Superiorization: An optimization heuristic for medical physics
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Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas,
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Cd. Universitaria, C.P. 04510, Mexico City, Mexico
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Purpose: To describe and mathematically validate the superiorization methodol-
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ogy, which is a recently-developed heuristic approach to optimization, and to discuss
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its applicability to medical physics problem formulations that specify the desired
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solution (of physically given or otherwise obtained constraints) by an optimization
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criterion.
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Methods: The superiorization methodology is presented as a heuristic solver for
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a large class of constrained optimization problems. The constraints come from the
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desire to produce a solution that is constraints-compatible, in the sense of meeting
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requirements provided by physically or otherwise obtained constraints. The underly-
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ing idea is that many iterative algorithms for finding such a solution are perturbation
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resilient in the sense that, even if certain kinds of changes are made at the end of
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each iterative step, the algorithm still produces a constraints-compatible solution.
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This property is exploited by using permitted changes to steer the algorithm to a
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solution that is not only constraints-compatible, but is also desirable according to
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a specified optimization criterion. The approach is very general, it is applicable to
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many iterative procedures and optimization criteria used in medical physics.
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Results: The main practical contribution is a procedure for automatically pro-
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ducing from any given iterative algorithm its superiorized version, which will supply
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solutions that are superior according to a given optimization criterion. It is shown
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that if the original iterative algorithm satisfies certain mathematical conditions, then
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the output of its superiorized version is guaranteed to be as constraints-compatible as
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the output of the original algorithm, but it is superior to the latter according to the
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optimization criterion. This intuitive description is made precise in the paper and
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the stated claims are rigorously proved. Superiorization is illustrated on simulated
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computerized tomography data of a head cross-section and, in spite of its general-
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ity, superiorization is shown to be competitive to an optimization algorithm that is
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specifically designed to minimize total variation.
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Conclusions: The range of applicability of superiorization to constrained opti-
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mization problems is very large.
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producing a superiorization algorithm from an algorithm aimed at only constraints-
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compatibility; while non-heuristic (exact) approaches need to be redesigned for a new
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optimization criterion. Thus superiorization provides a quick route to algorithms for
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the practical solution of constrained optimization problems.
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Keywords: superiorization, constrained optimization, heuristic optimization, tomography,
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Optimization is a tool that is used in many areas of Medical Physics. Prime examples are
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radiation therapy treatment planning and tomographic reconstruction, but there are others
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such as image registration. Some well-cited classical publications on the topic are1–12 and
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some recent articles are13–26.
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In a typical medical physics application, one uses constrained optimization, where the
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constraints come from the desire to produce a solution that is constraints-compatible, in
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the sense of meeting the requirements provided by physically or otherwise obtained con-
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straints. In radiation therapy treatment planning, the requirements are usually in the form
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of constraints prescribed by the treatment planner on the doses to be delivered at specific
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locations in the body. These doses in turn depend on information provided by an imaging
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instrument, typically a Magnetic Resonance Imaging (MRI) or a Computerized Tomogra-
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phy (CT) scanner. In tomography, the constraints come from the detector readings of the
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instrument. In such applications, it is typically the case that a large number of solutions
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would be considered good enough from the point of view of being constraints-compatible;
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to a large extent, but not entirely, due to the fact that there is uncertainty as to the exact
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nature of the constraints (for example, due to noise in the data collection). In such a case,
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an optimization criterion is introduced that helps us to distinguish the “better” constraints-
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compatible solutions (for example, this criterion could be the total dose to be delivered to
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the body, which may vary quite a bit between radiation therapy treatment plans that are
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compatible with the constraints on the doses delivered to individual locations).
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The superiorization methodology (see, for example,22,27–32) is a recently-developed heuris-
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tic approach to optimization. The word heuristic is used here in the sense that the process
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is not guaranteed to lead to an optimum according to the given criterion; approaches aimed
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at processes that are guaranteed in that sense are usually referred to as exact. Heuristic
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approaches have been found useful in practical applications of optimization, mainly because
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they are often computationally much less expensive than their exact counterparts, but nev-
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ertheless provide solutions that are appropriate for the application at hand33–35.
