A hybrid reconstruction algorithm for fast and accurate 4D cone-beam CT imaging.

PubMed

Yan, Hao; Zhen, Xin; Folkerts, Michael; Li, Yongbao; Pan, Tinsu; Cervino, Laura; Jiang, Steve B; Jia, Xun

2014-07-01

4D cone beam CT (4D-CBCT) has been utilized in radiation therapy to provide 4D image guidance in lung and upper abdomen area. However, clinical application of 4D-CBCT is currently limited due to the long scan time and low image quality. The purpose of this paper is to develop a new 4D-CBCT reconstruction method that restores volumetric images based on the 1-min scan data acquired with a standard 3D-CBCT protocol. The model optimizes a deformation vector field that deforms a patient-specific planning CT (p-CT), so that the calculated 4D-CBCT projections match measurements. A forward-backward splitting (FBS) method is invented to solve the optimization problem. It splits the original problem into two well-studied subproblems, i.e., image reconstruction and deformable image registration. By iteratively solving the two subproblems, FBS gradually yields correct deformation information, while maintaining high image quality. The whole workflow is implemented on a graphic-processing-unit to improve efficiency. Comprehensive evaluations have been conducted on a moving phantom and three real patient cases regarding the accuracy and quality of the reconstructed images, as well as the algorithm robustness and efficiency. The proposed algorithm reconstructs 4D-CBCT images from highly under-sampled projection data acquired with 1-min scans. Regarding the anatomical structure location accuracy, 0.204 mm average differences and 0.484 mm maximum difference are found for the phantom case, and the maximum differences of 0.3-0.5 mm for patients 1-3 are observed. As for the image quality, intensity errors below 5 and 20 HU compared to the planning CT are achieved for the phantom and the patient cases, respectively. Signal-noise-ratio values are improved by 12.74 and 5.12 times compared to results from FDK algorithm using the 1-min data and 4-min data, respectively. The computation time of the algorithm on a NVIDIA GTX590 card is 1-1.5 min per phase. High-quality 4D-CBCT imaging based on the clinically standard 1-min 3D CBCT scanning protocol is feasible via the proposed hybrid reconstruction algorithm.

Dual-energy imaging method to improve the image quality and the accuracy of dose calculation for cone-beam computed tomography.

PubMed

Men, Kuo; Dai, Jianrong; Chen, Xinyuan; Li, Minghui; Zhang, Ke; Huang, Peng

2017-04-01

To improve the image quality and accuracy of dose calculation for cone-beam computed tomography (CT) images through implementation of a dual-energy cone-beam computed tomography method (DE-CBCT), and evaluate the improvement quantitatively. Two sets of CBCT projections were acquired using the X-ray volumetric imaging (XVI) system on a Synergy (Elekta, Stockholm, Sweden) system with 120kV (high) and 70kV (low) X-rays, respectively. Then, the electron density relative to water (relative electron density (RED)) of each voxel was calculated using a projection-based dual-energy decomposition method. As a comparison, single-energy cone-beam computed tomography (SE-CBCT) was used to calculate RED with the Hounsfield unit-RED calibration curve generated by a CIRS phantom scan with identical imaging parameters. The imaging dose was measured with a dosimetry phantom. The image quality was evaluated quantitatively using a Catphan 503 phantom with the evaluation indices of the reproducibility of the RED values, high-contrast resolution (MTF 50% ), uniformity, and signal-to-noise ratio (SNR). Dose calculation of two simulated volumetric-modulated arc therapy plans using an Eclipse treatment-planning system (Varian Medical Systems, Palo Alto, CA, USA) was performed on an Alderson Rando Head and Neck (H&N) phantom and a Pelvis phantom. Fan-beam planning CT images for the H&N and Pelvis phantom were set as the reference. A global three-dimensional gamma analysis was used to compare dose distributions with the reference. The average gamma values for targets and OAR were analyzed with paired t-tests between DE-CBCT and SE-CBCT. In two scans (H&N scan and body scan), the imaging dose of DE-CBCT increased by 1.0% and decreased by 1.3%. It had a better reproducibility of the RED values (mean bias: 0.03 and 0.07) compared with SE-CBCT (mean bias: 0.13 and 0.16). It also improved the image uniformity (57.5% and 30.1%) and SNR (9.7% and 2.3%), but did not affect the MTF 50% . Gamma analyses of the 3D dose distribution with criteria of 1%/1mm showed a pass rate of 99.0-100% and 85.3-97.6% for DE-CBCT and 73.5-99.1% and 80.4-92.7% for SE-CBCT. The average gamma values were reduced significantly by DE-CBCT (p< 0.05). Gamma index maps showed that matching of the dose distribution between CBCT-based and reference was improved by DE-CBCT. DE-CBCT can achieve both better image quality and higher accuracy of dose calculation, and could be applied to adaptive radiotherapy. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Salivary calculus diagnosis with 3-dimensional cone-beam computed tomography.

PubMed

Dreiseidler, Timo; Ritter, Lutz; Rothamel, Daniel; Neugebauer, Jörg; Scheer, Martin; Mischkowski, Robert A

2010-07-01

The objective of this study was to evaluate cone-beam CT (CBCT) diagnoses of sialoliths in the major salivary glands. Twenty-nine CBCT images containing salivary calculi were retrospectively evaluated for image quality and artifact influence. Additionally, the reproducibility of calculus measurement and the differences between CBCT measurements and ultrasonography (US) and histomorphometry (HM) measurements were determined. Diagnostic sensitivity and specificity calculations were based on the observations of 3 masked clinicians, who reviewed a total of 58 CBCT volumes. Salivary calculi were sufficiently visualized in all patients. Metal artifacts were detected in images of 7 patients, and movement artifacts in 2. CBCT calculi measurements were highly reproducible, with mean differences of less than 350 microm. Mean CBCT measurements of calculi diameters differed from mean US measurements by approximately 500 microm and differed from mean HM measurements by approximately 1 mm. For calculus diagnoses, the mean sensitivity and specificity were both 98.85%. Although poor image qualities and artifacts can reduce diagnostic information, salivary calculi can be evaluated adequately with CBCT. CBCT measurements of calculi are highly reproducible and differ little from measurements made with US and HM. Diagnostic sensitivity and specificity levels with CBCT are as high as or higher than those obtained with other diagnostic methods. Because of its high diagnostic-information-to-radiation-dose ratio, CBCT is the preferable imaging modality for salivary calculus diagnosis. Copyright (c) 2010 Mosby, Inc. All rights reserved.

Intraoperative cone-beam computed tomography and multi-slice computed tomography in temporal bone imaging for surgical treatment.

PubMed

Erovic, Boban M; Chan, Harley H L; Daly, Michael J; Pothier, David D; Yu, Eugene; Coulson, Chris; Lai, Philip; Irish, Jonathan C

2014-01-01

Conventional computed tomography (CT) imaging is the standard imaging technique for temporal bone diseases, whereas cone-beam CT (CBCT) imaging is a very fast imaging tool with a significant less radiation dose compared with conventional CT. We hypothesize that a system for intraoperative cone-beam CT provides comparable image quality to diagnostic CT for identifying temporal bone anatomical landmarks in cadaveric specimens. Cross-sectional study. University tertiary care facility. Twenty cadaveric temporal bones were affixed into a head phantom and scanned with both a prototype cone-beam CT C-arm and multislice helical CT. Imaging performance was evaluated by 3 otologic surgeons and 1 head and neck radiologist. Participants were presented images in a randomized order and completed landmark identification questionnaires covering 21 structures. CBCT and multislice CT have comparable performance in identifying temporal structures. Three otologic surgeons indicated that CBCT provided statistically equivalent performance for 19 of 21 landmarks, with CBCT superior to CT for the chorda tympani and inferior for the crura of the stapes. Subgroup analysis showed that CBCT performed superiorly for temporal bone structures compared with CT. The radiologist rated CBCT and CT as statistically equivalent for 18 of 21 landmarks, with CT superior to CBCT for the crura of stapes, chorda tympani, and sigmoid sinus. CBCT provides comparable image quality to conventional CT for temporal bone anatomical sites in cadaveric specimens. Clinical applications of low-dose CBCT imaging in surgical planning, intraoperative guidance, and postoperative assessment are promising but require further investigation.

Characterization of Scattered X-Ray Photons in Dental Cone-Beam Computed Tomography.

PubMed

Yang, Ching-Ching

2016-01-01

Scatter is a very important artifact causing factor in dental cone-beam CT (CBCT), which has a major influence on the detectability of details within images. This work aimed to improve the image quality of dental CBCT through scatter correction. Scatter was estimated in the projection domain from the low frequency component of the difference between the raw CBCT projection and the projection obtained by extrapolating the model fitted to the raw projections acquired with 2 different sizes of axial field-of-view (FOV). The function for curve fitting was optimized by using Monte Carlo simulation. To validate the proposed method, an anthropomorphic phantom and a water-filled cylindrical phantom with rod inserts simulating different tissue materials were scanned using 120 kVp, 5 mA and 9-second scanning time covering an axial FOV of 4 cm and 13 cm. The detectability of the CT image was evaluated by calculating the contrast-to-noise ratio (CNR). Beam hardening and cupping artifacts were observed in CBCT images without scatter correction, especially in those acquired with 13 cm FOV. These artifacts were reduced in CBCT images corrected by the proposed method, demonstrating its efficacy on scatter correction. After scatter correction, the image quality of CBCT was improved in terms of target detectability which was quantified as the CNR for rod inserts in the cylindrical phantom. Hopefully the calculations performed in this work can provide a route to reach a high level of diagnostic image quality for CBCT imaging used in oral and maxillofacial structures whilst ensuring patient dose as low as reasonably achievable, which may ultimately make CBCT scan a reliable and safe tool in clinical practice.

Development of Prior Image-based, High-Quality, Low-Dose Kilovoltage Cone Beam CT for Use in Adaptive Radiotherapy of Prostate Cancer

DTIC Science & Technology

2012-05-01

employs kilovoltage (KV) cone- beam CT (CBCT) for guiding treatment. High quality CBCT images are important in achieving improved treatment effect...necessary for achieving successful adaptive RT. Kilovoltage cone-beam CT (CBCT) has shown its capability of yielding such images to guide the prostate cancer...study of low-dose intra-operative cone-beam CT for image- guided surgery,” Proc. SPIE, 7961, 79615P, 2011 10. X. Han, E. Pearson, J. Bian, S. Cho, E. Y

Two-dimensional antiscatter grid: A novel scatter rejection device for Cone-beam computed tomography.

PubMed

Alexeev, Timur; Kavanagh, Brian; Miften, Moyed; Altunbas, Cem

2018-02-01

Scattered radiation remains to be a major cause of image quality degradation in Flat Panel Detector (FPD)-based Cone-beam computed tomography (CBCT). We have been investigating a novel two-dimensional antiscatter grid (2D-ASG) concept to reduce scatter intensity, and hence improve CBCT image quality. We present the first CBCT imaging experiments performed with the 2D-ASG prototype, and demonstrate its efficacy in improving CBCT image quality. A 2D-ASG prototype with septa focused to x-ray source was additively manufactured from tungsten and mounted on a Varian TrueBeam CBCT system. CBCT projections of phantoms were acquired with an offset detector geometry using TrueBeam's "developer" mode. To minimize the effect of gantry flex, projections were gain corrected on angle-specific bases. CBCT images were reconstructed using a filtered backprojection algorithm and image quality improvement was quantified by measuring contrast-to-noise ratio (CNR) and CT number accuracy in images acquired with no antiscatter grid (NO-ASG), conventional one dimensional antiscatter grid (1D-ASG), and the 2D-ASG prototype. A significant improvement in contrast resolution was achieved using our 2D-ASG prototype compared to results of 1D-ASG and NO-ASG acquisitions. Compared to NO-ASG and 1D-ASG experiments, the CNR of material inserts improved by as much as 86% and 54% respectively. Using 2D-ASG, CT number underestimation in water equivalent material section of the phantom was reduced by up to 325 HU when compared to NO-ASG and up to 179 HU when compared to 1D-ASG. We successfully performed the first CBCT imaging experiments with a 2D-ASG prototype. 2D-ASG provided significantly higher CT number accuracy, higher CNR, and diminished scatter-induced image artifacts in qualitative evaluations. We strongly believe that utilization of a 2D-ASG may potentially lead to better soft tissue visualization in CBCT and may enable novel clinical applications that require high CT number accuracy. © 2017 American Association of Physicists in Medicine.

A comparative study for image quality and radiation dose of a cone beam computed tomography scanner and a multislice computed tomography scanner for paranasal sinus imaging.

PubMed

De Cock, Jens; Zanca, Federica; Canning, John; Pauwels, Ruben; Hermans, Robert

2015-07-01

To evaluate image quality and radiation dose of a state of the art cone beam computed tomography (CBCT) system and a multislice computed tomography (MSCT) system in patients with sinonasal poliposis. In this retrospective study two radiologists evaluated 57 patients with sinonasal poliposis who underwent a CBCT or MSCT sinus examination, along with a control group of 90 patients with normal radiological findings. Tissue doses were measured using a phantom model with thermoluminescent dosimeters (TLD). Overall image quality in CBCT was scored significantly higher than in MSCT in patients with normal radiologic findings (p-value: 0.00001). In patients with sinonasal poliposis, MSCT scored significantly higher than CBCT (p-value: 0.00001). The average effective dose for MSCT was 42% higher compared to CBCT (108 μSv vs 63 μSv). CBCT and MSCT are both suited for the evaluation of sinonasal poliposis. In patients with sinonasal poliposis, clinically important structures of the paranasal sinuses can be better delineated with MSCT, whereas in patients without sinonasal poliposis, CBCT turns out to define the important structures of the sinonasal region better. However, given the lower radiation dose, CBCT can be considered for the evaluation of the sinonasal structures in patients with sinonasal poliposis. • CBCT and MSCT are both suited for evaluation of sinonasal poliposis. • Effective dose for MSCT was 42% higher compared to CBCT. • In patients with sinonasal poliposis, clinically important anatomical structures are better delineated with MSCT. • In patients with normal radiological findings, clinically important anatomical structures are better delineated with CBCT.

CBCT-based bone quality assessment: are Hounsfield units applicable?

PubMed Central

Jacobs, R; Singer, S R; Mupparapu, M

2015-01-01

CBCT is a widely applied imaging modality in dentistry. It enables the visualization of high-contrast structures of the oral region (bone, teeth, air cavities) at a high resolution. CBCT is now commonly used for the assessment of bone quality, primarily for pre-operative implant planning. Traditionally, bone quality parameters and classifications were primarily based on bone density, which could be estimated through the use of Hounsfield units derived from multidetector CT (MDCT) data sets. However, there are crucial differences between MDCT and CBCT, which complicates the use of quantitative gray values (GVs) for the latter. From experimental as well as clinical research, it can be seen that great variability of GVs can exist on CBCT images owing to various reasons that are inherently associated with this technique (i.e. the limited field size, relatively high amount of scattered radiation and limitations of currently applied reconstruction algorithms). Although attempts have been made to correct for GV variability, it can be postulated that the quantitative use of GVs in CBCT should be generally avoided at this time. In addition, recent research and clinical findings have shifted the paradigm of bone quality from a density-based analysis to a structural evaluation of the bone. The ever-improving image quality of CBCT allows it to display trabecular bone patterns, indicating that it may be possible to apply structural analysis methods that are commonly used in micro-CT and histology. PMID:25315442

A hybrid reconstruction algorithm for fast and accurate 4D cone-beam CT imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yan, Hao; Folkerts, Michael; Jiang, Steve B., E-mail: xun.jia@utsouthwestern.edu, E-mail: steve.jiang@UTSouthwestern.edu

2014-07-15

Purpose: 4D cone beam CT (4D-CBCT) has been utilized in radiation therapy to provide 4D image guidance in lung and upper abdomen area. However, clinical application of 4D-CBCT is currently limited due to the long scan time and low image quality. The purpose of this paper is to develop a new 4D-CBCT reconstruction method that restores volumetric images based on the 1-min scan data acquired with a standard 3D-CBCT protocol. Methods: The model optimizes a deformation vector field that deforms a patient-specific planning CT (p-CT), so that the calculated 4D-CBCT projections match measurements. A forward-backward splitting (FBS) method is inventedmore » to solve the optimization problem. It splits the original problem into two well-studied subproblems, i.e., image reconstruction and deformable image registration. By iteratively solving the two subproblems, FBS gradually yields correct deformation information, while maintaining high image quality. The whole workflow is implemented on a graphic-processing-unit to improve efficiency. Comprehensive evaluations have been conducted on a moving phantom and three real patient cases regarding the accuracy and quality of the reconstructed images, as well as the algorithm robustness and efficiency. Results: The proposed algorithm reconstructs 4D-CBCT images from highly under-sampled projection data acquired with 1-min scans. Regarding the anatomical structure location accuracy, 0.204 mm average differences and 0.484 mm maximum difference are found for the phantom case, and the maximum differences of 0.3–0.5 mm for patients 1–3 are observed. As for the image quality, intensity errors below 5 and 20 HU compared to the planning CT are achieved for the phantom and the patient cases, respectively. Signal-noise-ratio values are improved by 12.74 and 5.12 times compared to results from FDK algorithm using the 1-min data and 4-min data, respectively. The computation time of the algorithm on a NVIDIA GTX590 card is 1–1.5 min per phase. Conclusions: High-quality 4D-CBCT imaging based on the clinically standard 1-min 3D CBCT scanning protocol is feasible via the proposed hybrid reconstruction algorithm.« less

Analysis of intensity variability in multislice and cone beam computed tomography.

PubMed

Nackaerts, Olivia; Maes, Frederik; Yan, Hua; Couto Souza, Paulo; Pauwels, Ruben; Jacobs, Reinhilde

2011-08-01

The aim of this study was to evaluate the variability of intensity values in cone beam computed tomography (CBCT) imaging compared with multislice computed tomography Hounsfield units (MSCT HU) in order to assess the reliability of density assessments using CBCT images. A quality control phantom was scanned with an MSCT scanner and five CBCT scanners. In one CBCT scanner, the phantom was scanned repeatedly in the same and in different positions. Images were analyzed using registration to a mathematical model. MSCT images were used as a reference. Density profiles of MSCT showed stable HU values, whereas in CBCT imaging the intensity values were variable over the profile. Repositioning of the phantom resulted in large fluctuations in intensity values. The use of intensity values in CBCT images is not reliable, because the values are influenced by device, imaging parameters and positioning. © 2011 John Wiley & Sons A/S.

Cervical soft tissue imaging using a mobile CBCT scanner with a flat panel detector in comparison with corresponding CT and MRI data sets.

PubMed

Heiland, Max; Pohlenz, Philipp; Blessmann, Marco; Habermann, Christian R; Oesterhelweg, Lars; Begemann, Philipp C; Schmidgunst, Christian; Blake, Felix A S; Püschel, Klaus; Schmelzle, Rainer; Schulze, Dirk

2007-12-01

The aim of this study was to evaluate soft tissue image quality of a mobile cone-beam computed tomography (CBCT) scanner with an integrated flat-panel detector. Eight fresh human cadavers were used in this study. For evaluation of soft tissue visualization, CBCT data sets and corresponding computed tomography (CT) and magnetic resonance imaging (MRI) data sets were acquired. Evaluation was performed with the help of 10 defined cervical anatomical structures. The statistical analysis of the scoring results of 3 examiners revealed the CBCT images to be of inferior quality regarding the visualization of most of the predefined structures. Visualization without a significant difference was found regarding the demarcation of the vertebral bodies and the pyramidal cartilages, the arteriosclerosis of the carotids (compared with CT), and the laryngeal skeleton (compared with MRI). Regarding arteriosclerosis of the carotids compared with MRI, CBCT proved to be superior. The integration of a flat-panel detector improves soft tissue visualization using a mobile CBCT scanner.

WE-AB-207A-07: A Planning CT-Guided Scatter Artifact Correction Method for CBCT Images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, X; Liu, T; Dong, X

Purpose: Cone beam computed tomography (CBCT) imaging is on increasing demand for high-performance image-guided radiotherapy such as online tumor delineation and dose calculation. However, the current CBCT imaging has severe scatter artifacts and its current clinical application is therefore limited to patient setup based mainly on the bony structures. This study’s purpose is to develop a CBCT artifact correction method. Methods: The proposed scatter correction method utilizes the planning CT to improve CBCT image quality. First, an image registration is used to match the planning CT with the CBCT to reduce the geometry difference between the two images. Then, themore » planning CT-based prior information is entered into the Bayesian deconvolution framework to iteratively perform a scatter artifact correction for the CBCT mages. This technique was evaluated using Catphan phantoms with multiple inserts. Contrast-to-noise ratios (CNR) and signal-to-noise ratios (SNR), and the image spatial nonuniformity (ISN) in selected volume of interests (VOIs) were calculated to assess the proposed correction method. Results: Post scatter correction, the CNR increased by a factor of 1.96, 3.22, 3.20, 3.46, 3.44, 1.97 and 1.65, and the SNR increased by a factor 1.05, 2.09, 1.71, 3.95, 2.52, 1.54 and 1.84 for the Air, PMP, LDPE, Polystryrene, Acrylic, Delrin and Teflon inserts, respectively. The ISN decreased from 21.1% to 4.7% in the corrected images. All values of CNR, SNR and ISN in the corrected CBCT image were much closer to those in the planning CT images. The results demonstrated that the proposed method reduces the relevant artifacts and recovers CT numbers. Conclusion: We have developed a novel CBCT artifact correction method based on CT image, and demonstrated that the proposed CT-guided correction method could significantly reduce scatter artifacts and improve the image quality. This method has great potential to correct CBCT images allowing its use in adaptive radiotherapy.« less

Cone beam computed tomography in implant dentistry: recommendations for clinical use.

PubMed

Jacobs, Reinhilde; Salmon, Benjamin; Codari, Marina; Hassan, Bassam; Bornstein, Michael M

2018-05-15

In implant dentistry, three-dimensional (3D) imaging can be realised by dental cone beam computed tomography (CBCT), offering volumetric data on jaw bones and teeth with relatively low radiation doses and costs. The latter may explain why the market has been steadily growing since the first dental CBCT system appeared two decades ago. More than 85 different CBCT devices are currently available and this exponential growth has created a gap between scientific evidence and existing CBCT machines. Indeed, research for one CBCT machine cannot be automatically applied to other systems. Supported by a narrative review, recommendations for justified and optimized CBCT imaging in oral implant dentistry are provided. The huge range in dose and diagnostic image quality requires further optimization and justification prior to clinical use. Yet, indications in implant dentistry may go beyond diagnostics. In fact, the inherent 3D datasets may further allow surgical planning and transfer to surgery via 3D printing or navigation. Nonetheless, effective radiation doses of distinct dental CBCT machines and protocols may largely vary with equivalent doses ranging between 2 to 200 panoramic radiographs, even for similar indications. Likewise, such variation is also noticed for diagnostic image quality, which reveals a massive variability amongst CBCT technologies and exposure protocols. For anatomical model making, the so-called segmentation accuracy may reach up to 200 μm, but considering wide variations in machine performance, larger inaccuracies may apply. This also holds true for linear measures, with accuracies of 200 μm being feasible, while sometimes fivefold inaccuracy levels may be reached. Diagnostic image quality may also be dramatically hampered by patient factors, such as motion and metal artefacts. Apart from radiodiagnostic possibilities, CBCT may offer a huge therapeutic potential, related to surgical guides and further prosthetic rehabilitation. Those additional opportunities may surely clarify part of the success of using CBCT for presurgical implant planning and its transfer to surgery and prosthetic solutions. Hence, dental CBCT could be justified for presurgical diagnosis, preoperative planning and peroperative transfer for oral implant rehabilitation, whilst striving for optimisation of CBCT based machine-dependent, patient-specific and indication-oriented variables.

Evaluation of a cone beam computed tomography geometry for image guided small animal irradiation.

PubMed

Yang, Yidong; Armour, Michael; Wang, Ken Kang-Hsin; Gandhi, Nishant; Iordachita, Iulian; Siewerdsen, Jeffrey; Wong, John

2015-07-07

The conventional imaging geometry for small animal cone beam computed tomography (CBCT) is that a detector panel rotates around the head-to-tail axis of an imaged animal ('tubular' geometry). Another unusual but possible imaging geometry is that the detector panel rotates around the anterior-to-posterior axis of the animal ('pancake' geometry). The small animal radiation research platform developed at Johns Hopkins University employs the pancake geometry where a prone-positioned animal is rotated horizontally between an x-ray source and detector panel. This study is to assess the CBCT image quality in the pancake geometry and investigate potential methods for improvement. We compared CBCT images acquired in the pancake geometry with those acquired in the tubular geometry when the phantom/animal was placed upright simulating the conventional CBCT geometry. Results showed signal-to-noise and contrast-to-noise ratios in the pancake geometry were reduced in comparison to the tubular geometry at the same dose level. But the overall spatial resolution within the transverse plane of the imaged cylinder/animal was better in the pancake geometry. A modest exposure increase to two folds in the pancake geometry can improve image quality to a level close to the tubular geometry. Image quality can also be improved by inclining the animal, which reduces streak artifacts caused by bony structures. The major factor resulting in the inferior image quality in the pancake geometry is the elevated beam attenuation along the long axis of the phantom/animal and consequently increased scatter-to-primary ratio in that orientation. Not withstanding, the image quality in the pancake-geometry CBCT is adequate to support image guided animal positioning, while providing unique advantages of non-coplanar and multiple mice irradiation. This study also provides useful knowledge about the image quality in the two very different imaging geometries, i.e. pancake and tubular geometry, respectively.

Evaluation of a Cone Beam Computed Tomography Geometry for Image Guided Small Animal Irradiation

PubMed Central

Yang, Yidong; Armour, Michael; Wang, Ken Kang-Hsin; Gandhi, Nishant; Iordachita, Iulian; Siewerdsen, Jeffrey; Wong, John

2015-01-01

The conventional imaging geometry for small animal cone beam computed tomography (CBCT) is that a detector panel rotates around the head-to-tail axis of an imaged animal (“tubular” geometry). Another unusual but possible imaging geometry is that the detector panel rotates around the anterior-to-posterior axis of the animal (“pancake” geometry). The small animal radiation research platform (SARRP) developed at Johns Hopkins University employs the pancake geometry where a prone-positioned animal is rotated horizontally between an x-ray source and detector panel. This study is to assess the CBCT image quality in the pancake geometry and investigate potential methods for improvement. We compared CBCT images acquired in the pancake geometry with those acquired in the tubular geometry when the phantom/animal was placed upright simulating the conventional CBCT geometry. Results showed signal-to-noise and contrast-to-noise ratios in the pancake geometry were reduced in comparison to the tubular geometry at the same dose level. But the overall spatial resolution within the transverse plane of the imaged cylinder/animal was better in the pancake geometry. A modest exposure increase to two folds in the pancake geometry can improve image quality to a level close to the tubular geometry. Image quality can also be improved by inclining the animal, which reduces streak artifacts caused by bony structures. The major factor resulting in the inferior image quality in the pancake geometry is the elevated beam attenuation along the long axis of the phantom/animal and consequently increased scatter-to-primary ratio in that orientation. Notwithstanding, the image quality in the pancake-geometry CBCT is adequate to support image guided animal positioning, while providing unique advantages of non-coplanar and multiple mice irradiation. This study also provides useful knowledge about the image quality in the two very different imaging geometries, i.e., pancake and tubular geometry, respectively. PMID:26083659

Optimizing Cone Beam Computed Tomography (CBCT) System for Image Guided Radiation Therapy

NASA Astrophysics Data System (ADS)

Park, Chun Joo

Cone Beam Computed Tomography (CBCT) system is the most widely used imaging device in image guided radiation therapy (IGRT), where set of 3D volumetric image of patient can be reconstructed to identify and correct position setup errors prior to the radiation treatment. This CBCT system can significantly improve precision of on-line setup errors of patient position and tumor target localization prior to the treatment. However, there are still a number of issues that needs to be investigated with CBCT system such as 1) progressively increasing defective pixels in imaging detectors by its frequent usage, 2) hazardous radiation exposure to patients during the CBCT imaging, 3) degradation of image quality due to patients' respiratory motion when CBCT is acquired and 4) unknown knowledge of certain anatomical features such as liver, due to lack of soft-tissue contrast which makes tumor motion verification challenging. In this dissertation, we explore on optimizing the use of cone beam computed tomography (CBCT) system under such circumstances. We begin by introducing general concept of IGRT. We then present the development of automated defective pixel detection algorithm for X-ray imagers that is used for CBCT imaging using wavelet analysis. We next investigate on developing fast and efficient low-dose volumetric reconstruction techniques which includes 1) fast digital tomosynthesis reconstruction using general-purpose graphics processing unit (GPGPU) programming and 2) fast low-dose CBCT image reconstruction based on the Gradient-Projection-Barzilai-Borwein formulation (GP-BB). We further developed two efficient approaches that could reduce the degradation of CBCT images from respiratory motion. First, we propose reconstructing four dimensional (4D) CBCT and DTS using respiratory signal extracted from fiducial markers implanted in liver. Second, novel motion-map constrained image reconstruction (MCIR) is proposed that allows reconstruction of high quality and high phase resolution 4DCBCT images with no more than the imaging dose used in a standard Free Breathing 3DCBCT (FB-3DCBCT) scan. Finally, we demonstrate a method to analyze motion characteristics of liver that are particularly important for image guided stereotactic body radiation therapy (IG-SBRT). It is anticipated that all the approaches proposed in this study, which are both technically and clinically feasible, will allow much improvement in IGRT process.

Image quality improvement in cone-beam CT using the super-resolution technique.

