Patent Description:
In x-ray dental volume tomography, a three-dimensional (3D) tomographic image of the patient jaw is reconstructed based on two-dimensional (2D) x-ray images. Metal objects such as metallic fillings or implants in the patient's mouth can cause metal artefacts in the final three-dimensional tomographic image. The metal artefacts appear as dark or light stripes as shown in <FIG>. These artefacts can complicate the medical diagnosis. A conventional method of metal artifact reduction is shown in <FIG>. In the conventional method, first the two-dimensional x-ray images are acquired and subsequently used to reconstruct a three-dimensional (3D) tomographic image. Thereafter, the locations of the metal objects in the two-dimensional x-ray images are determined through a time-consuming analysis of the three-dimensional tomographic image. Knowing the locations of the metal objects, subsequently the metal artefacts in the two-dimensional x-ray images are corrected through classical image processing. Finally, a metal artifact-reduced three-dimensional tomographic image is reconstructed based on the corrected and uncorrected two-dimensional x-ray images. <FIG> shows a tomogram in which the metal artefacts in <FIG> have been reduced through the method in <FIG>.

In many situations, only a part (V) i.e., a small volume, of the patient jaw (3a) as shown in <FIG>, is relevant to the diagnosis. In this case, only such small volume (V) of the patient jaw (3a) is irradiated from all angles and reconstructed. The remaining part of the patient jaw (3a) is not irradiated from all angles and is only seen in some of the acquired two-dimensional x-ray images and is not reconstructed. These two-dimensional x-ray images can cause metal artifacts in the final three-dimensional tomographic image as shown in <FIG> if there are metallic objects (6a) outside the small volume (V) to be reconstructed as shown in <FIG>, even when such small volume (V) would not contain any metal object (6b). <FIG> is a tomogram corresponding to the same section in <FIG> and has been reconstructed with the metal artefact reduction method according to the prior art as shown in <FIG>. The metal artefacts in <FIG> caused by the metal objects (6a) outside the small volume (V) cannot be corrected through the conventional method of metal artifact reduction shown in <FIG>, and thus, the conventional metal artifact reduction method is not reliable.

To avoid the above-mentioned first reconstruction step in the conventional method of <FIG>, and to prevent artifacts due to metal objects (6a) located outside the small volume (V) to be reconstructed, the detection of metal objects may be directly performed on the two-dimensional x-ray images. For this purpose, the two dimensional-x-ray images or alternatively the sinogram can be analyzed. A two-dimensional x-ray image represents the projection of the irradiated three-dimensional object, for instance, a patient jaw as shown in <FIG>. A sinogram is created when these projections taken at all angles are combined into an array of projections as shown in <FIG>. The trace of a metal object imaged over time defines curves in the sinogram as shown in <FIG>. For the detection of the metal objects in the two-dimensional x-ray images, classical image processing methods such as thresholding, edge detection may be used. However, due to other dense structures such as bones or dentins, it is difficult to achieve a reliable detection of the metal objects. The dense structures may be erroneously recognized as metal objects. The converse may also happen, and the metal objects with lower density may not be detected. In such cases, the metal artifact reduction based on classical image processing of the two-dimensional x-ray images may not be reliably achieved.

In the two-dimensional x-ray images, at the places where the metal objects are located, the data for reconstructing a 3D artifact-free tomographic image is generally missing. In the approach disclosed in <CIT> artificial intelligence is used to supplement the two-dimensional x-ray images where the data is missing. The sites including the missing data are initially determined through thresholding and subsequently supplemented with a trained artificial intelligence to reconstruct a metal artifact reduced three-dimensional tomographic image. However also this approach is prone to the disadvantages of the above-mentioned classical image processing techniques involving the use of thresholding.

<NPL>, disclose a segmentation method that is capable of segmenting metal structures in original raw CT data, the method is based on the use of Bayesian techniques and application of a Markov random field model, and after the metal is segmented, an interpolation method is used in combination with scaling of the metal signal, to replace the metal signal by a more appropriate signal intensity.

An objective of the present invention is to overcome the above-mentioned disadvantages of the prior art and to provide a method of metal artefact reduction in x-ray dental volume tomography.

This objective has been achieved by the metal artefact reduction method as defined in claim <NUM>, and the x-ray dental volume tomography system as defined in claim <NUM>. The subject-matters of the dependent claims relate to further developments.

The present invention provides a method of metal artefact reduction in x-ray dental volume tomography as defined in claim <NUM>.

Herein the use of the 2D mask in conjunction with the two-dimensional x-ray images is defined as being outside the scope of the invention as claimed, however, serves the purpose of better understanding the invention.

