Keiichi Nakagawa

Sho Ozaki, Shizuo Kaji, Toshikazu Imae et al.

Image-generative artificial intelligence (AI) has garnered significant attention in recent years. In particular, the diffusion model, a core component of generative AI, produces high-quality images with rich diversity. In this study, we proposed a novel computed tomography (CT) reconstruction method by combining the denoising diffusion probabilistic model with iterative CT reconstruction. In sharp contrast to previous studies, we optimized the fidelity loss of CT reconstruction with respect to the latent variable of the diffusion model, instead of the image and model parameters. To suppress the changes in anatomical structures produced by the diffusion model, we shallowed the diffusion and reverse processes and fixed a set of added noises in the reverse process to make it deterministic during the inference. We demonstrated the effectiveness of the proposed method through the sparse-projection CT reconstruction of 1/10 projection data. Despite the simplicity of the implementation, the proposed method has the potential to reconstruct high-quality images while preserving the patient's anatomical structures and was found to outperform existing methods, including iterative reconstruction, iterative reconstruction with total variation, and the diffusion model alone in terms of quantitative indices such as the structural similarity index and peak signal-to-noise ratio. We also explored further sparse-projection CT reconstruction using 1/20 projection data with the same trained diffusion model. As the number of iterations increased, the image quality improved comparable to that of 1/10 sparse-projection CT reconstruction. In principle, this method can be widely applied not only to CT but also to other imaging modalities.

Sho Ozaki, Shizuo Kaji, Kanabu Nawa et al.

In recent years, deep-learning-based image processing has emerged as a valuable tool for medical imaging owing to its high performance. However, the quality of deep-learning-based methods heavily relies on the amount of training data; the high cost of acquiring a large dataset is a limitation to their utilization in medical fields. Herein, based on deep learning, we developed a computed tomography (CT) modality conversion method requiring only a few unsupervised images. The proposed method is based on CycleGAN with several extensions tailored for CT images, which aims at preserving the structure in the processed images and reducing the amount of training data. This method was applied to realize the conversion of megavoltage computed tomography (MVCT) to kilovoltage computed tomography (kVCT) images. Training was conducted using several datasets acquired from patients with head and neck cancer. The size of the datasets ranged from 16 slices (two patients) to 2745 slices (137 patients) for MVCT and 2824 slices (98 patients) for kVCT. The required size of the training data was found to be as small as a few hundred slices. By statistical and visual evaluations, the quality improvement and structure preservation of the MVCT images converted by the proposed model were investigated. As a clinical benefit, it was observed by medical doctors that the converted images enhanced the precision of contouring. We developed an MVCT to kVCT conversion model based on deep learning, which can be trained using only a few hundred unpaired images. The stability of the model against changes in data size was demonstrated. This study promotes the reliable use of deep learning in clinical medicine by partially answering commonly asked questions, such as "Is our data sufficient?" and "How much data should we acquire?"