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Accurate and automatic segmentation of three-dimensional (3D) individual teeth from cone-beam computerized tomography (CBCT) images is a challenging problem because of the difficulty in separating an individual tooth from adjacent teeth and its surrounding alveolar bone. Thus, this paper proposes a fully automated method of identifying and segmenting 3D individual teeth from dental CBCT images. The proposed method addresses the aforementioned difficulty by developing a deep learning-based hierarchical multi-step model. First, it automatically generates upper and lower jaws panoramic images to overcome the computational complexity caused by high-dimensional data and the curse of dimensionality associated with limited training dataset. The obtained 2D panoramic images are then used to identify 2D individual teeth and capture loose- and tight- regions of interest (ROIs) of 3D individual teeth. Finally, accurate 3D individual tooth segmentation is achieved using both loose and tight ROIs. Experimental results showed that the proposed method achieved an F1-score of 93.35 percent for tooth identification and a Dice similarity coefficient of 94.79 percent for individual 3D tooth segmentation. The results demonstrate that the proposed method provides an effective clinical and practical framework for digital dentistry. [ABSTRACT FROM AUTHOR]

Limited angle reconstruction is a typical ill-posed problem in computed tomography (CT). Given incomplete projection data, images reconstructed by conventional analytical algorithms and iterative methods suffer from severe structural distortions and artifacts. In this paper, we proposed a self-augmented multi-stage deep-learning network (Sam’s Net) for end-to-end reconstruction of limited angle CT. With the merit of the alternating minimization technique, Sam’s Net integrates multi-stage self-constraints into cross-domain optimization to provide additional constraints on the manifold of neural networks. In practice, a sinogram completion network (SCNet) and artifact suppression network (ASNet), together with domain transformation layers constitute the backbone for cross-domain optimization. An online self-augmentation module was designed following the manner defined by alternating minimization, which enables a self-augmented learning procedure and multi-stage inference manner. Besides, a substitution operation was applied as a hard constraint for the solution space based on the data fidelity and a learnable weighting layer was constructed for data consistency refinement. Sam’s Net forms a new framework for ill-posed reconstruction problems. In the training phase, the self-augmented procedure guides the optimization into a tightened solution space with enriched diverse data distribution and enhanced data consistency. In the inference phase, multi-stage prediction can improve performance progressively. Extensive experiments with both simulated and practical projections under 90-degree and 120-degree fan-beam configurations validate that Sam’s Net can significantly improve the reconstruction quality with high stability and robustness. [ABSTRACT FROM AUTHOR]

Automatic liver tumor segmentation could offer assistance to radiologists in liver tumor diagnosis, and its performance has been significantly improved by recent deep learning based methods. These methods rely on large-scale well-annotated training datasets, but collecting such datasets is time-consuming and labor-intensive, which could hinder their performance in practical situations. Learning from synthetic data is an encouraging solution to address this problem. In our task, synthetic tumors can be injected to healthy images to form training pairs. However, directly applying the model trained using the synthetic tumor images on real test images performs poorly due to the domain shift problem. In this paper, we propose a novel approach, namely Synthetic-to-Real Test-Time Training (SR-TTT), to reduce the domain gap between synthetic training images and real test images. Specifically, we add a self-supervised auxiliary task, i.e., two-step reconstruction, which takes the output of the main segmentation task as its input to build an explicit connection between these two tasks. Moreover, we design a scheduled mixture strategy to avoid error accumulation and bias explosion in the training process. During test time, we adapt the segmentation model to each test image with self-supervision from the auxiliary task so as to improve the inference performance. The proposed method is extensively evaluated on two public datasets for liver tumor segmentation. The experimental results demonstrate that our proposed SR-TTT can effectively mitigate the synthetic-to-real domain shift problem in the liver tumor segmentation task, and is superior to existing state-of-the-art approaches. [ABSTRACT FROM AUTHOR]

