Contrast-Medium Anisotropy-Aware Tensor Total Variation Model for Robust Cerebral Perfusion CT Reconstruction with Low-Dose Scans.

Perfusion computed tomography (PCT) is critical in detecting cerebral ischemic lesions. PCT examination with low-dose scans can effectively reduce radiation exposure to patients at the cost of degraded images with severe noise and artifacts. Tensor total variation (TTV) models are powerful tools that can encode the regional continuous structures underlying a PCT object. In a TTV model, the sparsity structures of the contrast-medium concentration (CMC) across PCT frames are assumed to be isotropic with identical and independent distribution. However, this assumption is inconsistent with practical PCT tasks wherein the sparsity has evident variations and correlations. Such modeling deviation hampers the performance of TTV-based PCT reconstructions. To address this issue, we developed a novel contrast-medium anisotropy-aware tensor total variation (CMAA-TTV) model to describe the intrinsic anisotropy sparsity of the CMC in PCT imaging tasks. Instead of directly on the difference matrices, the CMAA-TTV model characterizes sparsity on a low-rank subspace of the difference matrices which are calculated from the input data adaptively, thus naturally encoding the intrinsic variant and correlated anisotropy sparsity structures of the CMC. We further proposed a robust and efficient PCT reconstruction algorithm to improve low-dose PCT reconstruction performance using the CMAA-TTV model. Experimental studies using a digital brain perfusion phantom, patient data with low-dose simulation and clinical patient data were performed to validate the effectiveness of the presented algorithm. The results demonstrate that the CMAA-TTV algorithm can achieve noticeable improvements over state-of-the-art methods in low-dose PCT reconstruction tasks.