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IEEE TRANSACTIONS ON MEDICAL IMAGING, VOL. 22, NO. 7, JULY 2003 837 Blind Deblurring of Spiral CT Images Ming Jiang*, Ge Wang, Fellow, IEEE, Margaret W. Skinner, Jay T. Rubinstein, Member, IEEE, and Michael W. Vannier, Member, IEEE Abstract—To discriminate fine anatomical features in the inner ear, it has been desirable that spiral computed tomography (CT) may perform beyond their current resolution limits with the aid of digital image processing techniques. In this paper, we develop a blind deblurring approach to enhance image resolution retrospectively without complete knowledge of the underlying point spread function (PSF). An oblique CT image can be approximated as the convolution of an isotropic Gaussian PSF and the actual cross section. Practically, the parameter of the PSF is often unavailable. Hence, estimation of the parameter for the underlying PSF is crucially important for blind image deblurring. Based on the iterative deblurring theory, we formulate an edge-to-noise ratio (ENR) to characterize the image quality change due to deblurring. Our blind deblurring algorithm estimates the parameter of the PSF by maximizing the ENR, and deblurs images. In the phantom studies, the blind deblurring algorithm reduces image blurring by about 24%, according to our blurring residual measure. Also, the blind deblurring algorithm works well in patient studies. After fully automatic blind deblurring, the conspicuity of the submillimeter features of the cochlea is substantially improved. Index Terms—Blind deblurring/deconvolution, cochlear implantation, computed tomography (CT), edge-to-noise ratio (ENR), EM algorithm, Gaussian blurring, spiral/helical CT. Spiral/helical computed tomography (CT) is advantageous in visualizing and measuring bony structures of the middle and inner ear preoperatively and geometric features of implanted metallic devices postoperatively [1]–[4]. However, CT scanners cannot resolve many important temporal bone details, especially those millimeter- or submillimeter-sized features of the middle and inner ear. It has been well established that digital deblurring is an effective strategy to enhance image resolution retrospectively [5]. However, the underlying point spread function (PSF) of the CT scanner is often unavailable in practice. Therefore, we are motivated to develop a blind deblurring approach for resolution improvement of spiral CT slices. On a single-slice scanner, it was validated that spiral CT can be modeled as a spatially invariant process with a three-dimensional Gaussian PSF [5]. Due to the introduction of multislice systems, we recently conducted a similar experiment on a multislice scanner, and obtained the same conclusion. Consequently, an arbitrary oblique cross section in an image volume can be approximated as a convolution of an isotropic two-dimensional Gaussian PSF and the actual cross section (1) I. INTRODUCTION T HE TEMPORAL bone is a set of complex paired structures on the skull base which contains the organ of hearing among others [1]. Treatment of severe-to-profound hearing loss often employs a multielectrode cochlear implant, inserted in the temporal bone. For those with this degree of hearing loss in both ears who derive little benefit from acoustic hearing aids, the American Medical Association and the American Academy of Otolaryngology-Head and Neck Surgery have recognized the cochlear implant as the standard treatment. Manuscript received April 19, 2001; revised January 11, 2003. This work was supported in part by the National Institute of Health (NIH) under Grant R01 DC03590, the National Basic Research Program of China under Grant G1998030606 and the National Science Foundation of China (NSFC) under Grant 60272018. The Associate Editor responsible for coordinating the review of this paper and recommending its publication was R. Leahy. Asterisk indicates corresponding author. *M. Jiang is with LMAM, School of Mathematical Sciences, Peking University, Beijing 100871, China. This work was performed while he was a visiting professor with CT/Micro-CT Laboratory, Department of Radiology, University of Iowa, Iowa City, IA 52242, USA (e-mail: [email protected], [email protected]). G. Wang is with CT/Micro-CT Laboratory, Department of Radiology, University of Iowa, Iowa City, IA 52242 USA. M. W. Skinner is with the Department of Otolaryngology-Head & Neck Surgery, Washington University, St. Louis, MO 63110 USA. J. T. Rubinstein is with the Department of Otolaryngology, University of Iowa, Iowa City, IA 52242 USA. M. W. Vannier is with the Department of Radiology, University of Iowa, Iowa City, IA 52242 USA. Digital Object Identifier 10.1109/TMI.2003.815075 is the where Gaussian