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Tonghe Wang

Publications and source records attributed to Tonghe Wang.

At least 37 records · Page 2Linked to original sources

Image-Domain Material Decomposition for Dual-energy CT using Unsupervised Learning with Data-fidelity Loss

Background: Dual-energy CT (DECT) and material decomposition play vital roles in quantitative medical imaging. However, the decomposition process may suffer from significant noise amplification, leading to severely degraded image signal-to-noise ratios (SNRs). While existing iterative algorithms perform noise suppression using different image priors, these heuristic image priors cannot accurately represent the features of the target image manifold. Although deep learning-based decomposition methods have been reported, these methods are in the supervised-learning framework requiring paired data for training, which is not readily available in clinical settings. Purpose: This work aims to develop an unsupervised-learning framework with data-measurement consistency for image-domain material decomposition in DECT.

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One-step Iterative Estimation of Effective Atomic Number and Electron Density for Dual Energy CT

Dual-energy computed tomography (DECT) is a promising technology that has shown a number of clinical advantages over conventional X-ray CT, such as improved material identification, artifact suppression, etc. For proton therapy treatment planning, besides material-selective images, maps of effective atomic number (Z) and relative electron density to that of water ($ρ_e$) can also be achieved and further employed to improve stopping power ratio accuracy and reduce range uncertainty. In this work, we propose a one-step iterative estimation method, which employs multi-domain gradient $L_0$-norm minimization, for Z and $ρ_e$ maps reconstruction. The algorithm was implemented on GPU to accelerate the predictive procedure and to support potential real-time adaptive treatment planning. The performance of the proposed method is demonstrated via both phantom and patient studies.

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Hippocampus Substructure Segmentation Using Morphological Vision Transformer Learning

Background: The hippocampus plays a crucial role in memory and cognition. Because of the associated toxicity from whole brain radiotherapy, more advanced treatment planning techniques prioritize hippocampal avoidance, which depends on an accurate segmentation of the small and complexly shaped hippocampus. Purpose: To achieve accurate segmentation of the anterior and posterior regions of the hippocampus from T1 weighted (T1w) MRI images, we developed a novel model, Hippo-Net, which uses a mutually enhanced strategy. Methods: The proposed model consists of two major parts: 1) a localization model is used to detect the volume-of-interest (VOI) of hippocampus. 2) An end-to-end morphological vision transformer network is used to perform substructures segmentation within the hippocampus VOI. A total of 260 T1w MRI datasets were used in this study. We conducted a five-fold cross-validation on the first 200 T1w MR images and then performed a hold-out test on the remaining 60 T1w MR images with the model trained on the first 200 images. Results: In five-fold cross-validation, the DSCs were 0.900+-0.029 and 0.886+-0.031for the hippocampus proper and parts of the subiculum, respectively. The MSD were 0.426+-0.115mm and 0.401+-0.100 mm for the hippocampus proper and parts of the subiculum, respectively. Conclusions: The proposed method showed great promise in automatically delineating hippocampus substructures on T1w MRI images. It may facilitate the current clinical workflow and reduce the physician effort.

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Synthetic CT Generation from MRI using 3D Transformer-based Denoising Diffusion Model

Magnetic resonance imaging (MRI)-based synthetic computed tomography (sCT) simplifies radiation therapy treatment planning by eliminating the need for CT simulation and error-prone image registration, ultimately reducing patient radiation dose and setup uncertainty. We propose an MRI-to-CT transformer-based denoising diffusion probabilistic model (MC-DDPM) to transform MRI into high-quality sCT to facilitate radiation treatment planning. MC-DDPM implements diffusion processes with a shifted-window transformer network to generate sCT from MRI. The proposed model consists of two processes: a forward process which adds Gaussian noise to real CT scans, and a reverse process in which a shifted-window transformer V-net (Swin-Vnet) denoises the noisy CT scans conditioned on the MRI from the same patient to produce noise-free CT scans. With an optimally trained Swin-Vnet, the reverse diffusion process was used to generate sCT scans matching MRI anatomy. We evaluated the proposed method by generating sCT from MRI on a brain dataset and a prostate dataset. Qualitative evaluation was performed using the mean absolute error (MAE) of Hounsfield unit (HU), peak signal to noise ratio (PSNR), multi-scale Structure Similarity index (MS-SSIM) and normalized cross correlation (NCC) indexes between ground truth CTs and sCTs. MC-DDPM generated brain sCTs with state-of-the-art quantitative results with MAE 43.317 HU, PSNR 27.046 dB, SSIM 0.965, and NCC 0.983. For the prostate dataset, MC-DDPM achieved MAE 59.953 HU, PSNR 26.920 dB, SSIM 0.849, and NCC 0.948. In conclusion, we have developed and validated a novel approach for generating CT images from routine MRIs using a transformer-based DDPM. This model effectively captures the complex relationship between CT and MRI images, allowing for robust and high-quality synthetic CT (sCT) images to be generated in minutes.