PubMed

Oyama, Asuka; Kumagai, Shinobu; Arai, Norikazu; Takata, Takeshi; Saikawa, Yusuke; Shiraishi, Kenshiro; Kobayashi, Takenori; Kotoku, Jun'ichi

2018-04-05

This study was conducted to improve cone-beam computed tomography (CBCT) image quality using the super-resolution technique, a method of inferring a high-resolution image from a low-resolution image. This technique is used with two matrices, so-called dictionaries, constructed respectively from high-resolution and low-resolution image bases. For this study, a CBCT image, as a low-resolution image, is represented as a linear combination of atoms, the image bases in the low-resolution dictionary. The corresponding super-resolution image was inferred by multiplying the coefficients and the high-resolution dictionary atoms extracted from planning CT images. To evaluate the proposed method, we computed the root mean square error (RMSE) and structural similarity (SSIM). The resulting RMSE and SSIM between the super-resolution images and the planning CT images were, respectively, as much as 0.81 and 1.29 times better than those obtained without using the super-resolution technique. We used super-resolution technique to improve the CBCT image quality.

Feasibility study of low-dose intra-operative cone-beam CT for image-guided surgery

NASA Astrophysics Data System (ADS)

Han, Xiao; Shi, Shuanghe; Bian, Junguo; Helm, Patrick; Sidky, Emil Y.; Pan, Xiaochuan

2011-03-01

Cone-beam computed tomography (CBCT) has been increasingly used during surgical procedures for providing accurate three-dimensional anatomical information for intra-operative navigation and verification. High-quality CBCT images are in general obtained through reconstruction from projection data acquired at hundreds of view angles, which is associated with a non-negligible amount of radiation exposure to the patient. In this work, we have applied a novel image-reconstruction algorithm, the adaptive-steepest-descent-POCS (ASD-POCS) algorithm, to reconstruct CBCT images from projection data at a significantly reduced number of view angles. Preliminary results from experimental studies involving both simulated data and real data show that images of comparable quality to those presently available in clinical image-guidance systems can be obtained by use of the ASD-POCS algorithm from a fraction of the projection data that are currently used. The result implies potential value of the proposed reconstruction technique for low-dose intra-operative CBCT imaging applications.

SU-F-J-30: Application of Intra-Fractional Imaging for Pretreatment CBCT of Breath-Hold Lung SBRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cao, D; Jermoumi, M; Mehta, V

2016-06-15

Purpose: Clinical implementation of gated lung SBRT requires tools to verify the accuracy of the target positioning on a daily basis. This is a particular challenge on Elekta linacs where the XVI imaging system does not interface directly to any commercial gating solution. In this study, we used the Elekta’s intra-fractional imaging functionality to perform the pretreatment CBCT verifications and evaluated both the image quality and gating accuracy. Methods: To use intrafraction imaging tools for pretreatment verifications, we planned a 360-degree arc with 1mmx5mm MLC opening. This beam was designed to drive the gantry during the gated CBCT data collection.more » A Catphan phantom was used to evaluate the image quality for the intra-fractional CBCT. A CIRS lung phantom with a 3cm sphereinsert and a moving chest plate were programmed with a simulated breathhold breathing pattern was used to check the gating accuracy. A C-Rad CatalystHD surface mapping system was used to provide the gating signal. Results: The total delivery time of the arc was 90 seconds. The uniformity and low contrast resolution for the intra-fractional CBCT was 1.5% and 3.6%, respectively. The values for the regular CBCT were 1.7% and 2.5%, respectively. The spatial resolution was 7 line-pairs/cm and the 3D spatial integrity was less than 1mm for the intra-fractional CBCT. The gated CBCT clearly demonstrated the accuracy of the gating image acquisition. Conclusion: The intra-fraction CBCT capabilities on an Elekta linac can be used to acquire pre-treatment gated images to verify the accuracy patient positioning. This imaging capability should provide for accurate patient alignments for the delivery of lung SBRT. This research was partially supported by Elekta.« less

Megavoltage planar and cone-beam imaging with low-Z targets: dependence of image quality improvement on beam energy and patient separation.

PubMed

Robar, James L; Connell, Tanner; Huang, Weihong; Kelly, Robin G

2009-09-01

The purpose of this study is to investigate the improvement of megavoltage planar and cone-beam CT (CBCT) image quality with the use of low atomic number (Z) external targets in the linear accelerator. In this investigation, two experimental megavoltage imaging beams were generated by using either 3.5 or 7.0 MeV electrons incident on aluminum targets installed above the level of the carousel in a linear accelerator (2100EX, Varian Medical, Inc., Palo Alto, CA). Images were acquired using an amorphous silicon detector panel. Contrast-to-noise ratio (CNR) in planar and CBCT images was measured as a function of dose and a comparison was made between the imaging beams and the standard 6 MV therapy beam. Phantoms of variable diameter were used to examine the loss of contrast due to beam hardening. Porcine imaging was conducted to examine qualitatively the advantages of the low-Z target approach in CBCT. In CBCT imaging CNR increases by factors as high as 2.4 and 4.3 for the 7.0 and 3.5 MeV/Al beams, respectively, compared to images acquired with 6 MV. Similar factors of improvement are observed in planar imaging. For the imaging beams, beam hardening causes a significant loss of the contrast advantage with increasing phantom diameter; however, for the 3.5 MeV/Al beam and a phantom diameter of 25 cm, a contrast advantage remains, with increases of contrast by factors of 1.5 and 3.4 over 6 MV for bone and lung inhale regions, respectively. The spatial resolution is improved slightly in CBCT images for the imaging beams. CBCT images of a porcine cranium demonstrate qualitatively the advantages of the low-Z target approach, showing greater contrast between tissues and improved visibility of fine detail. The use of low-Z external targets in the linear accelerator improves megavoltage planar and CBCT image quality significantly. CNR may be increased by a factor of 4 or greater. Improvement of the spatial resolution is also apparent.

Dedicated mobile volumetric cone-beam computed tomography for human brain imaging: A phantom study.

PubMed

Ryu, Jong-Hyun; Kim, Tae-Hoon; Jeong, Chang-Won; Jun, Hong-Young; Heo, Dong-Woon; Lee, Jinseok; Kim, Kyong-Woo; Yoon, Kwon-Ha

2015-01-01

Mobile computed tomography (CT) with a cone-beam source is increasingly used in the clinical field. Mobile cone-beam CT (CBCT) has great merits; however, its clinical utility for brain imaging has been limited due to problems including scan time and image quality. The aim of this study was to develop a dedicated mobile volumetric CBCT for obtaining brain images, and to optimize the imaging protocol using a brain phantom. The mobile volumetric CBCT system was evaluated with regards to scan time and image quality, measured as signal-to-noise-ratio (SNR), contrast-to-noise-ratio (CNR), spatial resolution (10% MTF), and effective dose. Brain images were obtained using a CT phantom. The CT scan took 5.14 s at 360 projection views. SNR and CNR were 5.67 and 14.5 at 120 kV/10 mA. SNR and CNR values showed slight improvement as the x-ray voltage and current increased (p < 0.001). Effective dose and 10% MTF were 0.92 mSv and 360 μ m at 120 kV/10 mA. Various intracranial structures were clearly visible in the brain phantom images. Using this CBCT under optimal imaging acquisition conditions, it is possible to obtain human brain images with low radiation dose, reproducible image quality, and fast scan time.

Use of Cone Beam Computed Tomography in Endodontics

PubMed Central

Scarfe, William C.; Levin, Martin D.; Gane, David; Farman, Allan G.

2009-01-01

Cone Beam Computed Tomography (CBCT) is a diagnostic imaging modality that provides high-quality, accurate three-dimensional (3D) representations of the osseous elements of the maxillofacial skeleton. CBCT systems are available that provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and posttreatment evaluation. This article provides a literature review and pictorial demonstration of CBCT as an imaging adjunct for endodontics. PMID:20379362

Application of a newly developed software program for image quality assessment in cone-beam computed tomography.

PubMed

de Oliveira, Marcus Vinicius Linhares; Santos, António Carvalho; Paulo, Graciano; Campos, Paulo Sergio Flores; Santos, Joana

2017-06-01

The purpose of this study was to apply a newly developed free software program, at low cost and with minimal time, to evaluate the quality of dental and maxillofacial cone-beam computed tomography (CBCT) images. A polymethyl methacrylate (PMMA) phantom, CQP-IFBA, was scanned in 3 CBCT units with 7 protocols. A macro program was developed, using the free software ImageJ, to automatically evaluate the image quality parameters. The image quality evaluation was based on 8 parameters: uniformity, the signal-to-noise ratio (SNR), noise, the contrast-to-noise ratio (CNR), spatial resolution, the artifact index, geometric accuracy, and low-contrast resolution. The image uniformity and noise depended on the protocol that was applied. Regarding the CNR, high-density structures were more sensitive to the effect of scanning parameters. There were no significant differences between SNR and CNR in centered and peripheral objects. The geometric accuracy assessment showed that all the distance measurements were lower than the real values. Low-contrast resolution was influenced by the scanning parameters, and the 1-mm rod present in the phantom was not depicted in any of the 3 CBCT units. Smaller voxel sizes presented higher spatial resolution. There were no significant differences among the protocols regarding artifact presence. This software package provided a fast, low-cost, and feasible method for the evaluation of image quality parameters in CBCT.

Preliminary evaluation of the dosimetric accuracy of cone-beam computed tomography for cases with respiratory motion

NASA Astrophysics Data System (ADS)

Kim, Dong Wook; Bae, Sunhyun; Chung, Weon Kuu; Lee, Yoonhee

2014-04-01

Cone-beam computed tomography (CBCT) images are currently used for patient positioning and adaptive dose calculation; however, the degree of CBCT uncertainty in cases of respiratory motion remains an interesting issue. This study evaluated the uncertainty of CBCT-based dose calculations for a moving target. Using a phantom, we estimated differences in the geometries and the Hounsfield units (HU) between CT and CBCT. The calculated dose distributions based on CT and CBCT images were also compared using a radiation treatment planning system, and the comparison included cases with respiratory motion. The geometrical uncertainties of the CT and the CBCT images were less than 0.15 cm. The HU differences between CT and CBCT images for standard-dose-head, high-quality-head, normal-pelvis, and low-dose-thorax modes were 31, 36, 23, and 33 HU, respectively. The gamma (3%, 0.3 cm)-dose distribution between CT and CBCT was greater than 1 in 99% of the area. The gamma-dose distribution between CT and CBCT during respiratory motion was also greater than 1 in 99% of the area. The uncertainty of the CBCT-based dose calculation was evaluated for cases with respiratory motion. In conclusion, image distortion due to motion did not significantly influence dosimetric parameters.

Five-dimensional motion compensation for respiratory and cardiac motion with cone-beam CT of the thorax region

NASA Astrophysics Data System (ADS)

Sauppe, Sebastian; Hahn, Andreas; Brehm, Marcus; Paysan, Pascal; Seghers, Dieter; Kachelrieß, Marc

2016-03-01

We propose an adapted method of our previously published five-dimensional (5D) motion compensation (MoCo) algorithm1, developed for micro-CT imaging of small animals, to provide for the first time motion artifact-free 5D cone-beam CT (CBCT) images from a conventional flat detector-based CBCT scan of clinical patients. Image quality of retrospectively respiratory- and cardiac-gated volumes from flat detector CBCT scans is deteriorated by severe sparse projection artifacts. These artifacts further complicate motion estimation, as it is required for MoCo image reconstruction. For high quality 5D CBCT images at the same x-ray dose and the same number of projections as todays 3D CBCT we developed a double MoCo approach based on motion vector fields (MVFs) for respiratory and cardiac motion. In a first step our already published four-dimensional (4D) artifact-specific cyclic motion-compensation (acMoCo) approach is applied to compensate for the respiratory patient motion. With this information a cyclic phase-gated deformable heart registration algorithm is applied to the respiratory motion-compensated 4D CBCT data, thus resulting in cardiac MVFs. We apply these MVFs on double-gated images and thereby respiratory and cardiac motion-compensated 5D CBCT images are obtained. Our 5D MoCo approach processing patient data acquired with the TrueBeam 4D CBCT system (Varian Medical Systems). Our double MoCo approach turned out to be very efficient and removed nearly all streak artifacts due to making use of 100% of the projection data for each reconstructed frame. The 5D MoCo patient data show fine details and no motion blurring, even in regions close to the heart where motion is fastest.

Shading correction algorithm for cone-beam CT in radiotherapy: extensive clinical validation of image quality improvement

NASA Astrophysics Data System (ADS)

Joshi, K. D.; Marchant, T. E.; Moore, C. J.

2017-03-01

A shading correction algorithm for the improvement of cone-beam CT (CBCT) images (Phys. Med. Biol. 53 5719{33) has been further developed, optimised and validated extensively using 135 clinical CBCT images of patients undergoing radiotherapy treatment of the pelvis, lungs and head and neck. An automated technique has been developed to efficiently analyse the large number of clinical images. Small regions of similar tissue (for example fat tissue) are automatically identified using CT images. The same regions on the corresponding CBCT image are analysed to ensure that they do not contain pixels representing multiple types of tissue. The mean value of all selected pixels and the non-uniformity, defined as the median absolute deviation of the mean values in each small region, are calculated. Comparisons between CT and raw and corrected CBCT images are then made. Analysis of fat regions in pelvis images shows an average difference in mean pixel value between CT and CBCT of 136:0 HU in raw CBCT images, which is reduced to 2:0 HU after the application of the shading correction algorithm. The average difference in non-uniformity of fat pixels is reduced from 33:7 in raw CBCT to 2:8 in shading-corrected CBCT images. Similar results are obtained in the analysis of lung and head and neck images.

Directional sinogram interpolation for motion weighted 4D cone-beam CT reconstruction

NASA Astrophysics Data System (ADS)

Zhang, Hua; Kruis, Matthijs; Sonke, Jan-Jakob

2017-03-01

The image quality of respiratory sorted four-dimensional (4D) cone-beam (CB) computed tomography (CT) is often limited by streak artifacts due to insufficient projections. A motion weighted reconstruction (MWR) method is proposed to decrease streak artifacts and improve image quality. Firstly, respiratory correlated CBCT projections were interpolated by directional sinogram interpolation (DSI) to generate additional CB projections for each phase and subsequently reconstructed. Secondly, local motion was estimated by deformable image registration of the interpolated 4D CBCT. Thirdly, a regular 3D FDK CBCT was reconstructed from the non-interpolated projections. Finally, weights were assigned to each voxel, based on the local motion, and then were used to combine the 3D FDK CBCT and interpolated 4D CBCT to generate the final 4D image. MWR method was compared with regular 4D CBCT scans as well as McKinnon and Bates (MKB) based reconstructions. Comparisons were made in terms of (1) comparing the steepness of an extracted profile from the boundary of the region-of-interest (ROI), (2) contrast-to-noise ratio (CNR) inside certain ROIs, and (3) the root-mean-square-error (RMSE) between the planning CT and CBCT inside a homogeneous moving region. Comparisons were made for both a phantom and four patient scans. In a 4D phantom, RMSE were reduced by 24.7% and 38.7% for MKB and MWR respectively, compared to conventional 4D CBCT. Meanwhile, interpolation induced blur was minimal in static regions for MWR based reconstructions. In regions with considerable respiratory motion, image blur using MWR is less than the MKB and 3D Feldkamp (FDK) methods. In the lung cancer patients, average CNRs of MKB, DSI and MWR improved by a factor 1.7, 2.8 and 3.5 respectively relative to 4D FDK. MWR effectively reduces RMSE in 4D cone-beam CT and improves the image quality in both the static and respiratory moving regions compared to 4D FDK and MKB methods.

Directional sinogram interpolation for motion weighted 4D cone-beam CT reconstruction.

PubMed

Zhang, Hua; Kruis, Matthijs; Sonke, Jan-Jakob

2017-03-21

The image quality of respiratory sorted four-dimensional (4D) cone-beam (CB) computed tomography (CT) is often limited by streak artifacts due to insufficient projections. A motion weighted reconstruction (MWR) method is proposed to decrease streak artifacts and improve image quality. Firstly, respiratory correlated CBCT projections were interpolated by directional sinogram interpolation (DSI) to generate additional CB projections for each phase and subsequently reconstructed. Secondly, local motion was estimated by deformable image registration of the interpolated 4D CBCT. Thirdly, a regular 3D FDK CBCT was reconstructed from the non-interpolated projections. Finally, weights were assigned to each voxel, based on the local motion, and then were used to combine the 3D FDK CBCT and interpolated 4D CBCT to generate the final 4D image. MWR method was compared with regular 4D CBCT scans as well as McKinnon and Bates (MKB) based reconstructions. Comparisons were made in terms of (1) comparing the steepness of an extracted profile from the boundary of the region-of-interest (ROI), (2) contrast-to-noise ratio (CNR) inside certain ROIs, and (3) the root-mean-square-error (RMSE) between the planning CT and CBCT inside a homogeneous moving region. Comparisons were made for both a phantom and four patient scans. In a 4D phantom, RMSE were reduced by 24.7% and 38.7% for MKB and MWR respectively, compared to conventional 4D CBCT. Meanwhile, interpolation induced blur was minimal in static regions for MWR based reconstructions. In regions with considerable respiratory motion, image blur using MWR is less than the MKB and 3D Feldkamp (FDK) methods. In the lung cancer patients, average CNRs of MKB, DSI and MWR improved by a factor 1.7, 2.8 and 3.5 respectively relative to 4D FDK. MWR effectively reduces RMSE in 4D cone-beam CT and improves the image quality in both the static and respiratory moving regions compared to 4D FDK and MKB methods.

Comparison of an adaptive local thresholding method on CBCT and µCT endodontic images

NASA Astrophysics Data System (ADS)

Michetti, Jérôme; Basarab, Adrian; Diemer, Franck; Kouame, Denis

2018-01-01

Root canal segmentation on cone beam computed tomography (CBCT) images is difficult because of the noise level, resolution limitations, beam hardening and dental morphological variations. An image processing framework, based on an adaptive local threshold method, was evaluated on CBCT images acquired on extracted teeth. A comparison with high quality segmented endodontic images on micro computed tomography (µCT) images acquired from the same teeth was carried out using a dedicated registration process. Each segmented tooth was evaluated according to volume and root canal sections through the area and the Feret’s diameter. The proposed method is shown to overcome the limitations of CBCT and to provide an automated and adaptive complete endodontic segmentation. Despite a slight underestimation (-4, 08%), the local threshold segmentation method based on edge-detection was shown to be fast and accurate. Strong correlations between CBCT and µCT segmentations were found both for the root canal area and diameter (respectively 0.98 and 0.88). Our findings suggest that combining CBCT imaging with this image processing framework may benefit experimental endodontology, teaching and could represent a first development step towards the clinical use of endodontic CBCT segmentation during pulp cavity treatment.

MR-CBCT image-guided system for radiotherapy of orthotopic rat prostate tumors.

PubMed

Chiu, Tsuicheng D; Arai, Tatsuya J; Campbell Iii, James; Jiang, Steve B; Mason, Ralph P; Stojadinovic, Strahinja

2018-01-01

Multi-modality image-guided radiotherapy is the standard of care in contemporary cancer management; however, it is not common in preclinical settings due to both hardware and software limitations. Soft tissue lesions, such as orthotopic prostate tumors, are difficult to identify using cone beam computed tomography (CBCT) imaging alone. In this study, we characterized a research magnetic resonance (MR) scanner for preclinical studies and created a protocol for combined MR-CBCT image-guided small animal radiotherapy. Two in-house dual-modality, MR and CBCT compatible, phantoms were designed and manufactured using 3D printing technology. The phantoms were used for quality assurance tests and to facilitate end-to-end testing for combined preclinical MR and CBCT based treatment planning. MR and CBCT images of the phantoms were acquired utilizing a Varian 4.7 T scanner and XRad-225Cx irradiator, respectively. The geometry distortion was assessed by comparing MR images to phantom blueprints and CBCT. The corrected MR scans were co-registered with CBCT and subsequently used for treatment planning. The fidelity of 3D printed phantoms compared to the blueprint design yielded favorable agreement as verified with the CBCT measurements. The geometric distortion, which varied between -5% and 11% throughout the scanning volume, was substantially reduced to within 0.4% after correction. The distortion free MR images were co-registered with the corresponding CBCT images and imported into a commercial treatment planning software SmART Plan. The planning target volume (PTV) was on average 19% smaller when contoured on the corrected MR-CBCT images relative to raw images without distortion correction. An MR-CBCT based preclinical workflow was successfully designed and implemented for small animal radiotherapy. Combined MR-CBCT image-guided radiotherapy for preclinical research potentially delivers enhanced relevance to human radiotherapy for various disease sites. This novel protocol is wide-ranging and not limited to the orthotopic prostate tumor study presented in the study.

The Influence of a Dietary Protocol on Cone Beam CT-Guided Radiotherapy for Prostate Cancer Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smitsmans, Monique H.P.; Pos, Floris J.; Bois, Josien de

2008-07-15

Purpose: To evaluate the influence of a dietary protocol on cone beam computed tomography (CBCT) image quality, which is an indirect indicator for short-term (intrafraction) prostate motion, and on interfraction motion. Image quality is affected by motion (e.g., moving gas) during imaging and influences the performance of automatic prostate localization on CBCT scans. Methods and Materials: Twenty-six patients (336 CBCT scans) followed the dietary protocol and 23 patients (240 CBCT scans) did not. Prostates were automatically localized by using three dimensional (3D) gray-value registration (GR). Feces and (moving) gas occurrence in the CBCT scans, the success rate of 3D-GR, andmore » the statistics of prostate motion data were assessed. Results: Feces, gas, and moving gas significantly decreased from 55%, 61%, and 43% of scans in the nondiet group to 31%, 47%, and 28% in the diet group (all p < 0.001). Since there is a known relation between gas and short-term prostate motion, intrafraction prostate motion probably also decreased. The success rate of 3D-GR improved from 83% to 94% (p < 0.001). A decrease in random interfraction prostate motion also was found, which was not significant after Bonferroni's correction. Significant deviations from planning CT position for rotations around the left-right axis were found in both groups. Conclusions: The dietary protocol significantly decreased the incidence of feces and (moving) gas. As a result, CBCT image quality and the success rate of 3D-GR significantly increased. A trend exists that random interfraction prostate motion decreases. Using a dietary protocol therefore is advisable, also without CBCT-based image guidance.« less

Study of Variation in Dose Calculation Accuracy Between kV Cone-Beam Computed Tomography and kV fan-Beam Computed Tomography

PubMed Central

Kaliyaperumal, Venkatesan; Raphael, C. Jomon; Varghese, K. Mathew; Gopu, Paul; Sivakumar, S.; Boban, Minu; Raj, N. Arunai Nambi; Senthilnathan, K.; Babu, P. Ramesh

2017-01-01

Cone-beam computed tomography (CBCT) images are presently used for geometric verification for daily patient positioning. In this work, we have compared the images of CBCT with the images of conventional fan beam CT (FBCT) in terms of image quality and Hounsfield units (HUs). We also compared the dose calculated using CBCT with that of FBCT. Homogenous RW3 plates and Catphan phantom were scanned by FBCT and CBCT. In RW3 and Catphan phantom, percentage depth dose (PDD), profiles, isodose distributions (for intensity modulated radiotherapy plans), and calculated dose volume histograms were compared. The HU difference was within ± 20 HU (central region) and ± 30 HU (peripheral region) for homogeneous RW3 plates. In the Catphan phantom, the difference in HU was ± 20 HU in the central area and peripheral areas. The HU differences were within ± 30 HU for all HU ranges starting from −1000 to 990 in phantom and patient images. In treatment plans done with simple symmetric and asymmetric fields, dose difference (DD) between CBCT plan and FBCT plan was within 1.2% for both phantoms. In intensity modulated radiotherapy (IMRT) treatment plans, for different target volumes, the difference was <2%. This feasibility study investigated HU variation and dose calculation accuracy between FBCT and CBCT based planning and has validated inverse planning algorithms with CBCT. In our study, we observed a larger deviation of HU values in the peripheral region compared to the central region. This is due to the ring artifact and scatter contribution which may prevent the use of CBCT as the primary imaging modality for radiotherapy treatment planning. The reconstruction algorithm needs to be modified further for improving the image quality and accuracy in HU values. However, our study with TG-119 and intensity modulated radiotherapy test targets shows that CBCT can be used for adaptive replanning as the recalculation of dose with the anisotropic analytical algorithm is in full accord with conventional planning CT except in the build-up regions. Patient images with CBCT have to be carefully analyzed for any artifacts before using them for such dose calculations. PMID:28974864

WE-AB-207A-08: BEST IN PHYSICS (IMAGING): Advanced Scatter Correction and Iterative Reconstruction for Improved Cone-Beam CT Imaging On the TrueBeam Radiotherapy Machine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, A; Paysan, P; Brehm, M

2016-06-15

Purpose: To improve CBCT image quality for image-guided radiotherapy by applying advanced reconstruction algorithms to overcome scatter, noise, and artifact limitations Methods: CBCT is used extensively for patient setup in radiotherapy. However, image quality generally falls short of diagnostic CT, limiting soft-tissue based positioning and potential applications such as adaptive radiotherapy. The conventional TrueBeam CBCT reconstructor uses a basic scatter correction and FDK reconstruction, resulting in residual scatter artifacts, suboptimal image noise characteristics, and other artifacts like cone-beam artifacts. We have developed an advanced scatter correction that uses a finite-element solver (AcurosCTS) to model the behavior of photons as theymore » pass (and scatter) through the object. Furthermore, iterative reconstruction is applied to the scatter-corrected projections, enforcing data consistency with statistical weighting and applying an edge-preserving image regularizer to reduce image noise. The combined algorithms have been implemented on a GPU. CBCT projections from clinically operating TrueBeam systems have been used to compare image quality between the conventional and improved reconstruction methods. Planning CT images of the same patients have also been compared. Results: The advanced scatter correction removes shading and inhomogeneity artifacts, reducing the scatter artifact from 99.5 HU to 13.7 HU in a typical pelvis case. Iterative reconstruction provides further benefit by reducing image noise and eliminating streak artifacts, thereby improving soft-tissue visualization. In a clinical head and pelvis CBCT, the noise was reduced by 43% and 48%, respectively, with no change in spatial resolution (assessed visually). Additional benefits include reduction of cone-beam artifacts and reduction of metal artifacts due to intrinsic downweighting of corrupted rays. Conclusion: The combination of an advanced scatter correction with iterative reconstruction substantially improves CBCT image quality. It is anticipated that clinically acceptable reconstruction times will result from a multi-GPU implementation (the algorithms are under active development and not yet commercially available). All authors are employees of and (may) own stock of Varian Medical Systems.« less

Cone-beam CT of traumatic brain injury using statistical reconstruction with a post-artifact-correction noise model

NASA Astrophysics Data System (ADS)

Dang, H.; Stayman, J. W.; Sisniega, A.; Xu, J.; Zbijewski, W.; Yorkston, J.; Aygun, N.; Koliatsos, V.; Siewerdsen, J. H.

2015-03-01

Traumatic brain injury (TBI) is a major cause of death and disability. The current front-line imaging modality for TBI detection is CT, which reliably detects intracranial hemorrhage (fresh blood contrast 30-50 HU, size down to 1 mm) in non-contrast-enhanced exams. Compared to CT, flat-panel detector (FPD) cone-beam CT (CBCT) systems offer lower cost, greater portability, and smaller footprint suitable for point-of-care deployment. We are developing FPD-CBCT to facilitate TBI detection at the point-of-care such as in emergent, ambulance, sports, and military applications. However, current FPD-CBCT systems generally face challenges in low-contrast, soft-tissue imaging. Model-based reconstruction can improve image quality in soft-tissue imaging compared to conventional filtered back-projection (FBP) by leveraging high-fidelity forward model and sophisticated regularization. In FPD-CBCT TBI imaging, measurement noise characteristics undergo substantial change following artifact correction, resulting in non-negligible noise amplification. In this work, we extend the penalized weighted least-squares (PWLS) image reconstruction to include the two dominant artifact corrections (scatter and beam hardening) in FPD-CBCT TBI imaging by correctly modeling the variance change following each correction. Experiments were performed on a CBCT test-bench using an anthropomorphic phantom emulating intra-parenchymal hemorrhage in acute TBI, and the proposed method demonstrated an improvement in blood-brain contrast-to-noise ratio (CNR = 14.2) compared to FBP (CNR = 9.6) and PWLS using conventional weights (CNR = 11.6) at fixed spatial resolution (1 mm edge-spread width at the target contrast). The results support the hypothesis that FPD-CBCT can fulfill the image quality requirements for reliable TBI detection, using high-fidelity artifact correction and statistical reconstruction with accurate post-artifact-correction noise models.

