Deep Learning-Based Multi-View Projection Synthesis Approach for Improving the Quality of Sparse-View CBCT in Image-Guided Radiotherapy.

While radiation hazards induced by cone-beam computed tomography (CBCT) in image-guided radiotherapy (IGRT) can be reduced by sparse-view sampling, the image quality is inevitably degraded. We propose a deep learning-based multi-view projection synthesis (DLMPS) approach to improve the quality of sparse-view low-dose CBCT images. In the proposed DLMPS approach, linear interpolation was first applied to sparse-view projections and the projections were rearranged into sinograms; these sinograms were processed with a sinogram restoration model and then rearranged back into projections. The sinogram restoration model was modified from the 2D U-Net by incorporating dynamic convolutional layers and residual learning techniques. The DLMPS approach was trained, validated, and tested on CBCT data from 163, 30, and 30 real patients respectively. Sparse-view projection datasets with 1/4 and 1/8 of the original sampling rate were simulated, and the corresponding full-view projection datasets were restored via the DLMPS approach. Tomographic images were reconstructed using the Feldkamp-Davis-Kress algorithm. Quantitative metrics including root-mean-square error (RMSE), peak signal-to-noise ratio (PSNR), structural similarity (SSIM), and feature similarity (FSIM) were calculated in both the projection and image domains to evaluate the performance of the DLMPS approach. The DLMPS approach was compared with 11 state-of-the-art (SOTA) models, including CNN and Transformer architectures. For 1/4 sparse-view reconstruction task, the proposed DLMPS approach achieved averaged RMSE, PSNR, SSIM, and FSIM values of 0.0271, 45.93 dB, 0.9817, and 0.9587 in the projection domain, and 0.000885, 37.63 dB, 0.9074, and 0.9885 in the image domain, respectively. For 1/8 sparse-view reconstruction task, the DLMPS approach achieved averaged RMSE, PSNR, SSIM, and FSIM values of 0.0304, 44.85 dB, 0.9785, and 0.9524 in the projection domain, and 0.001057, 36.05 dB, 0.8786, and 0.9774 in the image domain, respectively. The DLMPS approach outperformed all the 11 SOTA models in both the projection and image domains for 1/4 and 1/8 sparse-view reconstruction tasks. The proposed DLMPS approach effectively improves the quality of sparse-view CBCT images in IGRT by accurately synthesizing missing projections, exhibiting potential in substantially reducing imaging dose to patients with minimal loss of image quality.