function with standard deviation parameter , the noise term, the oblique section of interest, i.e., the is the actual cross section, which is the blurred image, and truth in the real world. An estimate of the real image is called a restored or deblurred image. In practice, the parameter is not precisely known for an arbitrary oblique cross section. Hence, we need a blind deblurring approach to restore the real image. Blind deblurring/deconvolution is to recover an actual image without complete knowledge of the associated system PSF. Blind deblurring methods were recently reviewed [6]–[8]. The blind deblurring methods reviewed in [6], [7] require that the PSF and the actual image must be irreducible. However, this critical assumption is invalid in the Gaussian blurring case. The Gaussian PSF is reducible: if . This property might have rendered the blind deblurring problem the most difficult. Even in the noiseless case, the problem is well known as the ill-posed inverse problem of heat transfer. Therefore, existing algorithms for Gaussian blind deblurring have not been successful. To appreciate this situation better, let us look at a popular blind deblurring technique, also referred to as the double iteration scheme, developed by Holmes et al. [9]. As discussed in [8], the convergence of this iteration scheme remains unknown; the worse news is that, with an inappropriate initial guess, the estimated PSF may converge to a function, making the deblurred image the same as the observed image . In [9], heuristic constraints were added to incorporate some prior information 0278-0062/03$17.00 © 2003 IEEE 838 IEEE TRANSACTIONS ON MEDICAL IMAGING, VOL. 22, NO. 7, JULY 2003 about the PSF into the algorithm, but these means were not effective. There are Bayesian approaches that utilize prior information about the image and the PSF, such as the total variation [10] and other priors [11], [12]. These approaches introduce new problems of estimating the hyper-parameters. Furthermore, the convergence of the algorithms are not well understood [8]. In [13], a spectrum domain approach was studied to deblur images obtained with Gaussian or Lorentzian PSFs. In this case, the PSF is detected from one-dimensional (1-D) Fourier analysis of a selected profile in a blurred image. A noniterative image deblurring technique, “slow evolution constraint backward” (SECB), uses this detected PSF to deblur the image. This approach only works for a special class of images, and it requires much interactive work to adjust the parameters. Our goal is to develop a blind deblurring algorithm to effectively restore Gaussian blurred CT images, especially images of the temporal bone for cochlear implantation. Essentially, what we need is a good estimate of the parameter . Then, we can apply the established expectation-maximization (EM) deblurring algorithm [5]. To estimate the parameter , we believe that the key is to analyze the edge and noise effects, based on the classic results on edge and noise associated with EM iteration [14]. We define an edge-to-noise ratio (ENR), and propose an “ENR maximization principle” to estimate the optimal for blind deblurring. The outline of this paper is as follows. In Section II, we first present the four key components of our approach: 1) Csiszár’s axiomatic discrepancy measure; 2) the EM algorithm; 3) the edge and noise effects with the EM algorithm; and 4) the ENR maximization principle; then, we propose our blind deblurring algorithm. In Section III, we describe the phantom and patient data. In Section IV, we report numerical and experimental results. Primarily, the characteristics of the ENR is studied in extensive simulation to validate the proposed “ENR maximization principle”. The behavior of the algorithm is also studied in the case of noisy data. Then, the feasibility of our blind deblurring algorithm is demonstrated in patient studies. In Section V, we discuss relevant issues and future refinements of the methodology, and conclude the paper. II. METHOD A. Discrepancy Measure For two nonnegative distributions and , the discrepancy measure consistent with Csiszár’s axioms [15] is the -divergence, or generalized Kullback distance (2) where is the pixel position in the image plane in our case. This algorithm has a long successful history with various important applications [16]–[18]. It is well known that the algorithm converges in either the deterministic sense of the -divergence or the statistical sense of the Poisson likelihood its [18], [19]. Additionally, given a positive initial guess intermediate iterates are always nonnegative, and preserve the . In this paper, we always energy, i.e., use a positive constant image as the initial guess, whose value is the mean of the input image. The