X-ray computed tomography (CT) is of great clinical significance in medical practice because it can provide anatomical information about the human body without invasion, while its radiation risk has continued to attract public concerns. Reducing the radiation dose may induce noise and artifacts to the reconstructed images, which will interfere with the judgments of radiologists. Previous studies have confirmed that deep learning (DL) is promising for improving low-dose CT imaging. However, almost all the DL-based methods suffer from subtle structure degeneration and blurring effect after aggressive denoising, which has become the general challenging issue. This paper develops the Comprehensive Learning Enabled Adversarial Reconstruction (CLEAR) method to tackle the above problems. CLEAR achieves subtle structure enhanced low-dose CT imaging through a progressive improvement strategy. First, the generator established on the comprehensive domain can extract more features than the one built on degraded CT images and directly map raw projections to high-quality CT images, which is significantly different from the routine GAN practice. Second, a multi-level loss is assigned to the generator to push all the network components to be updated towards high-quality reconstruction, preserving the consistency between generated images and gold-standard images. Finally, following the WGAN-GP modality, CLEAR can migrate the real statistical properties to the generated images to alleviate over-smoothing. Qualitative and quantitative analyses have demonstrated the competitive performance of CLEAR in terms of noise suppression, structural fidelity and visual perception improvement. [ABSTRACT FROM AUTHOR]

The current mainstream computed tomography (CT) reconstruction methods based on deep learning usually need to fix the scanning geometry and dose level, which significantly aggravates the training costs and requires more training data for real clinical applications. In this paper, we propose a parameter-dependent framework (PDF) that trains a reconstruction network with data originating from multiple alternative geometries and dose levels simultaneously. In the proposed PDF, the geometry and dose level are parameterized and fed into two multilayer perceptrons (MLPs). The outputs of the MLPs are used to modulate the feature maps of the CT reconstruction network, which condition the network outputs on different geometries and dose levels. The experiments show that our proposed method can obtain competitive performance compared to the original network trained with either specific or mixed geometry and dose level, which can efficiently save extra training costs for multiple geometries and dose levels. [ABSTRACT FROM AUTHOR]

X-ray computed tomography (CT) uses different filter kernels to highlight different structures. Since the raw sinogram data is usually removed after the reconstruction, in case there is additional need for other types of kernel images that were not previously generated, the patient may need to be scanned again. Accordingly, there exists increasing demand for post-hoc image domain conversion from one kernel to another without sacrificing the image quality. In this paper, we propose a novel unsupervised continuous kernel conversion method using cycle-consistent generative adversarial network (cycleGAN) with adaptive instance normalization (AdaIN). Even without paired training data, not only can our network translate the images between two different kernels, but it can also convert images along the interpolation path between the two kernel domains. We also show that the quality of generated images can be further improved if intermediate kernel domain images are available. Experimental results confirm that our method not only enables accurate kernel conversion that is comparable to supervised learning methods, but also generates intermediate kernel images in the unseen domain that are useful for hypopharyngeal cancer diagnosis. [ABSTRACT FROM AUTHOR]

Reducing the exposure to X-ray radiation while maintaining a clinically acceptable image quality is desirable in various CT applications. To realize low-dose CT (LdCT) imaging, model-based iterative reconstruction (MBIR) algorithms are widely adopted, but they require proper prior knowledge assumptions in the sinogram and/or image domains and involve tedious manual optimization of multiple parameters. In this paper, we propose a deep learning (DL)-based strategy for MBIR to simultaneously address prior knowledge design and MBIR parameter selection in one optimization framework. Specifically, a parameterized plug-and-play alternating direction method of multipliers (3pADMM) is proposed for the general penalized weighted least-squares model, and then, by adopting the basic idea of DL, the parameterized plug-and-play (3p) prior and the related parameters are optimized simultaneously in a single framework using a large number of training data. The main contribution of this paper is that the 3p prior and the related parameters in the proposed 3pADMM framework can be supervised and optimized simultaneously to achieve robust LdCT reconstruction performance. Experimental results obtained on clinical patient datasets demonstrate that the proposed method can achieve promising gains over existing algorithms for LdCT image reconstruction in terms of noise-induced artifact suppression and edge detail preservation. [ABSTRACT FROM AUTHOR]