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Data-Driven Volumetric Image Generation from Surface Structures using a Patient-Specific Deep Leaning Model

The advent of computed tomography significantly improves patient health regarding diagnosis, prognosis, and treatment planning and verification. However, tomographic imaging escalates concomitant radiation doses to patients, inducing potential secondary cancer. We demonstrate the feasibility of a data-driven approach to synthesize volumetric images using patient surface images, which can be obtained from a zero-dose surface imaging system. This study includes 500 computed tomography (CT) image sets from 50 patients. Compared to the ground truth CT, the synthetic images result in the evaluation metric values of 26.9 Hounsfield units, 39.1dB, and 0.965 regarding the mean absolute error, peak signal-to-noise ratio, and structural similarity index measure. This approach provides a data integration solution that can potentially enable real-time imaging, which is free of radiation-induced risk and could be applied to image-guided medical procedures.

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Cycle-guided Denoising Diffusion Probability Model for 3D Cross-modality MRI Synthesis

This study aims to develop a novel Cycle-guided Denoising Diffusion Probability Model (CG-DDPM) for cross-modality MRI synthesis. The CG-DDPM deploys two DDPMs that condition each other to generate synthetic images from two different MRI pulse sequences. The two DDPMs exchange random latent noise in the reverse processes, which helps to regularize both DDPMs and generate matching images in two modalities. This improves image-to-image translation ac-curacy. We evaluated the CG-DDPM quantitatively using mean absolute error (MAE), multi-scale structural similarity index measure (MSSIM), and peak sig-nal-to-noise ratio (PSNR), as well as the network synthesis consistency, on the BraTS2020 dataset. Our proposed method showed high accuracy and reliable consistency for MRI synthesis. In addition, we compared the CG-DDPM with several other state-of-the-art networks and demonstrated statistically significant improvements in the image quality of synthetic MRIs. The proposed method enhances the capability of current multimodal MRI synthesis approaches, which could contribute to more accurate diagnosis and better treatment planning for patients by synthesizing additional MRI modalities.

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Deep Learning in MRI-guided Radiation Therapy: A Systematic Review

MRI-guided radiation therapy (MRgRT) offers a precise and adaptive approach to treatment planning. Deep learning applications which augment the capabilities of MRgRT are systematically reviewed. MRI-guided radiation therapy offers a precise, adaptive approach to treatment planning. Deep learning applications which augment the capabilities of MRgRT are systematically reviewed with emphasis placed on underlying methods. Studies are further categorized into the areas of segmentation, synthesis, radiomics, and real time MRI. Finally, clinical implications, current challenges, and future directions are discussed.

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CBCT-Based Synthetic CT Image Generation Using Conditional Denoising Diffusion Probabilistic Model

Background: Daily or weekly cone-beam computed tomography (CBCT) scans are commonly used for accurate patient positioning during the image-guided radiotherapy (IGRT) process, making it an ideal option for adaptive radiotherapy (ART) replanning. However, the presence of severe artifacts and inaccurate Hounsfield unit (HU) values prevent its use for quantitative applications such as organ segmentation and dose calculation. To enable the clinical practice of online ART, it is crucial to obtain CBCT scans with a quality comparable to that of a CT scan. Purpose: This work aims to develop a conditional diffusion model to perform image translation from the CBCT to the CT domain for the image quality improvement of CBCT. Methods: The proposed method is a conditional denoising diffusion probabilistic model (DDPM) that utilizes a time-embedded U-net architecture with residual and attention blocks to gradually transform standard Gaussian noise to the target CT distribution conditioned on the CBCT. The model was trained on deformed planning CT (dpCT) and CBCT image pairs, and its feasibility was verified in brain patient study and head-and-neck (H&N) patient study. The performance of the proposed algorithm was evaluated using mean absolute error (MAE), peak signal-to-noise ratio (PSNR) and normalized cross-correlation (NCC) metrics on generated synthetic CT (sCT) samples. The proposed method was also compared to four other diffusion model-based sCT generation methods. Conclusions: The proposed conditional DDPM method can generate sCT from CBCT with accurate HU numbers and reduced artifacts, enabling accurate CBCT-based organ segmentation and dose calculation for online ART.

