Coupled Diffusion Models for Metal Artifact Reduction of Clinical Dental CBCT Images

Metal dental implants may introduce metal artifacts (MA) during the CBCT imaging process, causing significant interference in subsequent diagnosis. In recent years, many deep learning methods for metal artifact reduction (MAR) have been proposed. Due to the huge difference between synthetic and clinical MA, supervised learning MAR methods may perform poorly in clinical settings. Many existing unsupervised MAR methods trained on clinical data often suffer from incorrect dental morphology. To alleviate the above problems, in this paper, we propose a new MAR method of Coupled Diffusion Models (CDM) for clinical dental CBCT images. Specifically, we separately train two diffusion models on clinical MA-degraded images and clinical clean images to obtain prior information, respectively. During the denoising process, the variances of noise levels are calculated from MA images and the prior of diffusion models. Then we develop a noise transformation module between the two diffusion models to transform the MA noise image into a new initial value for the denoising process. Our designs effectively exploit the inherent transformation between the misaligned MA-degraded images and clean images. Additionally, we introduce an MA-adaptive inference technique to better accommodate the MA degradation in different areas of an MA-degraded image. Experiments on our clinical dataset demonstrate that our CDM outperforms the comparison methods on both objective metrics and visual quality, especially for severe MA degradation. We will publicly release our code.