3D Non-Rigid Alignment of Low-Dose Scans Allows to Correct for Saturation in Lower Extremity Cone-Beam CT

Jennifer Maier, Andreas Maier, Bjoern Eskofier, Rebecca Fahrig, Jang Hwan Choi

Research output: Contribution to journalArticlepeer-review


Detector saturation in cone-beam computed tomography occurs when an object of highly varying shape and material composition is imaged using an automatic exposure control (AEC) system. When imaging a subject's knees, high beam energy ensures the visibility of internal structures but leads to overexposure in less dense border regions. In this work, we propose to use an additional low-dose scan to correct the saturation artifacts of AEC scans. Overexposed pixels are identified in the projection images of the AEC scan using histogram-based thresholding. The saturation-free pixels from the AEC scan are combined with the skin border pixels of the low-dose scan prior to volumetric reconstruction. To compensate for patient motion between the two scans, a 3D non-rigid alignment of the projection images in a backward-forward-projection process based on fiducial marker positions is proposed. On numerical simulations, the projection combination improved the structural similarity index measure from 0.883 to 0.999. Further evaluations were performed on two in vivo subject knee acquisitions, one without and one with motion between the AEC and low-dose scans. Saturation-free reference images were acquired using a beam attenuator. The proposed method could qualitatively restore the information of peripheral tissue structures. Applying the 3D non-rigid alignment made it possible to use the projection images with inter-scan subject motion for projection image combination. The increase in radiation exposure due to the additional low-dose scan was found to be negligibly low. The presented methods allow simple but effective correction of saturation artifacts.

Original languageEnglish
Article number9427569
Pages (from-to)71821-71831
Number of pages11
JournalIEEE Access
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© 2013 IEEE.


  • Automatic exposure control
  • C-arm cone-beam CT
  • X-ray imaging and computed tomography
  • detector saturation
  • lower extremity
  • non-rigid reconstruction
  • overexposure artifacts


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