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Deep Learning-based Multi-Organ CT Segmentation with Adversarial Data Augmentation

In this work, we propose an adversarial attack-based data augmentation method to improve the deep-learning-based segmentation algorithm for the delineation of Organs-At-Risk (OAR) in abdominal Computed Tomography (CT) to facilitate radiation therapy. We introduce Adversarial Feature Attack for Medical Image (AFA-MI) augmentation, which forces the segmentation network to learn out-of-distribution statistics and improve generalization and robustness to noises. AFA-MI augmentation consists of three steps: 1) generate adversarial noises by Fast Gradient Sign Method (FGSM) on the intermediate features of the segmentation network's encoder; 2) inject the generated adversarial noises into the network, intentionally compromising performance; 3) optimize the network with both clean and adversarial features. Experiments are conducted segmenting the heart, left and right kidney, liver, left and right lung, spinal cord, and stomach. We first evaluate the AFA-MI augmentation using nnUnet and TT-Vnet on the test data from a public abdominal dataset and an institutional dataset. In addition, we validate how AFA-MI affects the networks' robustness to the noisy data by evaluating the networks with added Gaussian noises of varying magnitudes to the institutional dataset. Network performance is quantitatively evaluated using Dice Similarity Coefficient (DSC) for volume-based accuracy. Also, Hausdorff Distance (HD) is applied for surface-based accuracy. On the public dataset, nnUnet with AFA-MI achieves DSC = 0.85 and HD = 6.16 millimeters (mm); and TT-Vnet achieves DSC = 0.86 and HD = 5.62 mm. AFA-MI augmentation further improves all contour accuracies up to 0.217 DSC score when tested on images with Gaussian noises. AFA-MI augmentation is therefore demonstrated to improve segmentation performance and robustness in CT multi-organ segmentation.

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A Blockchain-Based Distributed Computational Resource Trading Strategy for Internet of Things Considering Multiple Preferences

Computational task offloading based on edge computing can deal with the performance bottleneck of traditional cloud-based systems for Internet of things (IoT). To further optimize computing efficiency and resource allocation, collaborative offloading has been put forward to enable the offloading from edge devices to IoT terminal devices. However, there still lack incentive mechanisms to encourage participants to take over tasks from others. To counter this situation, this paper proposes a distributed computational resource trading strategy addressing multiple preferences of IoT users. Unlike most existing works, the objective of our trading strategy comprehensively considers different satisfaction degrees with task delay, energy consumption, price, and user reputation of both requesters and collaborators. The system design uses blockchain to enhance the decentralization, security, and automation. Compared with the trading method based on classical double auction matching mechanism, our trading strategy has more tasks offloaded and executed, and the trading results are friendlier to collaborators with good reputation.

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Early in vivo Radiation Damage Quantification for Pediatric Craniospinal Irradiation Using Longitudinal MRI for Intensity Modulated Proton Therapy

Purpose: Proton vertebral body sparing craniospinal irradiation (VBS CSI) treats the thecal sac while avoiding the anterior vertebral bodies in effort to reduce myelosuppression and growth inhibition. However, robust treatment planning needs to compensate proton range uncertainty, contributing unwanted doses within the vertebral bodies. This work aims to develop an early in vivo radiation damage quantification method using longitudinal magnetic resonance (MR) scans to quantify dose effect during fractionated CSI. Materials and methods: Ten pediatric patients were enrolled in a prospective clinical trial of proton VBS CSI receiving 23.4-36 Gy. Monte Carlo robust planning was used with spinal clinical target volumes defined as the thecal sac and neural foramina. T1/T2-weighted MR scans were acquired before, during, and after treatments to detect transition from hematopoietic to less metabolically active fatty marrow. MR signal intensity histograms at each time point were analyzed and fitted by multi-Gaussian models to quantify radiation damages. Results: Fatty marrow filtration was observed on MR images as early as the fifth fraction of treatment. Maximum radiation-induced marrow damage occurred 40-50 days from the treatment start, followed by marrow regeneration. The mean damage ratios were 0.23, 0.41, 0.59, and 0.54 corresponding to 10, 20, 40, and 60 days from the treatment start. Conclusions: We demonstrated a non-invasive method to identify early vertebral marrow damage based on radiation-induced fatty marrow replacement. The proposed method can be potentially used to quantify the quality of CSI vertebral sparing to preserve metabolically active hematopoietic bone marrow.

