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Purpose  Dual‐energy  CT  ( DECT ) has been increasingly used in imaging applications because of its capability for material differentiation. However, material decomposition suffers from magnified noise from two  CT  images of independent scans, leading to severe degradation of image quality. Existing algorithms exhibit suboptimal decomposition performance because they fail to fully depict the mapping relationship between  DECT  images and basis materials under noisy conditions. Convolutional neural network exhibits great promise in the modeling of data coupling and has recently become an important technique in medical imaging application. Inspired by its impressive potential, we developed a new Butterfly network to perform the image domain dual material decomposition.    Methods  The Butterfly network is derived from the model of image domain  DECT  decomposition by exploring the geometric relationship between the mapping functions of the data model and network components. The network is designed as the double‐entry double‐out crossover architecture based on the decomposition formulation. It enters a pair of dual‐energy images as inputs and defines the ground true decomposed images as each label. The crossover architecture, which plays an important role in material decomposition, is designed to implement the information exchange between the two material generation pathways in the network. The proposed network is further applied on the digital phantom and clinical data to evaluate its performance.    Results  The qualitative and quantitative evaluations of the material decomposition of digital phantoms and clinical data indicate that the proposed network outperforms its counterparts. For the digital phantom, the proposed network reduces the standard deviation ( SD ) of noise in tissue, bone, and mixture regions by an average of 95.75% and 86.58% compared with the direct matrix inversion and the conventional iterative method, respectively. The line profiles and image biases of the decomposition results of digital phantom indicate that the proposed network provides the decomposition results closest to the ground truth. The proposed network reduces the  SD  of the noise in decomposed images of clinical head data by over 90% and 80% compared with the direct matrix inversion and conventional iterative method, respectively. As the modulation transfer function decreases to 50%, the proposed network increases the spatial resolution by average factors of 1.34 and 1.17 compared with the direct matrix inversion and conventional iterative methods, respectively. The proposed network is further applied to the clinical abdomen data. Among the three methods, the proposed method received the highest score from six radiologists in the visual inspection of noise suppression in the clinical data.    Conclusions  We develop a model‐based Butterfly network to perform image domain material decomposition for  DECT . The decomposition results of digital phantom validate its capability of decomposing two basis materials from  DECT  images. The proposed approach also leads to higher decomposition quality in noise suppression on clinical datasets as compared with those using conventional schemes.

Image domain dual material decomposition for dual‐energy CT using butterfly network