X-ray Computed Tomography (CT) is widely used in clinical applications such as diagnosis and image-guided interventions. In this paper, we propose a new deep learning based model for CT image reconstruction with the backbone network architecture built by unrolling an iterative algorithm. However, unlike the existing strategy to include as many data-adaptive components in the unrolled dynamics model as possible, we find that it is enough to only learn the parts where traditional designs mostly rely on intuitions and experience. More specifically, we propose to learn an initializer for the conjugate gradient (CG) algorithm that involved in one of the subproblems of the backbone model. Other components, such as image priors and hyperparameters, are kept as the original design. Since a hypernetwork is introduced to inference on the initialization of the CG module, it makes the proposed model a certain meta-learning model. Therefore, we shall call the proposed model the meta-inversion network (MetaInv-Net). The proposed MetaInv-Net can be designed with much less trainable parameters while still preserves its superior image reconstruction performance than some state-of-the-art deep models in CT imaging. In simulated and real data experiments, MetaInv-Net performs very well and can be generalized beyond the training setting, i.e., to other scanning settings, noise levels, and data sets. [ABSTRACT FROM AUTHOR]

Metal artifacts commonly appear in computed tomography (CT) images of the patient body with metal implants and can affect disease diagnosis. Known deep learning and traditional metal trace restoring methods did not effectively restore details and sinogram consistency information in X-ray CT sinograms, hence often causing considerable secondary artifacts in CT images. In this paper, we propose a new cross-domain metal trace restoring network which promotes sinogram consistency while reducing metal artifacts and recovering tissue details in CT images. Our new approach includes a cross-domain procedure that ensures information exchange between the image domain and the sinogram domain in order to help them promote and complement each other. Under this cross-domain structure, we develop a hierarchical analytic network (HAN) to recover fine details of metal trace, and utilize the perceptual loss to guide HAN to concentrate on the absorption of sinogram consistency information of metal trace. To allow our entire cross-domain network to be trained end-to-end efficiently and reduce the graphic memory usage and time cost, we propose effective and differentiable forward projection (FP) and filtered back-projection (FBP) layers based on FP and FBP algorithms. We use both simulated and clinical datasets in three different clinical scenarios to evaluate our proposed network’s practicality and universality. Both quantitative and qualitative evaluation results show that our new network outperforms state-of-the-art metal artifact reduction methods. In addition, the elapsed time analysis shows that our proposed method meets the clinical time requirement. [ABSTRACT FROM AUTHOR]

Conebeam CT using a circular trajectory is quite often used for various applications due to its relative simple geometry. For conebeam geometry, Feldkamp, Davis and Kress algorithm is regarded as the standard reconstruction method, but this algorithm suffers from so-called conebeam artifacts as the cone angle increases. Various model-based iterative reconstruction methods have been developed to reduce the cone-beam artifacts, but these algorithms usually require multiple applications of computational expensive forward and backprojections. In this paper, we develop a novel deep learning approach for accurate conebeam artifact removal. In particular, our deep network, designed on the differentiated backprojection domain, performs a data-driven inversion of an ill-posed deconvolution problem associated with the Hilbert transform. The reconstruction results along the coronal and sagittal directions are then combined using a spectral blending technique to minimize the spectral leakage. Experimental results under various conditions confirmed that our method generalizes well and outperforms the existing iterative methods despite significantly reduced runtime complexity. [ABSTRACT FROM AUTHOR]