A major advantageous effect of the present invention is that the metal objects can be more reliably detected through directly and solely analyzing the 2D x-ray images or the sinogram by using 2D/3D masks that are generated through the trained artificial intelligence algorithm. Thereby, the need for initially reconstructing and analyzing the 3D tomographic image with metal objects can be obviated, and thus the process time can be comparatively shortened, and the process load can be comparatively reduced. Hence, the speed of reconstructing a metal artefact reduced 3D tomographic images has been improved. Another major advantageous effect of the present invention is that metallic objects that are not in the reconstructed volume can be reliably detected, and the metal artifacts caused by these metallic objects can be reduced. Thus, the metal artefact reduction method of the present invention has an improved tomographic image quality independently from the size of the volume to be reconstructed. Another major advantageous effect of the present invention is that the artificial intelligence algorithm can be continually trained with the help of real/virtual data including 2D x-ray images taken from the patient jaw or a calibration body from various angles, and thus the generation of 2D/3D mask for detecting the metal objects can be accordingly improved through such training. Thereby, the medical diagnosis can be increasingly facilitated.

According to the present invention, the three-dimensional tomographic image may be reconstructed in two alternative ways. In the first alternative, the method further comprises a step of correcting the two-dimensional x-ray images or the sinogram by means of the generated 2D masks or the 3D masks respectively, wherein in the reconstruction step, the three-dimensional tomographic image is reconstructed based on the corrected two-dimensional x-ray images or the corrected sinogram. In the second alternative, in the reconstruction step the three-dimensional tomographic image is reconstructed respectively based on the two-dimensional x-ray images or the sinogram as originally obtained and the 2D masks or the 3D masks as generated.

According to the present invention, the 2D/3D masks are preferably 2D/3D binary masks. Alternatively, probability masks or confidence masks may be used.

According to the present invention, the two-dimensional x-ray images or the sinogram may be corrected through classical image processing. Alternatively, another artificial intelligence algorithm may be used for correcting the two-dimensional x-ray images. This artificial intelligence algorithm can be trained with two-dimensional x-ray images data acquired from different patient jaws.

According to the present invention, the reconstruction of the three-dimensional tomographic image may be based solely on the corrected two-dimensional x-ray images or the corrected sinogram such that the metal objects are not present in the final three-dimensional tomographic image. Alternatively, the reconstruction of the three-dimensional tomographic image may be additionally based on the uncorrected two-dimensional x-ray images or the uncorrected sinogram such that the metal objects are present in the three-dimensional tomographic image.

According to the present invention, the artificial intelligence algorithm is trained by using data pairs, where each pair consists of a two-dimensional x-ray image and an associated 2D mask which represents the location of any metal objects in the associated two-dimensional x-ray image. Alternatively, the artificial intelligence algorithm may be trained with a sinogram and an associated 3D mask. The two-dimensional x-ray images are generated through an x-ray source and a detector through a revolution around the patient jaw. The 2D masks or the 3D mask used for the training are obtained through the locations of the metal objects in the two-dimensional x-ray images or the sinogram. One way of obtaining them is by analyzing a three-dimensional tomographic image in which metal artefacts have not been corrected (e.g. by thresholding or other image processing techniques) and subsequently transferring the found masks to the two-dimensional x-ray images or the sinogram (e.g. by means of a forward projection). Alternatively, the 2D masks and/or the 3D mask used in the training step may be manually generated from two-dimensional x-ray images and/or sinograms in which metal artefacts have not be corrected.

According to the present invention, the two-dimensional x-ray images or the sinogram to be obtained is not limited to the entire patient jaw and may also correspond to a part of the patient jaw such as a small volume. Such small volumes may be different in location, size and shape. The metal artefact reduction method may be applied to any small volume even when it is free of metal objects and the patient jaw includes one or more metal object outside the small volume.

The present invention also provides an x-ray dental volume tomography system which has an x-ray unit and a tomographic reconstruction unit. The x-ray unit has an acquisition means for acquiring the two-dimensional x-ray images or the sinogram of at least part of a patient jaw i.e., a small volume, through relatively rotating an x-ray source and a detector around the patient jaw. The part of the patient jaw to be examined can be selected by the user, and accordingly irradiated to prevent overdosing of the patient. The tomographic reconstruction unit also has an image processing means which executes the method according to the present invention for metal artefact reduction in x-ray dental volume tomography.

In the subsequent description, the present invention will be described in more detail by using exemplary embodiments and by referring to the drawings, wherein.

The reference numbers shown in the drawings denote the elements as listed below and will be referred to in the subsequent description of the exemplary embodiments.

<FIG> shows an x-ray unit (<NUM>) according to an embodiment of the present invention. The x-ray unit (<NUM>) has an acquisition means for acquiring two-dimensional x-ray images (<NUM>) or a sinogram (<NUM>) of at least part (V) of a patient jaw (3a) i.e., a small volume, through relatively rotating an x-ray source (<NUM>) and a detector (<NUM>) around the patient jaw (3a). The x-ray unit (<NUM>) is connectable to a tomographic reconstruction unit which has an image processing means which is adapted to execute the method of metal artefact reduction in x-ray dental volume tomography according to the present invention. The x-ray unit (<NUM>) and the tomographic reconstruction unit together configure an x-ray dental volume tomography system according to the present invention.

<FIG> shows the steps (S1,S2,S3,S4) of the method of metal artefact reduction in x-ray dental volume tomography according to a first alternative embodiment of the present invention.

