Cone-beam ct for neurosurgical guidance: High-fidelity artifacts correction for soft-tissue contrast resolution

P. Wu, A. Sisniega, A. Uneri, R. Han, M. Ketcha, C. K. Jones, P. Vagdargi, X. Zhang, M. Luciano, W. S. Anderson, J. H. Siewerdsen

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Purpose: Intraoperative cone-beam CT (CBCT) plays an important role in neurosurgical guidance but is conventionally limited to high-contrast bone visualization. This work reports a high-fidelity artifacts correction pipeline to advance image quality beyond conventional limits and achieve soft-tissue contrast resolution even in the presence of multiple metal objects - specifically, a stereotactic head frame. Methods: A new metal artifact reduction (MAR) method was developed based on a convolutional neural network (CNN) that simultaneously estimates metal-induced bias and metal path length in the projection domain. To improve generalizability of the network, a physics-based method was developed to generate highly accurate simulated, metalcontaminated projection training data. The MAR method was integrated with previously proposed artifacts correction methods (lag, glare, scatter, and beam-hardening) to form a high-fidelity artifacts correction pipeline. The proposed methods were tested using an intraoperative CBCT system (O-arm, Medtronic) emulating a realistic setup in stereotactic neurosurgery, including nominal (20 cm) and extended (40 cm) field of view (FOV) protocols. Results: The physics-based data generation method provided accurate simulation of metal in projection data, including scatter, polyenergetic, quantum noise, and electronic noise effects. The artifacts correction pipeline was able to accommodate both 20 cm and 40 cm FOV protocols and demonstrated ∼80% improvement in image uniformity and ∼20% increase in contrast-to-noise ratio (CNR). Fully corrected images in the smaller FOV mode exhibited ∼32% increase in CNR compared to the 40 cm FOV mode, showing the method's ability to handle truncated metal objects outside the FOV. Conclusion: The image quality of intraoperative CBCT was greatly improved with the proposed artifacts correction pipeline, with clear improvement in soft-tissue contrast resolution (e.g., cerebral ventricles) even in the presence of a complex metal stereotactic frame. Such capability gives clearer visualization of structures of interest for intracranial neurosurgery, and it provides an important basis for future work aiming to deformably register preoperative MRI to intraoperative CBCT. Ongoing work includes clinical studies now underway.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2021
Subtitle of host publicationPhysics of Medical Imaging
EditorsHilde Bosmans, Wei Zhao, Lifeng Yu
ISBN (Electronic)9781510640191
StatePublished - 2021
EventMedical Imaging 2021: Physics of Medical Imaging - Virtual, Online, United States
Duration: Feb 15 2021Feb 19 2021

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


ConferenceMedical Imaging 2021: Physics of Medical Imaging
Country/TerritoryUnited States
CityVirtual, Online


  • 3d image reconstruction
  • Artifact correction
  • Cone-beam ct
  • Image quality
  • Metal artifacts
  • Neurosurgery

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics
  • Biomaterials
  • Radiology Nuclear Medicine and imaging


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