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The underlying idea of the superiorization approach is the following. In many applica-
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tions there exists a computationally-efficient iterative algorithm that produces a constraints-
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compatible solution for the given constraints. (An example of this for radiation therapy
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treatment planning is reported in36, its clinical use is discussed in15.) Furthermore, often
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the algorithm is perturbation resilient in the sense that, even if certain kinds of changes are
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made at the end of each iterative step, the algorithm still produces a constraints-compatible
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solution27–30. This property is exploited in the superiorization approach by using such per-
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turbations to steer the algorithm to a solution that is not only constraints-compatible, but is
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also desirable according to a specified optimization criterion. The approach is very general,
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it is applicable to many iterative procedures and optimization criteria.
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The current paper presents a major advance in the practice and theory of superiorization.
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The previous publications22,27–32 used the intuitive idea to present some superiorization
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algorithms, in this paper the reader will find a totally automatic procedure that turns an
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iterative algorithm into its superiorized version. This version will produce an output that
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is as constraints-compatible as the output of the original algorithm, but it is superior to
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that according to an optimization criterion.
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true for a very large class of iterative algorithms and for optimization criteria in general,
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typical restrictions (such as convexity) on the optimization criterion are not essential for
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the material presented below. In order to make precise and validate this broad claim, we
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present here a new theoretical framework. The framework of29 is a precursor of what we
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present here, but it is a restricted one, since it assumes that the constraints can be all
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satisfied simultaneously, which is often false in medical physics applications. There is no
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such restriction in the presentation below.
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The idea of designing algorithms that use interlacing steps of two different kinds (in our
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case, one kind of steps aim at constraints-compatibility and the other kind of steps aim at
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improvement of the optimization criterion) is well-established and, in fact, is made use of
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in many approaches that have been proposed with exact constrained optimization in mind;
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see, for example, the works of Helou Neto and De Pierro37,38, of Nurminski39, of Combettes
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and coworkers40,41, of Sidky and Pan and coworkers23,42,43 and of Defrise and coworkers44.
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However, none of these approaches can do what can be done by the superiorization approach
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as presented below, namely the automatic production of a heuristic constrained optimization
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algorithm from an iterative algorithm for constraints-compatibility. For example, in37 it is
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assumed (just as in the theory presented in our29) that all the constraints can be satisfied
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simultaneously.
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A major motivator for the additional theory presented in the current paper is to get rid
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of this assumption, which is not reasonable when handling real problems of medical physics.
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Motivated by similar considerations, Helou Neto and De Pierro38 present an alternative
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approach that does not require this unreasonable assumption. However, in order to solve
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such a problem, they end up with iterative algorithms of a particular form rather than having
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the generality of being able to turn any constraints-compatibility seeking algorithm into a
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superiorized one capable of handling constrained optimization. Also, the assumptions they
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have to make in order to prove their convergence result (their Theorem 15) indicate that
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their approach is applicable to a smaller class of constrained optimization problems than
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the superiorization approach whose applicability seems to be more general. However, for
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the mathematical purist, we point out that they present an exact constrained optimization
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algorithm, while superiorization is a heuristic approach. Whether this is relevant to medical
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physics practice is not clear: exact algorithms are not run forever, but are stopped according
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to some stopping-rule, the relevant questions in comparing two algorithms are the quality
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of the actual output and the computation time needed to obtain it.
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Ultimately, the quality of the outputs should be evaluated by some figures of merit
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relevant to the medical task at hand.
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involves superiorization is in30 (Section 4.3), which reports on comparing in CT the efficacy
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of constrained optimization reconstruction algorithms for the detection of low-contrast brain
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tumors by using the method of statistical hypothesis testing (which provides a P-value that
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indicates the significance by which we can reject the null hypothesis that the two algorithms
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are equally efficacious in favor of the alternative that one is preferable). Such studies bundle
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together two things: (i) the formulation of the constrained optimization task and (ii) the
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performance of the algorithm in performing that task. The first of these requires a translation
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of the medical aim into a mathematical model, it is important that this model should be
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appropriately chosen.