EM algorithm assumes nonnegative valued images, but CT numbers in Hounsfield units (HU) can be negative. However, the general blurring model still holds after real and observed images are simultaneously offset by a constant. Specifically, an appropriate positive constant, for example, 1024 HU, can be added to a spiral CT image for nonnegativity. Then, deblurring can be performed. After that, the same constant must be subtracted from the deblurred image. C. Noise and Edge Effects A classic study on the noise and edge effects of the EM algorithm were performed by Snyder et al. [14]. The following summary is edited based on [14] and supported by our results: The images obtained with the EM algorithm can be quite encouraging initially. The estimates appear to have better resolution, signal-to-noise ratio, and contrast. However, as the iteration process goes on, some disturbing “artifacts” become evident. Images appear to be more “noisy” as the successive estimates approach the maximum-likelihood estimate of . At the same time, sharp transitions or edges in the image become greatly accentuated with substantial overshoots, much like the wellknown Gibbs phenomenon. The noise effect appears as large peaks and valleys seemingly randomly distributed throughout the image. The edge effect appears as ridges and valleys that follow edges in the underlying image. Snyder et al. demonstrated that deblurring with a sieve for a blurred version of the ideal function effectively reduced both noise and edge artifacts [14]. The only additional processing for the regularized EM algorithm is that an EM estimate is postfiltered to obtain a desirable estimate. In other words, in the case of Gaussian blurring we can improve the EM algorithm in the following way. First, EM iterations are performed with a different Gaussian kernel. Then, the deblurred image is blurred by be the real blurring value. Let another Gaussian kernel. Let , , and are related by (4) are the kernel widths of the Gaussian PSFs where , , and called deblurring, sieve, and resolution widths, respectively. The as follows: algorithm then iterates with B. EM Algorithm Assume the linear space-invariant blurring model (1) in the nonnegative space, the EM algorithm iterates as follows: (3) where . and (5) After with iterations, the final result is obtained by postfiltering is the restored image at iteration (6) JIANG et al.: BLIND DEBLURRING OF SPIRAL CT IMAGES 839 Although the choices of the sieve and resolution widths were not dictated by any existing theory, the following qualitative comments can be made: • “The overshoot (at edges) is seen to be a weak function of the sieve; in general, the overshoot increases slightly with wider sieves” [14]. • “The overshoot is a strong function of the resolution width; the overshoot decreases rapidly as the resolution-kernel width is increased” [14]. • “The overshoot increases with iteration number” [14]. • “An assumed density that is too narrow unintentionally results in an estimate of a blurred version of the radioactivity distribution; an assumed density that is too wide introduces an unintentional sieve, and the estimate produced is of the presieve intensity unless a postfilter corresponding to the mismatch is applied; such an estimate can be quite noisy in appearance” [14]. D. Edge-to-Noise Ratio To quantify the noise effect, we use Csiszár’s axiomatic discrepancy measure. The noise effect is defined as the discrepancy of a blurred image and its mean. We can estimate the mean as where is the image deblurred by the EM algorithm with iterations and the deblurring . The noise effect with respect to a deblurring and an iteration number is, thus, expressed as (7) To quantify the edge effect, we compare a deblurred image and an estimated mean of the blurred image (8) Heuristically, this measure characterizes changes near edges after deblurring. may result in Choosing by simply maximizing a deblurred image with exaggerated edges and unacceptable noise, since the noise effect is not included in the object function. Clearly, we need a balance between the edge effect and the noise effect . This consideration leads to the following “edge-to-noise ratio” (ENR, in the same spirit of the signal-to-noise ratio) (9) Based on the ENR, we have the following. ENR Maximization Principle: The optimal parameter for deblurring should be so chosen that the is maximized. E. Blind Deblurring Algorithm Our algorithm consists of two stages: 1) preparation, and 2) restoration. The first stage is to determine the parameters for the second stage. The second stage applies the ENR maximization principle to find the parameter and deblur an image. Specifically, we have the following. ENR-Based Blind Deblurring Algorithm: First