title: Low-dose computed tomography image restoration using previous normal-dose scan.
abstract: OBJECTIVE
  In current computed tomography (CT) examinations, the associated x-ray radiation dose is of a significant concern to patients and operators. A simple and cost-effective means to perform the examinations is to lower the milliampere-seconds (mAs) or kVp parameter (or delivering less x-ray energy to the body) as low as reasonably achievable in data acquisition. However, lowering the mAs parameter will unavoidably increase data noise and the noise would propagate into the CT image if no adequate noise control is applied during image reconstruction. Since a normal-dose high diagnostic CT image scanned previously may be available in some clinical applications, such as CT perfusion imaging and CT angiography (CTA), this paper presents an innovative way to utilize the normal-dose scan as a priori information to induce signal restoration of the current low-dose CT image series.
  
  
  METHODS
  Unlike conventional local operations on neighboring image voxels, nonlocal means (NLM) algorithm utilizes the redundancy of information across the whole image. This paper adapts the NLM to utilize the redundancy of information in the previous normal-dose scan and further exploits ways to optimize the nonlocal weights for low-dose image restoration in the NLM framework. The resulting algorithm is called the previous normal-dose scan induced nonlocal means (ndiNLM). Because of the optimized nature of nonlocal weights calculation, the ndiNLM algorithm does not depend heavily on image registration between the current low-dose and the previous normal-dose CT scans. Furthermore, the smoothing parameter involved in the ndiNLM algorithm can be adaptively estimated based on the image noise relationship between the current low-dose and the previous normal-dose scanning protocols.
  
  
  RESULTS
  Qualitative and quantitative evaluations were carried out on a physical phantom as well as clinical abdominal and brain perfusion CT scans in terms of accuracy and resolution properties. The gain by the use of the previous normal-dose scan via the presented ndiNLM algorithm is noticeable as compared to a similar approach without using the previous normal-dose scan.
  
  
  CONCLUSIONS
  For low-dose CT image restoration, the presented ndiNLM method is robust in preserving the spatial resolution and identifying the low-contrast structure. The authors can draw the conclusion that the presented ndiNLM algorithm may be useful for some clinical applications such as in perfusion imaging, radiotherapy, tumor surveillance, etc.
authors: Department of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong 510515, China. jerome@mil.sunysb.edu
authors: Jianhua
authors: J
authors: Ma
authors: Jing
authors: J
authors: Huang
authors: Qianjin
authors: Q
authors: Feng
authors: Hua
authors: H
authors: Zhang
authors: Hongbing
authors: H
authors: Lu
authors: Zhengrong
authors: Z
authors: Liang
authors: Wufan
authors: W
authors: Chen
mesh_terms: D000465:Algorithms; D000792:Angiography / Q000379:methods*; D001932:Brain Neoplasms / Q000473:pathology; D006801:Humans; D015233:Models, Statistical; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D010477:Perfusion; D019047:Phantoms, Imaging; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D011878:Radiotherapy / Q000379:methods; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*