In a first step (S1), two-dimensional x-ray images (<NUM>) or a sinogram (<NUM>) of at least part (V) of a patient jaw (3a) is obtained from the acquisition means of the x-ray unit (<NUM>). In the second step (S2), the metal objects (<NUM>) in the two-dimensional x-ray images (<NUM>) or the sinogram (<NUM>) are detected by using a trained artificial intelligence algorithm which generates either 2D masks (<NUM>) that represent the metal objects (<NUM>) in the two-dimensional x-ray images (<NUM>) or 3D masks which represent the metal objects (<NUM>) in the sinogram (<NUM>), respectively. In addition, other 2D masks or 3D masks obtained from a classical algorithm can be optionally used in combination to those generated through the trained artificial intelligence algorithm to optimize the detection. In a third step (S3), the two-dimensional x-ray images (<NUM>) or the sinogram (<NUM>) are corrected at least by means of the generated 2D masks (<NUM>) or the 3D masks respectively. This correction may be performed through classical image processing. Alternatively, the correction may be performed through another trained artificial intelligence algorithm. In step (S4), a three-dimensional tomographic image (<NUM>) based on the corrected two-dimensional x-ray images (<NUM>) or the corrected sinogram (<NUM>) is reconstructed. Alternatively, the reconstruction of the three-dimensional tomographic image (<NUM>) may be based on the corrected and the uncorrected two-dimensional x-ray images (<NUM>) or the corrected and the uncorrected sinogram (<NUM>) so that the metal objects (<NUM>), if any, are also shown in the three-dimensional tomographic image (<NUM>).

<FIG> shows the steps (S1,S2,S5) of the method of metal artefact reduction in x-ray dental volume tomography according to a second alternative embodiment of the present invention. In the second alternative embodiment, the third step (S3) is dispensed with. And the three-dimensional tomographic image (<NUM>) is reconstructed respectively based on the two-dimensional x-ray images (<NUM>) or the sinogram (<NUM>) as originally obtained and the 2D masks (<NUM>) or the 3D masks as generated.

For comparison, <FIG> shows a tomogram according to the prior art with metal artefacts that are caused by metal objects (6a) outside the reconstructed small volume (V). <FIG> shows a tomogram corresponding to the same section in <FIG>, reconstructed with the metal artefact reduction method according to the present invention.

The artificial intelligence algorithm is trained by using data pairs. In the subsequent description, the reference signs having a prime denote the elements similar to those without the prime, but which have been used in the training step of the method. Each data pair includes a two-dimensional x-ray image (<NUM>') and an associated 2D mask (<NUM>') which represents the 2D location of any metal object (<NUM>') in the associated two-dimensional image (<NUM>'). Alternatively, each data pair includes a sinogram (<NUM>') and an associated 3D mask which represents the 3D location of any metal object (<NUM>') in the sinogram (<NUM>'). Herein the two-dimensional x-ray images (<NUM>') and the sinogram (<NUM>') of the data pairs correspond, preferably to the entire patient jaw (3a') of an arbitrary patient (<NUM>'), which have been generated through an x-ray source (<NUM>') and a detector (<NUM>') through a relative revolution preferably completely around the patient jaw (3a'). The 2D masks (<NUM>') and the 3D mask used in the training step may be obtained by analyzing a three-dimensional tomographic image (<NUM>') in which the metal artifacts have not be corrected. For instance, the 2D masks (<NUM>') and/or the 3D masks used for the training can be obtained from the prior art method in <FIG> as a by-product which result from the analyzing step. Alternatively, the 2D masks (<NUM>') and/or the 3D masks used in the training step may be manually generated from two-dimensional images (<NUM>') and/or sinograms (<NUM>') in which metal artefacts have not be corrected.

In another embodiment, the tomographic reconstruction unit has an input means for retrieving the trained artificial intelligence algorithm for generating the 2D masks (<NUM>) and the 3D masks. The input means may be a wireless connection or wired connections that can be connected to a network or the like for data retrieval.

In another embodiment, the acquisition means is adapted to user-selectively acquire two-dimensional x-ray images (<NUM>) or the sinogram (<NUM>) that corresponds to one of a plurality of different parts (V) of the patient jaw (3a) which have respectively different volumes. The user can select the parts (V) to be irradiated and adjust the size thereof.

In another embodiment, the method is provided in form of a computer-readable program which has codes for causing a computer-based x-ray dental volume tomography system to perform the above-described steps of the metal artefact reduction method in x-ray dental volume tomography.

Claim 1:
A method of metal artefact reduction in x-ray dental volume tomography, the method comprising:
a step (S1) of obtaining a sinogram (<NUM>) of at least part (V) of a patient jaw (3a), acquired through relatively rotating an x-ray source (<NUM>) and a detector (<NUM>) around the patient jaw (3a);
the method being characterized by further comprising:
a step (S2) of detecting metal objects (<NUM>) in the sinogram (<NUM>) by using at least a trained artificial intelligence algorithm to generate 3D masks which represent the metal objects (<NUM>) in the sinogram (<NUM>); and
a step (S4;S5) of reconstructing a three dimensional tomographic image (<NUM>) based on the sinogram (<NUM>) and the 3D masks as generated.