Stage. Preparation: Step 1.1. Initialization: Design the phantom(s); Specify the permissible range [ ] of ; Choose an image deblurring residual measure. Step 1.2. Estimate the optimal iteration number . Second Stage. Restoration: Step 2.1. Input a blurred image. by Step 2.2. Estimate the optimal . maximizing the Step 2.3. Deblur the image with the obtained in Step 2.2. Since the ENR depends on a deblurred image, the choice of the iteration number is important to estimate the deblurring kernel . In the first stage, we determine an optimal iteration number in an average sense for a class of images. This task is done in numerical simulation with an appropriately designed phantom and an image deblurring residual measure. Note that the phantom must be representative of the class of images to be processed, and summarize our domain knowledge effectively. In the second stage, the search for the optimal deblurring is formulated as a 1-D maximization problem, given an itera] can be estimated based tion number . The range [ on the data from CT quality assurance tests [5]. The choice of a 1-D maximization algorithm depends on the user’s preference. ” which In this paper, we use the Matlab function “ is a combination of golden section search and parabolic interpolation. To compute the ENR, the algorithm needs to run the EM algorithm for each value generated by the 1-D optimization algorithm. The first stage is a one-pass process. The parameters obtained from the first stage can be repeatedly used in the second stage to deblur images of the same class. In practice, results from Step 2.2 may be used in Step 2.3. III. MATERIALS A. Phantom of the Cochlea Since our main interest is to deblur sectional CT images of the temporal bone, especially the cochlea, we utilize an idealized cross section of the human cochlea as shown in Fig. 1(a) [5]. The upper image represents a horizontal histological section through one cochlea, while the lower one represents a vertical section through another cochlea. The phantom was made as follows. Decalcified and celloidin embedded, grossly normal, right temporal bones from two adults were serially sectioned, one horizontally and the other vertically. The sections were then stained with hematoxylin and eosin. A midmodiolar section from each cochlea was projected at 40 times onto a drawing paper. Then, a tracing of the three main structures was made, which are the cochlea scalae, soft tissue and bone. A transparent precision ruler (0.5 mm) was then projected onto the paper, and the tick marks were traced to show the magnification factor. The draw- 840 IEEE TRANSACTIONS ON MEDICAL IMAGING, VOL. 22, NO. 7, JULY 2003 (a) (b) (c) (d) (e) (f) Fig. 1. Original, blurred, and deblurred images of the phantom of the cochlea. (a) Original image. (b) Blurred image with (c) = 0:4 and n = 30, (d) = 0:4 and n = 80, (e) = 0:4 and n = 120, and (f) = 0:4 and n = 140. ings were then digitally scanned into Adobe Photoshop (Adobe Systems Inc., Mountain View, CA), scaled to 0.1-mm square pixels, and combined into one image of 100 100 pixels. Mean CT numbers for fluid (perilymph and endolymph in the cochlear scalae), soft tissue and bone were estimated from real spiral CT scans as 443, 214, and 2384 HU, respectively, and then assigned to corresponding classes in the combined image. B. Patient Data The patient was scanned using a Toshiba Xpress/SX spiral CT scanner (Toshiba Corp., Tokyo, Japan). The imaging protocol uses 1-mm collimation and 1-mm table feed per gantry rotation. Images were reconstructed via half-scan interpolation at 0.1-mm longitudinal interval. A 18-cm field of view (FOV) is first used, and then restricted to a 51-mm FOV via direct reconstruction. As a result, isotropic voxels of 0.1 cubic millimeters are obtained. IV. RESULTS In Section IV-A, we validate the ENR principle by computing the ENR as a function of and in numerical simulation with the phantom of the cochlea. The accuracy of the estimated deblurring is also studied. In Section IV-B, we describe real results on blind deblurring with patient data. Specific issues ], determination include specification of a range [ of the optimal iteration number , and the computational time. In Section IV-C, we study the robustness of the algorithm in is presence of image noise. In the following, the unit of is [0.08, 0.6]. mm, and the range of A. Validation to 1) ENR Distributions: The ENR distributions with respect and are computed via extensive numerical computation = 0:4. Deblurred image with and plotted for visualization and analysis. The process is as follows. 