Development of Prior Image-Based, High-Quality, Low-Dose Kilovoltage Cone Beam CT for Use in Adaptive Radiotherapy of Prostate Cancer

DTIC Science & Technology

2011-05-01

for the research in the next year. The aims in the next year include further develop- ment of the prior image- based , narrowly collimated CBCT imaging...further investigation planned for the next year. 5 BODY 1 Research Accomplishments 1.1 Implement narrow beam collimation for CBCT ROI imaging I have...noise level to mimic different mAs used in clinical and research modes of the CBCT system. Based upon experiences with the numerical phantom, I designed

TU-H-CAMPUS-JeP1-04: Deformable Image Registration Performances in Pelvis Patients: Impact of CBCT Image Quality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fusella, M; Loi, G; Fiandra, C

Purpose: To investigate the accuracy and robustness, against image noise and artifacts (typical of CBCT images), of a commercial algorithm for deformable image registration (DIR), to propagate regions of interest (ROIs) in computational phantoms based on real prostate patient images. Methods: The Anaconda DIR algorithm, implemented in RayStation was tested. Two specific Deformation Vector Fields (DVFs) were applied to the reference data set (CTref) using the ImSimQA software, obtaining two deformed CTs. For each dataset twenty-four different level of noise and/or capping artifacts were applied to simulate CBCT images. DIR was performed between CTref and each deformed CTs and CBCTs.more » In order to investigate the relationship between image quality parameters and the DIR results (expressed by a logit transform of the Dice Index) a bilinear regression was defined. Results: More than 550 DIR-mapped ROIs were analyzed. The Statistical analysis states that deformation strenght and artifacts were significant prognostic factors of DIR performances, while noise appeared to have a minor role in DIR process as implemented in RayStation as expected by the image similarity metric built in the registration algorithm. Capping artifacts reveals a determinant role for the accuracy of DIR results. Two optimal values for capping artifacts were found to obtain acceptable DIR results (DICE> 075/ 0.85). Various clinical CBCT acquisition protocol were reported to evaluate the significance of the study. Conclusion: This work illustrates the impact of image quality on DIR performance. Clinical issues like Adaptive Radiation Therapy (ART) and Dose Accumulation need accurate and robust DIR software. The RayStation DIR algorithm resulted robust against noise, but sensitive to image artifacts. This result highlights the need of robustness quality assurance against image noise and artifacts in the commissioning of a DIR commercial system and underlines the importance to adopt optimized protocols for CBCT image acquisitions in ART clinical implementation.« less

Radiation dose and image quality of X-ray volume imaging systems: cone-beam computed tomography, digital subtraction angiography and digital fluoroscopy.

PubMed

Paul, Jijo; Jacobi, Volkmar; Farhang, Mohammad; Bazrafshan, Babak; Vogl, Thomas J; Mbalisike, Emmanuel C

2013-06-01

Radiation dose and image quality estimation of three X-ray volume imaging (XVI) systems. A total of 126 patients were examined using three XVI systems (groups 1-3) and their data were retrospectively analysed from 2007 to 2012. Each group consisted of 42 patients and each patient was examined using cone-beam computed tomography (CBCT), digital subtraction angiography (DSA) and digital fluoroscopy (DF). Dose parameters such as dose-area product (DAP), skin entry dose (SED) and image quality parameters such as Hounsfield unit (HU), noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were estimated and compared using appropriate statistical tests. Mean DAP and SED were lower in recent XVI than its previous counterparts in CBCT, DSA and DF. HU of all measured locations was non-significant between the groups except the hepatic artery. Noise showed significant difference among groups (P < 0.05). Regarding CNR and SNR, the recent XVI showed a higher and significant difference compared to its previous versions. Qualitatively, CBCT showed significance between versions unlike the DSA and DF which showed non-significance. A reduction of radiation dose was obtained for the recent-generation XVI system in CBCT, DSA and DF. Image noise was significantly lower; SNR and CNR were higher than in previous versions. The technological advancements and the reduction in the number of frames led to a significant dose reduction and improved image quality with the recent-generation XVI system. • X-ray volume imaging (XVI) systems are increasingly used for interventional radiological procedures. • More modern XVI systems use lower radiation doses compared with earlier counterparts. • Furthermore more modern XVI systems provide higher image quality. • Technological advances reduce radiation dose and improve image quality.

Volume of interest CBCT and tube current modulation for image guidance using dynamic kV collimation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parsons, David, E-mail: david.parsons@dal.ca, E-mail: james.robar@nshealth.ca; Robar, James L., E-mail: david.parsons@dal.ca, E-mail: james.robar@nshealth.ca

2016-04-15

Purpose: The focus of this work is the development of a novel blade collimation system enabling volume of interest (VOI) CBCT with tube current modulation using the kV image guidance source on a linear accelerator. Advantages of the system are assessed, particularly with regard to reduction and localization of dose and improvement of image quality. Methods: A four blade dynamic kV collimator was developed to track a VOI during a CBCT acquisition. The current prototype is capable of tracking an arbitrary volume defined by the treatment planner for subsequent CBCT guidance. During gantry rotation, the collimator tracks the VOI withmore » adjustment of position and dimension. CBCT image quality was investigated as a function of collimator dimension, while maintaining the same dose to the VOI, for a 22.2 cm diameter cylindrical water phantom with a 9 mm diameter bone insert centered on isocenter. Dose distributions were modeled using a dynamic BEAMnrc library and DOSXYZnrc. The resulting VOI dose distributions were compared to full-field CBCT distributions to quantify dose reduction and localization to the target volume. A novel method of optimizing x-ray tube current during CBCT acquisition was developed and assessed with regard to contrast-to-noise ratio (CNR) and imaging dose. Results: Measurements show that the VOI CBCT method using the dynamic blade system yields an increase in contrast-to-noise ratio by a factor of approximately 2.2. Depending upon the anatomical site, dose was reduced to 15%–80% of the full-field CBCT value along the central axis plane and down to less than 1% out of plane. The use of tube current modulation allowed for specification of a desired SNR within projection data. For approximately the same dose to the VOI, CNR was further increased by a factor of 1.2 for modulated VOI CBCT, giving a combined improvement of 2.6 compared to full-field CBCT. Conclusions: The present dynamic blade system provides significant improvements in CNR for the same imaging dose and localization of imaging dose to a predefined volume of interest. The approach is compatible with tube current modulation, allowing optimization of the imaging protocol.« less

Regularization design for high-quality cone-beam CT of intracranial hemorrhage using statistical reconstruction

NASA Astrophysics Data System (ADS)

Dang, H.; Stayman, J. W.; Xu, J.; Sisniega, A.; Zbijewski, W.; Wang, X.; Foos, D. H.; Aygun, N.; Koliatsos, V. E.; Siewerdsen, J. H.

2016-03-01

Intracranial hemorrhage (ICH) is associated with pathologies such as hemorrhagic stroke and traumatic brain injury. Multi-detector CT is the current front-line imaging modality for detecting ICH (fresh blood contrast 40-80 HU, down to 1 mm). Flat-panel detector (FPD) cone-beam CT (CBCT) offers a potential alternative with a smaller scanner footprint, greater portability, and lower cost potentially well suited to deployment at the point of care outside standard diagnostic radiology and emergency room settings. Previous studies have suggested reliable detection of ICH down to 3 mm in CBCT using high-fidelity artifact correction and penalized weighted least-squared (PWLS) image reconstruction with a post-artifact-correction noise model. However, ICH reconstructed by traditional image regularization exhibits nonuniform spatial resolution and noise due to interaction between the statistical weights and regularization, which potentially degrades the detectability of ICH. In this work, we propose three regularization methods designed to overcome these challenges. The first two compute spatially varying certainty for uniform spatial resolution and noise, respectively. The third computes spatially varying regularization strength to achieve uniform "detectability," combining both spatial resolution and noise in a manner analogous to a delta-function detection task. Experiments were conducted on a CBCT test-bench, and image quality was evaluated for simulated ICH in different regions of an anthropomorphic head. The first two methods improved the uniformity in spatial resolution and noise compared to traditional regularization. The third exhibited the highest uniformity in detectability among all methods and best overall image quality. The proposed regularization provides a valuable means to achieve uniform image quality in CBCT of ICH and is being incorporated in a CBCT prototype for ICH imaging.

Inverse determination of the penalty parameter in penalized weighted least-squares algorithm for noise reduction of low-dose CBCT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Jing; Guan, Huaiqun; Solberg, Timothy

2011-07-15

Purpose: A statistical projection restoration algorithm based on the penalized weighted least-squares (PWLS) criterion can substantially improve the image quality of low-dose CBCT images. The performance of PWLS is largely dependent on the choice of the penalty parameter. Previously, the penalty parameter was chosen empirically by trial and error. In this work, the authors developed an inverse technique to calculate the penalty parameter in PWLS for noise suppression of low-dose CBCT in image guided radiotherapy (IGRT). Methods: In IGRT, a daily CBCT is acquired for the same patient during a treatment course. In this work, the authors acquired the CBCTmore » with a high-mAs protocol for the first session and then a lower mAs protocol for the subsequent sessions. The high-mAs projections served as the goal (ideal) toward, which the low-mAs projections were to be smoothed by minimizing the PWLS objective function. The penalty parameter was determined through an inverse calculation of the derivative of the objective function incorporating both the high and low-mAs projections. Then the parameter obtained can be used for PWLS to smooth the noise in low-dose projections. CBCT projections for a CatPhan 600 and an anthropomorphic head phantom, as well as for a brain patient, were used to evaluate the performance of the proposed technique. Results: The penalty parameter in PWLS was obtained for each CBCT projection using the proposed strategy. The noise in the low-dose CBCT images reconstructed from the smoothed projections was greatly suppressed. Image quality in PWLS-processed low-dose CBCT was comparable to its corresponding high-dose CBCT. Conclusions: A technique was proposed to estimate the penalty parameter for PWLS algorithm. It provides an objective and efficient way to obtain the penalty parameter for image restoration algorithms that require predefined smoothing parameters.« less

WE-G-18A-01: JUNIOR INVESTIGATOR WINNER - Low-Dose C-Arm Cone-Beam CT with Model-Based Image Reconstruction for High-Quality Guidance of Neurosurgical Intervention

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, A; Stayman, J; Otake, Y

Purpose: To address the challenges of image quality, radiation dose, and reconstruction speed in intraoperative cone-beam CT (CBCT) for neurosurgery by combining model-based image reconstruction (MBIR) with accelerated algorithmic and computational methods. Methods: Preclinical studies involved a mobile C-arm for CBCT imaging of two anthropomorphic head phantoms that included simulated imaging targets (ventricles, soft-tissue structures/bleeds) and neurosurgical procedures (deep brain stimulation (DBS) electrode insertion) for assessment of image quality. The penalized likelihood (PL) framework was used for MBIR, incorporating a statistical model with image regularization via an edgepreserving penalty. To accelerate PL reconstruction, the ordered-subset, separable quadratic surrogates (OS-SQS) algorithmmore » was modified to incorporate Nesterov's method and implemented on a multi-GPU system. A fair comparison of image quality between PL and conventional filtered backprojection (FBP) was performed by selecting reconstruction parameters that provided matched low-contrast spatial resolution. Results: CBCT images of the head phantoms demonstrated that PL reconstruction improved image quality (∼28% higher CNR) even at half the radiation dose (3.3 mGy) compared to FBP. A combination of Nesterov's method and fast projectors yielded a PL reconstruction run-time of 251 sec (cf., 5729 sec for OS-SQS, 13 sec for FBP). Insertion of a DBS electrode resulted in severe metal artifact streaks in FBP reconstructions, whereas PL was intrinsically robust against metal artifact. The combination of noise and artifact was reduced from 32.2 HU in FBP to 9.5 HU in PL, thereby providing better assessment of device placement and potential complications. Conclusion: The methods can be applied to intraoperative CBCT for guidance and verification of neurosurgical procedures (DBS electrode insertion, biopsy, tumor resection) and detection of complications (intracranial hemorrhage). Significant improvement in image quality, dose reduction, and reconstruction time of ∼4 min will enable practical deployment of low-dose C-arm CBCT within the operating room. AAPM Research Seed Funding (2013-2014); NIH Fellowship F32EB017571; Siemens Healthcare (XP Division)« less

A biomechanical modeling guided simultaneous motion estimation and image reconstruction technique (SMEIR-Bio) for 4D-CBCT reconstruction

NASA Astrophysics Data System (ADS)

Huang, Xiaokun; Zhang, You; Wang, Jing

2017-03-01

Four-dimensional (4D) cone-beam computed tomography (CBCT) enables motion tracking of anatomical structures and removes artifacts introduced by motion. However, the imaging time/dose of 4D-CBCT is substantially longer/higher than traditional 3D-CBCT. We previously developed a simultaneous motion estimation and image reconstruction (SMEIR) algorithm, to reconstruct high-quality 4D-CBCT from limited number of projections to reduce the imaging time/dose. However, the accuracy of SMEIR is limited in reconstructing low-contrast regions with fine structure details. In this study, we incorporate biomechanical modeling into the SMEIR algorithm (SMEIR-Bio), to improve the reconstruction accuracy at low-contrast regions with fine details. The efficacy of SMEIR-Bio is evaluated using 11 lung patient cases and compared to that of the original SMEIR algorithm. Qualitative and quantitative comparisons showed that SMEIR-Bio greatly enhances the accuracy of reconstructed 4D-CBCT volume in low-contrast regions, which can potentially benefit multiple clinical applications including the treatment outcome analysis.

Image quality in thoracic 4D cone-beam CT: A sensitivity analysis of respiratory signal, binning method, reconstruction algorithm, and projection angular spacing

PubMed Central

Shieh, Chun-Chien; Kipritidis, John; O’Brien, Ricky T.; Kuncic, Zdenka; Keall, Paul J.

2014-01-01

Purpose: Respiratory signal, binning method, and reconstruction algorithm are three major controllable factors affecting image quality in thoracic 4D cone-beam CT (4D-CBCT), which is widely used in image guided radiotherapy (IGRT). Previous studies have investigated each of these factors individually, but no integrated sensitivity analysis has been performed. In addition, projection angular spacing is also a key factor in reconstruction, but how it affects image quality is not obvious. An investigation of the impacts of these four factors on image quality can help determine the most effective strategy in improving 4D-CBCT for IGRT. Methods: Fourteen 4D-CBCT patient projection datasets with various respiratory motion features were reconstructed with the following controllable factors: (i) respiratory signal (real-time position management, projection image intensity analysis, or fiducial marker tracking), (ii) binning method (phase, displacement, or equal-projection-density displacement binning), and (iii) reconstruction algorithm [Feldkamp–Davis–Kress (FDK), McKinnon–Bates (MKB), or adaptive-steepest-descent projection-onto-convex-sets (ASD-POCS)]. The image quality was quantified using signal-to-noise ratio (SNR), contrast-to-noise ratio, and edge-response width in order to assess noise/streaking and blur. The SNR values were also analyzed with respect to the maximum, mean, and root-mean-squared-error (RMSE) projection angular spacing to investigate how projection angular spacing affects image quality. Results: The choice of respiratory signals was found to have no significant impact on image quality. Displacement-based binning was found to be less prone to motion artifacts compared to phase binning in more than half of the cases, but was shown to suffer from large interbin image quality variation and large projection angular gaps. Both MKB and ASD-POCS resulted in noticeably improved image quality almost 100% of the time relative to FDK. In addition, SNR values were found to increase with decreasing RMSE values of projection angular gaps with strong correlations (r ≈ −0.7) regardless of the reconstruction algorithm used. Conclusions: Based on the authors’ results, displacement-based binning methods, better reconstruction algorithms, and the acquisition of even projection angular views are the most important factors to consider for improving thoracic 4D-CBCT image quality. In view of the practical issues with displacement-based binning and the fact that projection angular spacing is not currently directly controllable, development of better reconstruction algorithms represents the most effective strategy for improving image quality in thoracic 4D-CBCT for IGRT applications at the current stage. PMID:24694143

Feasibility of CBCT dosimetry for IMRT using a normoxic polymethacrylic-acid gel dosimeter

NASA Astrophysics Data System (ADS)

Bong, Ji Hye; Kwon, Soo-Il; Kim, Kum Bae; Kim, Mi Suk; Jung, Hai Jo; Ji, Young Hoon; Ko, In Ok; Park, Ji Ae; Kim, Kyeong Min

2013-09-01

The purpose of this study is to evaluate the availability of cone-beam computed tomography(CBCT) for gel dosimetry. The absorbed dose was analyzed by using intensity-modulated radiation therapy(IMRT) to irradiate several tumor shapes with a calculated dose and several tumor acquiring images with CBCT in order to verify the possibility of reading a dose on the polymer gel dosimeter by means of the CBCT image. The results were compared with those obtained using magnetic resonance imaging(MRI) and CT. The linear correlation coefficients at doses less than 10 Gy for the polymer gel dosimeter were 0.967, 0.933 and 0.985 for MRI, CT and CBCT, respectively. The dose profile was symmetric on the basis of the vertical axis in a circular shape, and the uniformity was 2.50% for the MRI and 8.73% for both the CT and the CBCT. In addition, the gradient in the MR image of the gel dosimeter irradiated in an H shape was 109.88 while the gradients of the CT and the CBCT were 71.95 and 14.62, respectively. Based on better image quality, the present study showed that CBCT dosimetry for IMRT could be restrictively performed using a normoxic polymethacrylic-acid gel dosimeter.

SU-F-J-39: Dose Reduction Strategy Using Attenuation-Based Tube Current Modulation Method in CBCT for IGRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Son, K; Lee, H; Kim, C

2016-06-15

Purpose: To reduce radiation dose to the patients, tube current modulation (TCM) method has been actively used in diagnostic CT systems. However, TCM method has not yet been applied to a kV-CBCT system on a LINAC machine. The purpose of this study is to investigate whether the use of TCM method is desirable in kV-CBCT system for IGRT. We have developed an attenuation-based tube current modulation (a-TCM) method using the prior knowledge of treatment CT image of a patient. Methods: Patients go through a diagnostic CT scan for RT planning; therefore, using this prior information of CT images, one canmore » estimate the total attenuation of an x-ray through the patient body in a CBCT setting for radiation therapy. We performed a numerical study incorporating major factors into account such as polychromatic x-ray, scatter, noise, and bow-tie filter to demonstrate that a-TCM method can produce equivalent quality of images at reduced imaging radiation doses. Using the CT projector program, 680 projection images of the pediatric XCAT phantom were obtained both in conventional scanning condition, i.e., without modulating the tube current, and in the proposed a-TCM scanning condition. FDK reconstruction algorithm was used for image reconstruction, and the organ dose due to imaging radiation has been calculated in both cases and compared using GATE/Geant4 simulation toolkit. Results: Reconstructed CT images in the a-TCM method showed similar SSIM values and noise properties to the reference images acquired by the conventional CBCT. In addition, reduction of organ doses ranged from 12% to 27%. Conclusion: We have successfully demonstrated the feasibility and dosimetric merit of the a-TCM method for kV-CBCT, and envision that it can be a useful option of CBCT scanning that provides patient dose reduction without degrading image quality.« less

Patient movement characteristics and the impact on CBCT image quality and interpretability.

PubMed

Spin-Neto, Rubens; Costa, Cláudio; Salgado, Daniela Mra; Zambrana, Nataly Rm; Gotfredsen, Erik; Wenzel, Ann

2018-01-01

To assess the impact of patient movement characteristics and metal/radiopaque materials in the field-of-view (FOV) on CBCT image quality and interpretability. 162 CBCT examinations were performed in 134 consecutive (i.e. prospective data collection) patients (age average: 27.2 years; range: 9-73). An accelerometer-gyroscope system registered patient's head position during examination. The threshold for movement definition was set at ≥0.5-mm movement distance based on accelerometer-gyroscope recording. Movement complexity was defined as uniplanar/multiplanar. Three observers scored independently: presence of stripe (i.e. streak) artefacts (absent/"enamel stripes"/"metal stripes"/"movement stripes"), overall unsharpness (absent/present) and image interpretability (interpretable/not interpretable). Kappa statistics assessed interobserver agreement. χ 2 tests analysed whether movement distance, movement complexity and metal/radiopaque material in the FOV affected image quality and image interpretability. Relevant risk factors (p ≤ 0.20) were entered into a multivariate logistic regression analysis with "not interpretable" as the outcome. Interobserver agreement for image interpretability was good (average = 0.65). Movement distance and presence of metal/radiopaque materials significantly affected image quality and interpretability. There were 22-28 cases, in which the observers stated the image was not interpretable. Small movements (i.e. <3 mm) did not significantly affect image interpretability. For movements ≥ 3 mm, the risk that a case was scored as "not interpretable" was significantly (p ≤ 0.05) increased [OR 3.2-11.3; 95% CI (0.70-65.47)]. Metal/radiopaque material was also a significant (p ≤ 0.05) risk factor (OR 3.61-5.05). Patient movement ≥3 mm and metal/radiopaque material in the FOV significantly affected CBCT image quality and interpretability.

Influence of patient position and other inherent factors on image quality in two different cone beam computed tomography (CBCT) devices.

PubMed

Lindfors, Ninita; Lund, Henrik; Johansson, Hans; Ekestubbe, Annika

2017-01-01

The aim of this in vitro study was to evaluate how a deviation from the horizontal plane, affects the image quality in two different CBCT-devices. A phantom head SK150 (RANDO, The Phantom Laboratory, Salem, NY, USA) was examined in two CBCT-units: Accuitomo 80 and Veraviewepocs 3D R100 (J. Morita Mfg. Corp. Kyoto, Japan). The phantom head was placed with the hard palate parallel to the horizontal plane and tilted 20 ° backwards. Exposures were performed with different field of views (FOVs), voxel sizes, slice thicknesses and exposure settings. Effective dose was calculated using PCXMC 2.0 (STUK, Helsinki, Finland). Image quality was assessed using contrast-to-noise-ratio (CNR). Region of interest (ROI) was set at three different levels of the mandibular bone and soft tissue, uni- and bilaterally in small and large FOVs, respectively. CNR values were calculated by CT-value and standard deviation for each ROI. Factor analysis was used to analyze the material. Tilting the phantom head backwards rendered significantly higher mean CNR values regardless of FOV. The effective dose was lower in small than in large FOVs and varied to a larger extent between CBCT-devices in large FOVs. Head position can affect the image quality. Tilting the head backward improved image quality in the mandibular region. However, if influenced by other variables e.g. motion artifacts in a clinical situation, remains to be further investigated. Image quality assessed using CNR values to investigate the influence of different patient positions and FOVs.

Statistical reconstruction for cone-beam CT with a post-artifact-correction noise model: application to high-quality head imaging

NASA Astrophysics Data System (ADS)

Dang, H.; Stayman, J. W.; Sisniega, A.; Xu, J.; Zbijewski, W.; Wang, X.; Foos, D. H.; Aygun, N.; Koliatsos, V. E.; Siewerdsen, J. H.

2015-08-01

Non-contrast CT reliably detects fresh blood in the brain and is the current front-line imaging modality for intracranial hemorrhage such as that occurring in acute traumatic brain injury (contrast ~40-80 HU, size  >  1 mm). We are developing flat-panel detector (FPD) cone-beam CT (CBCT) to facilitate such diagnosis in a low-cost, mobile platform suitable for point-of-care deployment. Such a system may offer benefits in the ICU, urgent care/concussion clinic, ambulance, and sports and military theatres. However, current FPD-CBCT systems face significant challenges that confound low-contrast, soft-tissue imaging. Artifact correction can overcome major sources of bias in FPD-CBCT but imparts noise amplification in filtered backprojection (FBP). Model-based reconstruction improves soft-tissue image quality compared to FBP by leveraging a high-fidelity forward model and image regularization. In this work, we develop a novel penalized weighted least-squares (PWLS) image reconstruction method with a noise model that includes accurate modeling of the noise characteristics associated with the two dominant artifact corrections (scatter and beam-hardening) in CBCT and utilizes modified weights to compensate for noise amplification imparted by each correction. Experiments included real data acquired on a FPD-CBCT test-bench and an anthropomorphic head phantom emulating intra-parenchymal hemorrhage. The proposed PWLS method demonstrated superior noise-resolution tradeoffs in comparison to FBP and PWLS with conventional weights (viz. at matched 0.50 mm spatial resolution, CNR = 11.9 compared to CNR = 5.6 and CNR = 9.9, respectively) and substantially reduced image noise especially in challenging regions such as skull base. The results support the hypothesis that with high-fidelity artifact correction and statistical reconstruction using an accurate post-artifact-correction noise model, FPD-CBCT can achieve image quality allowing reliable detection of intracranial hemorrhage.

Cone-Beam CT with a Flat-Panel Detector: From Image Science to Image-Guided Surgery

PubMed Central

Siewerdsen, Jeffrey H.

2011-01-01

The development of large-area flat-panel x-ray detectors (FPDs) has spurred investigation in a spectrum of advanced medical imaging applications, including tomosynthesis and cone-beam CT (CBCT). Recent research has extended image quality metrics and theoretical models to such applications, providing a quantitative foundation for the assessment of imaging performance as well as a general framework for the design, optimization, and translation of such technologies to new applications. For example, cascaded systems models of Fourier domain metrics, such as noise-equivalent quanta (NEQ), have been extended to these modalities to describe the propagation of signal and noise through the image acquisition and reconstruction chain and to quantify the factors that govern spatial resolution, image noise, and detectability. Moreover, such models have demonstrated basic agreement with human observer performance for a broad range of imaging conditions and imaging tasks. These developments in image science have formed a foundation for the knowledgeable development and translation of CBCT to new applications in image-guided interventions - for example, CBCT implemented on a mobile surgical C-arm for intraoperative 3D imaging. The ability to acquire high-quality 3D images on demand during surgical intervention overcomes conventional limitations of surgical guidance in the context of preoperative images alone. A prototype mobile C-arm developed in academic-industry partnership demonstrates CBCT with low radiation dose, sub-mm spatial resolution, and soft-tissue visibility potentially approaching that of diagnostic CT. Integration of the 3D imaging system with real-time tracking, deformable registration, endoscopic video, and 3D visualization offers a promising addition to the surgical arsenal in interventions ranging from head-and-neck / skull base surgery to spine, orthopaedic, thoracic, and abdominal surgeries. Cadaver studies show the potential for significant boosts in surgical performance under CBCT guidance, and early clinical trials demonstrate feasibility, workflow, and image quality within the surgical theatre. PMID:22942510

Common-mask guided image reconstruction (c-MGIR) for enhanced 4D cone-beam computed tomography

NASA Astrophysics Data System (ADS)

Park, Justin C.; Zhang, Hao; Chen, Yunmei; Fan, Qiyong; Li, Jonathan G.; Liu, Chihray; Lu, Bo

2015-12-01

Compared to 3D cone beam computed tomography (3D CBCT), the image quality of commercially available four-dimensional (4D) CBCT is severely impaired due to the insufficient amount of projection data available for each phase. Since the traditional Feldkamp-Davis-Kress (FDK)-based algorithm is infeasible for reconstructing high quality 4D CBCT images with limited projections, investigators had developed several compress-sensing (CS) based algorithms to improve image quality. The aim of this study is to develop a novel algorithm which can provide better image quality than the FDK and other CS based algorithms with limited projections. We named this algorithm ‘the common mask guided image reconstruction’ (c-MGIR). In c-MGIR, the unknown CBCT volume is mathematically modeled as a combination of phase-specific motion vectors and phase-independent static vectors. The common-mask matrix, which is the key concept behind the c-MGIR algorithm, separates the common static part across all phase images from the possible moving part in each phase image. The moving part and the static part of the volumes were then alternatively updated by solving two sub-minimization problems iteratively. As the novel mathematical transformation allows the static volume and moving volumes to be updated (during each iteration) with global projections and ‘well’ solved static volume respectively, the algorithm was able to reduce the noise and under-sampling artifact (an issue faced by other algorithms) to the maximum extent. To evaluate the performance of our proposed c-MGIR, we utilized imaging data from both numerical phantoms and a lung cancer patient. The qualities of the images reconstructed with c-MGIR were compared with (1) standard FDK algorithm, (2) conventional total variation (CTV) based algorithm, (3) prior image constrained compressed sensing (PICCS) algorithm, and (4) motion-map constrained image reconstruction (MCIR) algorithm, respectively. To improve the efficiency of the algorithm, the code was implemented with a graphic processing unit for parallel processing purposes. Root mean square error (RMSE) between the ground truth and reconstructed volumes of the numerical phantom were in the descending order of FDK, CTV, PICCS, MCIR, and c-MGIR for all phases. Specifically, the means and the standard deviations of the RMSE of FDK, CTV, PICCS, MCIR and c-MGIR for all phases were 42.64  ±  6.5%, 3.63  ±  0.83%, 1.31%  ±  0.09%, 0.86%  ±  0.11% and 0.52 %  ±  0.02%, respectively. The image quality of the patient case also indicated the superiority of c-MGIR compared to other algorithms. The results indicated that clinically viable 4D CBCT images can be reconstructed while requiring no more projection data than a typical clinical 3D CBCT scan. This makes c-MGIR a potential online reconstruction algorithm for 4D CBCT, which can provide much better image quality than other available algorithms, while requiring less dose and potentially less scanning time.

Common-mask guided image reconstruction (c-MGIR) for enhanced 4D cone-beam computed tomography.

