Four-dimensional cone-beam computed tomography (4D CBCT) provides respiration-resolved images and can be used for image-guided radiation therapy. However, the ability to reveal respiratory motion comes at the cost of image artifacts. As raw projection data are sorted into multiple respiratory phases, there is a limited number of cone-beam projections available for image reconstruction. Consequently, the 4D CBCT images are covered by severe streak artifacts. Although several deep learning-based methods have been proposed to address this issue, most algorithms employ ordinary network models, neglecting the intrinsic structural prior within 4D CBCT images. In this paper, we first explore the origin and appearance of streak artifacts in 4D CBCT images.Specifically, we find that streak artifacts exhibit a periodic rotational motion along with the patient's respiration. This unique motion pattern inspires us to distinguish the artifacts from the desired anatomical structures in the spatiotemporal domain. Thereafter, we propose a spatiotemporal neural network named RSTAR-Net with separable and circular convolutions for Rotational Streak Artifact Reduction. The specially designed model effectively encodes dynamic image features, facilitating the recovery of 4D CBCT images. Moreover, RSTAR-Net is also lightweight and computationally efficient. Extensive experiments substantiate the effectiveness of our proposed method, and RSTAR-Net shows superior performance to comparison methods.
Since the invention of modern CT systems, metal artifacts have been a persistent problem. Due to increased scattering, amplified noise, and insufficient data collection, it is more difficult to suppress metal artifacts in cone-beam CT, limiting its use in human- and robot-assisted spine surgeries where metallic guidewires and screws are commonly used. In this paper, we demonstrate that conventional image-domain segmentation-based MAR methods are unable to eliminate metal artifacts for intraoperative CBCT images with guidewires. To solve this problem, we present a fine-grained projection-domain segmentation-based MAR method termed PDS-MAR, in which metal traces are augmented and segmented in the projection domain before being inpainted using triangular interpolation. In addition, a metal reconstruction phase is proposed to restore metal areas in the image domain. The digital phantom study and real CBCT data study demonstrate that the proposed algorithm achieves significantly better artifact suppression than other comparing methods and has the potential to advance the use of intraoperative CBCT imaging in clinical spine surgeries.