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Deep learning-based Fast Volumetric Image Generation for Image-guided Proton FLASH Radiotherapy

Proton FLASH therapy leverages ultra-high dose-rate radiation to enhance the sparing of organs at risk without compromising tumor control probability. To prepare for the delivery of high doses to targets, we aim to develop a deep learning-based image-guide framework to enable fast volumetric image reconstruction for accurate target localization before FLSAH beam delivery. The proposed framework comprises four modules, including orthogonal kV x-ray projection acquisition, DL-based volumetric image generation, image quality analyses, and water equivalent thickness evaluation. We investigated volumetric image reconstruction using four kV projection pairs with different source angles. Thirty lung patients were identified from the institutional database, and each patient contains a four-dimensional computed tomography dataset with ten respiratory phases. The retrospective patient study indicated that the proposed framework could reconstruct patient volumetric anatomy, including tumors and organs at risk from orthogonal x-ray projections. Considering all evaluation metrics, the kV projections with source angles of 135 and 225 degrees yielded the optimal volumetric images. The proposed framework has been demonstrated to reconstruct volumetric images with accurate lesion locations from two orthogonal x-ray projections. The embedded WET module can be used to detect potential proton beam-specific patient anatomy variations. The framework can deliver fast volumetric image generation and can potentially guide treatment delivery systems for proton FLASH therapy.

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Deformable Image Registration using Unsupervised Deep Learning for CBCT-guided Abdominal Radiotherapy

CBCTs in image-guided radiotherapy provide crucial anatomy information for patient setup and plan evaluation. Longitudinal CBCT image registration could quantify the inter-fractional anatomic changes. The purpose of this study is to propose an unsupervised deep learning based CBCT-CBCT deformable image registration. The proposed deformable registration workflow consists of training and inference stages that share the same feed-forward path through a spatial transformation-based network (STN). The STN consists of a global generative adversarial network (GlobalGAN) and a local GAN (LocalGAN) to predict the coarse- and fine-scale motions, respectively. The network was trained by minimizing the image similarity loss and the deformable vector field (DVF) regularization loss without the supervision of ground truth DVFs. During the inference stage, patches of local DVF were predicted by the trained LocalGAN and fused to form a whole-image DVF. The local whole-image DVF was subsequently combined with the GlobalGAN generated DVF to obtain final DVF. The proposed method was evaluated using 100 fractional CBCTs from 20 abdominal cancer patients in the experiments and 105 fractional CBCTs from a cohort of 21 different abdominal cancer patients in a holdout test. Qualitatively, the registration results show great alignment between the deformed CBCT images and the target CBCT image. Quantitatively, the average target registration error (TRE) calculated on the fiducial markers and manually identified landmarks was 1.91+-1.11 mm. The average mean absolute error (MAE), normalized cross correlation (NCC) between the deformed CBCT and target CBCT were 33.42+-7.48 HU, 0.94+-0.04, respectively. This promising registration method could provide fast and accurate longitudinal CBCT alignment to facilitate inter-fractional anatomic changes analysis and prediction.

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Automatic Inverse Treatment Planning for Gamma Knife Radiosurgery via Deep Reinforcement Learning

Purpose: Several inverse planning algorithms have been developed for Gamma Knife (GK) radiosurgery to determine a large number of plan parameters via solving an optimization problem, which typically consists of multiple objectives. The priorities among these objectives need to be repetitively adjusted to achieve a clinically good plan for each patient. This study aimed to achieve automatic and intelligent priority-tuning, by developing a deep reinforcement learning (DRL) based method to model the tuning behaviors of human planners. Methods: We built a priority-tuning policy network using deep convolutional neural networks. Its input was a vector composed of the plan metrics that were used in our institution for GK plan evaluation. The network can determine which tuning action to take, based on the observed quality of the intermediate plan. We trained the network using an end-to-end DRL framework to approximate the optimal action-value function. A scoring function was designed to measure the plan quality. Results: Vestibular schwannoma was chosen as the test bed in this study. The number of training, validation and testing cases were 5, 5, and 16, respectively. For these three datasets, the average plan scores with initial priorities were 3.63 $\pm$ 1.34, 3.83 $\pm$ 0.86 and 4.20 $\pm$ 0.78, respectively, while can be improved to 5.28 $\pm$ 0.23, 4.97 $\pm$ 0.44 and 5.22 $\pm$ 0.26 through manual priority tuning by human expert planners. Our network achieved competitive results with 5.42 $\pm$ 0.11, 5.10 $\pm$ 0. 42, 5.28 $\pm$ 0.20, respectively. Conclusions: Our network can generate GK plans of comparable or slightly higher quality comparing with the plans generated by human planners via manual priority tuning. The network can potentially be incorporated into the clinical workflow to improve GK planning efficiency.