PubMed

Park, Justin C; Zhang, Hao; Chen, Yunmei; Fan, Qiyong; Li, Jonathan G; Liu, Chihray; Lu, Bo

2015-12-07

Compared to 3D cone beam computed tomography (3D CBCT), the image quality of commercially available four-dimensional (4D) CBCT is severely impaired due to the insufficient amount of projection data available for each phase. Since the traditional Feldkamp-Davis-Kress (FDK)-based algorithm is infeasible for reconstructing high quality 4D CBCT images with limited projections, investigators had developed several compress-sensing (CS) based algorithms to improve image quality. The aim of this study is to develop a novel algorithm which can provide better image quality than the FDK and other CS based algorithms with limited projections. We named this algorithm 'the common mask guided image reconstruction' (c-MGIR).In c-MGIR, the unknown CBCT volume is mathematically modeled as a combination of phase-specific motion vectors and phase-independent static vectors. The common-mask matrix, which is the key concept behind the c-MGIR algorithm, separates the common static part across all phase images from the possible moving part in each phase image. The moving part and the static part of the volumes were then alternatively updated by solving two sub-minimization problems iteratively. As the novel mathematical transformation allows the static volume and moving volumes to be updated (during each iteration) with global projections and 'well' solved static volume respectively, the algorithm was able to reduce the noise and under-sampling artifact (an issue faced by other algorithms) to the maximum extent. To evaluate the performance of our proposed c-MGIR, we utilized imaging data from both numerical phantoms and a lung cancer patient. The qualities of the images reconstructed with c-MGIR were compared with (1) standard FDK algorithm, (2) conventional total variation (CTV) based algorithm, (3) prior image constrained compressed sensing (PICCS) algorithm, and (4) motion-map constrained image reconstruction (MCIR) algorithm, respectively. To improve the efficiency of the algorithm, the code was implemented with a graphic processing unit for parallel processing purposes.Root mean square error (RMSE) between the ground truth and reconstructed volumes of the numerical phantom were in the descending order of FDK, CTV, PICCS, MCIR, and c-MGIR for all phases. Specifically, the means and the standard deviations of the RMSE of FDK, CTV, PICCS, MCIR and c-MGIR for all phases were 42.64  ±  6.5%, 3.63  ±  0.83%, 1.31%  ±  0.09%, 0.86%  ±  0.11% and 0.52 %  ±  0.02%, respectively. The image quality of the patient case also indicated the superiority of c-MGIR compared to other algorithms.The results indicated that clinically viable 4D CBCT images can be reconstructed while requiring no more projection data than a typical clinical 3D CBCT scan. This makes c-MGIR a potential online reconstruction algorithm for 4D CBCT, which can provide much better image quality than other available algorithms, while requiring less dose and potentially less scanning time.

Accounting for patient size in the optimization of dose and image quality of pelvis cone beam CT protocols on the Varian OBI system.

PubMed

Wood, Tim J; Moore, Craig S; Horsfield, Carl J; Saunderson, John R; Beavis, Andrew W

2015-01-01

The purpose of this study was to develop size-based radiotherapy kilovoltage cone beam CT (CBCT) protocols for the pelvis. Image noise was measured in an elliptical phantom of varying size for a range of exposure factors. Based on a previously defined "small pelvis" reference patient and CBCT protocol, appropriate exposure factors for small, medium, large and extra-large patients were derived which approximate the image noise behaviour observed on a Philips CT scanner (Philips Medical Systems, Best, Netherlands) with automatic exposure control (AEC). Selection criteria, based on maximum tube current-time product per rotation selected during the radiotherapy treatment planning scan, were derived based on an audit of patient size. It has been demonstrated that 110 kVp yields acceptable image noise for reduced patient dose in pelvic CBCT scans of small, medium and large patients, when compared with manufacturer's default settings (125 kVp). Conversely, extra-large patients require increased exposure factors to give acceptable images. 57% of patients in the local population now receive much lower radiation doses, whereas 13% require higher doses (but now yield acceptable images). The implementation of size-based exposure protocols has significantly reduced radiation dose to the majority of patients with no negative impact on image quality. Increased doses are required on the largest patients to give adequate image quality. The development of size-based CBCT protocols that use the planning CT scan (with AEC) to determine which protocol is appropriate ensures adequate image quality whilst minimizing patient radiation dose.

Evaluation of non-rigid constrained CT/CBCT registration algorithms for delineation propagation in the context of prostate cancer radiotherapy

NASA Astrophysics Data System (ADS)

Rubeaux, Mathieu; Simon, Antoine; Gnep, Khemara; Colliaux, Jérémy; Acosta, Oscar; de Crevoisier, Renaud; Haigron, Pascal

2013-03-01

Image-Guided Radiation Therapy (IGRT) aims at increasing the precision of radiation dose delivery. In the context of prostate cancer, a planning Computed Tomography (CT) image with manually defined prostate and organs at risk (OAR) delineations is usually associated with daily Cone Beam Computed Tomography (CBCT) follow-up images. The CBCT images allow to visualize the prostate position and to reposition the patient accordingly. They also should be used to evaluate the dose received by the organs at each fraction of the treatment. To do so, the first step is a prostate and OAR segmentation on the daily CBCTs, which is very timeconsuming. To simplify this task, CT to CBCT non-rigid registration could be used in order to propagate the original CT delineations in the CBCT images. For this aim, we compared several non-rigid registration methods. They are all based on the Mutual Information (MI) similarity measure, and use a BSpline transformation model. But we add different constraints to this global scheme in order to evaluate their impact on the final results. These algorithms are investigated on two real datasets, representing a total of 70 CBCT on which a reference delineation has been realized. The evaluation is led using the Dice Similarity Coefficient (DSC) as a quality criteria. The experiments show that a rigid penalty term on the bones improves the final registration result, providing high quality propagated delineations.

Dental cone-beam CT reconstruction from limited-angle view data based on compressed-sensing (CS) theory for fast, low-dose X-ray imaging

NASA Astrophysics Data System (ADS)

Je, Uikyu; Cho, Hyosung; Lee, Minsik; Oh, Jieun; Park, Yeonok; Hong, Daeki; Park, Cheulkyu; Cho, Heemoon; Choi, Sungil; Koo, Yangseo

2014-06-01

Recently, reducing radiation doses has become an issue of critical importance in the broader radiological community. As a possible technical approach, especially, in dental cone-beam computed tomography (CBCT), reconstruction from limited-angle view data (< 360°) would enable fast scanning with reduced doses to the patient. In this study, we investigated and implemented an efficient reconstruction algorithm based on compressed-sensing (CS) theory for the scan geometry and performed systematic simulation works to investigate the image characteristics. We also performed experimental works by applying the algorithm to a commercially-available dental CBCT system to demonstrate its effectiveness for image reconstruction in incomplete data problems. We successfully reconstructed CBCT images with incomplete projections acquired at selected scan angles of 120, 150, 180, and 200° with a fixed angle step of 1.2° and evaluated the reconstruction quality quantitatively. Both simulation and experimental demonstrations of the CS-based reconstruction from limited-angle view data show that the algorithm can be applied directly to current dental CBCT systems for reducing the imaging doses and further improving the image quality.

SU-E-J-36: Comparison of CBCT Image Quality for Manufacturer Default Imaging Modes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nelson, G

Purpose CBCT is being increasingly used in patient setup for radiotherapy. Often the manufacturer default scan modes are used for performing these CBCT scans with the assumption that they are the best options. To quantitatively assess the image quality of these scan modes, all of the scan modes were tested as well as options with the reconstruction algorithm. Methods A CatPhan 504 phantom was scanned on a TrueBeam Linear Accelerator using the manufacturer scan modes (FSRT Head, Head, Image Gently, Pelvis, Pelvis Obese, Spotlight, & Thorax). The Head mode scan was then reconstructed multiple times with all filter options (Smooth,more » Standard, Sharp, & Ultra Sharp) and all Ring Suppression options (Disabled, Weak, Medium, & Strong). An open source ImageJ tool was created for analyzing the CatPhan 504 images. Results The MTF curve was primarily dictated by the voxel size and the filter used in the reconstruction algorithm. The filters also impact the image noise. The CNR was worst for the Image Gently mode, followed by FSRT Head and Head. The sharper the filter, the worse the CNR. HU varied significantly between scan modes. Pelvis Obese had lower than expected HU values than most while the Image Gently mode had higher than expected HU values. If a therapist tried to use preset window and level settings, they would not show the desired tissue for some scan modes. Conclusion Knowing the image quality of the set scan modes, will enable users to better optimize their setup CBCT. Evaluation of the scan mode image quality could improve setup efficiency and lead to better treatment outcomes.« less

A Biomechanical Modeling Guided CBCT Estimation Technique

PubMed Central

Zhang, You; Tehrani, Joubin Nasehi; Wang, Jing

2017-01-01

Two-dimensional-to-three-dimensional (2D-3D) deformation has emerged as a new technique to estimate cone-beam computed tomography (CBCT) images. The technique is based on deforming a prior high-quality 3D CT/CBCT image to form a new CBCT image, guided by limited-view 2D projections. The accuracy of this intensity-based technique, however, is often limited in low-contrast image regions with subtle intensity differences. The solved deformation vector fields (DVFs) can also be biomechanically unrealistic. To address these problems, we have developed a biomechanical modeling guided CBCT estimation technique (Bio-CBCT-est) by combining 2D-3D deformation with finite element analysis (FEA)-based biomechanical modeling of anatomical structures. Specifically, Bio-CBCT-est first extracts the 2D-3D deformation-generated displacement vectors at the high-contrast anatomical structure boundaries. The extracted surface deformation fields are subsequently used as the boundary conditions to drive structure-based FEA to correct and fine-tune the overall deformation fields, especially those at low-contrast regions within the structure. The resulting FEA-corrected deformation fields are then fed back into 2D-3D deformation to form an iterative loop, combining the benefits of intensity-based deformation and biomechanical modeling for CBCT estimation. Using eleven lung cancer patient cases, the accuracy of the Bio-CBCT-est technique has been compared to that of the 2D-3D deformation technique and the traditional CBCT reconstruction techniques. The accuracy was evaluated in the image domain, and also in the DVF domain through clinician-tracked lung landmarks. PMID:27831866

Fundamentals of cone beam computed tomography for a prosthodontist

PubMed Central

John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R. B.

2015-01-01

Cone beam computed tomography (CBCT, also referred to as C-arm computed tomography [CT], cone beam volume CT, or flat panel CT) is a medical imaging technique of X-ray CT where the X-rays are divergent, forming a cone.[1] CBCT systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimeter resolution in images of high diagnostic quality, with short scanning times (10–70 s) and radiation dosages reportedly up to 15–100 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. The aim of this article is to sensitize the Prosthodontist to CBCT technology, provide an overview of currently available maxillofacial CBCT systems and review the specific application of various CBCT display modes to clinical Prosthodontic practice. A MEDLINE search for relevant articles in this specific area of interest was conducted. The selected articles were critically reviewed and the data acquired were systematically compiled. PMID:26929479

Image quality in thoracic 4D cone-beam CT: A sensitivity analysis of respiratory signal, binning method, reconstruction algorithm, and projection angular spacing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shieh, Chun-Chien; Kipritidis, John; O’Brien, Ricky T.

Purpose: Respiratory signal, binning method, and reconstruction algorithm are three major controllable factors affecting image quality in thoracic 4D cone-beam CT (4D-CBCT), which is widely used in image guided radiotherapy (IGRT). Previous studies have investigated each of these factors individually, but no integrated sensitivity analysis has been performed. In addition, projection angular spacing is also a key factor in reconstruction, but how it affects image quality is not obvious. An investigation of the impacts of these four factors on image quality can help determine the most effective strategy in improving 4D-CBCT for IGRT. Methods: Fourteen 4D-CBCT patient projection datasets withmore » various respiratory motion features were reconstructed with the following controllable factors: (i) respiratory signal (real-time position management, projection image intensity analysis, or fiducial marker tracking), (ii) binning method (phase, displacement, or equal-projection-density displacement binning), and (iii) reconstruction algorithm [Feldkamp–Davis–Kress (FDK), McKinnon–Bates (MKB), or adaptive-steepest-descent projection-onto-convex-sets (ASD-POCS)]. The image quality was quantified using signal-to-noise ratio (SNR), contrast-to-noise ratio, and edge-response width in order to assess noise/streaking and blur. The SNR values were also analyzed with respect to the maximum, mean, and root-mean-squared-error (RMSE) projection angular spacing to investigate how projection angular spacing affects image quality. Results: The choice of respiratory signals was found to have no significant impact on image quality. Displacement-based binning was found to be less prone to motion artifacts compared to phase binning in more than half of the cases, but was shown to suffer from large interbin image quality variation and large projection angular gaps. Both MKB and ASD-POCS resulted in noticeably improved image quality almost 100% of the time relative to FDK. In addition, SNR values were found to increase with decreasing RMSE values of projection angular gaps with strong correlations (r ≈ −0.7) regardless of the reconstruction algorithm used. Conclusions: Based on the authors’ results, displacement-based binning methods, better reconstruction algorithms, and the acquisition of even projection angular views are the most important factors to consider for improving thoracic 4D-CBCT image quality. In view of the practical issues with displacement-based binning and the fact that projection angular spacing is not currently directly controllable, development of better reconstruction algorithms represents the most effective strategy for improving image quality in thoracic 4D-CBCT for IGRT applications at the current stage.« less

SU-F-I-02: Comparative Analysis and Constancy Check of Image Quality Parameters for Three Linear Accelerators Per TG 142 Protocol

DOE Office of Scientific and Technical Information (OSTI.GOV)

Altundal, Y; Pokhrel, D; Jiang, H

Purpose: To compare image quality parameters and assessing the image stability of three different linear accelerators (linac) for 2D and 3D imaging modalities: planar kV, MV images and cone-beam CT (CBCT). Methods: QCkV1, QC-3 and Cathpan-600 phantoms were utilized to acquire kV, MV and CBCT images respectively on monthly basis per TG142 QA protocol for over 2 years on 21Ex, NovalisTx and TrueBeam linacs. DICOM images were analyzed with the help of QA analysis software: PIPsPro from Standard Imaging. For planar kV and MV images, planar spatial resolution, contrast to noise ratio (CNR) and noise; for CBCT, HU values weremore » collected and analyzed. Results: Two years of monthly QA measurements were analyzed for the planar and CBCT images. Values were normalized to the mean and the standard deviations (STD) are presented. For the kV planar radiographic images the STD of spatial resolution for f30, f40, f50, CNR and noise for 21Ex are 0.006, 0.011, 0.013, 0.046, 0.026; Novalis-Tx are 0.009, 0.016, 0.016, 0.067, 0.053 ; TrueBeam are 0.007, 0.005, 0.009, 0.017, 0.016 respectively. For the MV planar radiographic images, the STD of spatial resolution for f30, f40, f50, CNR and noise for 21Ex are 0.009, 0.010, 0.008, 0.023, 0.023; for Novalix-Tx are 0.012, 0.010, 0.008, 0.029, 0.023 and for TrueBeam are 0.010, 0.010, 0.007, 0.022, 0.022 respectively. For the CBCT images, HU constancies of Air, Polystyrene, Teflon, PMP, LDPE and Delrin for 21Ex are 0.014, 0.070, 0.031, 0.053, 0.076, 0.087; for Novalis Tx are 0.019, 0.047, 0.035, 0.059, 0.077, 0.087 and for TrueBeam are 0.011, 0.044, 0.025, 0.044, 0.056, 0.020 respectively. Conclusion: These Imaging QA results demonstrated that the TrueBeam, performed better in terms of image quality stability for both kV planer and CBCT images as well as EPID MV images, however other two linacs were also satisfied TG142 guidelines.« less

SU-C-207-04: Reconstruction Artifact Reduction in X-Ray Cone Beam CT Using a Treatment Couch Model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lasio, G; Hu, E; Zhou, J

2015-06-15

Purpose: to mitigate artifacts induced by the presence of the RT treatment couch in on-board CBCT and improve image quality Methods: a model of a Varian IGRT couch is constructed using a CBCT scan of the couch in air. The model is used to generate a set of forward projections (FP) of the treatment couch at specified gantry angles. The model couch forward projections are then used to process CBCT scan projections which contain the couch in addition to the scan object (Catphan phantom), in order to remove the attenuation component of the couch at any given gantry angle. Priormore » to pre-processing with the model FP, the Catphan projection data is normalized to an air scan with bowtie filter. The filtered Catphan projections are used to reconstruct the CBCT with an in-house FDK algorithm. The artifact reduction in the processed CBCT scan is assessed visually, and the image quality improvement is measured with the CNR over a few selected ROIs of the Catphan modules. Results: Sufficient match between the forward projected data and the x-ray projections is achieved to allow filtering in attenuation space. Visual improvement of the couch induced artifacts is achieved, with a moderate expense of CNR. Conclusion: Couch model-based correction of CBCT projection data has a potential for qualitative improvement of clinical CBCT scans, without requiring position specific correction data. The technique could be used to produce models of other artifact inducing devices, such as immobilization boards, and reduce their impact on patient CBCT images.« less

SU-E-J-133: Autosegmentation of Linac CBCT: Improved Accuracy Via Penalized Likelihood Reconstruction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Y

2015-06-15

Purpose: To improve the quality of kV X-ray cone beam CT (CBCT) for use in radiotherapy delivery assessment and re-planning by using penalized likelihood (PL) iterative reconstruction and auto-segmentation accuracy of the resulting CBCTs as an image quality metric. Methods: Present filtered backprojection (FBP) CBCT reconstructions can be improved upon by PL reconstruction with image formation models and appropriate regularization constraints. We use two constraints: 1) image smoothing via an edge preserving filter, and 2) a constraint minimizing the differences between the reconstruction and a registered prior image. Reconstructions of prostate therapy CBCTs were computed with constraint 1 alone andmore » with both constraints. The prior images were planning CTs(pCT) deformable-registered to the FBP reconstructions. Anatomy segmentations were done using atlas-based auto-segmentation (Elekta ADMIRE). Results: We observed small but consistent improvements in the Dice similarity coefficients of PL reconstructions over the FBP results, and additional small improvements with the added prior image constraint. For a CBCT with anatomy very similar in appearance to the pCT, we observed these changes in the Dice metric: +2.9% (prostate), +8.6% (rectum), −1.9% (bladder). For a second CBCT with a very different rectum configuration, we observed +0.8% (prostate), +8.9% (rectum), −1.2% (bladder). For a third case with significant lateral truncation of the field of view, we observed: +0.8% (prostate), +8.9% (rectum), −1.2% (bladder). Adding the prior image constraint raised Dice measures by about 1%. Conclusion: Efficient and practical adaptive radiotherapy requires accurate deformable registration and accurate anatomy delineation. We show here small and consistent patterns of improved contour accuracy using PL iterative reconstruction compared with FBP reconstruction. However, the modest extent of these results and the pattern of differences across CBCT cases suggest that significant further development will be required to make CBCT useful to adaptive radiotherapy.« less

Accounting for patient size in the optimization of dose and image quality of pelvis cone beam CT protocols on the Varian OBI system

PubMed Central

Moore, Craig S; Horsfield, Carl J; Saunderson, John R; Beavis, Andrew W

2015-01-01

Objective: The purpose of this study was to develop size-based radiotherapy kilovoltage cone beam CT (CBCT) protocols for the pelvis. Methods: Image noise was measured in an elliptical phantom of varying size for a range of exposure factors. Based on a previously defined “small pelvis” reference patient and CBCT protocol, appropriate exposure factors for small, medium, large and extra-large patients were derived which approximate the image noise behaviour observed on a Philips CT scanner (Philips Medical Systems, Best, Netherlands) with automatic exposure control (AEC). Selection criteria, based on maximum tube current–time product per rotation selected during the radiotherapy treatment planning scan, were derived based on an audit of patient size. Results: It has been demonstrated that 110 kVp yields acceptable image noise for reduced patient dose in pelvic CBCT scans of small, medium and large patients, when compared with manufacturer's default settings (125 kVp). Conversely, extra-large patients require increased exposure factors to give acceptable images. 57% of patients in the local population now receive much lower radiation doses, whereas 13% require higher doses (but now yield acceptable images). Conclusion: The implementation of size-based exposure protocols has significantly reduced radiation dose to the majority of patients with no negative impact on image quality. Increased doses are required on the largest patients to give adequate image quality. Advances in knowledge: The development of size-based CBCT protocols that use the planning CT scan (with AEC) to determine which protocol is appropriate ensures adequate image quality whilst minimizing patient radiation dose. PMID:26419892

Algorithm-enabled exploration of image-quality potential of cone-beam CT in image-guided radiation therapy

NASA Astrophysics Data System (ADS)

Han, Xiao; Pearson, Erik; Pelizzari, Charles; Al-Hallaq, Hania; Sidky, Emil Y.; Bian, Junguo; Pan, Xiaochuan

2015-06-01

Kilo-voltage (KV) cone-beam computed tomography (CBCT) unit mounted onto a linear accelerator treatment system, often referred to as on-board imager (OBI), plays an increasingly important role in image-guided radiation therapy. While the FDK algorithm is currently used for reconstructing images from clinical OBI data, optimization-based reconstruction has also been investigated for OBI CBCT. An optimization-based reconstruction involves numerous parameters, which can significantly impact reconstruction properties (or utility). The success of an optimization-based reconstruction for a particular class of practical applications thus relies strongly on appropriate selection of parameter values. In the work, we focus on tailoring the constrained-TV-minimization-based reconstruction, an optimization-based reconstruction previously shown of some potential for CBCT imaging conditions of practical interest, to OBI imaging through appropriate selection of parameter values. In particular, for given real data of phantoms and patient collected with OBI CBCT, we first devise utility metrics specific to OBI-quality-assurance tasks and then apply them to guiding the selection of parameter values in constrained-TV-minimization-based reconstruction. The study results show that the reconstructions are with improvement, relative to clinical FDK reconstruction, in both visualization and quantitative assessments in terms of the devised utility metrics.

Image analysis for dental bone quality assessment using CBCT imaging

NASA Astrophysics Data System (ADS)

Suprijanto; Epsilawati, L.; Hajarini, M. S.; Juliastuti, E.; Susanti, H.

2016-03-01

Cone beam computerized tomography (CBCT) is one of X-ray imaging modalities that are applied in dentistry. Its modality can visualize the oral region in 3D and in a high resolution. CBCT jaw image has potential information for the assessment of bone quality that often used for pre-operative implant planning. We propose comparison method based on normalized histogram (NH) on the region of inter-dental septum and premolar teeth. Furthermore, the NH characteristic from normal and abnormal bone condition are compared and analyzed. Four test parameters are proposed, i.e. the difference between teeth and bone average intensity (s), the ratio between bone and teeth average intensity (n) of NH, the difference between teeth and bone peak value (Δp) of NH, and the ratio between teeth and bone of NH range (r). The results showed that n, s, and Δp have potential to be the classification parameters of dental calcium density.

The use of cone beam computed tomography in the postoperative assessment of orbital wall fracture reconstruction.

PubMed

Tsao, Kim; Cheng, Andrew; Goss, Alastair; Donovan, David

2014-07-01

Computed tomography (CT) is currently the standard in postoperative evaluation of orbital wall fracture reconstruction, but cone beam computed tomography (CBCT) offers potential advantages including reduced radiation dose and cost. The purpose of this study is to examine objectively the image quality of CBCT in the postoperative evaluation of orbital fracture reconstruction, its radiation dose, and cost compared with CT. Four consecutive patients with orbital wall fractures in whom surgery was indicated underwent orbital reconstruction with radio-opaque grafts (bone, titanium-reinforced polyethylene, and titanium plate) and were assessed postoperatively with orbital CBCT. CBCT was evaluated for its ability to provide objective information regarding the adequacy of orbital reconstruction, radiation dose, and cost. In all patients, CBCT was feasible and provided hard tissue image quality comparable to CT with significantly reduced radiation dose and cost. However, it has poorer soft tissue resolution, which limits its ability to identify the extraocular muscles, their relationship to the reconstructive graft, and potential muscle entrapment. CBCT is a viable alternative to CT in the routine postoperative evaluation of orbital fracture reconstruction. However, in the patient who develops gaze restriction postoperatively, conventional CT is preferred over CBCT for its superior soft tissue resolution to exclude extraocular muscle entrapment.

Co-registration of cone beam CT and preoperative MRI for improved accuracy of electrode localization following cochlear implantation.

PubMed

Dragovic, A S; Stringer, A K; Campbell, L; Shaul, C; O'Leary, S J; Briggs, R J

2018-05-01

To investigate the clinical usefulness and practicality of co-registration of Cone Beam CT (CBCT) with preoperative Magnetic Resonance Imaging (MRI) for intracochlear localization of electrodes after cochlear implantation. Images of 20 adult patients who underwent CBCT after implantation were co-registered with preoperative MRI scans. Time taken for co-registration was recorded. The images were analysed by clinicians of varying levels of expertise to determine electrode position and ease of interpretation. After a short learning curve, the average co-registration time was 10.78 minutes (StdDev 2.37). All clinicians found the co-registered images easier to interpret than CBCT alone. The mean concordance of CBCT vs. co-registered image analysis between consultant otologists was 60% (17-100%) and 86% (60-100%), respectively. The sensitivity and specificity for CBCT to identify Scala Vestibuli insertion or translocation was 100 and 75%, respectively. The negative predictive value was 100%. CBCT should be performed following adult cochlear implantation for audit and quality control of surgical technique. If SV insertion or translocation is suspected, co-registration with preoperative MRI should be performed to enable easier analysis. There will be a learning curve for this process in terms of both the co-registration and the interpretation of images by clinicians.

SU-F-I-11: Software Development for 4D-CBCT Research of Real-Time-Image Gated Spot Scanning Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fujii, T; Fujii, Y; Shimizu, S

Purpose: To acquire correct information for inside the body in patient positioning of Real-time-image Gated spot scanning Proton Therapy (RGPT), utilization of tomographic image at exhale phase of patient respiration obtained from 4-dimensional Cone beam CT (4D-CBCT) has been desired. We developed software named “Image Analysis Platform” for 4D-CBCT researches which has technique to segment projection-images based on 3D marker position in the body. The 3D marker position can be obtained by using two axes CBCT system at Hokkaido University Hospital Proton Therapy Center. Performance verification of the software was implemented. Methods: The software calculates 3D marker position retrospectively bymore » using matching positions on pair projection-images obtained by two axes fluoroscopy mode of CBCT system. Log data of 3D marker tracking are outputted after the tracking. By linking the Log data and gantry-angle file of projection-image, all projection-images are equally segmented to spatial five-phases according to marker 3D position of SI direction and saved to specified phase folder. Segmented projection-images are used for CBCT reconstruction of each phase. As performance verification of the software, test of segmented projection-images was implemented for sample CT phantom (Catphan) image acquired by two axes fluoroscopy mode of CBCT. Dummy marker was added on the images. Motion of the marker was modeled to move in 3D space. Motion type of marker is sin4 wave function has amplitude 10.0 mm/5.0 mm/0 mm, cycle 4 s/4 s/0 s for SI/AP/RL direction. Results: The marker was tracked within 0.58 mm accuracy in 3D for all images, and it was confirmed that all projection-images were segmented and saved to each phase folder correctly. Conclusion: We developed software for 4D-CBCT research which can segment projection-image based on 3D marker position. It will be helpful to create high quality of 4D-CBCT reconstruction image for RGPT.« less

Accuracy of image guidance using free-breathing cone-beam computed tomography for stereotactic lung radiotherapy.

PubMed

Kamomae, Takeshi; Monzen, Hajime; Nakayama, Shinichi; Mizote, Rika; Oonishi, Yuuichi; Kaneshige, Soichiro; Sakamoto, Takashi

2015-01-01

Movement of the target object during cone-beam computed tomography (CBCT) leads to motion blurring artifacts. The accuracy of manual image matching in image-guided radiotherapy depends on the image quality. We aimed to assess the accuracy of target position localization using free-breathing CBCT during stereotactic lung radiotherapy. The Vero4DRT linear accelerator device was used for the examinations. Reference point discrepancies between the MV X-ray beam and the CBCT system were calculated using a phantom device with a centrally mounted steel ball. The precision of manual image matching between the CBCT and the averaged intensity (AI) images restructured from four-dimensional CT (4DCT) was estimated with a respiratory motion phantom, as determined in evaluations by five independent operators. Reference point discrepancies between the MV X-ray beam and the CBCT image-guidance systems, categorized as left-right (LR), anterior-posterior (AP), and superior-inferior (SI), were 0.33 ± 0.09, 0.16 ± 0.07, and 0.05 ± 0.04 mm, respectively. The LR, AP, and SI values for residual errors from manual image matching were -0.03 ± 0.22, 0.07 ± 0.25, and -0.79 ± 0.68 mm, respectively. The accuracy of target position localization using the Vero4DRT system in our center was 1.07 ± 1.23 mm (2 SD). This study experimentally demonstrated the sufficient level of geometric accuracy using the free-breathing CBCT and the image-guidance system mounted on the Vero4DRT. However, the inter-observer variation and systematic localization error of image matching substantially affected the overall geometric accuracy. Therefore, when using the free-breathing CBCT images, careful consideration of image matching is especially important.

PROPOSAL FOR A SIMPLE AND EFFICIENT MONTHLY QUALITY MANAGEMENT PROGRAM ASSESSING THE CONSISTENCY OF ROBOTIC IMAGE-GUIDED SMALL ANIMAL RADIATION SYSTEMS

PubMed Central

Brodin, N. Patrik; Guha, Chandan; Tomé, Wolfgang A.

2015-01-01

Modern pre-clinical radiation therapy (RT) research requires high precision and accurate dosimetry to facilitate the translation of research findings into clinical practice. Several systems are available that provide precise delivery and on-board imaging capabilities, highlighting the need for a quality management program (QMP) to ensure consistent and accurate radiation dose delivery. An ongoing, simple, and efficient QMP for image-guided robotic small animal irradiators used in pre-clinical RT research is described. Protocols were developed and implemented to assess the dose output constancy (based on the AAPM TG-61 protocol), cone-beam computed tomography (CBCT) image quality and object representation accuracy (using a custom-designed imaging phantom), CBCT-guided target localization accuracy and consistency of the CBCT-based dose calculation. To facilitate an efficient read-out and limit the user dependence of the QMP data analysis, a semi-automatic image analysis and data representation program was developed using the technical computing software MATLAB. The results of the first six months experience using the suggested QMP for a Small Animal Radiation Research Platform (SARRP) are presented, with data collected on a bi-monthly basis. The dosimetric output constancy was established to be within ±1 %, the consistency of the image resolution was within ±0.2 mm, the accuracy of CBCT-guided target localization was within ±0.5 mm, and dose calculation consistency was within ±2 s (± 3 %) per treatment beam. Based on these results, this simple quality assurance program allows for the detection of inconsistencies in dosimetric or imaging parameters that are beyond the acceptable variability for a reliable and accurate pre-clinical RT system, on a monthly or bi-monthly basis. PMID:26425981

Proposal for a Simple and Efficient Monthly Quality Management Program Assessing the Consistency of Robotic Image-Guided Small Animal Radiation Systems.