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The superiorization approach is not about choosing this model, it kicks in once the model
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is chosen and aims at producing an output that is “good” according to the mathematical
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specifications of the constraints and of the optimization criterion. Thus superiorization has
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been used to compare the effects on the quality of the output in CT when the optimization
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criterion is specified by total variation (TV) versus by entropy28 or versus by the ℓ1-norm
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of the Haar transform32. However, the current paper is not about discussing how to trans-
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late the underlying medical physics task into a constrained optimization problem. For our
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purposes here, we are assuming that the mathematical model has been worked out and
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concentrate on the algorithmic approach for solving the resulting constrained optimization
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problem. We claim that the evaluation of such algorithms should not be based on the
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medical figures of merit mentioned at the beginning of the previous paragraph, but rather
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on their performance in solving the mathematical problem. If “good” solutions to the con-
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strained optimization problem are not medically efficacious, that indicates that something is
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wrong with the mathematical model and not that something is wrong with the algorithmic
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approach. For this reason, in this paper we will not carry out a careful investigation of the
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medical efficacy of any algorithm in the manner that we have done in30 (Section 4.3), but will
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restrict ourselves to a simple illustration of the performance of the superiorization approach
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as compared to the previously published algorithm of42 that is aimed at performing exact
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minimization.
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Examples of such studies already exist. Superiorization was compared in27 with Algorithm
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6 of40 and in45 with the algorithm of Goldstein and Osher that they refer to as TwIST46 with
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split Bregman47 as the substep. In both cases the implementation was done by the proposers
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of the algorithms. In these reported instances superiorization did well: the constraints-
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compatibility and the value of the function to be minimized were very similar for the outputs
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produced by the algorithms being compared, but the superiorization algorithm produced its
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output four times faster than the alternative. It would be unjustified to draw any general
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conclusions on the mathematical performance and speed of superiorization based on just a
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few experiments, but the reported results are encouraging.
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However, the main reason why we advocate superiorization is different from what is
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discussed above. The reason why we claim it to be helpful in medical physics research is
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that it has the potential of saving a lot of time and effort for the researcher. Let us consider
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a historical example. Likelihood optimization using the iterative process of expectation
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maximization (EM)48 gained immediate and wide acceptance in the emission tomography
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community. It was observed that irregular high amplitude patterns occurred in the image
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with a large number of iterations, but it was not until five years later that this problem
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was corrected49 by the use of a maximum a posteriority probability (MAP) algorithm with
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a multivariate Gaussian prior. Had we had at our disposal the superiorization approach,
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then the introduction of an optimization criterion (Gaussian or other) into the iterative
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expectation maximization (EM) process would have been a simple matter and we would
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have saved the time and effort spent on designing a special purpose algorithm for the MAP
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formulation. A TV -superiorization of the EM algorithm is presented in50.
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Even though our major claim for superiorization is that it provides a quick route to
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algorithms for the practical solution of constrained optimization problems, before leaving
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this introduction let us bring up a question that has to do with the performance of the
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resulting algorithms: Will superiorization produce superior results to those produced by
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contemporary MAP methods or is it faster than the better of such methods? At this stage
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we have not yet developed the mathematical notation to discuss this question in a rigorous
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manner, we return to it in Subsection II F.
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In the next section we present in detail the superiorization methodology. In the subse-
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quent section we provide an illustrative example by reporting on reconstructions produced
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by algorithms applied to simulated computerized tomography data of a head cross-section.
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In the final section we discuss our results and present our conclusions.
A.
Problem sets, proximity functions and ε-compatibility
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Although optimization is often studied in a more general context (such as in Hilbert or
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Banach spaces), in medical physics we usually deal with a special case, where optimization
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is performed in a Euclidean space RJ (the space of J-dimensional vectors of real numbers,
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where J is a positive integer). As often appropriate in practice, we further restrict the
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domain of optimization to a nonempty subset Ωof RJ (such as the nonnegative orthant RJ
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that consists of vectors all of whose components are nonnegative).
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We now turn to formalizing the notion of being compatible with given constraints, a
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notion that we have used informally in the previous section. In any application, there is a
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problem set T; each problem T ∈T is essentially a description of the constraints in that
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particular case. For example, for a tomographic scanner, the problem of reconstruction for
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a particular patient at a particular time is determined by the measurements taken by the
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scanner for that patient at that time. The intuitive notion of constraints-compatibility is
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formalized by the use of a proximity function Pr on T such that, for every T ∈T, PrT
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maps Ωinto R+, the set of nonnegative real numbers; i.e., PrT : Ω→R+. Intuitively we
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think of PrT (x) as an indicator of how incompatible x is with the constraints of T. For
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example, in tomography, PrT (x) should indicate by how much a proposed reconstruction
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that is described by an x in Ωviolates the constraints of the problem T that are provided
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by the measurements taken by the scanner. For example, if we use b to denote the vector
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of estimated line integrals based on the measurements obtained by the scanner and by A
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the system matrix of the scanner, then a possible choice for the proximity function is the
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norm-distance ∥b −Ax∥, which we will use as an example in the discussions that follow.