1. For each ranging from 0.1 to 0.5 mm with step length 0.05 mm, the phantom of the cochlea is blurred with the PSF , producing . is added by 2. Each blurred image . Poisson noise, degrading to is deblurred by the 3. Each image from EM algorithm with deblurring 0.08 to 0.6 mm with step length of from 0.005 mm and iteration number 10 to 200 with step length of 5. The . results are , values are computed 4. For each . as distributions are plotted. 5. The 0.2 and Fig. 2 contains representative ENR profiles for 0.45 mm, respectively. Based on these data, it is observed that for each of those fixed iteration numbers from 10 to 200, there in the interval exists a unique global maximum of increases with [0.08, 0.6], and the maximum of the iteration number . The same observations can be made for values under the above test conditions. other blurring 2) Estimation Accuracy: Given the ENR distributions computed above, we can readily find the maximum as follows: from 0.1 to 0.5 mm with 1. For each step length 0.05 mm, and for each from 10 to 200 with iteration number step length 5, find the maximum point with from 0.08 to 0.6 of with step length 0.005 mm; the maximi- JIANG et al.: BLIND DEBLURRING OF SPIRAL CT IMAGES 841 (a) Fig. 2. (b) ENR distributions keyed to the true blurring kernel . (a) ENR distribution with respect to (a) and n for = 0:2 and (b) and n for = 0:45 zer is taken as an approximation to the true maximum point of in the interval [0.08, 0.6], denoted . as 2. The estimation error is defined as (10) 3. The root-mean-squared error (RMSE) is computed by become evident. Hence, the iteration number , which is established above for the most accurate estimate of the true blurring kernel , may not necessarily produce the best image quality when it is used in the blind deblurring algorithm. Because our goal is to develop a “completely” blind deblurring technique for image quality as good as possible, the following strategy is designed to find the optimal iteration number . We use the RMSE to measure the image discrepancy of two images. The RMSE measure is defined as (12) RMSE RMSE (11) The results are presented in Fig. 3. In Fig. 3, it can be seen that is smaller for small iteration numbers the estimated increases with the iteration than the actual value , becomes number , and for large iteration numbers , values tested except , greater than . For all the there is an iteration number such that the estimation bias is close to zero. Furthermore, the RMSE of the errors reaches a global . Hence, there is no need for a larger iteraminimum at tion number to produce an accurate estimate of . B. Applications 1) Specification of the Permissible Interval for : Based on our earlier experience [5] and recent literature, the in-plane and through-plane Gaussian standard deviations are between 0.2–0.4 mm. Since those values are subject to change due to many factors including the location of a region of interest, a safe setting of the permissible deblurring interval should be . sufficiently large. Therefore, we set 2) Determination of the Optimal Iteration Number: There are two reasons for an optimal iteration number. First, as demonstrated in Section IV-A, the estimated deblurring increases with the iteration number. Second, as discussed in Section II-C, as the iteration number increases, the noise and edge effects for two images A and B. The following blurring residual is defined to measure the image quality change after deblurring a blurred image: RMSE RMSE (13) and are the where denotes the iteration number and as defined in phantom, its blurred version, and is, the better Section II-D, respectively. The smaller the deblurred image quality. Different values are estimated according to the ENR maximization principle with different iteration numbers. Then, we choose the iteration number that leads to the least blurring residual as the optimal iteration number. Fig. 4 shows the image blurring measures obtained from our deblurring experiments using the phantom of the cochlea, where 0.2, 0.3, and 0.45, 15–70 with step length of 5, real and the blurring residuals are computed of the images deblurred with values in Fig. 3. Then, the means of the blurring residuals for each are obtained Mean blurring residual (14) 842 IEEE TRANSACTIONS ON MEDICAL IMAGING, VOL. 22, NO. 7, JULY 2003 (a) (b) (c) (d) Fig. 3. Estimation error e( ; n) and RMSE as functions of the iteration number n = 15 to 70 with step length of 5. Estimation errors for = 0:2, (b) = 0:3, and (c) = 0:45. (d) RMSE as a function of the iteration number n. It can be observed in Fig. 4 that the iteration number yields the least blurring residual for the class of images in our application, and the mean blurring residual is reduced to about 76% by our blind deblurring algorithm. In other words, the reduction of image blurring is about 24%. , , and 3) Patient Studies: With the parameters determined in Section IV-B1 and Section IV-B2, the blind deblurring algorithm can be directly applied to patient data. It is found in our studies that the blind deblurring algorithm consistently produces excellent deblurring outcomes. As shown in Figs. 5 and 6, anatomical features are substantially clarified. 