PubMed

Brodin, N Patrik; Guha, Chandan; Tomé, Wolfgang A

2015-11-01

Modern pre-clinical radiation therapy (RT) research requires high precision and accurate dosimetry to facilitate the translation of research findings into clinical practice. Several systems are available that provide precise delivery and on-board imaging capabilities, highlighting the need for a quality management program (QMP) to ensure consistent and accurate radiation dose delivery. An ongoing, simple, and efficient QMP for image-guided robotic small animal irradiators used in pre-clinical RT research is described. Protocols were developed and implemented to assess the dose output constancy (based on the AAPM TG-61 protocol), cone-beam computed tomography (CBCT) image quality and object representation accuracy (using a custom-designed imaging phantom), CBCT-guided target localization accuracy and consistency of the CBCT-based dose calculation. To facilitate an efficient read-out and limit the user dependence of the QMP data analysis, a semi-automatic image analysis and data representation program was developed using the technical computing software MATLAB. The results of the first 6-mo experience using the suggested QMP for a Small Animal Radiation Research Platform (SARRP) are presented, with data collected on a bi-monthly basis. The dosimetric output constancy was established to be within ±1 %, the consistency of the image resolution was within ±0.2 mm, the accuracy of CBCT-guided target localization was within ±0.5 mm, and dose calculation consistency was within ±2 s (±3%) per treatment beam. Based on these results, this simple quality assurance program allows for the detection of inconsistencies in dosimetric or imaging parameters that are beyond the acceptable variability for a reliable and accurate pre-clinical RT system, on a monthly or bi-monthly basis.

SU-E-J-76: CBCT Reconstruction of a Full Couch Using Rigid Registration and Pre-Scanned Couch Image and Its Clinical Application

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu, E; Lasio, G; Lee, M

Purpose: Only a part of a treatment couch is reconstructed in CBCT due to the limited field of view (FOV). This often generates inaccurate results in the delivered dose evaluation with CBCT and more noise in the CBCT reconstruction. Full reconstruction of the couch at treatment setup can be used for more accurate exit beam dosimetry. The goal of this study is to develop a method to reconstruct a full treatment couch using a pre-scanned couch image and rigid registration. Methods: A full couch (Exact Couch, Varian) model image was reconstructed by rigidly registering and combining two sets of partialmore » CBCT images. The full couch model includes three parts: two side rails and a couch top. A patient CBCT was reconstructed with reconstruction grid size larger than the physical field of view to include the full couch. The image quality of the couch is not good due to data truncation, but good enough to allow rigid registration of the couch. A composite CBCT image of the patient plus couch has been generated from the original reconstruction by replacing couch portion with the pre-acquired model couch, rigidly registered to the original scan. We evaluated the clinical usefulness of this method by comparing treatment plans generated on the original and on the modified scans. Results: The full couch model could be attached to a patient CBCT image set via rigid image registration. Plan DVHs showed 1∼2% difference between plans with and without full couch modeling. Conclusion: The proposed method generated a full treatment couch CBCT model, which can be successfully registered to the original patient image. This method was also shown to be useful in generating more accurate dose distributions, by lowering 1∼2% dose in PTV and a few other critical organs. Part of this study is supported by NIH R01CA133539.« less

Kilovoltage cone-beam CT: Comparative dose and image quality evaluations in partial and full-angle scan protocols

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Sangroh; Yoo, Sua; Yin Fangfang

2010-07-15

Purpose: To assess imaging dose of partial and full-angle kilovoltage CBCT scan protocols and to evaluate image quality for each protocol. Methods: The authors obtained the CT dose index (CTDI) of the kilovoltage CBCT protocols in an on-board imager by ion chamber (IC) measurements and Monte Carlo (MC) simulations. A total of six new CBCT scan protocols were evaluated: Standard-dose head (100 kVp, 151 mA s, partial-angle), low-dose head (100 kVp, 75 mA s, partial-angle), high-quality head (100 kVp, 754 mA s, partial-angle), pelvis (125 kVp, 706 mA s, full-angle), pelvis spotlight (125 kVp, 752 mA s, partial-angle), and low-dosemore » thorax (110 kVp, 271 mA s, full-angle). Using the point dose method, various CTDI values were calculated by (1) the conventional weighted CTDI (CTDI{sub w}) calculation and (2) Bakalyar's method (CTDI{sub wb}). The MC simulations were performed to obtain the CTDI{sub w} and CTDI{sub wb}, as well as from (3) central slice averaging (CTDI{sub 2D}) and (4) volume averaging (CTDI{sub 3D}) techniques. The CTDI values of the new protocols were compared to those of the old protocols (full-angle CBCT protocols). Image quality of the new protocols was evaluated following the CBCT image quality assurance (QA) protocol [S. Yoo et al., ''A quality assurance program for the on-board imager registered ,'' Med. Phys. 33(11), 4431-4447 (2006)] testing Hounsfield unit (HU) linearity, spatial linearity/resolution, contrast resolution, and HU uniformity. Results: The CTDI{sub w} were found as 6.0, 3.2, 29.0, 25.4, 23.8, and 7.7 mGy for the new protocols, respectively. The CTDI{sub w} and CTDI{sub wb} differed within +3% between IC measurements and MC simulations. Method (2) results were within {+-}12% of method (1). In MC simulations, the CTDI{sub w} and CTDI{sub wb} were comparable to the CTDI{sub 2D} and CTDI{sub 3D} with the differences ranging from -4.3% to 20.6%. The CTDI{sub 3D} were smallest among all the CTDI values. CTDI{sub w} of the new protocols were found as {approx}14 times lower for standard head scan and 1.8 times lower for standard body scan than the old protocols, respectively. In the image quality QA tests, all the protocols except low-dose head and low-dose thorax protocols were within the tolerance in the HU verification test. The HU value for the two protocols was always higher than the nominal value. All the protocols passed the spatial linearity/resolution and HU uniformity tests. In the contrast resolution test, only high-quality head and pelvis scan protocols were within the tolerance. In addition, crescent effect was found in the partial-angle scan protocols. Conclusions: The authors found that CTDI{sub w} of the new CBCT protocols has been significantly reduced compared to the old protocols with acceptable image quality. The CTDI{sub w} values in the point dose method were close to the volume averaging method within 9%-21% for all the CBCT scan protocols. The Bakalyar's method produced more accurate dose estimation within 14%. The HU inaccuracy from low-dose head and low-dose thorax protocols can render incorrect dose results in the treatment planning system. When high soft-tissue contrast data are desired, high-quality head or pelvis scan protocol is recommended depending on the imaging area. The point dose method can be applicable to estimate CBCT dose with reasonable accuracy in the clinical environment.« less

SU-E-J-31: Monitor Interfractional Variation of Tumor Respiratory Motion Using 4D KV Conebeam Computed Tomography for Stereotactic Body Radiation Therapy of Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tai, A; Prior, P; Gore, E

Purpose: 4DCT has been widely used to generate internal tumor volume (ITV) for a lung tumor for treatment planning. However, lung tumors may show different respiratory motion on the treatment day. The purpose of this study is to evaluate 4D KV conebeam computed tomography (CBCT) for monitoring tumor interfractional motion variation between simulation and each fraction of stereotactic body radiation therapy (SBRT) for lung cancer. Methods: 4D KV CBCT was acquired with the Elekta XVI system. The accuracy of 4D KV CBCT for image-guided radiation therapy (IGRT) was tested with a dynamic thorax motion phantom (CIRS, Virginia) with a linearmore » amplitude of 2 cm. In addition, an adult anthropomorphic phantom (Alderson, Rando) with optically stimulated luminescence (OSL) dosimeters embedded at the center and periphery of a slab of solid water was used to measure the dose of 4D KV CBCT and to compare it with the dose with 3D KV CBCT. The image registration was performed by aligning\\ each phase images of 4D KV CBCT to the planning images and the final couch shifts were calculated as a mean of all these individual shifts along each direction.A workflow was established based on these quality assurance tests for lung cancer patients. Results: 4D KV CBCT does not increase imaging dose in comparison to 3D KV CBCT. Acquisition of 4D KV CBCT is 4 minutes as compared to 2 minutes for 3D KV CBCT. Most of patients showed a small daily variation of tumor respiratory motion about 2 mm. However, some patients may have more than 5 mm variations of tumor respiratory motion. Conclusion: The radiation dose does not increase with 4D KV CBCT. 4D KV CBCT is a useful tool for monitoring interfractional variations of tumor respiratory motion before SBRT of lung cancer patients.« less

A robotic C-arm cone beam CT system for image-guided proton therapy: design and performance.

PubMed

Hua, Chiaho; Yao, Weiguang; Kidani, Takao; Tomida, Kazuo; Ozawa, Saori; Nishimura, Takenori; Fujisawa, Tatsuya; Shinagawa, Ryousuke; Merchant, Thomas E

2017-11-01

A ceiling-mounted robotic C-arm cone beam CT (CBCT) system was developed for use with a 190° proton gantry system and a 6-degree-of-freedom robotic patient positioner. We report on the mechanical design, system accuracy, image quality, image guidance accuracy, imaging dose, workflow, safety and collision-avoidance. The robotic CBCT system couples a rotating C-ring to the C-arm concentrically with a kV X-ray tube and a flat-panel imager mounted to the C-ring. CBCT images are acquired with flex correction and maximally 360° rotation for a 53 cm field of view. The system was designed for clinical use with three imaging locations. Anthropomorphic phantoms were imaged to evaluate the image guidance accuracy. The position accuracy and repeatability of the robotic C-arm was high (<0.5 mm), as measured with a high-accuracy laser tracker. The isocentric accuracy of the C-ring rotation was within 0.7 mm. The coincidence of CBCT imaging and radiation isocentre was better than 1 mm. The average image guidance accuracy was within 1 mm and 1° for the anthropomorphic phantoms tested. Daily volumetric imaging for proton patient positioning was specified for routine clinical practice. Our novel gantry-independent robotic CBCT system provides high-accuracy volumetric image guidance for proton therapy. Advances in knowledge: Ceiling-mounted robotic CBCT provides a viable option than CT on-rails for partial gantry and fixed-beam proton systems with the added advantage of acquiring images at the treatment isocentre.

Conebeam CT of the head and neck, part 1: physical principles.

PubMed

Miracle, A C; Mukherji, S K

2009-06-01

Conebeam x-ray CT (CBCT) is a developing imaging technique designed to provide relatively low-dose high-spatial-resolution visualization of high-contrast structures in the head and neck and other anatomic areas. This first installment in a 2-part review will address the physical principles underlying CBCT imaging as it is used in dedicated head and neck scanners. Concepts related to CBCT acquisition geometry, flat panel detection, and image quality will be explored in detail. Particular emphasis will be placed on technical limitations to low-contrast detectability and radiation dose. Proposed methods of x-ray scatter reduction will also be discussed.

Automated bone segmentation from dental CBCT images using patch-based sparse representation and convex optimization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Li; Gao, Yaozong; Shi, Feng

Purpose: Cone-beam computed tomography (CBCT) is an increasingly utilized imaging modality for the diagnosis and treatment planning of the patients with craniomaxillofacial (CMF) deformities. Accurate segmentation of CBCT image is an essential step to generate three-dimensional (3D) models for the diagnosis and treatment planning of the patients with CMF deformities. However, due to the poor image quality, including very low signal-to-noise ratio and the widespread image artifacts such as noise, beam hardening, and inhomogeneity, it is challenging to segment the CBCT images. In this paper, the authors present a new automatic segmentation method to address these problems. Methods: To segmentmore » CBCT images, the authors propose a new method for fully automated CBCT segmentation by using patch-based sparse representation to (1) segment bony structures from the soft tissues and (2) further separate the mandible from the maxilla. Specifically, a region-specific registration strategy is first proposed to warp all the atlases to the current testing subject and then a sparse-based label propagation strategy is employed to estimate a patient-specific atlas from all aligned atlases. Finally, the patient-specific atlas is integrated into amaximum a posteriori probability-based convex segmentation framework for accurate segmentation. Results: The proposed method has been evaluated on a dataset with 15 CBCT images. The effectiveness of the proposed region-specific registration strategy and patient-specific atlas has been validated by comparing with the traditional registration strategy and population-based atlas. The experimental results show that the proposed method achieves the best segmentation accuracy by comparison with other state-of-the-art segmentation methods. Conclusions: The authors have proposed a new CBCT segmentation method by using patch-based sparse representation and convex optimization, which can achieve considerably accurate segmentation results in CBCT segmentation based on 15 patients.« less

Visualisation of the Bonebridge by means of CT and CBCT

PubMed Central

2013-01-01

Background With the Bonebridge, a new bone-anchored hearing aid has been available since March 2012. The objective of the study was to analyse the visualisation of the implant itself as well as its impact on the representation of the bony structures of the petrosal bone in CT, MRI and cone beam CT (CBCT). Methods The Bonebridge was implanted unilaterally in two completely prepared human heads. The radiological imaging by means of CBCT, 64-slice CT, 1.5-T and 3.0-T MRI was conducted both preoperatively and postoperatively. The images were subsequently evaluated from both the ENT medical and nd radiological perspectives. Results As anticipated, no visualisation of the implant or of the petrosal bones could be realised on MRI because of the interactive technology and the magnet artefact. In contrast, an excellent evaluability of the implant itself as well as of the surrounding neurovascular structures (sinus sigmoideus, skull base, middle ear, inner ear, inner auditory canal) was exhibited in both the CT and in the CBCT. Conclusion The Bonebridge can be excellently imaged with the radiological imaging technologies of CT and CBCT. In the process, CBCT shows discrete advantages in comparison with CT. No relevant restrictions in image quality in the evaluation of the bony structures of the petrosal bones could be seen. PMID:24004903

Validation of a deformable image registration technique for cone beam CT-based dose verification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moteabbed, M., E-mail: mmoteabbed@partners.org; Sharp, G. C.; Wang, Y.

2015-01-15

Purpose: As radiation therapy evolves toward more adaptive techniques, image guidance plays an increasingly important role, not only in patient setup but also in monitoring the delivered dose and adapting the treatment to patient changes. This study aimed to validate a method for evaluation of delivered intensity modulated radiotherapy (IMRT) dose based on multimodal deformable image registration (DIR) for prostate treatments. Methods: A pelvic phantom was scanned with CT and cone-beam computed tomography (CBCT). Both images were digitally deformed using two realistic patient-based deformation fields. The original CT was then registered to the deformed CBCT resulting in a secondary deformedmore » CT. The registration quality was assessed as the ability of the DIR method to recover the artificially induced deformations. The primary and secondary deformed CT images as well as vector fields were compared to evaluate the efficacy of the registration method and it’s suitability to be used for dose calculation. PLASTIMATCH, a free and open source software was used for deformable image registration. A B-spline algorithm with optimized parameters was used to achieve the best registration quality. Geometric image evaluation was performed through voxel-based Hounsfield unit (HU) and vector field comparison. For dosimetric evaluation, IMRT treatment plans were created and optimized on the original CT image and recomputed on the two warped images to be compared. The dose volume histograms were compared for the warped structures that were identical in both warped images. This procedure was repeated for the phantom with full, half full, and empty bladder. Results: The results indicated mean HU differences of up to 120 between registered and ground-truth deformed CT images. However, when the CBCT intensities were calibrated using a region of interest (ROI)-based calibration curve, these differences were reduced by up to 60%. Similarly, the mean differences in average vector field lengths decreased from 10.1 to 2.5 mm when CBCT was calibrated prior to registration. The results showed no dependence on the level of bladder filling. In comparison with the dose calculated on the primary deformed CT, differences in mean dose averaged over all organs were 0.2% and 3.9% for dose calculated on the secondary deformed CT with and without CBCT calibration, respectively, and 0.5% for dose calculated directly on the calibrated CBCT, for the full-bladder scenario. Gamma analysis for the distance to agreement of 2 mm and 2% of prescribed dose indicated a pass rate of 100% for both cases involving calibrated CBCT and on average 86% without CBCT calibration. Conclusions: Using deformable registration on the planning CT images to evaluate the IMRT dose based on daily CBCTs was found feasible. The proposed method will provide an accurate dose distribution using planning CT and pretreatment CBCT data, avoiding the additional uncertainties introduced by CBCT inhomogeneity and artifacts. This is a necessary initial step toward future image-guided adaptive radiotherapy of the prostate.« less

Metallic artifacts from internal scaphoid fracture fixation screws: comparison between C-arm flat-panel, cone-beam, and multidetector computed tomography.

PubMed

Finkenstaedt, Tim; Morsbach, Fabian; Calcagni, Maurizio; Vich, Magdalena; Pfirrmann, Christian W A; Alkadhi, Hatem; Runge, Val M; Andreisek, Gustav; Guggenberger, Roman

2014-08-01

The aim of this study was to compare image quality and extent of artifacts from scaphoid fracture fixation screws using different computed tomography (CT) modalities and radiation dose protocols. Imaging of 6 cadaveric wrists with artificial scaphoid fractures and different fixation screws was performed in 2 screw positions (45° and 90° orientation in relation to the x/y-axis) using multidetector CT (MDCT) and 2 flat-panel CT modalities, C-arm flat-panel CT (FPCT) and cone-beam CT (CBCT), the latter 2 with low and standard radiation dose protocols. Mean cartilage attenuation and metal artifact-induced absolute Hounsfield unit changes (= artifact extent) were measured. Two independent radiologists evaluated different image quality criteria using a 5-point Likert-scale. Interreader agreements (Cohen κ) were calculated. Mean absolute Hounsfield unit changes and quality ratings were compared using Friedman and Wilcoxon signed-rank tests. Artifact extent was significantly smaller for MDCT and standard-dose FPCT compared with CBCT low- and standard-dose acquisitions (all P < 0.05). No significant differences in artifact extent among different screw types and scanning positions were noted (P > 0.05). Both MDCT and FPCT standard-dose protocols showed equal ratings for screw bone interface, fracture line, and trabecular bone evaluation (P = 0.06, 0.2, and 0.2, respectively) and performed significantly better than FPCT low- and CBCT low- and standard-dose acquisitions (all P < 0.05). Good interreader agreement was found for image quality comparisons (Cohen κ = 0.76-0.78). Both MDCT and FPCT standard-dose acquisition showed comparatively less metal-induced artifacts and better overall image quality compared with FPCT low-dose and both CBCT acquisitions. Flat-panel CT may provide sufficient image quality to serve as a versatile CT alternative for postoperative imaging of internally fixated wrist fractures.

Three-dimensional evaluation of human jaw bone microarchitecture: correlation between the microarchitectural parameters of cone beam computed tomography and micro-computer tomography.

PubMed

Kim, Jo-Eun; Yi, Won-Jin; Heo, Min-Suk; Lee, Sam-Sun; Choi, Soon-Chul; Huh, Kyung-Hoe

2015-12-01

To evaluate the potential feasibility of cone beam computed tomography (CBCT) in the assessment of trabecular bone microarchitecture. Sixty-eight specimens from four pairs of human jaw were scanned using both micro-computed tomography (micro-CT) of 19.37-μm voxel size and CBCT of 100-μm voxel size. The correlation of 3-dimensional parameters between CBCT and micro-CT was evaluated. All parameters, except bone-specific surface and trabecular thickness, showed linear correlations between the 2 imaging modalities (P < .05). Among the parameters, bone volume, percent bone volume, trabecular separation, and degree of anisotropy (DA) of CBCT images showed strong correlations with those of micro-CT images. DA showed the strongest correlation (r = 0.693). Most microarchitectural parameters from CBCT were correlated with those from micro-CT. Some microarchitectural parameters, especially DA, could be used as strong predictors of bone quality in the human jaw. Copyright © 2015 Elsevier Inc. All rights reserved.

A comprehensive study on decreasing the kilovoltage cone-beam CT dose by reducing the projection number.

PubMed

Lu, Bo; Lu, Haibin; Palta, Jatinder

2010-05-12

The objective of this study was to evaluate the effect of kilovoltage cone-beam computed tomography (CBCT) on registration accuracy and image qualities with a reduced number of planar projections used in volumetric imaging reconstruction. The ultimate goal is to evaluate the possibility of reducing the patient dose while maintaining registration accuracy under different projection-number schemes for various clinical sites. An Elekta Synergy Linear accelerator with an onboard CBCT system was used in this study. The quality of the Elekta XVI cone-beam three-dimensional volumetric images reconstructed with a decreasing number of projections was quantitatively evaluated by a Catphan phantom. Subsequently, we tested the registration accuracy of imaging data sets on three rigid anthropomorphic phantoms and three real patient sites under the reduced projection-number (as low as 1/6th) reconstruction of CBCT data with different rectilinear shifts and rota-tions. CBCT scan results of the Catphan phantom indicated the CBCT images got noisier when the number of projections was reduced, but their spatial resolution and uniformity were hardly affected. The maximum registration errors under the small amount transformation of the reference CT images were found to be within 0.7 mm translation and 0.3 masculine rotation. However, when the projection number was lower than one-fourth of the full set with a large amount of transformation of reference CT images, the registration could easily be trapped into local minima solutions for a nonrigid anatomy. We concluded, by using projection-number reduction strategy under conscientious care, imaging-guided localization procedure could achieve a lower patient dose without losing the registration accuracy for various clinical sites and situations. A faster scanning time is the main advantage compared to the mA decrease-based, dose-reduction method.

Automated replication of cone beam CT-guided treatments in the Pinnacle(3) treatment planning system for adaptive radiotherapy.

PubMed

Hargrave, Catriona; Mason, Nicole; Guidi, Robyn; Miller, Julie-Anne; Becker, Jillian; Moores, Matthew; Mengersen, Kerrie; Poulsen, Michael; Harden, Fiona

2016-03-01

Time-consuming manual methods have been required to register cone-beam computed tomography (CBCT) images with plans in the Pinnacle(3) treatment planning system in order to replicate delivered treatments for adaptive radiotherapy. These methods rely on fiducial marker (FM) placement during CBCT acquisition or the image mid-point to localise the image isocentre. A quality assurance study was conducted to validate an automated CBCT-plan registration method utilising the Digital Imaging and Communications in Medicine (DICOM) Structure Set (RS) and Spatial Registration (RE) files created during online image-guided radiotherapy (IGRT). CBCTs of a phantom were acquired with FMs and predetermined setup errors using various online IGRT workflows. The CBCTs, DICOM RS and RE files were imported into Pinnacle(3) plans of the phantom and the resulting automated CBCT-plan registrations were compared to existing manual methods. A clinical protocol for the automated method was subsequently developed and tested retrospectively using CBCTs and plans for six bladder patients. The automated CBCT-plan registration method was successfully applied to thirty-four phantom CBCT images acquired with an online 0 mm action level workflow. Ten CBCTs acquired with other IGRT workflows required manual workarounds. This was addressed during the development and testing of the clinical protocol using twenty-eight patient CBCTs. The automated CBCT-plan registrations were instantaneous, replicating delivered treatments in Pinnacle(3) with errors of ±0.5 mm. These errors were comparable to mid-point-dependant manual registrations but superior to FM-dependant manual registrations. The automated CBCT-plan registration method quickly and reliably replicates delivered treatments in Pinnacle(3) for adaptive radiotherapy.

WE-G-BRF-03: A Quasi-Cine CBCT Reconstruction Technique for Real-Time On- Board Target Tracking of Lung Cancer Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Y; Yin, F; Ren, L

2014-06-15

Purpose: To develop a quasi-cine CBCT reconstruction technique that uses extremely-small angle (∼3°) projections to generate real-time high-quality lung CBCT images. Method: 4D-CBCT is obtained at the beginning and used as prior images. This study uses extremely-small angle (∼3°) on-board projections acquired at a single respiratory phase to reconstruct the CBCT image at this phase. An adaptive constrained free-form deformation (ACFD) method is developed to deform the prior 4D-CBCT volume at the same phase to reconstruct the new CBCT. Quasi-cine CBCT images are obtained by continuously reconstructing CBCT images at subsequent phases every 3° angle (∼0.5s). Note that the priormore » 4D-CBCT images are dynamically updated using the latest CBCT images. The 4D digital extended-cardiac-torso (XCAT) phantom was used to evaluate the efficacy of ACFD. A lung patient was simulated with a tumor baseline shift of 2mm along superior-inferior (SI) direction after every respiratory cycle for 5 cycles. Limited-angle projections were simulated for each cycle. The 4D-CBCT reconstructed by these projections were compared with the ground-truth generated in XCAT.Volume-percentage-difference (VPD) and center-of-mass-shift (COMS) were calculated between the reconstructed and the ground-truth tumors to evaluate their geometric differences.The ACFD was also compared to a principal-component-analysis based motion-modeling (MM) method. Results: Using orthogonal-view 3° projections, the VPD/COMS values for tumor baseline shifts of 2mm, 4mm, 6mm, 8mm, 10mm were 11.0%/0.3mm, 25.3%/2.7mm, 22.4%/2.9mm, 49.5%/5.4mm, 77.2%/8.1mm for the MM method, and 2.9%/0.7mm, 3.9%/0.8mm, 6.2%/1mm, 7.9%/1.2mm, 10.1%/1.1mm for the ACFD method. Using orthogonal-view 0° projections (1 projection only), the ACFD method yielded VPD/COMS results of 5.0%/0.9mm, 10.5%/1.2mm, 15.1%/1.4mm, 20.9%/1.6mm and 24.8%/1.6mm. Using single-view instead of orthogonal-view projections yielded less accurate results for ACFD. Conclusion: The ACFD method accurately reconstructs snapshot CBCT images using orthogonal-view 3° projections. It has a great potential to provide real-time quasi-cine CBCT images for verification in lung radiation therapy. The research is supported by grant from Varian Medical Systems.« less

Biplane interventional pediatric system with cone‐beam CT: dose and image quality characterization for the default protocols

PubMed Central

Vañó, Eliseo; Alejo, Luis; Ubeda, Carlos; Gutiérrez‐Larraya, Federico; Garayoa, Julia

2016-01-01

The aim of this study was to assess image quality and radiation dose of a biplane angiographic system with cone‐beam CT (CBCT) capability tuned for pediatric cardiac procedures. The results of this study can be used to explore dose reduction techniques. For pulsed fluoroscopy and cine modes, polymethyl methacrylate phantoms of various thicknesses and a Leeds TOR 18‐FG test object were employed. Various fields of view (FOV) were selected. For CBCT, the study employed head and body dose phantoms, Catphan 504, and an anthropomorphic cardiology phantom. The study also compared two 3D rotational angiography protocols. The entrance surface air kerma per frame increases by a factor of 3–12 when comparing cine and fluoroscopy frames. The biggest difference in the signal‐to‐noise ratio between fluoroscopy and cine modes occurs at FOV 32 cm because fluoroscopy is acquired at a 1440×1440 pixel matrix size and in unbinned mode, whereas cine is acquired at 720×720 pixels and in binned mode. The high‐contrast spatial resolution of cine is better than that of fluoroscopy, except for FOV 32 cm, because fluoroscopy mode with 32 cm FOV is unbinned. Acquiring CBCT series with a 16 cm head phantom using the standard dose protocol results in a threefold dose increase compared with the low‐dose protocol. Although the amount of noise present in the images acquired with the low‐dose protocol is much higher than that obtained with the standard mode, the images present better spatial resolution. A 1 mm diameter rod with 250 Hounsfield units can be distinguished in reconstructed images with an 8 mm slice width. Pediatric‐specific protocols provide lower doses while maintaining sufficient image quality. The system offers a novel 3D imaging mode. The acquisition of CBCT images results in increased doses administered to the patients, but also provides further diagnostic information contained in the volumetric images. The assessed CBCT protocols provide images that are noisy, but with very good spatial resolution. PACS number(s): 87.59.‐e, 87.59.‐C, 87.59.‐cf, 87.59.Dj, 87.57. uq PMID:27455474

Biplane interventional pediatric system with cone-beam CT: dose and image quality characterization for the default protocols.

PubMed

Corredoira, Eva; Vañó, Eliseo; Alejo, Luis; Ubeda, Carlos; Gutiérrez-Larraya, Federico; Garayoa, Julia

2016-07-08

The aim of this study was to assess image quality and radiation dose of a biplane angiographic system with cone-beam CT (CBCT) capability tuned for pediatric cardiac procedures. The results of this study can be used to explore dose reduction techniques. For pulsed fluoroscopy and cine modes, polymethyl methacrylate phantoms of various thicknesses and a Leeds TOR 18-FG test object were employed. Various fields of view (FOV) were selected. For CBCT, the study employed head and body dose phantoms, Catphan 504, and an anthropomorphic cardiology phantom. The study also compared two 3D rotational angiography protocols. The entrance surface air kerma per frame increases by a factor of 3-12 when comparing cine and fluoroscopy frames. The biggest difference in the signal-to- noise ratio between fluoroscopy and cine modes occurs at FOV 32 cm because fluoroscopy is acquired at a 1440 × 1440 pixel matrix size and in unbinned mode, whereas cine is acquired at 720 × 720 pixels and in binned mode. The high-contrast spatial resolution of cine is better than that of fluoroscopy, except for FOV 32 cm, because fluoroscopy mode with 32 cm FOV is unbinned. Acquiring CBCT series with a 16 cm head phantom using the standard dose protocol results in a threefold dose increase compared with the low-dose protocol. Although the amount of noise present in the images acquired with the low-dose protocol is much higher than that obtained with the standard mode, the images present better spatial resolution. A 1 mm diameter rod with 250 Hounsfield units can be distinguished in reconstructed images with an 8 mm slice width. Pediatric-specific protocols provide lower doses while maintaining sufficient image quality. The system offers a novel 3D imaging mode. The acquisition of CBCT images results in increased doses administered to the patients, but also provides further diagnostic information contained in the volumetric images. The assessed CBCT protocols provide images that are noisy, but with very good spatial resolution. © 2016 The Authors.

