An irregular metal trace inpainting network for x-ray CT metal artifact reduction

Purpose Metal implants in the patient's body can generate severe metal artifacts in x-ray computed tomography (CT) images. These artifacts may cover the tissues around the metal implants in CT images and even corrupt the tissue regions, thus affecting disease diagnosis using these images. Previous deep learning metal trace inpainting methods used both valid pixels of uncorrupted areas and invalid pixels of corrupted areas to patch metal trace (i.e., the holes of removed metal-corrupted regions). Such methods cannot recover fine details well and often suffer information mismatch due to interference of invalid pixels, thus incurring considerable secondary artifacts. In this paper, we develop a new irregular metal trace inpainting network for reducing metal artifacts. Methods We develop a new deep learning network to patch irregular metal trace in metal-corrupted sinograms to reduce metal artifacts for isometric fan-beam CT. Our new method patches irregular metal trace in CT sinograms using only valid pixels, avoiding interference from invalid pixels. Furthermore, to enable the inpainting network to recover as many details as possible, we design an auxiliary inpainting network to suppress the probable secondary artifacts in CT images to assist fine detail restoration. The image produced by the auxiliary network is then projected onto a sinogram via a forward projection (FP) algorithm and is fused with the sinogram predicted by the inpainting network in order to predict the final recovered sinogram. Our entire network is trained end-to-end to extract cross-domain information between the sinogram domain and CT image domain. Results We compare our proposed method with two traditional and four deep learning-based metal trace inpainting methods, and with an iterative reconstruction method on four datasets: dental fillings (panoramic and local perspectives), hip prostheses, and spine fixations. We use both quantitative and qualitative indices to evaluate our method, and the analyses suggest that our method reduces the most metal artifacts and produces the best quality CT images. Additionally, our proposed method takes 0.1512 s on average to process a CT slice, which meets the clinical requirement. Conclusions This paper proposes a new deep learning network to patch irregular metal trace in corrupted sinograms to reduce metal artifacts. Our method restores more fine details in irregular metal trace and has a superior capability on metal artifact reduction compared with state-of-the-art methods.