radiation source 500 through the reconstructed three-dimensional image 300.
• the generation of the two-dimensional image 350 may be by way of a neural network, such as a CNN, and in such cases, the CNN may incorporate one or more of denoising, super-resolution, or style transfer processes discussed elsewhere herein.
• a neural network may be a generative adversarial network (GAN).
• GAN generative adversarial network
• many or all of the steps described herein may be incorporated into a single network, such that CT volume data is provided to the network, and simulated CXR projections are output.
• the projection angle or orientation of the ray tracing process (440) may be adjusted in order to improve the resulting two-dimensional image 350.
• weighting of physical elements in the three-dimensional image 300 may be adjusted in order to improve the resulting two-dimensional image 350.
• an optional style transfer process may be applied, where a style is applied to the two-dimensional image.
• the style applied may be derived from a plurality of X-ray images (460), such as conventional planar X- ray images, and may be applied by way of an Al algorithm 360, such as a CNN.
• Al algorithm 360 such as a CNN.
• Such a style modifies the appearance of the two-dimensional image, but not the morphological contents of the underlying image.
• Such a process is discussed in more detail below in reference to FIG. 6 and may be used to generate a second two-dimensional image 370 in the “style” of a conventional X-ray.
• further processing may be applied to the two- dimensional image (470) following the ray tracing process (at 440).
• processing may include a denoising or super-resolution process applied to the image, and may be in place of or in addition to the application of such processes to the three-dimensional image.
• the two-dimensional image 350 or stylized image 370 may be presented to a user (480), such as a radiologist.
• a presentation may comprise presenting the image as if it were a conventional planar X-ray, or it may comprise incorporating the two-dimensional image 350 or stylized image 370 into a user interface with the three-dimensional image 300.
• the two-dimensional image 350 or stylized image 370 may be presented to the user with the three-dimensional image 300 and with an indicator incorporated into the three-dimensional image indicating a segment of the three- dimensional image represented in the two-dimensional image.
• the two- dimensional image 350 or stylized image 370 may be presented as a section view of the three-dimensional image 300, with the three-dimensional image contextualizing the section.
• the two-dimensional image 350 or stylized image 370 may then be used as an avatar to guide ULDCT reading, and Al feedback may be projected onto the two- dimensional image in order to help radiologists quickly identify problem areas to review and report in detail on the original ULDCT images.
• the three-dimensional CT imaging data may comprise spectral data.
• the simulated X-ray may similarly simulate a spectral X-ray.
• the method may be applied to photon counting or phase contract CT data sets, and the same may then be reflected in the resulting two- dimensional images.
• Figures 6A-C illustrate an implementation of a style transfer for use in the method of the present disclosure.
• a set of “style images,” such as that shown in FIG. 6A may be used to define a certain style of an image.
• An Al algorithm such as a CNN, may then be trained to apply a style derived from the “style images” to a received image.
• the image when an image, such as that shown in 6B, is received by the Al algorithm, the image may then be re-rendered and output in the style of the “style images,” as shown in FIG. 6C.
• a style may be derived from a specific artist, in this case Paul Klee, and applied to a generic portrait.
• the “style images” used to train the Al algorithm may be, for example, conventional X-ray (CXR) images.
• CXR X-ray
• the two-dimensional images 350 generated from the ULDCT three-dimensional images 300 may be transformed to appear more like CXR images.
• Such stylized images 370 may then be used in practice. It is noted that a style transfer does not change the morphological contents of an image, instead changing only its appearance. As such, the style transfer described is a conservative technique.
• the methods according to the present disclosure may be implemented on a computer as a computer implemented method, or in dedicated hardware, or in a combination of both.
• Executable code for a method according to the present disclosure may be stored on a computer program product.
• Examples of computer program products include memory devices, optical storage devices, integrated circuits, servers, online software, etc.
• the computer program product may include non-transitory program code stored on a computer readable medium for performing a method according to the present disclosure when said program product is executed on a computer.
• the computer program may include computer program code adapted to perform all the steps of a method according to the present disclosure when the computer program is run on a computer.
• the computer program may be embodied on a computer readable medium.

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