An investigation of kV CBCT image quality and dose reduction for volume-of-interest imaging using dynamic collimation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parsons, David, E-mail: david.parsons@dal.ca, E-mail: james.robar@cdha.nshealth.ca; Robar, James L., E-mail: david.parsons@dal.ca, E-mail: james.robar@cdha.nshealth.ca

2015-09-15

Purpose: The focus of this work was to investigate the improvements in image quality and dose reduction for volume-of-interest (VOI) kilovoltage-cone beam CT (CBCT) using dynamic collimation. Methods: A prototype iris aperture was used to track a VOI during a CBCT acquisition. The current aperture design is capable of 1D translation as a function of gantry angle and dynamic adjustment of the iris radius. The aperture occupies the location of the bow-tie filter on a Varian On-Board Imager system. CBCT and planar image quality were investigated as a function of aperture radius, while maintaining the same dose to the VOI,more » for a 20 cm diameter cylindrical water phantom with a 9 mm diameter bone insert centered on isocenter. Corresponding scatter-to-primary ratios (SPR) were determined at the detector plane with Monte Carlo simulation using EGSnrc. Dose distributions for various sizes VOI were modeled using a dynamic BEAMnrc library and DOSXYZnrc. The resulting VOI dose distributions were compared to full-field distributions. Results: SPR was reduced by a factor of 8.4 when decreasing iris diameter from 21.2 to 2.4 cm (at isocenter). Depending upon VOI location and size, dose was reduced to 16%–90% of the full-field value along the central axis plane and down to 4% along the axis of rotation, while maintaining the same dose to the VOI compared to full-field techniques. When maintaining constant dose to the VOI, this change in iris diameter corresponds to a factor increase of approximately 1.6 in image contrast and a factor decrease in image noise of approximately 1.2. This results in a measured gain in contrast-to-noise ratio by a factor of approximately 2.0. Conclusions: The presented VOI technique offers improved image quality for image-guided radiotherapy while sparing the surrounding volume of unnecessary dose compared to full-field techniques.« less

Detection of crestal radiolucencies around dental implants: an in vitro experimental study.

PubMed

Sirin, Yigit; Horasan, Sinan; Yaman, Duygu; Basegmez, Cansu; Tanyel, Cem; Aral, Ali; Guven, Koray

2012-07-01

The aim of this study was to compare the diagnostic potentials and practical advantages of different imaging modalities in detecting bone defects around dental implants. Crestal bone defects with sequentially larger diameters were randomly prepared around 100 implants that were inserted in bovine bone blocks. Conventional periapical radiography (PR), direct digital radiography (DDR), panoramic radiography (PANO), cone-beam computed tomography (CBCT), and multislice computed tomography (MSCT) were performed for all specimens. The diagnostic accuracies of the devices, confidence of the answers, subjective image quality, defect visibility in planar orientations, and duration of diagnosis were analyzed based on the interpretations of 7 calibrated observers. The agreement levels of intra- and interobserver scores were rated good. PR, DDR, and CBCT were mostly more accurate than PANO and MSCT (P < .05). Confidence levels were positively correlated with the defect size (ρ = 0.20, P < .01), and that of DDR was the highest (P < .05). The subjective image quality of PR and DDR was higher than that of CBCT, PANO, and MSCT (P < .05 for all comparisons). Axial-coronal-sagittal visibilities of the defects were higher for CBCT compared with MSCT (P < .05). The diagnostic time was shorter for DDR (P < .05) and longer for the tomographic systems (P < .05) than for the other devices. DDR may provide a faster and more confident diagnostic option that is as accurate as PR in detecting peri-implant radiolucencies. CBCT has a comparable potential to these intraoral systems but with slower decision making and lower image quality, whereas PANO and MSCT become more reliable when bone defects have a diameter that is at least 1.5 mm larger than that of the implant. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Reconstructing cone-beam CT with spatially varying qualities for adaptive radiotherapy: a proof-of-principle study.

PubMed

Lu, Wenting; Yan, Hao; Gu, Xuejun; Tian, Zhen; Luo, Ouyang; Yang, Liu; Zhou, Linghong; Cervino, Laura; Wang, Jing; Jiang, Steve; Jia, Xun

2014-10-21

With the aim of maximally reducing imaging dose while meeting requirements for adaptive radiation therapy (ART), we propose in this paper a new cone beam CT (CBCT) acquisition and reconstruction method that delivers images with a low noise level inside a region of interest (ROI) and a relatively high noise level outside the ROI. The acquired projection images include two groups: densely sampled projections at a low exposure with a large field of view (FOV) and sparsely sampled projections at a high exposure with a small FOV corresponding to the ROI. A new algorithm combining the conventional filtered back-projection algorithm and the tight-frame iterative reconstruction algorithm is also designed to reconstruct the CBCT based on these projection data. We have validated our method on a simulated head-and-neck (HN) patient case, a semi-real experiment conducted on a HN cancer patient under a full-fan scan mode, as well as a Catphan phantom under a half-fan scan mode. Relative root-mean-square errors (RRMSEs) of less than 3% for the entire image and ~1% within the ROI compared to the ground truth have been observed. These numbers demonstrate the ability of our proposed method to reconstruct high-quality images inside the ROI. As for the part outside ROI, although the images are relatively noisy, it can still provide sufficient information for radiation dose calculations in ART. Dose distributions calculated on our CBCT image and on a standard CBCT image are in agreement, with a mean relative difference of 0.082% inside the ROI and 0.038% outside the ROI. Compared with the standard clinical CBCT scheme, an imaging dose reduction of approximately 3-6 times inside the ROI was achieved, as well as an 8 times outside the ROI. Regarding computational efficiency, it takes 1-3 min to reconstruct a CBCT image depending on the number of projections used. These results indicate that the proposed method has the potential for application in ART.

Periapical and endodontic status scale based on periapical bone lesions and endodontic treatment quality evaluation using cone-beam computed tomography.

PubMed

Venskutonis, Tadas; Plotino, Gianluca; Tocci, Luigi; Gambarini, Gianluca; Maminskas, Julius; Juodzbalys, Gintaras

2015-02-01

The purpose of this study was to present a new periapical and endodontic status scale (PESS) that is based on the complex periapical index (COPI), which was designed for the identification and classification of periapical bone lesions in cases of apical periodontitis, and the endodontically treated tooth index, which was designed for endodontic treatment quality evaluation by means of cone-beam computed tomographic (CBCT) analysis. Periapical and endodontic status parameters were selected from the already known indexes and scientific literature for radiologic evaluation. Radiographic images (CBCT imaging, digital orthopantomography [DOR], and digital periapical radiography) from 55 patients were analyzed. All parameters were evaluated on CBCT, DOR, and digital periapical radiographic images by 2 external observers. The statistical analysis was performed with software SPSS version 19.0 (SPSS Inc, Chicago, IL). Chi-square tests were used to compare frequencies of qualitative variables. The level of significance was set at P ≤ .05. Overall intraobserver and interobserver agreements were very good and good, respectively. CBCT analysis found more lesions and lesions of bigger dimension (P < .001). CBCT imaging was also superior in locating lesions in the apical part on the side compared with DOR and in the diagnosis of cortical bone destruction compared with both methods (P < .001). Through CBCT analysis, more root canals and more canals associated with lesions were found. The most informative and reproducible periapical and endodontic status parameters were selected, and a new PESS was proposed. The classification proposed in the present study seems to be reproducible and objective and adds helpful information with respect to the existing indexes. Future studies need to be conducted to validate PESS. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Potential of dosage reduction in cone-beam-computed tomography (CBCT) for radiological diagnostics of the paranasal sinuses.

PubMed

Güldner, C; Ningo, A; Voigt, J; Diogo, I; Heinrichs, J; Weber, R; Wilhelm, T; Fiebich, M

2013-03-01

More than 10 years ago, cone-beam-computed tomography (CBCT) was introduced in ENT radiology. Until now, the focus of research was to evaluate clinical limits of this technique. The aim of this work is the evaluation of specific dosages and the identification of potential optimization in the performance of CBCT of the paranasal sinuses. Based on different tube parameters (tube current, tube voltage, and rotation angles), images of the nose and the paranasal sinuses were taken on a phantom head with the Accu-I-tomo F17 (Morita, Kyoto, Japan). The dosages applied to the lens and parotid gland were measured with OSL dosimetry. The imaging quality was evaluated by independent observers. All datasets were reviewed according to a checklist of surgically important anatomic structures. Even for lowest radiation exposure (4 mA, 76 kV, 180°, computed tomography dosage index (CTDI) = 1.8 mGy), the imaging quality was sufficient. Of course a significant reduction of the imaging quality could be seen, so a reliable mean was set for 4 mA, 84 kV, and 180° rotation angle (CTDI = 2.4 mGy). In this combination, a reduction of 92 % in lens-dose and of 77 % of dosage at the parotid gland was observed in comparison to the maximal possible adjustments (8 mA, 90 kV, 360°, CTDI = 10.9 mGy). There is potential for optimization in CBCT. Changing the rotation angle (180° instead of 360°) leads to a dose reduction of 50 %. Furthermore from clinical point of view in case of chronic rhinosinusitis a relevant reduction of dosage is possible. Therefore, it is necessary to intensify the interdisciplinary discussion about the disease specifics required quality of imaging.

SU-D-17A-02: Four-Dimensional CBCT Using Conventional CBCT Dataset and Iterative Subtraction Algorithm of a Lung Patient

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu, E; Lasio, G; Yi, B

2014-06-01

Purpose: The Iterative Subtraction Algorithm (ISA) method generates retrospectively a pre-selected motion phase cone-beam CT image from the full motion cone-beam CT acquired at standard rotation speed. This work evaluates ISA method with real lung patient data. Methods: The goal of the ISA algorithm is to extract motion and no- motion components form the full reconstruction CBCT. The workflow consists of subtracting from the full CBCT all of the undesired motion phases and obtain a motion de-blurred single-phase CBCT image, followed by iteration of this subtraction process. ISA is realized as follows: 1) The projections are sorted to various phases,more » and from all phases, a full reconstruction is performed to generate an image CTM. 2) Generate forward projections of CTM at the desired phase projection angles, the subtraction of projection and the forward projection will reconstruct a CTSub1, which diminishes the desired phase component. 3) By adding back the CTSub1 to CTm, no motion CBCT, CTS1, can be computed. 4) CTS1 still contains residual motion component. 5) This residual motion component can be further reduced by iteration.The ISA 4DCBCT technique was implemented using Varian Trilogy accelerator OBI system. To evaluate the method, a lung patient CBCT dataset was used. The reconstruction algorithm is FDK. Results: The single phase CBCT reconstruction generated via ISA successfully isolates the desired motion phase from the full motion CBCT, effectively reducing motion blur. It also shows improved image quality, with reduced streak artifacts with respect to the reconstructions from unprocessed phase-sorted projections only. Conclusion: A CBCT motion de-blurring algorithm, ISA, has been developed and evaluated with lung patient data. The algorithm allows improved visualization of a single phase motion extracted from a standard CBCT dataset. This study has been supported by National Institute of Health through R01CA133539.« less

SU-E-I-01: Iterative CBCT Reconstruction with a Feature-Preserving Penalty

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lyu, Q; Li, B; Southern Medical University, Guangzhou

2015-06-15

Purpose: Low-dose CBCT is desired in various clinical applications. Iterative image reconstruction algorithms have shown advantages in suppressing noise in low-dose CBCT. However, due to the smoothness constraint enforced during the reconstruction process, edges may be blurred and image features may lose in the reconstructed image. In this work, we proposed a new penalty design to preserve image features in the image reconstructed by iterative algorithms. Methods: Low-dose CBCT is reconstructed by minimizing the penalized weighted least-squares (PWLS) objective function. Binary Robust Independent Elementary Features (BRIEF) of the image were integrated into the penalty of PWLS. BRIEF is a generalmore » purpose point descriptor that can be used to identify important features of an image. In this work, BRIEF distance of two neighboring pixels was used to weigh the smoothing parameter in PWLS. For pixels of large BRIEF distance, weaker smooth constraint will be enforced. Image features will be better preserved through such a design. The performance of the PWLS algorithm with BRIEF penalty was evaluated by a CatPhan 600 phantom. Results: The image quality reconstructed by the proposed PWLS-BRIEF algorithm is superior to that by the conventional PWLS method and the standard FDK method. At matched noise level, edges in PWLS-BRIEF reconstructed image are better preserved. Conclusion: This study demonstrated that the proposed PWLS-BRIEF algorithm has great potential on preserving image features in low-dose CBCT.« less

Clinical introduction of image lag correction for a cone beam CT system.

PubMed

Stankovic, Uros; Ploeger, Lennert S; Sonke, Jan-Jakob; van Herk, Marcel

2016-03-01

Image lag in the flat-panel detector used for Linac integrated cone beam computed tomography (CBCT) has a degrading effect on CBCT image quality. The most prominent visible artifact is the presence of bright semicircular structure in the transverse view of the scans, known also as radar artifact. Several correction strategies have been proposed, but until now the clinical introduction of such corrections remains unreported. In November 2013, the authors have clinically implemented a previously proposed image lag correction on all of their machines at their main site in Amsterdam. The purpose of this study was to retrospectively evaluate the effect of the correction on the quality of CBCT images and evaluate the required calibration frequency. Image lag was measured in five clinical CBCT systems (Elekta Synergy 4.6) using an in-house developed beam interrupting device that stops the x-ray beam midway through the data acquisition of an unattenuated beam for calibration. A triple exponential falling edge response was fitted to the measured data and used to correct image lag from projection images with an infinite response. This filter, including an extrapolation for saturated pixels, was incorporated in the authors' in-house developed clinical cbct reconstruction software. To investigate the short-term stability of the lag and associated parameters, a series of five image lag measurement over a period of three months was performed. For quantitative analysis, the authors have retrospectively selected ten patients treated in the pelvic region. The apparent contrast was quantified in polar coordinates for scans reconstructed using the parameters obtained from different dates with and without saturation handling. Visually, the radar artifact was minimal in scans reconstructed using image lag correction especially when saturation handling was used. In patient imaging, there was a significant reduction of the apparent contrast from 43 ± 16.7 to 15.5 ± 11.9 HU without the saturation handling and to 9.6 ± 12.1 HU with the saturation handling, depending on the date of the calibration. The image lag correction parameters were stable over a period of 3 months. The computational load was increased by approximately 10%, not endangering the fast in-line reconstruction. The lag correction was successfully implemented clinically and removed most image lag artifacts thus improving the image quality. Image lag correction parameters were stable for 3 months indicating low frequency of calibration requirements.

TH-EF-BRA-03: Assessment of Data-Driven Respiratory Motion-Compensation Methods for 4D-CBCT Image Registration and Reconstruction Using Clinical Datasets

DOE Office of Scientific and Technical Information (OSTI.GOV)

Riblett, MJ; Weiss, E; Hugo, GD

Purpose: To evaluate the performance of a 4D-CBCT registration and reconstruction method that corrects for respiratory motion and enhances image quality under clinically relevant conditions. Methods: Building on previous work, which tested feasibility of a motion-compensation workflow using image datasets superior to clinical acquisitions, this study assesses workflow performance under clinical conditions in terms of image quality improvement. Evaluated workflows utilized a combination of groupwise deformable image registration (DIR) and image reconstruction. Four-dimensional cone beam CT (4D-CBCT) FDK reconstructions were registered to either mean or respiratory phase reference frame images to model respiratory motion. The resulting 4D transformation was usedmore » to deform projection data during the FDK backprojection operation to create a motion-compensated reconstruction. To simulate clinically realistic conditions, superior quality projection datasets were sampled using a phase-binned striding method. Tissue interface sharpness (TIS) was defined as the slope of a sigmoid curve fit to the lung-diaphragm boundary or to the carina tissue-airway boundary when no diaphragm was discernable. Image quality improvement was assessed in 19 clinical cases by evaluating mitigation of view-aliasing artifacts, tissue interface sharpness recovery, and noise reduction. Results: For clinical datasets, evaluated average TIS recovery relative to base 4D-CBCT reconstructions was observed to be 87% using fixed-frame registration alone; 87% using fixed-frame with motion-compensated reconstruction; 92% using mean-frame registration alone; and 90% using mean-frame with motion-compensated reconstruction. Soft tissue noise was reduced on average by 43% and 44% for the fixed-frame registration and registration with motion-compensation methods, respectively, and by 40% and 42% for the corresponding mean-frame methods. Considerable reductions in view aliasing artifacts were observed for each method. Conclusion: Data-driven groupwise registration and motion-compensated reconstruction have the potential to improve the quality of 4D-CBCT images acquired under clinical conditions. For clinical image datasets, the addition of motion compensation after groupwise registration visibly reduced artifact impact. This work was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA166119. Hugo and Weiss hold a research agreement with Philips Healthcare and license agreement with Varian Medical Systems. Weiss receives royalties from UpToDate. Christensen receives funds from Roger Koch to support research.« less

Self-Calibration of Cone-Beam CT Geometry Using 3D-2D Image Registration: Development and Application to Task-Based Imaging with a Robotic C-Arm

PubMed Central

Ouadah, S.; Stayman, J. W.; Gang, G.; Uneri, A.; Ehtiati, T.; Siewerdsen, J. H.

2015-01-01

Purpose Robotic C-arm systems are capable of general noncircular orbits whose trajectories can be driven by the particular imaging task. However obtaining accurate calibrations for reconstruction in such geometries can be a challenging problem. This work proposes a method to perform a unique geometric calibration of an arbitrary C-arm orbit by registering 2D projections to a previously acquired 3D image to determine the transformation parameters representing the system geometry. Methods Experiments involved a cone-beam CT (CBCT) bench system, a robotic C-arm, and three phantoms. A robust 3D-2D registration process was used to compute the 9 degree of freedom (DOF) transformation between each projection and an existing 3D image by maximizing normalized gradient information with a digitally reconstructed radiograph (DRR) of the 3D volume. The quality of the resulting “self-calibration” was evaluated in terms of the agreement with an established calibration method using a BB phantom as well as image quality in the resulting CBCT reconstruction. Results The self-calibration yielded CBCT images without significant difference in spatial resolution from the standard (“true”) calibration methods (p-value >0.05 for all three phantoms), and the differences between CBCT images reconstructed using the “self” and “true” calibration methods were on the order of 10−3 mm−1. Maximum error in magnification was 3.2%, and back-projection ray placement was within 0.5 mm. Conclusion The proposed geometric “self” calibration provides a means for 3D imaging on general non-circular orbits in CBCT systems for which a geometric calibration is either not available or not reproducible. The method forms the basis of advanced “task-based” 3D imaging methods now in development for robotic C-arms. PMID:26388661

The Use of Cone Beam Computed Tomography for Image Guided Gamma Knife Stereotactic Radiosurgery: Initial Clinical Evaluation.

PubMed

Li, Winnie; Cho, Young-Bin; Ansell, Steve; Laperriere, Normand; Ménard, Cynthia; Millar, Barbara-Ann; Zadeh, Gelareh; Kongkham, Paul; Bernstein, Mark; Jaffray, David A; Chung, Caroline

2016-09-01

The present study used cone beam computed tomography (CBCT) to measure the inter- and intrafraction uncertainties for intracranial stereotactic radiosurgery (SRS) using the Leksell Gamma Knife (GK). Using a novel CBCT system adapted to the GK radiosurgery treatment unit, CBCT images were acquired immediately before and after treatment for each treatment session within the context of a research ethics board-approved prospective clinical trial. Patients were immobilized in the Leksell coordinate frame (LCF) for both volumetric CBCT imaging and GK-SRS delivery. The relative displacement of the patient's skull to the stereotactic reference (interfraction motion) was measured for each CBCT scan. Differences between the pre- and post-treatment CBCT scans were used to determine the intrafraction motion. We analyzed 20 pre- and 17 post-treatment CBCT scans in 20 LCF patients treated with SRS. The mean translational pretreatment setup error ± standard deviation in the left-right, anteroposterior, and craniocaudal directions was -0.19 ± 0.32, 0.06 ± 0.27, and -0.23 ± 0.2 mm, with a maximum of -0.74, -0.53, and -0.68 mm, respectively. After an average time between the pre- and post-treatment CBCT scans of 82 minutes (range 27-170), the mean intrafraction error ± standard deviation for the LCF was -0.03 ± 0.05, -0.03 ± 0.18, and -0.03 ± 0.12 mm in the left-right, anteroposterior, and craniocaudual direction, respectively. Using CBCT on a prototype image guided GK Perfexion unit, we were able to measure the inter- and intrafraction positional changes for GK-SRS using the invasive frame. In the era of image guided radiation therapy, the use of CBCT image guidance for both frame- and non-frame-based immobilization systems could serve as a useful quality assurance tool. Our preliminary measurements can guide the application of achievable thresholds for inter- and intrafraction discrepancy when moving to a frameless approach. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Evaluation of imaging quality for flat-panel detector based low dose C-arm CT system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seo, Chang-Woo; Cha, Bo Kyung; Jeon, Sungchae

The image quality associated with the extent of the angle of gantry rotation, the number of projection views, and the dose of X-ray radiation was investigated in flat-panel detector (FPD) based C-arm cone-beam computed tomography (CBCT) system for medical applications. A prototype CBCT system for the projection acquisition used the X-ray tube (A-132, Varian inc.) having rhenium-tungsten molybdenum target and flat panel a-Si X-ray detector (PaxScan 4030CB, Varian inc.) having a 397 x 298 mm active area with 388 μm pixel pitch and 1024 x 768 pixels in 2 by 2 binning mode. The performance comparison of X-ray imaging qualitymore » was carried out using the Feldkamp, Davis, and Kress (FDK) reconstruction algorithm between different conditions of projection acquisition. In this work, head-and-dental (75 kVp/20 mA) and chest (90 kVp/25 mA) phantoms were used to evaluate the image quality. The 361 (30 fps x 12 s) projection data during 360 deg. gantry rotation with 1 deg. interval for the 3D reconstruction were acquired. Parke weighting function were applied to handle redundant data and improve the reconstructed image quality in a mobile C-arm system with limited rotation angles. The reconstructed 3D images were investigated for comparison of qualitative image quality in terms of scan protocols (projection views, rotation angles and exposure dose). Furthermore, the performance evaluation in image quality will be investigated regarding X-ray dose and limited projection data for a FPD based mobile C-arm CBCT system. (authors)« less

A level set method for cupping artifact correction in cone-beam CT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xie, Shipeng; Li, Haibo; Ge, Qi

2015-08-15

Purpose: To reduce cupping artifacts and improve the contrast-to-noise ratio in cone-beam computed tomography (CBCT). Methods: A level set method is proposed to reduce cupping artifacts in the reconstructed image of CBCT. The authors derive a local intensity clustering property of the CBCT image and define a local clustering criterion function of the image intensities in a neighborhood of each point. This criterion function defines an energy in terms of the level set functions, which represent a segmentation result and the cupping artifacts. The cupping artifacts are estimated as a result of minimizing this energy. Results: The cupping artifacts inmore » CBCT are reduced by an average of 90%. The results indicate that the level set-based algorithm is practical and effective for reducing the cupping artifacts and preserving the quality of the reconstructed image. Conclusions: The proposed method focuses on the reconstructed image without requiring any additional physical equipment, is easily implemented, and provides cupping correction through a single-scan acquisition. The experimental results demonstrate that the proposed method successfully reduces the cupping artifacts.« less

Should image rotation be addressed during routine cone-beam CT quality assurance?

NASA Astrophysics Data System (ADS)

Ayan, Ahmet S.; Lin, Haibo; Yeager, Caitlyn; Deville, Curtiland; McDonough, James; Zhu, Timothy C.; Anderson, Nathan; Bar Ad, Voichita; Lu, Hsiao-Ming; Both, Stefan

2013-02-01

The purpose of this study is to investigate whether quality assurance (QA) for cone-beam computed tomography (CBCT) image rotation is necessary in order to ensure the accuracy of CBCT based image-guided radiation therapy (IGRT) and adaptive radiotherapy (ART). Misregistration of angular coordinates during CBCT acquisition may lead to a rotated reconstructed image. If target localization is performed based on this image, an under- or over-dosage of the target volume (TV) and organs at risk (OARs) may occur. Therefore, patient CT image sets were rotated by 1° up to 3° and the treatment plans were recalculated to quantify changes in dose-volume histograms. A computer code in C++ was written to model the TV displacement and overlap area of an ellipse shape at the target and dose prescription levels corresponding to the image rotation. We investigated clinical scenarios in IGRT and ART in order to study the implications of image rotation on dose distributions for: (1) lateral TV and isocenter (SBRT), (2) central TV and isocenter (IMRT), (3) lateral TV and isocenter (IMRT). Mathematical analysis showed the dose coverage of TV depends on its shape, size, location, and orientation relative to the isocenter. Evaluation of three first scenario for θ = 1° showed variations in TV D95 in the context of IGRT and ART when compared to the original plan were within 2.7 ± 2.6% and 7.7 ± 6.9% respectively while variations in the second and third scenarios were less significant (<0.5%) for the angular range evaluated. However a larger degree of variation was found in terms of minimum and maximum doses for target and OARs. The rotation of CBCT image data sets may have significant dosimetric consequences in IGRT and ART. The TV's location relative to isocenter and shape determine the extent of alterations in dose indicators. Our findings suggest that a CBCT QA criterion of 1° would be a reasonable action level to ensure accurate dose delivery.

SU-F-J-205: Effect of Cone Beam Factor On Cone Beam CT Number Accuracy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yao, W; Hua, C; Farr, J

Purpose: To examine the suitability of a Catphan™ 700 phantom for image quality QA of a cone beam computed tomography (CBCT) system deployed for proton therapy. Methods: Catphan phantoms, particularly Catphan™ 504, are commonly used in image quality QA for CBCT. As a newer product, Catphan™ 700 offers more tissue equivalent inserts which may be useful for generating the electron density – CT number curve for CBCT based treatment planning. The sensitometry-and-geometry module used in Catphan™ 700 is located at the end of the phantom and after the resolution line pair module. In Catphan™ 504 the line pair module ismore » located at the end of the phantom and after the sensitometry-and-geometry module. To investigate the effect of difference in location on CT number accuracy due to the cone beam factor, we scanned the Catphan™ 700 with the central plane of CBCT at the center of the phantom, line pair and sensitometry-andgeometry modules of the phantom, respectively. The protocol head and thorax scan modes were used. For each position, scans were repeated 4 times. Results: For the head scan mode, the standard deviation (SD) of the CT numbers of each insert under 4 repeated scans was up to 20 HU, 11 HU, and 11 HU, respectively, for the central plane of CBCT located at the center of the phantom, line pair, and sensitometry-and-geometry modules of the phantom. The mean of the SD was 9.9 HU, 5.7 HU, and 5.9 HU, respectively. For the thorax mode, the mean of the SD was 4.5 HU, 4.4 HU, and 4.4 HU, respectively. The assessment of image quality based on resolution and spatial linearity was not affected by imaging location changes. Conclusion: When the Catphan™ 700 was aligned to the center of imaging region, the CT number accuracy test may not meet expectations. We recommend reconfiguration of the modules.« less

Assessment of the accuracy and stability of frameless gamma knife radiosurgery.

PubMed

Chung, Hyun-Tai; Park, Woo-Yoon; Kim, Tae Hoon; Kim, Yong Kyun; Chun, Kook Jin

2018-06-03

The aim of this study was to assess the accuracy and stability of frameless gamma knife radiosurgery (GKRS). The accuracies of the radiation isocenter and patient couch movement were evaluated by film dosimetry with a half-year cycle. Radiation isocenter assessment with a diode detector and cone-beam computed tomography (CBCT) image accuracy tests were performed daily with a vendor-provided tool for one and a half years after installation. CBCT image quality was examined twice a month with a phantom. The accuracy of image coregistration using CBCT images was studied using magnetic resonance (MR) and computed tomography (CT) images of another phantom. The overall positional accuracy was measured in whole procedure tests using film dosimetry with an anthropomorphic phantom. The positional errors of the radiation isocenter at the center and at an extreme position were both less than 0.1 mm. The three-dimensional deviation of the CBCT coordinate system was stable for one and a half years (mean 0.04 ± 0.02 mm). Image coregistration revealed a difference of 0.2 ± 0.1 mm between CT and CBCT images and a deviation of 0.4 ± 0.2 mm between MR and CBCT images. The whole procedure test of the positional accuracy of the mask-based irradiation revealed an accuracy of 0.5 ± 0.6 mm. The radiation isocenter accuracy, patient couch movement accuracy, and Gamma Knife Icon CBCT accuracy were all approximately 0.1 mm and were stable for one and a half years. The coordinate system assigned to MR images through coregistration was more accurate than the system defined by fiducial markers. Possible patient motion during irradiation should be considered when evaluating the overall accuracy of frameless GKRS. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Iterative image-domain ring artifact removal in cone-beam CT

NASA Astrophysics Data System (ADS)

Liang, Xiaokun; Zhang, Zhicheng; Niu, Tianye; Yu, Shaode; Wu, Shibin; Li, Zhicheng; Zhang, Huailing; Xie, Yaoqin

2017-07-01

Ring artifacts in cone beam computed tomography (CBCT) images are caused by pixel gain variations using flat-panel detectors, and may lead to structured non-uniformities and deterioration of image quality. The purpose of this study is to propose a method of general ring artifact removal in CBCT images. This method is based on the polar coordinate system, where the ring artifacts manifest as stripe artifacts. Using relative total variation, the CBCT images are first smoothed to generate template images with fewer image details and ring artifacts. By subtracting the template images from the CBCT images, residual images with image details and ring artifacts are generated. As the ring artifact manifests as a stripe artifact in a polar coordinate system, the artifact image can be extracted by mean value from the residual image; the image details are generated by subtracting the artifact image from the residual image. Finally, the image details are compensated to the template image to generate the corrected images. The proposed framework is iterated until the differences in the extracted ring artifacts are minimized. We use a 3D Shepp-Logan phantom, Catphan©504 phantom, uniform acrylic cylinder, and images from a head patient to evaluate the proposed method. In the experiments using simulated data, the spatial uniformity is increased by 1.68 times and the structural similarity index is increased from 87.12% to 95.50% using the proposed method. In the experiment using clinical data, our method shows high efficiency in ring artifact removal while preserving the image structure and detail. The iterative approach we propose for ring artifact removal in cone-beam CT is practical and attractive for CBCT guided radiation therapy.

