High-density objects such as metal prostheses, surgical clips, or dental fillings generate streak-like artifacts in computed tomography images. We present a novel method for metal artifact reduction by in-painting missing information into the corrupted sinogram. The information is provided by a tissue-class model extracted from the distorted image. To this end the image is first adaptively filtered to reduce the noise content and to smooth out streak artifacts. Consecutively, the image is segmented into different material classes using a clustering algorithm. The corrupted and missing information in the original sinogram is completed using the forward projected information from the tissue-class model. The performance of the correction method is assessed on phantom images. Clinical images featuring a broad spectrum of metal artifacts are studied. Phantom and clinical studies show that metal artifacts, such as streaks, are significantly reduced and shadows in the image are eliminated. Furthermore, the novel approach improves detectability of organ contours. This can be of great relevance, for instance, in radiation therapy planning, where images affected by metal artifacts may lead to suboptimal treatment plans.

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This paper systematically evaluates a pharmacokinetic compartmental model for identifying tumor hypoxia using dynamic positron-emission-tomography (PET) imaging with 18F-fluoromisonidazole (FMISO). A generic irreversible one-plasma two-tissue compartmental model was used. A dynamic PET image dataset was simulated with 3 tumor regions -- normoxic, hypoxic and necrotic, embedded in a normal-tissue background, and with an image-based arterial input function. Each voxelized tissue’s time-activity-curve (TAC) was simulated with typical values of kinetic parameters, as deduced from FMISO-PET data from 9 head-and-neck cancer patients. The dynamic dataset was first produced without any statistical noise to ensure that correct kinetic parameters were reproducible. Next, to investigate the stability of kinetic parameter estimation in the presence of noise, 1000 noisy samples of the dynamic dataset were generated, from which 1000 noisy estimates of kinetic parameters were calculated and used to estimate the sample mean and covariance matrix. It is found that a more peaked input function gave less variation in various kinetic parameters, and the variation of kinetic parameters could also be reduced by two region-of-interest averaging techniques. To further investigate how bias in the arterial input function affected the kinetic parameter estimation, a shift error was introduced in the peak-amplitude and peak-location of the input TAC, and the bias of various kinetic parameters calculated. In summary, mathematical phantom studies have been used to determine the statistical accuracy and precision of model-based kinetic analysis, which helps to validate this analysis and provides guidance in planning clinical dynamic FMISO-PET studies.

An emerging technology, CT ventilation imaging has been translated into the clinic and used in functional image-guided radiotherapy for the first time. This milestone represents an important first step toward hypothetically reduced pulmonary toxicity in lung cancer radiotherapy.

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