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Artificial Intelligence in Tumor Subregion Analysis Based on Medical Imaging: A Review

Medical imaging is widely used in cancer diagnosis and treatment, and artificial intelligence (AI) has achieved tremendous success in various tasks of medical image analysis. This paper reviews AI-based tumor subregion analysis in medical imaging. We summarize the latest AI-based methods for tumor subregion analysis and their applications. Specifically, we categorize the AI-based methods by training strategy: supervised and unsupervised. A detailed review of each category is presented, highlighting important contributions and achievements. Specific challenges and potential AI applications in tumor subregion analysis are discussed.

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Generative Adversarial Network for Image Synthesis

This chapter reviews recent developments of generative adversarial networks (GAN)-based methods for medical and biomedical image synthesis tasks. These methods are classified into conditional GAN and Cycle-GAN according to the network architecture designs. For each category, a literature survey is given, which covers discussions of the network architecture designs, highlights important contributions and identifies specific challenges.

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Synthetic MRI-aided Head-and-Neck Organs-at-Risk Auto-Delineation for CBCT-guided Adaptive Radiotherapy

Purpose: Organ-at-risk (OAR) delineation is a key step for cone-beam CT (CBCT) based adaptive radiotherapy planning that can be a time-consuming, labor-intensive, and subject-to-variability process. We aim to develop a fully automated approach aided by synthetic MRI for rapid and accurate CBCT multi-organ contouring in head-and-neck (HN) cancer patients. MRI has superb soft-tissue contrasts, while CBCT offers bony-structure contrasts. Using the complementary information provided by MRI and CBCT is expected to enable accurate multi-organ segmentation in HN cancer patients. In our proposed method, MR images are firstly synthesized using a pre-trained cycle-consistent generative adversarial network given CBCT. The features of CBCT and synthetic MRI are then extracted using dual pyramid networks for final delineation of organs. CBCT images and their corresponding manual contours were used as pairs to train and test the proposed model. Quantitative metrics including Dice similarity coefficient (DSC) were used to evaluate the proposed method. The proposed method was evaluated on a cohort of 65 HN cancer patients. CBCT images were collected from those patients who received proton therapy. Overall, DSC values of 0.87, 0.79/0.79, 0.89/0.89, 0.90, 0.75/0.77, 0.86, 0.66, 0.78/0.77, 0.96, 0.89/0.89, 0.832, and 0.84 for commonly used OARs for treatment planning including brain stem, left/right cochlea, left/right eye, larynx, left/right lens, mandible, optic chiasm, left/right optic nerve, oral cavity, left/right parotid, pharynx, and spinal cord, respectively, were achieved. In this study, we developed a synthetic MRI-aided HN CBCT auto-segmentation method based on deep learning. It provides a rapid and accurate OAR auto-delineation approach, which can be used for adaptive radiation therapy.

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A plan quality control method of treatment planning for Gamma Knife radiosurgery

With many variables to adjust, conventional manual forward planning for Gamma Knife (GK) radiosurgery is very complicated and cumbersome. The resulting plan quality heavily depends on planners skills, experiences and devoted efforts, and varies significantly among cases, planners, and institutions. Quality control for GK planning is desired to consistently provide high-quality plan to each patient. In this study, we proposed a quality control method for GK planning by building a database of high-quality GK plans. Patient anatomy was described by target volume, target shape complexity, and spatial relationship between target and nearby organs, which determine GK planning difficulty level. Plan quality was evaluated using target coverage, selectivity, intermediate dose spillage, maximum dose to 0.1 cc of brainstem, mean dose of ipsilateral cochlea, and beam-on time. When a new plan is created, a high-quality plan that has the most similar target volume size and shape complexity will be identified from the database. A model has also been built to predict the dose to brainstem and cochlea based on their overlap volume histograms. The identified reference plan and the predicted organ dose will help planners to make quality control decisions accordingly. To validate this method, we have built a database for vestibular schwannoma, which are considered to be challenging for GK planning due to the irregularly-shaped target and its proximity to brainstem and cochlea. Five cases were tested, among which one case was considered to be of high quality and four cases had a lower plan quality than prediction. These four cases were replanned and got substantially improved. Our results have demonstrated the efficacy of our proposed quality control method. This method may also be used as a plan quality prediction method to facilitate the development of automatic treatment planning for GK radiosurgery.

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