GPU-based fast cone beam CT reconstruction from undersampled and noisy projection data via total variation.

PubMed

Jia, Xun; Lou, Yifei; Li, Ruijiang; Song, William Y; Jiang, Steve B

2010-04-01

Cone-beam CT (CBCT) plays an important role in image guided radiation therapy (IGRT). However, the large radiation dose from serial CBCT scans in most IGRT procedures raises a clinical concern, especially for pediatric patients who are essentially excluded from receiving IGRT for this reason. The goal of this work is to develop a fast GPU-based algorithm to reconstruct CBCT from undersampled and noisy projection data so as to lower the imaging dose. The CBCT is reconstructed by minimizing an energy functional consisting of a data fidelity term and a total variation regularization term. The authors developed a GPU-friendly version of the forward-backward splitting algorithm to solve this model. A multigrid technique is also employed. It is found that 20-40 x-ray projections are sufficient to reconstruct images with satisfactory quality for IGRT. The reconstruction time ranges from 77 to 130 s on an NVIDIA Tesla C1060 (NVIDIA, Santa Clara, CA) GPU card, depending on the number of projections used, which is estimated about 100 times faster than similar iterative reconstruction approaches. Moreover, phantom studies indicate that the algorithm enables the CBCT to be reconstructed under a scanning protocol with as low as 0.1 mA s/projection. Comparing with currently widely used full-fan head and neck scanning protocol of approximately 360 projections with 0.4 mA s/projection, it is estimated that an overall 36-72 times dose reduction has been achieved in our fast CBCT reconstruction algorithm. This work indicates that the developed GPU-based CBCT reconstruction algorithm is capable of lowering imaging dose considerably. The high computation efficiency in this algorithm makes the iterative CBCT reconstruction approach applicable in real clinical environments.

Optimization-based reconstruction for reduction of CBCT artifact in IGRT

NASA Astrophysics Data System (ADS)

Xia, Dan; Zhang, Zheng; Paysan, Pascal; Seghers, Dieter; Brehm, Marcus; Munro, Peter; Sidky, Emil Y.; Pelizzari, Charles; Pan, Xiaochuan

2016-04-01

Kilo-voltage cone-beam computed tomography (CBCT) plays an important role in image guided radiation therapy (IGRT) by providing 3D spatial information of tumor potentially useful for optimizing treatment planning. In current IGRT CBCT system, reconstructed images obtained with analytic algorithms, such as FDK algorithm and its variants, may contain artifacts. In an attempt to compensate for the artifacts, we investigate optimization-based reconstruction algorithms such as the ASD-POCS algorithm for potentially reducing arti- facts in IGRT CBCT images. In this study, using data acquired with a physical phantom and a patient subject, we demonstrate that the ASD-POCS reconstruction can significantly reduce artifacts observed in clinical re- constructions. Moreover, patient images reconstructed by use of the ASD-POCS algorithm indicate a contrast level of soft-tissue improved over that of the clinical reconstruction. We have also performed reconstructions from sparse-view data, and observe that, for current clinical imaging conditions, ASD-POCS reconstructions from data collected at one half of the current clinical projection views appear to show image quality, in terms of spatial and soft-tissue-contrast resolution, higher than that of the corresponding clinical reconstructions.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Winnie; Cho, Young-Bin; Department of Radiation Oncology, University of Toronto, Toronto, Ontario

Purpose: The present study used cone beam computed tomography (CBCT) to measure the inter- and intrafraction uncertainties for intracranial stereotactic radiosurgery (SRS) using the Leksell Gamma Knife (GK). Methods and Materials: Using a novel CBCT system adapted to the GK radiosurgery treatment unit, CBCT images were acquired immediately before and after treatment for each treatment session within the context of a research ethics board–approved prospective clinical trial. Patients were immobilized in the Leksell coordinate frame (LCF) for both volumetric CBCT imaging and GK-SRS delivery. The relative displacement of the patient's skull to the stereotactic reference (interfraction motion) was measured formore » each CBCT scan. Differences between the pre- and post-treatment CBCT scans were used to determine the intrafraction motion. Results: We analyzed 20 pre- and 17 post-treatment CBCT scans in 20 LCF patients treated with SRS. The mean translational pretreatment setup error ± standard deviation in the left-right, anteroposterior, and craniocaudal directions was −0.19 ± 0.32, 0.06 ± 0.27, and −0.23 ± 0.2 mm, with a maximum of −0.74, −0.53, and −0.68 mm, respectively. After an average time between the pre- and post-treatment CBCT scans of 82 minutes (range 27-170), the mean intrafraction error ± standard deviation for the LCF was −0.03 ± 0.05, −0.03 ± 0.18, and −0.03 ± 0.12 mm in the left-right, anteroposterior, and craniocaudual direction, respectively. Conclusions: Using CBCT on a prototype image guided GK Perfexion unit, we were able to measure the inter- and intrafraction positional changes for GK-SRS using the invasive frame. In the era of image guided radiation therapy, the use of CBCT image guidance for both frame- and non–frame-based immobilization systems could serve as a useful quality assurance tool. Our preliminary measurements can guide the application of achievable thresholds for inter- and intrafraction discrepancy when moving to a frameless approach.« less

SU-D-BRF-04: Digital Tomosynthesis for Improved Daily Setup in Treatment of Liver Lesions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Armstrong, H; Jones, B; Miften, M

Purpose: Daily localization of liver lesions with cone-beam CT (CBCT) is difficult due to poor image quality caused by scatter, respiratory motion, and the lack of radiographic contrast between the liver parenchyma and the lesion(s). Digital tomosynthesis (DTS) is investigated as a modality to improve liver visualization and lesion/parenchyma contrast for daily setup. Methods: An in-house tool was developed to generate DTS images using a point-by-point filtered back-projection method from on-board CBCT projection data. DTS image planes are generated in a user defined orientation to visualize the anatomy at various depths. Reference DTS images are obtained from forward projection ofmore » the planning CT dataset at each projection angle. The CBCT DTS image set can then be registered to the reference DTS image set as a means for localization. Contour data from the planning CT's associate RT Structure file and forward projected similarly to the planning CT data. DTS images are created for each contoured structure, which can then be overlaid onto the DTS images for organ volume visualization. Results: High resolution DTS images generated from CBCT projections show fine anatomical detail, including small blood vessels, within the patient. However, the reference DTS images generated from forward projection of the planning CT lacks this level of detail due to the low resolution of the CT voxels as compared to the pixel size in the projection images; typically 1mm-by-1mm-by-3mm (lat, vrt, lng) for the planning CT vs. 0.4mm-by-0.4mm for CBCT projections. Overlaying of the contours onto the DTS image allows for visualization of structures of interest. Conclusion: The ability to generate DTS images over a limited range of projection angles allows for reduction in the amount of respiratory motion within each acquisition. DTS may provide improved visualization of structures and lesions as compared to CBCT for highly mobile tumors.« less

SU-F-J-32: Do We Need KV Imaging During CBCT Based Patient Set-Up for Lung Radiation Therapy?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gopal, A; Zhou, J; Prado, K

Purpose: To evaluate the role of 2D kilovoltage (kV) imaging to complement cone beam CT (CBCT) imaging in a shift threshold based image guided radiation therapy (IGRT) strategy for conventional lung radiotherapy. Methods: A retrospective study was conducted by analyzing IGRT couch shift trends for 15 patients that received lung radiation therapy to evaluate the benefit of performing orthogonal kV imaging prior to CBCT imaging. Herein, a shift threshold based IGRT protocol was applied, which would mandate additional CBCT verification if the applied patient shifts exceeded 3 mm to avoid intraobserver variability in CBCT registration and to confirm table shifts.more » For each patient, two IGRT strategies: kV + CBCT and CBCT alone, were compared and the recorded patient shifts were categorized into whether additional CBCT acquisition would have been mandated or not. The effectiveness of either strategy was gauged by the likelihood of needing additional CBCT imaging for accurate patient set-up. Results: The use of CBCT alone was 6 times more likely to require an additional CBCT than KV+CBCT, for a 3 mm shift threshold (88% vs 14%). The likelihood of additional CBCT verification generally increased with lower shift thresholds, and was significantly lower when kV+CBCT was used (7% with 5 mm shift threshold, 36% with 2 mm threshold), than with CBCT alone (61% with 5 mm shift threshold, 97% with 2 mm threshold). With CBCT alone, treatment time increased by 2.2 min and dose increased by 1.9 cGy per fraction on average due to additional CBCT with a 3mm shift threshold. Conclusion: The benefit of kV imaging to screen for gross misalignments led to more accurate CBCT based patient localization compared with using CBCT alone. The subsequently reduced need for additional CBCT verification will minimize treatment time and result in less overall patient imaging dose.« less

SU-E-J-220: Evaluation of Atlas-Based Auto-Segmentation (ABAS) in Head-And-Neck Adaptive Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Q; Yan, D

2014-06-01

Purpose: Evaluate the accuracy of atlas-based auto segmentation of organs at risk (OARs) on both helical CT (HCT) and cone beam CT (CBCT) images in head and neck (HN) cancer adaptive radiotherapy (ART). Methods: Six HN patients treated in the ART process were included in this study. For each patient, three images were selected: pretreatment planning CT (PreTx-HCT), in treatment CT for replanning (InTx-HCT) and a CBCT acquired in the same day of the InTx-HCT. Three clinical procedures of auto segmentation and deformable registration performed in the ART process were evaluated: a) auto segmentation on PreTx-HCT using multi-subject atlases, b)more » intra-patient propagation of OARs from PreTx-HCT to InTx-HCT using deformable HCT-to-HCT image registration, and c) intra-patient propagation of OARs from PreTx-HCT to CBCT using deformable CBCT-to-HCT image registration. Seven OARs (brainstem, cord, L/R parotid, L/R submandibular gland and mandible) were manually contoured on PreTx-HCT and InTx-HCT for comparison. In addition, manual contours on InTx-CT were copied on the same day CBCT, and a local region rigid body registration was performed accordingly for each individual OAR. For procedures a) and b), auto contours were compared to manual contours, and for c) auto contours were compared to those rigidly transferred contours on CBCT. Dice similarity coefficients (DSC) and mean surface distances of agreement (MSDA) were calculated for evaluation. Results: For procedure a), the mean DSC/MSDA of most OARs are >80%/±2mm. For intra-patient HCT-to-HCT propagation, the Resultimproved to >85%/±1.5mm. Compared to HCT-to-HCT, the mean DSC for HCT-to-CBCT propagation drops ∼2–3% and MSDA increases ∼0.2mm. This Resultindicates that the inferior imaging quality of CBCT seems only degrade auto propagation performance slightly. Conclusion: Auto segmentation and deformable propagation can generate OAR structures on HCT and CBCT images with clinically acceptable accuracy. Therefore, they can be reliably implemented in the clinical HN ART process.« less

Assessment of female breast dose for thoracic cone-beam CT using MOSFET dosimeters.

PubMed

Sun, Wenzhao; Wang, Bin; Qiu, Bo; Liang, Jian; Xie, Weihao; Deng, Xiaowu; Qi, Zhenyu

2017-03-21

To assess the breast dose during a routine thoracic cone-beam CT (CBCT) check with the efforts to explore the possible dose reduction strategy. Metal oxide semiconductor field-effect transistor (MOSFET) dosimeters were used to measure breast surface doses during a thorax kV CBCT scan in an anthropomorphic phantom. Breast doses for different scanning protocols and breast sizes were compared. Dose reduction was attempted by using partial arc CBCT scan with bowtie filter. The impact of this dose reduction strategy on image registration accuracy was investigated. The average breast surface doses were 20.02 mGy and 11.65 mGy for thoracic CBCT without filtration and with filtration, respectively. This indicates a dose reduction of 41.8% by use of bowtie filter. It was found 220° partial arc scanning significantly reduced the dose to contralateral breast (44.4% lower than ipsilateral breast), while the image registration accuracy was not compromised. Breast dose reduction can be achieved by using ipsilateral 220° partial arc scan with bowtie filter. This strategy also provides sufficient image quality for thorax image registration in daily patient positioning verification.

Cone-beam computed tomography in the assessment of periapical lesions in endodontically treated teeth

PubMed Central

Gambarini, Gianluca; Piasecki, Lucila; Miccoli, Gabriele; Gaimari, Gianfranco; Nardo, Dario Di; Testarelli, Luca

2018-01-01

Objective: This study aimed to evaluate the relationship between the quality of the coronal restoration and the root canal filling on the periapical status of endodontically treated teeth using CBCT. Materials and Methods: CBCT data were obtained from the records of patients who deny any dental treatment in the 2 years prior to the CBCT examination. CBCT images (90 kVp and 7 mA, exposure time of 23 s, and a voxel size of 0.2 mm, with a field of view of 13 cm × 13 cm) of 1011 endodontically treated teeth were observed. A score was given to the quality of the root filling and the quality of the coronal restoration. Statistical Analysis Used: Data were statistically analyzed to correlate the periapical status with gender, dental group. and quality of endodontic treatment and restoration (Chi-square test with a significance level of P < 0.001). Results: Absence of periapical periodontitis was found in 54.9% of the cases. The periapical outcome was not related to gender or dental group (P > 0.05). A statistically significant factor (Chi-square test, P < 0.0001) resulted when different qualities of sealing were compared. Conclusions: CBCT showed that high-quality root canal treatments followed by an adequate coronal sealing restoration avoid the presence of periapical periodontitis in time. PMID:29657539

Improved image quality of cone beam CT scans for radiotherapy image guidance using fiber-interspaced antiscatter grid

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stankovic, Uros; Herk, Marcel van; Ploeger, Lennert S.

Purpose: Medical linear accelerator mounted cone beam CT (CBCT) scanner provides useful soft tissue contrast for purposes of image guidance in radiotherapy. The presence of extensive scattered radiation has a negative effect on soft tissue visibility and uniformity of CBCT scans. Antiscatter grids (ASG) are used in the field of diagnostic radiography to mitigate the scatter. They usually do increase the contrast of the scan, but simultaneously increase the noise. Therefore, and considering other scatter mitigation mechanisms present in a CBCT scanner, the applicability of ASGs with aluminum interspacing for a wide range of imaging conditions has been inconclusive inmore » previous studies. In recent years, grids using fiber interspacers have appeared, providing grids with higher scatter rejection while maintaining reasonable transmission of primary radiation. The purpose of this study was to evaluate the impact of one such grid on CBCT image quality. Methods: The grid used (Philips Medical Systems) had ratio of 21:1, frequency 36 lp/cm, and nominal selectivity of 11.9. It was mounted on the kV flat panel detector of an Elekta Synergy linear accelerator and tested in a phantom and a clinical study. Due to the flex of the linac and presence of gridline artifacts an angle dependent gain correction algorithm was devised to mitigate resulting artifacts. Scan reconstruction was performed using XVI4.5 augmented with inhouse developed image lag correction and Hounsfield unit calibration. To determine the necessary parameters for Hounsfield unit calibration and software scatter correction parameters, the Catphan 600 (The Phantom Laboratory) phantom was used. Image quality parameters were evaluated using CIRS CBCT Image Quality and Electron Density Phantom (CIRS) in two different geometries: one modeling head and neck and other pelvic region. Phantoms were acquired with and without the grid and reconstructed with and without software correction which was adapted for the different acquisition scenarios. Parameters used in the phantom study weret{sub cup} for nonuniformity and contrast-to-noise ratio (CNR) for soft tissue visibility. Clinical scans were evaluated in an observer study in which four experienced radiotherapy technologists rated soft tissue visibility and uniformity of scans with and without the grid. Results: The proposed angle dependent gain correction algorithm suppressed the visible ring artifacts. Grid had a beneficial impact on nonuniformity, contrast to noise ratio, and Hounsfield unit accuracy for both scanning geometries. The nonuniformity reduced by 90% for head sized object and 91% for pelvic-sized object. CNR improved compared to no corrections on average by a factor 2.8 for the head sized object, and 2.2 for the pelvic sized phantom. Grid outperformed software correction alone, but adding additional software correction to the grid was overall the best strategy. In the observer study, a significant improvement was found in both soft tissue visibility and nonuniformity of scans when grid is used. Conclusions: The evaluated fiber-interspaced grid improved the image quality of the CBCT system for broad range of imaging conditions. Clinical scans show significant improvement in soft tissue visibility and uniformity without the need to increase the imaging dose.« less

Improved image quality of cone beam CT scans for radiotherapy image guidance using fiber-interspaced antiscatter grid.

PubMed

Stankovic, Uros; van Herk, Marcel; Ploeger, Lennert S; Sonke, Jan-Jakob

2014-06-01

Medical linear accelerator mounted cone beam CT (CBCT) scanner provides useful soft tissue contrast for purposes of image guidance in radiotherapy. The presence of extensive scattered radiation has a negative effect on soft tissue visibility and uniformity of CBCT scans. Antiscatter grids (ASG) are used in the field of diagnostic radiography to mitigate the scatter. They usually do increase the contrast of the scan, but simultaneously increase the noise. Therefore, and considering other scatter mitigation mechanisms present in a CBCT scanner, the applicability of ASGs with aluminum interspacing for a wide range of imaging conditions has been inconclusive in previous studies. In recent years, grids using fiber interspacers have appeared, providing grids with higher scatter rejection while maintaining reasonable transmission of primary radiation. The purpose of this study was to evaluate the impact of one such grid on CBCT image quality. The grid used (Philips Medical Systems) had ratio of 21:1, frequency 36 lp/cm, and nominal selectivity of 11.9. It was mounted on the kV flat panel detector of an Elekta Synergy linear accelerator and tested in a phantom and a clinical study. Due to the flex of the linac and presence of gridline artifacts an angle dependent gain correction algorithm was devised to mitigate resulting artifacts. Scan reconstruction was performed using XVI4.5 augmented with inhouse developed image lag correction and Hounsfield unit calibration. To determine the necessary parameters for Hounsfield unit calibration and software scatter correction parameters, the Catphan 600 (The Phantom Laboratory) phantom was used. Image quality parameters were evaluated using CIRS CBCT Image Quality and Electron Density Phantom (CIRS) in two different geometries: one modeling head and neck and other pelvic region. Phantoms were acquired with and without the grid and reconstructed with and without software correction which was adapted for the different acquisition scenarios. Parameters used in the phantom study were t(cup) for nonuniformity and contrast-to-noise ratio (CNR) for soft tissue visibility. Clinical scans were evaluated in an observer study in which four experienced radiotherapy technologists rated soft tissue visibility and uniformity of scans with and without the grid. The proposed angle dependent gain correction algorithm suppressed the visible ring artifacts. Grid had a beneficial impact on nonuniformity, contrast to noise ratio, and Hounsfield unit accuracy for both scanning geometries. The nonuniformity reduced by 90% for head sized object and 91% for pelvic-sized object. CNR improved compared to no corrections on average by a factor 2.8 for the head sized object, and 2.2 for the pelvic sized phantom. Grid outperformed software correction alone, but adding additional software correction to the grid was overall the best strategy. In the observer study, a significant improvement was found in both soft tissue visibility and nonuniformity of scans when grid is used. The evaluated fiber-interspaced grid improved the image quality of the CBCT system for broad range of imaging conditions. Clinical scans show significant improvement in soft tissue visibility and uniformity without the need to increase the imaging dose.

Quality control in cone-beam computed tomography (CBCT) EFOMP-ESTRO-IAEA protocol (summary report).

PubMed

de Las Heras Gala, Hugo; Torresin, Alberto; Dasu, Alexandru; Rampado, Osvaldo; Delis, Harry; Hernández Girón, Irene; Theodorakou, Chrysoula; Andersson, Jonas; Holroyd, John; Nilsson, Mats; Edyvean, Sue; Gershan, Vesna; Hadid-Beurrier, Lama; Hoog, Christopher; Delpon, Gregory; Sancho Kolster, Ismael; Peterlin, Primož; Garayoa Roca, Julia; Caprile, Paola; Zervides, Costas

2017-07-01

The aim of the guideline presented in this article is to unify the test parameters for image quality evaluation and radiation output in all types of cone-beam computed tomography (CBCT) systems. The applications of CBCT spread over dental and interventional radiology, guided surgery and radiotherapy. The chosen tests provide the means to objectively evaluate the performance and monitor the constancy of the imaging chain. Experience from all involved associations has been collected to achieve a consensus that is rigorous and helpful for the practice. The guideline recommends to assess image quality in terms of uniformity, geometrical precision, voxel density values (or Hounsfield units where available), noise, low contrast resolution and spatial resolution measurements. These tests usually require the use of a phantom and evaluation software. Radiation output can be determined with a kerma-area product meter attached to the tube case. Alternatively, a solid state dosimeter attached to the flat panel and a simple geometric relationship can be used to calculate the dose to the isocentre. Summary tables including action levels and recommended frequencies for each test, as well as relevant references, are provided. If the radiation output or image quality deviates from expected values, or exceeds documented action levels for a given system, a more in depth system analysis (using conventional tests) and corrective maintenance work may be required. Copyright © 2017. Published by Elsevier Ltd.

SU-E-J-13: A Study to Establish the Effect of CBCT Image Rotational Displacement on IGRT and ART Lung SBRT Treatments.

PubMed

Yeager, C; Lin, H; Ayan, A; McDonough, J; Both, S

2012-06-01

To determine whether the accuracy of CBCT based IGRT and ART lung SBRT treatments may require extra quality assurance (QA) steps. During CBCT Rando phantom acquisition we detected an unexpected ∼2° image rotation when comparing the CW and CCW acquired scans. Misregistered angular coordinates may Result in a rotated reconstructed image and the target localization may lead to an under- or over-dosage of the target volume (TV) and organs at risk (OARs). The effect of image rotation on CBCT-guided lung SBRT was retrospectively examined in a group of six patients treated at our institution. Patient CT sets were rotated by 1,2, and 3°. Treatment plans were recalculated using these rotated images to examine changes of dose-volume histogram indicators for IGRT and ART guided treatments. C++ simulations were run to evaluate the effect of CBCT image rotation. We determined through mathematical analysis that the dose coverage of the TV is dependent on its shape, location and orientation relative to isocenter. Dosimetric evaluation of lung SBRT patients showed that even for 1< Ñ 2 <3°, changes in D95 to the PTV were from 2.3 ± 2.1 to 11.5 ± 3.9% for IGRT and from 8.5 ± 8.4 to 16.6 ± 8.0% for ART. Significant changes were also detected at critical structure level. When IGRT and ART are employed for lung SBRT treatments, significant dosimetric changes may Result from the rotation of CBCT image data sets. The extent of alterations in dose indicators depends on both the shape of the TV and its relative location to isocenter. Based on our results, angular alignment of CBCT to <1° is essential in maintaining accurate dose delivery of IGRT and ART based lung SBRT treatments. © 2012 American Association of Physicists in Medicine.

A Practical Cone-beam CT Scatter Correction Method with Optimized Monte Carlo Simulations for Image-Guided Radiation Therapy

PubMed Central

Xu, Yuan; Bai, Ti; Yan, Hao; Ouyang, Luo; Pompos, Arnold; Wang, Jing; Zhou, Linghong; Jiang, Steve B.; Jia, Xun

2015-01-01

Cone-beam CT (CBCT) has become the standard image guidance tool for patient setup in image-guided radiation therapy. However, due to its large illumination field, scattered photons severely degrade its image quality. While kernel-based scatter correction methods have been used routinely in the clinic, it is still desirable to develop Monte Carlo (MC) simulation-based methods due to their accuracy. However, the high computational burden of the MC method has prevented routine clinical application. This paper reports our recent development of a practical method of MC-based scatter estimation and removal for CBCT. In contrast with conventional MC approaches that estimate scatter signals using a scatter-contaminated CBCT image, our method used a planning CT image for MC simulation, which has the advantages of accurate image intensity and absence of image truncation. In our method, the planning CT was first rigidly registered with the CBCT. Scatter signals were then estimated via MC simulation. After scatter signals were removed from the raw CBCT projections, a corrected CBCT image was reconstructed. The entire workflow was implemented on a GPU platform for high computational efficiency. Strategies such as projection denoising, CT image downsampling, and interpolation along the angular direction were employed to further enhance the calculation speed. We studied the impact of key parameters in the workflow on the resulting accuracy and efficiency, based on which the optimal parameter values were determined. Our method was evaluated in numerical simulation, phantom, and real patient cases. In the simulation cases, our method reduced mean HU errors from 44 HU to 3 HU and from 78 HU to 9 HU in the full-fan and the half-fan cases, respectively. In both the phantom and the patient cases, image artifacts caused by scatter, such as ring artifacts around the bowtie area, were reduced. With all the techniques employed, we achieved computation time of less than 30 sec including the time for both the scatter estimation and CBCT reconstruction steps. The efficacy of our method and its high computational efficiency make our method attractive for clinical use. PMID:25860299

TU-AB-204-03: Advances in CBCT for Orhtopaedics and Bone Health Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zbijewski, W.

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both themore » likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)« less

TU-AB-204-01: Advances in C-Arm CBCT for Brain Perfusion Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, G.

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both themore » likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)« less

TU-AB-204-04: Advances in CBCT for Breast Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boone, J.

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both themore » likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)« less

Clinical introduction of image lag correction for a cone beam CT system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stankovic, Uros; Ploeger, Lennert S.; Sonke, Jan-Jakob, E-mail: j.sonke@nki.nl

Purpose: Image lag in the flat-panel detector used for Linac integrated cone beam computed tomography (CBCT) has a degrading effect on CBCT image quality. The most prominent visible artifact is the presence of bright semicircular structure in the transverse view of the scans, known also as radar artifact. Several correction strategies have been proposed, but until now the clinical introduction of such corrections remains unreported. In November 2013, the authors have clinically implemented a previously proposed image lag correction on all of their machines at their main site in Amsterdam. The purpose of this study was to retrospectively evaluate themore » effect of the correction on the quality of CBCT images and evaluate the required calibration frequency. Methods: Image lag was measured in five clinical CBCT systems (Elekta Synergy 4.6) using an in-house developed beam interrupting device that stops the x-ray beam midway through the data acquisition of an unattenuated beam for calibration. A triple exponential falling edge response was fitted to the measured data and used to correct image lag from projection images with an infinite response. This filter, including an extrapolation for saturated pixels, was incorporated in the authors’ in-house developed clinical CBCT reconstruction software. To investigate the short-term stability of the lag and associated parameters, a series of five image lag measurement over a period of three months was performed. For quantitative analysis, the authors have retrospectively selected ten patients treated in the pelvic region. The apparent contrast was quantified in polar coordinates for scans reconstructed using the parameters obtained from different dates with and without saturation handling. Results: Visually, the radar artifact was minimal in scans reconstructed using image lag correction especially when saturation handling was used. In patient imaging, there was a significant reduction of the apparent contrast from 43 ± 16.7 to 15.5 ± 11.9 HU without the saturation handling and to 9.6 ± 12.1 HU with the saturation handling, depending on the date of the calibration. The image lag correction parameters were stable over a period of 3 months. The computational load was increased by approximately 10%, not endangering the fast in-line reconstruction. Conclusions: The lag correction was successfully implemented clinically and removed most image lag artifacts thus improving the image quality. Image lag correction parameters were stable for 3 months indicating low frequency of calibration requirements.« less

SU-F-J-183: Interior Region-Of-Interest Tomography by Using Inverse Geometry System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, K; Kim, D; Kang, S

2016-06-15

Purpose: The inverse geometry computed tomography (IGCT) composed of multiple source and small size detector has several merits such as reduction of scatter effect and large volumetric imaging within one rotation without cone-beam artifact, compared to conventional cone-beam computed tomography (CBCT). By using this multi-source characteristics, we intend to present a selective and multiple interior region-of-interest (ROI) imaging method by using a designed source on-off sequence of IGCT. Methods: All of the IGCT sources are operated one by one sequentially, and each projection in the shape of narrow cone-beam covers its own partial volume of full field of view (FOV)more » determined from system geometry. Thus, through controlling multi source operation, limited irradiation within ROI is possible and selective radon space data for ROI imaging can be acquired without additional X-ray filtration. With this feature, we designed a source on-off sequence for multi ROI-IGCT imaging, and projections of ROI-IGCT were generated by using the on-off sequence. Multi ROI-IGCT images were reconstructed by using filtered back-projection algorithm. All these imaging process of our study has been performed by utilizing digital phantom and patient CT data. ROI-IGCT images of the phantom were compared to CBCT image and the phantom data for the image quality evaluation. Results: Image quality of ROI-IGCT was comparable to that of CBCT. However, the distal axial-plane from the FOV center, large cone-angle region, ROI-IGCT showed uniform image quality without significant cone-beam artifact contrary to CBCT. Conclusion: ROI-IGCT showed comparable image quality and has the capability to provide multi ROI image within a rotation. Projection of ROI-IGCT is performed by selective irradiation, hence unnecessary imaging dose to non-interest region can be reduced. In this regard, it seems to be useful for diagnostic or image guidance purpose in radiotherapy such as low dose target localization and patient alignment. This research was supported by the Mid-career Researcher Program through NRF funded by the Ministry of Science, ICT & Future Planning of Korea (NRF-2014R1A2A1A10050270) and by the Radiation Technology R&D program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (No. 2013M2A2A7038291)« less

Self-calibration of cone-beam CT geometry using 3D–2D image registration

PubMed Central

Ouadah, S; Stayman, J W; Gang, G J; Ehtiati, T; Siewerdsen, J H

2016-01-01

Robotic C-arms are capable of complex orbits that can increase field of view, reduce artifacts, improve image quality, and/or reduce dose; however, it can be challenging to obtain accurate, reproducible geometric calibration required for image reconstruction for such complex orbits. This work presents a method for geometric calibration for an arbitrary source-detector orbit by registering 2D projection data to a previously acquired 3D image. It also yields a method by which calibration of simple circular orbits can be improved. The registration uses a normalized gradient information similarity metric and the covariance matrix adaptation-evolution strategy optimizer for robustness against local minima and changes in image content. The resulting transformation provides a ‘self-calibration’ of system geometry. The algorithm was tested in phantom studies using both a cone-beam CT (CBCT) test-bench and a robotic C-arm (Artis Zeego, Siemens Healthcare) for circular and non-circular orbits. Self-calibration performance was evaluated in terms of the full-width at half-maximum (FWHM) of the point spread function in CBCT reconstructions, the reprojection error (RPE) of steel ball bearings placed on each phantom, and the overall quality and presence of artifacts in CBCT images. In all cases, self-calibration improved the FWHM—e.g. on the CBCT bench, FWHM = 0.86 mm for conventional calibration compared to 0.65 mm for self-calibration (p < 0.001). Similar improvements were measured in RPE—e.g. on the robotic C-arm, RPE = 0.73 mm for conventional calibration compared to 0.55 mm for self-calibration (p < 0.001). Visible improvement was evident in CBCT reconstructions using self-calibration, particularly about high-contrast, high-frequency objects (e.g. temporal bone air cells and a surgical needle). The results indicate that self-calibration can improve even upon systems with presumably accurate geometric calibration and is applicable to situations where conventional calibration is not feasible, such as complex non-circular CBCT orbits and systems with irreproducible source-detector trajectory. PMID:26961687

Self-calibration of cone-beam CT geometry using 3D-2D image registration

NASA Astrophysics Data System (ADS)

Ouadah, S.; Stayman, J. W.; Gang, G. J.; Ehtiati, T.; Siewerdsen, J. H.