Differential phase-contrast computed tomography (DPC-CT) is a powerful analysis tool for soft-tissue and low-atomic-number samples. Limited by the implementation conditions, DPC-CT with incomplete projections happens quite often. Conventional reconstruction algorithms face difficulty when given incomplete data. They usually involve complicated parameter selection operations, which are also sensitive to noise and are time-consuming. In this paper, we report a new deep learning reconstruction framework for incomplete data DPC-CT. It involves the tight coupling of the deep learning neural network and DPC-CT reconstruction algorithm in the domain of DPC projection sinograms. The estimated result is not an artifact caused by the incomplete data, but a complete phase-contrast projection sinogram. After training, this framework is determined and can be used to reconstruct the final DPC-CT images for a given incomplete projection sinogram. Taking the sparse-view, limited-view and missing-view DPC-CT as examples, this framework is validated and demonstrated with synthetic and experimental data sets. Compared with other methods, our framework can achieve the best imaging quality at a faster speed and with fewer parameters. This work supports the application of the state-of-the-art deep learning theory in the field of DPC-CT. [ABSTRACT FROM AUTHOR]

The Radon transform is widely used in physical and life sciences, and one of its major applications is in medical X-ray computed tomography (CT), which is significantly important in disease screening and diagnosis. In this paper, we propose a novel reconstruction framework for Radon inversion with deep learning (DL) techniques. For simplicity, the proposed framework is denoted as iRadonMAP, i.e., inverse Radon transform approximation. Specifically, we construct an interpretable neural network that contains three dedicated components. The first component is a fully connected filtering (FCF) layer along the rotation angle direction in the sinogram domain, and the second one is a sinusoidal back-projection (SBP) layer, which back-projects the filtered sinogram data into the spatial domain. Next, a common network structure is added to further improve the overall performance. iRadonMAP is first pretrained on a large number of generic images from the ImageNet database and then fine-tuned with clinical patient data. The experimental results demonstrate the feasibility of the proposed iRadonMAP framework for Radon inversion. [ABSTRACT FROM AUTHOR]

In this paper, we present a semi-supervised deep learning approach to accurately recover high-resolution (HR) CT images from low-resolution (LR) counterparts. Specifically, with the generative adversarial network (GAN) as the building block, we enforce the cycle-consistency in terms of the Wasserstein distance to establish a nonlinear end-to-end mapping from noisy LR input images to denoised and deblurred HR outputs. We also include the joint constraints in the loss function to facilitate structural preservation. In this process, we incorporate deep convolutional neural network (CNN), residual learning, and network in network techniques for feature extraction and restoration. In contrast to the current trend of increasing network depth and complexity to boost the imaging performance, we apply a parallel ${1}\times {1}$ CNN to compress the output of the hidden layer and optimize the number of layers and the number of filters for each convolutional layer. The quantitative and qualitative evaluative results demonstrate that our proposed model is accurate, efficient and robust for super-resolution (SR) image restoration from noisy LR input images. In particular, we validate our composite SR networks on three large-scale CT datasets, and obtain promising results as compared to the other state-of-the-art methods. [ABSTRACT FROM AUTHOR]

The wide applications of X-ray computed tomography (CT) bring low-dose CT (LDCT) into a clinical prerequisite, but reducing the radiation exposure in CT often leads to significantly increased noise and artifacts, which might lower the judgment accuracy of radiologists. In this paper, we put forward a domain progressive 3D residual convolution network (DP-ResNet) for the LDCT imaging procedure that contains three stages: sinogram domain network (SD-net), filtered back projection (FBP), and image domain network (ID-net). Though both are based on the residual network structure, the SD-net and ID-net provide complementary effect on improving the final LDCT quality. The experimental results with both simulated and real projection data show that this domain progressive deep-learning network achieves significantly improved performance by combing the network processing in the two domains. [ABSTRACT FROM AUTHOR]

