Decision Making in Orthopedic Surgery Through Hyper Low Dose Images
Summary
The focus of this project is to reduce the amount of radiation received by the patient and surgeon during pelvic reconstruction surgery. We enable the use of low-dose images by using a deep learning pipeline to extract structural information from the low-dose image. This concept replaces the need for hundreds of high-dose digital radiographs.
Students: Mariya Kazachkova, Michael Mudgett
Mentors: Mathias Unberath, Bastian Bier, Nico Zaech, Nassir Navab, Greg Osgood
Example of results from deep learning pipeline.
Background, Specific Aims, and Significance
In pelvic reconstruction surgery, digital radiographs are used to guide the surgeon through the procedure. This style of imaging provides a clear view of the bones as well as the instrumentation as it is inserted. However, over 100 digital radiogrpahs are typically taken per k-wire inserted and the high dose of radiation inflicted by the x-rays can be dangerous to sensitive areas near the pelvis. Low-dose fluoroscopy is a safer alternative which provides continuous video and is used in many procedures, such as endovascular surgery. Due to the large amount of soft tissue in the abdomen, fluoroscopic images do not give the surgeon a clear view of the workspace.
The goal of our project is to create and train a network which, when fed a low-dose image, can reproduce an analogous high-dose image that a surgeon can make use of in the operating room.
This has two implications:
1. A smaller dose of radiation will be transferred to the patient and surgeon.
2. The imaging process will be sped up and live video will give the surgeon more confidence while placing instrumentation.
Deliverables
Minimum: (4/1/18)
Simulate a set of x-ray images with varying dose/spectra
Implement and train a de-noising network (code + documentation)
Expected: (4/22/18)
Functional de-noising pipeline to improve quality of low-dose images (code + documentation)
Chosen dose profile to minimize dose but maximize image quality
Maximum: (5/6/18)
LSTM network for improving live fluoroscopic video
Technical Approach
Our technical approach of this project is to take a large set of simulated x-ray images and use them to train a neural network. The data set will contain images of multiple pelvises at varying angles to make the network robust.
Network:
Conditional GAN (Generative Adversarial Network) produces estimated high-dose image from input low-dose image
GAT (Generalized Anscombe Transform) layer stabilizes noise on low-dose image using estimated high-dose image as guide
Deep CNN learns noise of the stabilized low-dose image
Inverse-GAT layer returns the denoised low-dose image to its original domain
Dependencies
Milestones and Status
Milestone name: Set of X-ray Images
Planned Date: 3/18/18
Expected Date: 3/18/18
Status: Complete
Milestone name: De-Noising Network
Planned Date: 4/1/18
Expected Date: 4/1/18
Status: Complete
Milestone name: Pipeline with VAE
Planned Date: 4/22/18
Expected Date: 4/22/18
Status: Complete
Milestone name: LSTM for live fluoroscopy
Reports and presentations
Project Plan
Project Background Reading
Project Checkpoint
Paper Seminar Presentations
Teaser Slide
Project Final Presentation
Project Final Report
Project Bibliography
H. Chen et al., “Low-dose CT denoising with convolutional neural network,” 2017 IEEE 14th International Symposium on Biomedical Imaging (ISBI 2017), Melbourne, VIC, 2017, pp. 143-146.
J. M. Wolterink, T. Leiner, M. A. Viergever and I. Išgum, “Generative Adversarial Networks for Noise Reduction in Low-Dose CT,” in IEEE Transactions on Medical Imaging, vol. 36, no. 12, pp. 2536-2545, Dec. 2017.
Dong C., Loy C.C., He K., Tang X. (2014) Learning a Deep Convolutional Network for Image Super-Resolution. In: Fleet D., Pajdla T., Schiele B., Tuytelaars T. (eds) Computer Vision – ECCV 2014. ECCV 2014. Lecture Notes in Computer Science, vol 8692.
Badal, A. and Badano, A. (2009), Accelerating Monte Carlo simulations of photon transport in a voxelized geometry using a massively parallel graphics processing unit. Med. Phys., 36: 4878–4880.
A. Badal and A. Badano, “Monte Carlo simulation of X-ray imaging using a graphics processing unit,” 2009 IEEE Nuclear Science Symposium Conference Record (NSS/MIC), Orlando, FL, 2009, pp. 4081-4084.
J. Baro, J. Sempau, J.M. Fernandez-Varea, F. Salvat, “PENELOPE: An algorithm for Monte Carlo simulation of the penetration and energy loss of electrons and positrons in matter,” Nuclear Instruments and Methods in Physics Research Section B: Beam Interactions with Materials and Atoms, Volume 100, Issue 1, 1995, Pages 31-46.
L. Gondara, “Medical Image Denoising Using Convolutional Denoising Autoencoders,” 2016 IEEE 16th International Conference on Data Mining Workshops (ICDMW), Barcelona, 2016, pp. 241-246.
Other Resources and Project Files