4) Computational Time: Our blind deblurring code is in MatLab on a Windows 2000 Dell workstation with 1-GHz Pentium III processor. The original data are converted from Analyze format to raw binary data via Analyze™ [20]. The total blind deblurring time is 1390 s for Fig. 6. It appears that our algorithm is impractical at the first glance, but the time is for a complete blind deblurring procedure without any user’s interaction. Usually, it only takes 2–5 min to produce satisfactory images, since the maximum of the ENR function is easy to attain given the parabolic shape of the ENR functional for a fixed (see Fig. 2). C. Robustness To evaluate the noise tolerance of our blind deblurring algorithm, we use the same phantom image , set the blurring , generate the blurred image , and add the Gaussian noise with different standard deviations to . Then, we estimate the optimal deblurring from the noisy image by . Table I lists the the ENR maximization principle with noise level , estimated deblurring , estimation error , RMSE measures of blurred image and deblurred image with respect to the phantom image , as well as blurring residuals after blind deblurring. The noise level range from 0 to 80 HU is selected based on clinical CT data. It is found in Table I that for low noise levels the estimated values are very close to the truth. Also, the estimated is fairly stable with respect to the noise level change. JIANG et al.: BLIND DEBLURRING OF SPIRAL CT IMAGES 843 (a) (b) (c) (d) Fig. 4. Image quality improvements as the percentage change of blurring in terms of RMSE. Blurring residuals for (a) = 0:2, (b) = 0:3, and (c) = 0:45. (d) Means of the blurring residuals. V. DISCUSSIONS AND CONCLUSION In terms of the sieve and resolution widths, the value essuggests use of timated by the ENR principle with the resolution width larger than the sieve width, i.e., the deblurring width should be smaller than the blurring width. Based on the studies on the effects of sieve and resolution widths [14], a deblurring closer but smaller than the real is preferred for better image quality. Fortunately, Fig. 3 shows that the estimated are generally smaller than deblurring values with the real blurring . As a result, the EM algorithm converges more rapidly, as pointed out by Snyder et al. “In general, we see more rapid convergence of the EM algorithm when the width of the resolution kernel exceeds the width of the sieve kernel” [14, p. 236]. This is an additional merit of our blind deblurring algorithm. is not symmetric in its Since the discrepancy measure arguments, we can have alternative definitions of noise and edge effects by swapping its arguments. Moreover, the discrepancy can also be measured by the Euclidean distance. Although the current ENR-based algorithm already performs well, the performance of other ratio measures is of interest for further study [21]. The blind deblurring algorithm can be accelerated using parallel computing techniques. One can search for the optimal deblurring in several subintervals, and switch the searching processes to other subintervals with appropriate signaling. The present implementation is for proof-of-concept, and not optimized for speed. Even with simple parallel programming, the blind deblurring time should be greatly reduced. Furthermore, ordered-subset techniques may be applied in image and/or data domains for major speed gains [22]. We emphasize that the ENR idea may be applicable to deblurring algorithms other than the EM algorithm. An essential point we make in this paper is that a priori information about the actual image and the quantification of the edge and noise effects 844 IEEE TRANSACTIONS ON MEDICAL IMAGING, VOL. 22, NO. 7, JULY 2003 (a) Fig. 5. Blind deblurring of an image through the left temporal bone. (a) Original 200 and = 0:33. (b) 2 300 CT image through the left cochlea. (b) Blind deblurred with n = 30 (a) (b) Fig. 6. Blind deblurring of an image in the region of the basal turn of the cochlea. (a) Original 300 (b) Blind deblurred with n = 30 and = 3:54. 2 260 CT image through the basal turn of the cochlea. TABLE I ESTIMATED DEBLURRING AT DIFFERENT NOISE LEVELS JIANG et al.: BLIND DEBLURRING OF SPIRAL CT IMAGES can be utilized to significantly improve the ill-posedness of the blind deblurring problem. In conclusion, we have developed a blind deblurring algorithm to improve spiral CT image resolution for cochlear implantation. 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