Edges tend to be over-smoothed in total variation (TV) regularized under-sampled images. In this paper, symmetric residual convolutional neural network (SR-CNN), a deep learning based model, was proposed to enhance the sharpness of edges and detailed anatomical structures in under-sampled cone-beam computed tomography (CBCT). For training, CBCT images were reconstructed using TV-based method from limited projections simulated from the ground truth CT, and were fed into SR-CNN, which was trained to learn a restoring pattern from under-sampled images to the ground truth. For testing, under-sampled CBCT was reconstructed using TV regularization and was then augmented by SR-CNN. Performance of SR-CNN was evaluated using phantom and patient images of various disease sites acquired at different institutions both qualitatively and quantitatively using structure similarity (SSIM) and peak signal-to-noise ratio (PSNR). SR-CNN substantially enhanced image details in the TV-based CBCT across all experiments. In the patient study using real projections, SR-CNN augmented CBCT images reconstructed from as low as 120 half-fan projections to image quality comparable to the reference fully-sampled FDK reconstruction using 900 projections. In the tumor localization study, improvements in the tumor localization accuracy were made by the SR-CNN augmented images compared with the conventional FDK and TV-based images. SR-CNN demonstrated robustness against noise levels and projection number reductions and generalization for various disease sites and datasets from different institutions. Overall, the SR-CNN-based image augmentation technique was efficient and effective in considerably enhancing edges and anatomical structures in under-sampled 3D/4D-CBCT, which can be very valuable for image-guided radiotherapy. [ABSTRACT FROM AUTHOR]

Computed tomography (CT) is widely used in medical diagnosis and non-destructive detection. Image reconstruction in CT aims to accurately recover pixel values from measured line integrals, i.e., the summed pixel values along straight lines. Provided that the acquired data satisfy the data sufficiency condition as well as other conditions regarding the view angle sampling interval and the severity of transverse data truncation, researchers have discovered many solutions to accurately reconstruct the image. However, if these conditions are violated, accurate image reconstruction from line integrals remains an intellectual challenge. In this paper, a deep learning method with a common network architecture, termed iCT-Net, was developed and trained to accurately reconstruct images for previously solved and unsolved CT reconstruction problems with high quantitative accuracy. Particularly, accurate reconstructions were achieved for the case when the sparse view reconstruction problem (i.e., compressed sensing problem) is entangled with the classical interior tomographic problems. [ABSTRACT FROM AUTHOR]

Machine learning algorithms can have difficulties adapting to data from different sources, for example from different imaging modalities. We present and analyze three techniques for unsupervised cross-modality feature learning, using a shared autoencoder-like convolutional network that learns a common representation from multi-modal data. We investigate a form of feature normalization, a learning objective that minimizes cross-modality differences, and modality dropout, in which the network is trained with varying subsets of modalities. We measure the same-modality and cross-modality classification accuracies and explore whether the models learn modality-specific or shared features. This paper presents experiments on two public data sets, with knee images from two MRI modalities, provided by the Osteoarthritis Initiative, and brain tumor segmentation on four MRI modalities from the BRATS challenge. All three approaches improved the cross-modality classification accuracy, with modality dropout and per-feature normalization giving the largest improvement. We observed that the networks tend to learn a combination of cross-modality and modality-specific features. Overall, a combination of all three methods produced the most cross-modality features and the highest cross-modality classification accuracy, while maintaining most of the same-modality accuracy. [ABSTRACT FROM AUTHOR]

In this paper, we present a new deep learning framework for 3-D tomographic reconstruction. To this end, we map filtered back-projection-type algorithms to neural networks. However, the back-projection cannot be implemented as a fully connected layer due to its memory requirements. To overcome this problem, we propose a new type of cone-beam back-projection layer, efficiently calculating the forward pass. We derive this layer’s backward pass as a projection operation. Unlike most deep learning approaches for reconstruction, our new layer permits joint optimization of correction steps in volume and projection domain. Evaluation is performed numerically on a public data set in a limited angle setting showing a consistent improvement over analytical algorithms while keeping the same computational test-time complexity by design. In the region of interest, the peak signal-to-noise ratio has increased by 23%. In addition, we show that the learned algorithm can be interpreted using known concepts from cone beam reconstruction: the network is able to automatically learn strategies such as compensation weights and apodization windows. [ABSTRACT FROM AUTHOR]

