Unsupervised Metal Artifact Reduction in Dental CBCT using Fine-tuned Cycle-Consistent Adversarial Networks
Authors: G. L. T. Chamika, S. N. A. Dhanapala, P. H. S. V. Nimalaweera, Maheshi B. Dissanayake, Ruwan D. Jayasinghe
Organizations: Department of Electrical and Electronic Engineering, University of Peradeniya, Peradeniya, Sri Lanka · Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
Abstract
Metal artifacts generated by dental implants significantly degrade cone-beam computed tomography (CBCT) volumes, obscuring critical anatomical structures and compromising diagnostic precision. To address this, an unsupervised deep learning framework has been proposed for Metal Artifact Reduction (MAR) utilizing a Cycle-Consistent Adversarial Network (CycleGAN) optimized for high-fidelity restoration. Unlike supervised methods that rely on unattainable voxel-aligned paired datasets, the proposed approach leverages an unpaired dataset of approximately 4,000 images, curated from the public ToothFairy dataset. The architecture integrates U-Net-based generators and PatchGAN discriminators, specifically tuned to mitigate generative hallucinations and preserve morphological integrity. Quantitative benchmarking on a held-out test set demonstrates a 34.6% improvement in the Blind/Referenceless Image Spatial Quality Evaluator (BRISQUE) score, a substantial reduction in Fréchet Inception Distance (FID) from 207.03 to 157.04, and a superior Structural Similarity Index Measure (SSIM) of 0.9105. The framework achieves real-time efficiency with a 3.03 ms inference time per slice, effectively suppressing artifacts while preserving anatomical detail. Expert validation confirms high fidelity; however, to ensure reliability in extreme cases, the architecture is recommended as a clinical decision-support tool under human-in-the-loop oversight. By enhancing diagnostic clarity via a scalable software pipeline, this study provides a robust solution for high-fidelity dental implant imaging.
Cone Beam Computed Tomography (CBCT) is pivotal for 3D diagnostic imaging in dentistry. However, the development of robust AI models for volumetric analysis is often constrained by the scarcity of large, annotated datasets. Self-supervised learning (SSL), particularly Masked Image Modeling (MIM), offers a promising pathway to leverage unlabeled data. A limitation of standard MIM is its reliance on random masking, which fails to prioritize diagnostically critical regions in dental CBCT volumes, such as subtle pathological changes and intricate anatomical boundaries. To address this, we propose ATMask, a novel adaptive masking strategy. Instead of applying random masks or employing computationally intensive attention modules, ATMask computes an inter-slice texture variation map to identify regions with high structural or textural complexity. These high-variation areas are then selectively masked during pre-training, compelling the model to learn richer contextual representations essential for inferring complex 3D morphological transitions. Furthermore, we contribute the first large-scale CBCT dataset, curated from both public and private sources, comprising 6,314 scans, for the dental AI model pretraining. Extensive experiments on three downstream dental CBCT tasks demonstrate that our ATMask enables more data-efficient and powerful representation learning than standard random masking and other advanced SSL baselines. The dataset and code will be released.
X-ray computed tomography (CT) suffers from severe metal artifacts when high-attenuation objects such as dental fillings or orthopedic implants are present. These artifacts originate from the polychromatic nature of X-rays, where attenuation varies strongly with photon energy and material composition, breaking the monochromatic assumption used by conventional reconstruction algorithms. Recent neural rendering approaches attempt to address this mismatch through differentiable polychromatic projection models, but they still struggle with smoothness bias, loss of fine structures, and prohibitive computation when extended to large-scale cone-beam CT. We introduce a splat-based metal artifact reduction framework that incorporates a physically grounded polychromatic forward model into a continuous Gaussian representation for cone-beam CT. Each Gaussian encodes the energy-dependent attenuation of the underlying material using a compact material parameterization, which enables efficient joint optimization of geometric and material properties without relying on a metal mask. This compact attenuation formulation captures the essential variation across biological tissues and metallic implants, allowing our model to explain metal-induced nonlinearity while preserving high-frequency structure. Experiments on simulated and real cone-beam CT scans show that our method converges significantly faster and suppresses metal artifacts more effectively than existing reconstruction and neural field-based approaches.
Cone-beam computed tomography (CBCT) enables volumetric reconstruction from X-ray projections, but suffers from severe artifacts--especially beam hardening--when imaging materials with high attenuation such as metals. These artifacts arise from the polychromatic nature of X-rays and are not properly addressed by conventional monochromatic reconstruction algorithms. While recent neural representation-based methods offer improved reconstruction quality, they are computationally expensive and often impractical for deployment. We propose a novel physics-inspired, self-calibrating metal artifact reduction method that efficiently reconstructs 3D CBCT volumes while correcting beam hardening artifacts. Our method integrates a polychromatic X-ray projection model, material-dependent attenuation profiles, and system response modeling into a Gaussian Splatting framework. Unlike prior work, we eliminate the need for manual metal masks or strong prior assumptions, and we optimize both reconstruction parameters and X-ray spectral characteristics jointly during training. We further introduce a high-fidelity synthetic CBCT dataset generation pipeline validated on Monte-Carlo x-ray simulation toolbox and release new datasets with severe metal-induced artifacts to support the community. This is the first splat-based method for reducing beam hardening in CBCT. Extensive experiments on both synthetic and real-world datasets demonstrate that our method outperforms state-of-the-art approaches in artifact suppression and reconstruction accuracy.