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An alternative legitimate choice for the proximity function is the Kullback-Leibler distance
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KL(b, Ax), which is the negative log-likelihood of a statistical model in tomography. The
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special case PrT (x) = 0 is interpreted by saying that x is perfectly compatible with the
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constraints; due to the presence of noise in practical applications, it is quite conceivable
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that there is no x that is perfectly compatible with the constraints, and we accept an x
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as constraints-compatible as long as the value of PrT (x) is considered to be small enough
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to justify that decision. Combining these two concepts leads to the notion of a problem
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structure, which is a pair ⟨T, Pr⟩, where T is a nonempty problem set and Pr is a proximity
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function on T. For a problem structure ⟨T, Pr⟩, a problem T ∈T, a nonnegative ε and an
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x ∈Ω, we say that x is ε-compatible with T provided that PrT (x) ≤ε.
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As an example (whose applicability to tomographic reconstruction is illustrated in Section
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III), consider the problem structure that arises from the desire to find nonnegative solutions
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of sequences of blocks of linear equations. Then the appropriate choices are Ω= RJ
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the problem structure is ⟨S, Res⟩, where the problem set S is
(1)
and the proximity function Res on S is defined, for any problem S
I=1
(bi −⟨ai, x⟩)2.
(2)
Note that each element of this problem set S specifies an ordered sequence of W blocks
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of linear equations of the form ⟨ai, x⟩= bi where ⟨∗, ∗⟩denotes the inner product in RJ
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(and thus S is an appropriate representation of the so-called “ordered subsets” approach to
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tomographic reconstruction51, as well as of other earlier-published block-iterative methods
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that proposed essentially the same idea52–54). The proximity function Res on S is the residual
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that we get when a particular x is substituted into all the equations of a particular problem
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We now define the concept of an algorithm in the general context of problem structures.
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For technical reasons that will become clear as we proceed with our development, we intro-
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duce an additional set ∆, such that Ω⊆∆⊆RJ. (Both Ωand ∆are assumed to be known
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and fixed for any particular problem structure ⟨T, Pr⟩.) An algorithm P for a problem
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structure ⟨T, Pr⟩assigns to each problem T ∈T an operator PT : ∆→Ω. This definition is
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used to define iterative processes that, for any initial point x ∈Ω, produce the (potentially)
∞
k=0 (that is, the sequence x, PTx, PT (PTx) , · · · ) of points in
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Ω. We discuss below how such a potentially infinite process is terminated in practice.
Selecting Ω= Rj
+ and ∆= RJ for the problem structure ⟨S, Res⟩of the previous subsec-
(3)
where S is the problem specified above (2) and, for 1 ≤w ≤W, BSw : ∆→∆is defined by
(4)
where ∥a∥denotes the norm of the vector a in RJ, and Q : ∆→Ωis defined by
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(Qx)j = max {0, xj} , for 1 ≤j ≤J.
(5)
Note that RS : ∆→Ω. This specific algorithm R is a typical example of the so-called block-
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iterative methods mentioned above. Except for the presence of Q in (3), which enforces
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nonnegativity of the components, it is identical to an algorithm used and illustrated in31.
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With the Q absent from the definition of the algorithm, Ωhas to be the whole of RJ; the
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practical consequence of the presence versus the absence of Q in the tomographic application
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is illustrated in Subsection III D. We note also that special cases of the presented algorithm
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include the classical reconstruction methods ART (if ℓw = 1, for 1 ≤w ≤W) and SIRT (if
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W = 1); see, for example, Chapters 11 and 12 of55.
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For a problem structure ⟨T, Pr⟩, a T ∈T, an ε ∈R+ and a sequence R =
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of points in Ω, we use O (T, ε, R) to denote the x ∈Ωthat has the following properties:
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PrT(x) ≤ε and there is a nonnegative integer K such that xK = x and, for all nonnegative