Sparse-view computed tomography (CT) holds great promise for speeding up data acquisition and reducing radiation dose in CT scans. Recent advances in reconstruction algorithms for sparse-view CT, such as iterative reconstruction algorithms, obtained high-quality image while requiring advanced computing power. Lately, deep learning (DL) has been widely used in various applications and has obtained many remarkable outcomes. In this paper, we propose a new method for sparse-view CT reconstruction based on the DL approach. The method can be divided into two steps. First, filter backprojection (FBP) was used to reconstruct the CT image from sparsely sampled sinogram. Then, the FBP results were fed to a DL neural network, which is a DenseNet and deconvolution-based network (DD-Net). The DD-Net combines the advantages of DenseNet and deconvolution and applies shortcut connections to concatenate DenseNet and deconvolution to accelerate the training speed of the network; all of those operations can greatly increase the depth of network while enhancing the expression ability of the network. After the training, the proposed DD-Net achieved a competitive performance relative to the state-of-the-art methods in terms of streaking artifacts removal and structure preservation. Compared with the other state-of-the-art reconstruction methods, the DD-Net method can increase the structure similarity by up to 18% and reduce the root mean square error by up to 42%. These results indicate that DD-Net has great potential for sparse-view CT image reconstruction. [ABSTRACT FROM AUTHOR]

The continuous development and extensive use of computed tomography (CT) in medical practice has raised a public concern over the associated radiation dose to the patient. Reducing the radiation dose may lead to increased noise and artifacts, which can adversely affect the radiologists’ judgment and confidence. Hence, advanced image reconstruction from low-dose CT data is needed to improve the diagnostic performance, which is a challenging problem due to its ill-posed nature. Over the past years, various low-dose CT methods have produced impressive results. However, most of the algorithms developed for this application, including the recently popularized deep learning techniques, aim for minimizing the mean-squared error (MSE) between a denoised CT image and the ground truth under generic penalties. Although the peak signal-to-noise ratio is improved, MSE- or weighted-MSE-based methods can compromise the visibility of important structural details after aggressive denoising. This paper introduces a new CT image denoising method based on the generative adversarial network (GAN) with Wasserstein distance and perceptual similarity. The Wasserstein distance is a key concept of the optimal transport theory and promises to improve the performance of GAN. The perceptual loss suppresses noise by comparing the perceptual features of a denoised output against those of the ground truth in an established feature space, while the GAN focuses more on migrating the data noise distribution from strong to weak statistically. Therefore, our proposed method transfers our knowledge of visual perception to the image denoising task and is capable of not only reducing the image noise level but also trying to keep the critical information at the same time. Promising results have been obtained in our experiments with clinical CT images. [ABSTRACT FROM AUTHOR]

X-ray computed tomography (CT) using sparse projection views is a recent approach to reduce the radiation dose. However, due to the insufficient projection views, an analytic reconstruction approach using the filtered back projection (FBP) produces severe streaking artifacts. Recently, deep learning approaches using large receptive field neural networks such as U-Net have demonstrated impressive performance for sparse-view CT reconstruction. However, theoretical justification is still lacking. Inspired by the recent theory of deep convolutional framelets, the main goal of this paper is, therefore, to reveal the limitation of U-Net and propose new multi-resolution deep learning schemes. In particular, we show that the alternative U-Net variants such as dual frame and tight frame U-Nets satisfy the so-called frame condition which makes them better for effective recovery of high frequency edges in sparse-view CT. Using extensive experiments with real patient data set, we demonstrate that the new network architectures provide better reconstruction performance. [ABSTRACT FROM AUTHOR]

