X2CT-FLOW: Maximum a posteriori reconstruction using a progressive flow-based deep generative model for ultra sparse-view computed tomography in ultra low-dose protocols

Ultra sparse-view computed tomography (CT) algorithms can reduce radiation exposure of patients, but those algorithms lack an explicit cycle consistency loss minimization and an explicit log-likelihood maximization in testing. Here, we propose X2CT-FLOW for the maximum a posteriori (MAP) reconstruction of a three-dimensional (3D) chest CT image from a single or a few two-dimensional (2D) projection images using a progressive flow-based deep generative model, especially for ultra low-dose protocols. The MAP reconstruction can simultaneously optimize the cycle consistency loss and the log-likelihood. The proposed algorithm is built upon a newly developed progressive flow-based deep generative model, which is featured with exact log-likelihood estimation, efficient sampling, and progressive learning. We applied X2CT-FLOW to reconstruction of 3D chest CT images from biplanar projection images without noise contamination (assuming a standard-dose protocol) and with strong noise contamination (assuming an ultra low-dose protocol). With the standard-dose protocol, our images reconstructed from 2D projected images and 3D ground-truth CT images showed good agreement in terms of structural similarity (SSIM, 0.7675 on average), peak signal-to-noise ratio (PSNR, 25.89 dB on average), mean absolute error (MAE, 0.02364 on average), and normalized root mean square error (NRMSE, 0.05731 on average). Moreover, with the ultra low-dose protocol, our images reconstructed from 2D projected images and the 3D ground-truth CT images also showed good agreement in terms of SSIM (0.7008 on average), PSNR (23.58 dB on average), MAE (0.02991 on average), and NRMSE (0.07349 on average).