In the presence of metal implants, metal artifacts are introduced to x-ray computed tomography CT images. Although a large number of metal artifact reduction (MAR) methods have been proposed in the past decades, MAR is still one of the major problems in clinical x-ray CT. In this paper, we develop a convolutional neural network (CNN)-based open MAR framework, which fuses the information from the original and corrected images to suppress artifacts. The proposed approach consists of two phases. In the CNN training phase, we build a database consisting of metal-free, metal-inserted and pre-corrected CT images, and image patches are extracted and used for CNN training. In the MAR phase, the uncorrected and pre-corrected images are used as the input of the trained CNN to generate a CNN image with reduced artifacts. To further reduce the remaining artifacts, water equivalent tissues in a CNN image are set to a uniform value to yield a CNN prior, whose forward projections are used to replace the metal-affected projections, followed by the FBP reconstruction. The effectiveness of the proposed method is validated on both simulated and real data. Experimental results demonstrate the superior MAR capability of the proposed method to its competitors in terms of artifact suppression and preservation of anatomical structures in the vicinity of metal implants. [ABSTRACT FROM AUTHOR]

Compressive sensing (CS) has proved effective for tomographic reconstruction from sparsely collected data or under-sampled measurements, which are practically important for few-view computed tomography (CT), tomosynthesis, interior tomography, and so on. To perform sparse-data CT, the iterative reconstruction commonly uses regularizers in the CS framework. Currently, how to choose the parameters adaptively for regularization is a major open problem. In this paper, inspired by the idea of machine learning especially deep learning, we unfold the state-of-the-art “fields of experts”-based iterative reconstruction scheme up to a number of iterations for data-driven training, construct a learned experts’ assessment-based reconstruction network (LEARN) for sparse-data CT, and demonstrate the feasibility and merits of our LEARN network. The experimental results with our proposed LEARN network produces a superior performance with the well-known Mayo Clinic low-dose challenge data set relative to the several state-of-the-art methods, in terms of artifact reduction, feature preservation, and computational speed. This is consistent to our insight that because all the regularization terms and parameters used in the iterative reconstruction are now learned from the training data, our LEARN network utilizes application-oriented knowledge more effectively and recovers underlying images more favorably than competing algorithms. Also, the number of layers in the LEARN network is only 50, reducing the computational complexity of typical iterative algorithms by orders of magnitude. [ABSTRACT FROM AUTHOR]

Heavy smokers undergoing screening with low-dose chest CT are affected by cardiovascular disease as much as by lung cancer. Low-dose chest CT scans acquired in screening enable quantification of atherosclerotic calcifications and thus enable identification of subjects at increased cardiovascular risk. This paper presents a method for automatic detection of coronary artery, thoracic aorta, and cardiac valve calcifications in low-dose chest CT using two consecutive convolutional neural networks. The first network identifies and labels potential calcifications according to their anatomical location and the second network identifies true calcifications among the detected candidates. This method was trained and evaluated on a set of 1744 CT scans from the National Lung Screening Trial. To determine whether any reconstruction or only images reconstructed with soft tissue filters can be used for calcification detection, we evaluated the method on soft and medium/sharp filter reconstructions separately. On soft filter reconstructions, the method achieved F1 scores of 0.89, 0.89, 0.67, and 0.55 for coronary artery, thoracic aorta, aortic valve, and mitral valve calcifications, respectively. On sharp filter reconstructions, the F1 scores were 0.84, 0.81, 0.64, and 0.66, respectively. Linearly weighted kappa coefficients for risk category assignment based on per subject coronary artery calcium were 0.91 and 0.90 for soft and sharp filter reconstructions, respectively. These results demonstrate that the presented method enables reliable automatic cardiovascular risk assessment in all low-dose chest CT scans acquired for lung cancer screening. [ABSTRACT FROM PUBLISHER]