2016-04-01

Robotic C-arms are capable of complex orbits that can increase field of view, reduce artifacts, improve image quality, and/or reduce dose; however, it can be challenging to obtain accurate, reproducible geometric calibration required for image reconstruction for such complex orbits. This work presents a method for geometric calibration for an arbitrary source-detector orbit by registering 2D projection data to a previously acquired 3D image. It also yields a method by which calibration of simple circular orbits can be improved. The registration uses a normalized gradient information similarity metric and the covariance matrix adaptation-evolution strategy optimizer for robustness against local minima and changes in image content. The resulting transformation provides a ‘self-calibration’ of system geometry. The algorithm was tested in phantom studies using both a cone-beam CT (CBCT) test-bench and a robotic C-arm (Artis Zeego, Siemens Healthcare) for circular and non-circular orbits. Self-calibration performance was evaluated in terms of the full-width at half-maximum (FWHM) of the point spread function in CBCT reconstructions, the reprojection error (RPE) of steel ball bearings placed on each phantom, and the overall quality and presence of artifacts in CBCT images. In all cases, self-calibration improved the FWHM—e.g. on the CBCT bench, FWHM  =  0.86 mm for conventional calibration compared to 0.65 mm for self-calibration (p  <  0.001). Similar improvements were measured in RPE—e.g. on the robotic C-arm, RPE  =  0.73 mm for conventional calibration compared to 0.55 mm for self-calibration (p  <  0.001). Visible improvement was evident in CBCT reconstructions using self-calibration, particularly about high-contrast, high-frequency objects (e.g. temporal bone air cells and a surgical needle). The results indicate that self-calibration can improve even upon systems with presumably accurate geometric calibration and is applicable to situations where conventional calibration is not feasible, such as complex non-circular CBCT orbits and systems with irreproducible source-detector trajectory.

SU-D-BRA-07: Applications of Combined KV/MV CBCT Imaging with a High-DQE MV Detector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bazalova-Carter, M; Newson, M; Wang, A

Purpose: To investigate whether a high detection quantum efficiency (DQE) MV detector makes combined kV/MV CBCT clinically practical. Methods: Combined kV/MV CBCT was studied for scan time reduction (STR) and metal artifact reduction (MAR). 6MV CBCT data (dose rate = 0.017 MU/degree) were collected using 1) a novel focused pixelated cadmium tungstate (CWO) scintillator (15mm thickness, DQE(0) = 22%, 0.784mm pixel pitch) coupled to a flat panel imager, and 2) a commercial portal imager with a 133mg/cm{sup 2} gadolinium oxysulfide (GOS) screen (DQE(0) = 1.2%). The 100kVp data were acquired using a commercial imager employing a columnar cesium iodide scintillatormore » (DQE(0) = 70%) with a dose rate of 0.0016 cGy/degree. For STR, MV and kV projections spanning 105° were combined to constitute a complete CBCT scan. Total dose was ∼2cGy and acquisition time was 18s. For MAR, only the metalcorrupted pixels in the kV projections were replaced with MV data resulting in a total dose of less than 1cGy for a 360° scan. Image quality was assessed using an 18-cm diameter electron density phantom with nine tissue inserts, some of which were replaced with steel rods for MAR studies. Results: The CWO contrast-to-noise ratio (CNR) was ∼4.0x higher than the GOS CNR and was ∼4.8x lower than the kV CNR when normalized for dose. When CWO MV data were combined with kV data for STR, all contrast inserts were visible, but only two were detectable in the composite kV/GOS image. Metal artifacts were greatly reduced using the kV/MV MAR technique with all contrast inserts clearly visible in the composite kV/CWO image but only two inserts visible in the composite kV/GOS image. Conclusion: We have demonstrated that a high DQE MV detector significantly improves kV/MV CBCT image quality thus enabling scan time reduction and metal artifact reduction without a severe dose penalty. AW and JS-L are employees of Varian, RF is an employee of Siemens.« less

TU-AB-204-02: Advances in C-Arm CBCT for Cardiac Interventions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fahrig, R.

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both themore » likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)« less

SU-E-J-10: A Moving-Blocker-Based Strategy for Simultaneous Megavoltage and Kilovoltage Scatter Correction in Cone-Beam Computed Tomography Image Acquired During Volumetric Modulated Arc Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ouyang, L; Lee, H; Wang, J

2014-06-01

Purpose: To evaluate a moving-blocker-based approach in estimating and correcting megavoltage (MV) and kilovoltage (kV) scatter contamination in kV cone-beam computed tomography (CBCT) acquired during volumetric modulated arc therapy (VMAT). Methods: XML code was generated to enable concurrent CBCT acquisition and VMAT delivery in Varian TrueBeam developer mode. A physical attenuator (i.e., “blocker”) consisting of equal spaced lead strips (3.2mm strip width and 3.2mm gap in between) was mounted between the x-ray source and patient at a source to blocker distance of 232mm. The blocker was simulated to be moving back and forth along the gantry rotation axis during themore » CBCT acquisition. Both MV and kV scatter signal were estimated simultaneously from the blocked regions of the imaging panel, and interpolated into the un-blocked regions. Scatter corrected CBCT was then reconstructed from un-blocked projections after scatter subtraction using an iterative image reconstruction algorithm based on constraint optimization. Experimental studies were performed on a Catphan 600 phantom and an anthropomorphic pelvis phantom to demonstrate the feasibility of using moving blocker for MV-kV scatter correction. Results: MV scatter greatly degrades the CBCT image quality by increasing the CT number inaccuracy and decreasing the image contrast, in addition to the shading artifacts caused by kV scatter. The artifacts were substantially reduced in the moving blocker corrected CBCT images in both Catphan and pelvis phantoms. Quantitatively, CT number error in selected regions of interest reduced from 377 in the kV-MV contaminated CBCT image to 38 for the Catphan phantom. Conclusions: The moving-blockerbased strategy can successfully correct MV and kV scatter simultaneously in CBCT projection data acquired with concurrent VMAT delivery. This work was supported in part by a grant from the Cancer Prevention and Research Institute of Texas (RP130109) and a grant from the American Cancer Society (RSG-13-326-01-CCE)« less

LBP-based penalized weighted least-squares approach to low-dose cone-beam computed tomography reconstruction

NASA Astrophysics Data System (ADS)

Ma, Ming; Wang, Huafeng; Liu, Yan; Zhang, Hao; Gu, Xianfeng; Liang, Zhengrong

2014-03-01

Cone-beam computed tomography (CBCT) has attracted growing interest of researchers in image reconstruction. The mAs level of the X-ray tube current, in practical application of CBCT, is mitigated in order to reduce the CBCT dose. The lowering of the X-ray tube current, however, results in the degradation of image quality. Thus, low-dose CBCT image reconstruction is in effect a noise problem. To acquire clinically acceptable quality of image, and keep the X-ray tube current as low as achievable in the meanwhile, some penalized weighted least-squares (PWLS)-based image reconstruction algorithms have been developed. One representative strategy in previous work is to model the prior information for solution regularization using an anisotropic penalty term. To enhance the edge preserving and noise suppressing in a finer scale, a novel algorithm combining the local binary pattern (LBP) with penalized weighted leastsquares (PWLS), called LBP-PWLS-based image reconstruction algorithm, is proposed in this work. The proposed LBP-PWLS-based algorithm adaptively encourages strong diffusion on the local spot/flat region around a voxel and less diffusion on edge/corner ones by adjusting the penalty for cost function, after the LBP is utilized to detect the region around the voxel as spot, flat and edge ones. The LBP-PWLS-based reconstruction algorithm was evaluated using the sinogram data acquired by a clinical CT scanner from the CatPhan® 600 phantom. Experimental results on the noiseresolution tradeoff measurement and other quantitative measurements demonstrated its feasibility and effectiveness in edge preserving and noise suppressing in comparison with a previous PWLS reconstruction algorithm.

WE-G-18A-04: 3D Dictionary Learning Based Statistical Iterative Reconstruction for Low-Dose Cone Beam CT Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bai, T; UT Southwestern Medical Center, Dallas, TX; Yan, H

2014-06-15

Purpose: To develop a 3D dictionary learning based statistical reconstruction algorithm on graphic processing units (GPU), to improve the quality of low-dose cone beam CT (CBCT) imaging with high efficiency. Methods: A 3D dictionary containing 256 small volumes (atoms) of 3x3x3 voxels was trained from a high quality volume image. During reconstruction, we utilized a Cholesky decomposition based orthogonal matching pursuit algorithm to find a sparse representation on this dictionary basis of each patch in the reconstructed image, in order to regularize the image quality. To accelerate the time-consuming sparse coding in the 3D case, we implemented our algorithm inmore » a parallel fashion by taking advantage of the tremendous computational power of GPU. Evaluations are performed based on a head-neck patient case. FDK reconstruction with full dataset of 364 projections is used as the reference. We compared the proposed 3D dictionary learning based method with a tight frame (TF) based one using a subset data of 121 projections. The image qualities under different resolutions in z-direction, with or without statistical weighting are also studied. Results: Compared to the TF-based CBCT reconstruction, our experiments indicated that 3D dictionary learning based CBCT reconstruction is able to recover finer structures, to remove more streaking artifacts, and is less susceptible to blocky artifacts. It is also observed that statistical reconstruction approach is sensitive to inconsistency between the forward and backward projection operations in parallel computing. Using high a spatial resolution along z direction helps improving the algorithm robustness. Conclusion: 3D dictionary learning based CBCT reconstruction algorithm is able to sense the structural information while suppressing noise, and hence to achieve high quality reconstruction. The GPU realization of the whole algorithm offers a significant efficiency enhancement, making this algorithm more feasible for potential clinical application. A high zresolution is preferred to stabilize statistical iterative reconstruction. This work was supported in part by NIH(1R01CA154747-01), NSFC((No. 61172163), Research Fund for the Doctoral Program of Higher Education of China (No. 20110201110011), China Scholarship Council.« less

Half-Fan-Based Intensity-Weighted Region-of-Interest Imaging for Low-Dose Cone-Beam CT in Image-Guided Radiation Therapy.

PubMed

Yoo, Boyeol; Son, Kihong; Pua, Rizza; Kim, Jinsung; Solodov, Alexander; Cho, Seungryong

2016-10-01

With the increased use of computed tomography (CT) in clinics, dose reduction is the most important feature people seek when considering new CT techniques or applications. We developed an intensity-weighted region-of-interest (IWROI) imaging method in an exact half-fan geometry to reduce the imaging radiation dose to patients in cone-beam CT (CBCT) for image-guided radiation therapy (IGRT). While dose reduction is highly desirable, preserving the high-quality images of the ROI is also important for target localization in IGRT. An intensity-weighting (IW) filter made of copper was mounted in place of a bowtie filter on the X-ray tube unit of an on-board imager (OBI) system such that the filter can substantially reduce radiation exposure to the outer ROI. In addition to mounting the IW filter, the lead-blade collimation of the OBI was adjusted to produce an exact half-fan scanning geometry for a further reduction of the radiation dose. The chord-based rebinned backprojection-filtration (BPF) algorithm in circular CBCT was implemented for image reconstruction, and a humanoid pelvis phantom was used for the IWROI imaging experiment. The IWROI image of the phantom was successfully reconstructed after beam-quality correction, and it was registered to the reference image within an acceptable level of tolerance. Dosimetric measurements revealed that the dose is reduced by approximately 61% in the inner ROI and by 73% in the outer ROI compared to the conventional bowtie filter-based half-fan scan. The IWROI method substantially reduces the imaging radiation dose and provides reconstructed images with an acceptable level of quality for patient setup and target localization. The proposed half-fan-based IWROI imaging technique can add a valuable option to CBCT in IGRT applications.

Comparison of Tissue Density in Hounsfield Units in Computed Tomography and Cone Beam Computed Tomography.

PubMed

Varshowsaz, Masoud; Goorang, Sepideh; Ehsani, Sara; Azizi, Zeynab; Rahimian, Sepideh

2016-03-01

Bone quality and quantity assessment is one of the most important steps in implant treatment planning. Different methods such as computed tomography (CT) and recently suggested cone beam computed tomography (CBCT) with lower radiation dose and less time and cost are used for bone density assessment. This in vitro study aimed to compare the tissue density values in Hounsfield units (HUs) in CBCT and CT scans of different tissue phantoms with two different thicknesses, two different image acquisition settings and in three locations in the phantoms. Four different tissue phantoms namely hard tissue, soft tissue, air and water were scanned by three different CBCT and a CT system in two thicknesses (full and half) and two image acquisition settings (high and low kVp and mA). The images were analyzed at three sites (middle, periphery and intermediate) using eFilm software. The difference in density values was analyzed by ANOVA and correction coefficient test (P<0.05). There was a significant difference between density values in CBCT and CT scans in most situations, and CBCT values were not similar to CT values in any of the phantoms in different thicknesses and acquisition parameters or the three different sites. The correction coefficients confirmed the results. CBCT is not reliable for tissue density assessment. The results were not affected by changes in thickness, acquisition parameters or locations.

TU-AB-204-00: Advances in Cone-Beam CT and Emerging Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both themore » likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)« less

Should image rotation be addressed during routine cone-beam CT quality assurance?

PubMed

Ayan, Ahmet S; Lin, Haibo; Yeager, Caitlyn; Deville, Curtiland; McDonough, James; Zhu, Timothy C; Anderson, Nathan; Bar Ad, Voichita; Lu, Hsiao-Ming; Both, Stefan

2013-02-21

The purpose of this study is to investigate whether quality assurance (QA) for cone-beam computed tomography (CBCT) image rotation is necessary in order to ensure the accuracy of CBCT based image-guided radiation therapy (IGRT) and adaptive radiotherapy (ART). Misregistration of angular coordinates during CBCT acquisition may lead to a rotated reconstructed image. If target localization is performed based on this image, an under- or over-dosage of the target volume (TV) and organs at risk (OARs) may occur. Therefore, patient CT image sets were rotated by 1° up to 3° and the treatment plans were recalculated to quantify changes in dose-volume histograms. A computer code in C++ was written to model the TV displacement and overlap area of an ellipse shape at the target and dose prescription levels corresponding to the image rotation. We investigated clinical scenarios in IGRT and ART in order to study the implications of image rotation on dose distributions for: (1) lateral TV and isocenter (SBRT), (2) central TV and isocenter (IMRT), (3) lateral TV and isocenter (IMRT). Mathematical analysis showed the dose coverage of TV depends on its shape, size, location, and orientation relative to the isocenter. Evaluation of three first scenario for θ = 1° showed variations in TV D95 in the context of IGRT and ART when compared to the original plan were within 2.7 ± 2.6% and 7.7 ± 6.9% respectively while variations in the second and third scenarios were less significant (<0.5%) for the angular range evaluated. However a larger degree of variation was found in terms of minimum and maximum doses for target and OARs. The rotation of CBCT image data sets may have significant dosimetric consequences in IGRT and ART. The TV's location relative to isocenter and shape determine the extent of alterations in dose indicators. Our findings suggest that a CBCT QA criterion of 1° would be a reasonable action level to ensure accurate dose delivery.

Cone Beam Computed Tomographic imaging in orthodontics.

PubMed

Scarfe, W C; Azevedo, B; Toghyani, S; Farman, A G

2017-03-01

Over the last 15 years, cone beam computed tomographic (CBCT) imaging has emerged as an important supplemental radiographic technique for orthodontic diagnosis and treatment planning, especially in situations which require an understanding of the complex anatomic relationships and surrounding structures of the maxillofacial skeleton. CBCT imaging provides unique features and advantages to enhance orthodontic practice over conventional extraoral radiographic imaging. While it is the responsibility of each practitioner to make a decision, in tandem with the patient/family, consensus-derived, evidence-based clinical guidelines are available to assist the clinician in the decision-making process. Specific recommendations provide selection guidance based on variables such as phase of treatment, clinically-assessed treatment difficulty, the presence of dental and/or skeletal modifying conditions, and pathology. CBCT imaging in orthodontics should always be considered wisely as children have conservatively, on average, a three to five times greater radiation risk compared with adults for the same exposure. The purpose of this paper is to provide an understanding of the operation of CBCT equipment as it relates to image quality and dose, highlight the benefits of the technique in orthodontic practice, and provide guidance on appropriate clinical use with respect to radiation dose and relative risk, particularly for the paediatric patient. © 2017 Australian Dental Association.

A novel phantom and procedure providing submillimeter accuracy in daily QA tests of accelerators used for stereotactic radiosurgery*.

PubMed

Brezovich, Ivan A; Popple, Richard A; Duan, Jun; Shen, Sui; Wu, Xingen; Benhabib, Sidi; Huang, Mi; Cardan, Rex A

2016-07-08

Stereotactic radiosurgery (SRS) places great demands on spatial accuracy. Steel BBs used as markers in quality assurance (QA) phantoms are clearly visible in MV and planar kV images, but artifacts compromise cone-beam CT (CBCT) isocenter localization. The purpose of this work was to develop a QA phantom for measuring with sub-mm accuracy isocenter congruence of planar kV, MV, and CBCT imaging systems and to design a practical QA procedure that includes daily Winston-Lutz (WL) tests and does not require computer aid. The salient feature of the phantom (Universal Alignment Ball (UAB)) is a novel marker for precisely localizing isocenters of CBCT, planar kV, and MV beams. It consists of a 25.4mm diameter sphere of polymethylmetacrylate (PMMA) containing a concentric 6.35mm diameter tungsten carbide ball. The large density difference between PMMA and the polystyrene foam in which the PMMA sphere is embedded yields a sharp image of the sphere for accurate CBCT registration. The tungsten carbide ball serves in finding isocenter in planar kV and MV images and in doing WL tests. With the aid of the UAB, CBCT isocenter was located within 0.10 ± 0.05 mm of its true positon, and MV isocenter was pinpointed in planar images to within 0.06 ± 0.04mm. In clinical morning QA tests extending over an 18 months period the UAB consistently yielded measurements with sub-mm accuracy. The average distance between isocenter defined by orthogonal kV images and CBCT measured 0.16 ± 0.12 mm. In WL tests the central ray of anterior beams defined by a 1.5 × 1.5 cm2 MLC field agreed with CBCT isocenter within 0.03 ± 0.14 mm in the lateral direction and within 0.10 ± 0.19 mm in the longitudinal direction. Lateral MV beams approached CBCT isocenter within 0.00 ± 0.11 mm in the vertical direction and within -0.14 ± 0.15 mm longitudinally. It took therapists about 10 min to do the tests. The novel QA phantom allows pinpointing CBCT and MV isocenter positions to better than 0.2 mm, using visual image registration. Under CBCT guidance, MLC-defined beams are deliverable with sub-mm spatial accuracy. The QA procedure is practical for daily tests by therapists. © 2016 The Authors

A comprehensive study on the relationship between the image quality and imaging dose in low-dose cone beam CT

NASA Astrophysics Data System (ADS)

Yan, Hao; Cervino, Laura; Jia, Xun; Jiang, Steve B.

2012-04-01

While compressed sensing (CS)-based algorithms have been developed for the low-dose cone beam CT (CBCT) reconstruction, a clear understanding of the relationship between the image quality and imaging dose at low-dose levels is needed. In this paper, we qualitatively investigate this subject in a comprehensive manner with extensive experimental and simulation studies. The basic idea is to plot both the image quality and imaging dose together as functions of the number of projections and mAs per projection over the whole clinically relevant range. On this basis, a clear understanding of the tradeoff between the image quality and imaging dose can be achieved and optimal low-dose CBCT scan protocols can be developed to maximize the dose reduction while minimizing the image quality loss for various imaging tasks in image-guided radiation therapy (IGRT). Main findings of this work include (1) under the CS-based reconstruction framework, image quality has little degradation over a large range of dose variation. Image quality degradation becomes evident when the imaging dose (approximated with the x-ray tube load) is decreased below 100 total mAs. An imaging dose lower than 40 total mAs leads to a dramatic image degradation, and thus should be used cautiously. Optimal low-dose CBCT scan protocols likely fall in the dose range of 40-100 total mAs, depending on the specific IGRT applications. (2) Among different scan protocols at a constant low-dose level, the super sparse-view reconstruction with the projection number less than 50 is the most challenging case, even with strong regularization. Better image quality can be acquired with low mAs protocols. (3) The optimal scan protocol is the combination of a medium number of projections and a medium level of mAs/view. This is more evident when the dose is around 72.8 total mAs or below and when the ROI is a low-contrast or high-resolution object. Based on our results, the optimal number of projections is around 90 to 120. (4) The clinically acceptable lowest imaging dose level is task dependent. In our study, 72.8 mAs is a safe dose level for visualizing low-contrast objects, while 12.2 total mAs is sufficient for detecting high-contrast objects of diameter greater than 3 mm.

TU-FG-BRB-11: Design and Evaluation of a Robotic C-Arm CBCT System for Image-Guided Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hua, C; Yao, W; Farr, J

Purpose: To describe the design and performance of a ceiling-mounted robotic C-arm CBCT system for image-guided proton therapy. Methods: Uniquely different from traditional C-arm CBCT used in interventional radiology, the imaging system was designed to provide volumetric image guidance for patients treated on a 190-degree proton gantry system and a 6 degree-of-freedom (DOF) robotic patient positioner. The mounting of robotic arms to the ceiling rails, rather than gantry or nozzle, provides the flexibility in imaging locations (isocenter, iso+27cm in X, iso+100cm in Y) in the room and easier upgrade as technology advances. A kV X-ray tube and a 43×43cm flatmore » panel imager were mounted to a rotating C-ring (87cm diameter), which is coupled to the C-arm concentrically. Both C-arm and the robotic arm remain stationary during imaging to maintain high position accuracy. Source-to-axis distance and source-to-imager distance are 100 and 150cm, respectively. A 14:1 focused anti-scatter grid and a bowtie filer are used for image acquisition. A unique automatic collimator device of 4 independent blades for adjusting field of view and reducing patient dose has also been developed. Results: Sub-millimeter position accuracy and repeatability of the robotic C-arm were measured with a laser tracker. High quality CBCT images for positioning can be acquired with a weighted CTDI of 3.6mGy (head in 200° full fan mode: 100kV, 20mA, 20ms, 10fps)-8.7 mGy (pelvis in 360° half fan mode: 125kV, 42mA, 20ms, 10fps). Image guidance accuracy achieved <1mm (3D vector) with automatic 3D-3D registration for anthropomorphic head and pelvis phantoms. Since November 2015, 22 proton therapy patients have undergone daily CBCT imaging for 6 DOF positioning. Conclusion: Decoupled from gantry and nozzle, this CBCT system provides a unique solution for volumetric image guidance with half/partial proton gantry systems. We demonstrated that daily CBCT can be integrated into proton therapy for pre-treatment position verification.« less

SU-D-206-01: Employing a Novel Consensus Optimization Strategy to Achieve Iterative Cone Beam CT Reconstruction On a Multi-GPU Platform

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, B; Southern Medical University, Guangzhou, Guangdong; Tian, Z

Purpose: While compressed sensing-based cone-beam CT (CBCT) iterative reconstruction techniques have demonstrated tremendous capability of reconstructing high-quality images from undersampled noisy data, its long computation time still hinders wide application in routine clinic. The purpose of this study is to develop a reconstruction framework that employs modern consensus optimization techniques to achieve CBCT reconstruction on a multi-GPU platform for improved computational efficiency. Methods: Total projection data were evenly distributed to multiple GPUs. Each GPU performed reconstruction using its own projection data with a conventional total variation regularization approach to ensure image quality. In addition, the solutions from GPUs were subjectmore » to a consistency constraint that they should be identical. We solved the optimization problem with all the constraints considered rigorously using an alternating direction method of multipliers (ADMM) algorithm. The reconstruction framework was implemented using OpenCL on a platform with two Nvidia GTX590 GPU cards, each with two GPUs. We studied the performance of our method and demonstrated its advantages through a simulation case with a NCAT phantom and an experimental case with a Catphan phantom. Result: Compared with the CBCT images reconstructed using conventional FDK method with full projection datasets, our proposed method achieved comparable image quality with about one third projection numbers. The computation time on the multi-GPU platform was ∼55 s and ∼ 35 s in the two cases respectively, achieving a speedup factor of ∼ 3.0 compared with single GPU reconstruction. Conclusion: We have developed a consensus ADMM-based CBCT reconstruction method which enabled performing reconstruction on a multi-GPU platform. The achieved efficiency made this method clinically attractive.« less

SU-F-BRCD-09: Total Variation (TV) Based Fast Convergent Iterative CBCT Reconstruction with GPU Acceleration.

PubMed

Xu, Q; Yang, D; Tan, J; Anastasio, M

2012-06-01

To improve image quality and reduce imaging dose in CBCT for radiation therapy applications and to realize near real-time image reconstruction based on use of a fast convergence iterative algorithm and acceleration by multi-GPUs. An iterative image reconstruction that sought to minimize a weighted least squares cost function that employed total variation (TV) regularization was employed to mitigate projection data incompleteness and noise. To achieve rapid 3D image reconstruction (< 1 min), a highly optimized multiple-GPU implementation of the algorithm was developed. The convergence rate and reconstruction accuracy were evaluated using a modified 3D Shepp-Logan digital phantom and a Catphan-600 physical phantom. The reconstructed images were compared with the clinical FDK reconstruction results. Digital phantom studies showed that only 15 iterations and 60 iterations are needed to achieve algorithm convergence for 360-view and 60-view cases, respectively. The RMSE was reduced to 10-4 and 10-2, respectively, by using 15 iterations for each case. Our algorithm required 5.4s to complete one iteration for the 60-view case using one Tesla C2075 GPU. The few-view study indicated that our iterative algorithm has great potential to reduce the imaging dose and preserve good image quality. For the physical Catphan studies, the images obtained from the iterative algorithm possessed better spatial resolution and higher SNRs than those obtained from by use of a clinical FDK reconstruction algorithm. We have developed a fast convergence iterative algorithm for CBCT image reconstruction. The developed algorithm yielded images with better spatial resolution and higher SNR than those produced by a commercial FDK tool. In addition, from the few-view study, the iterative algorithm has shown great potential for significantly reducing imaging dose. We expect that the developed reconstruction approach will facilitate applications including IGART and patient daily CBCT-based treatment localization. © 2012 American Association of Physicists in Medicine.

Mobile C-arm cone-beam CT for guidance of spine surgery: Image quality, radiation dose, and integration with interventional guidance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schafer, S.; Nithiananthan, S.; Mirota, D. J.

Purpose: A flat-panel detector based mobile isocentric C-arm for cone-beam CT (CBCT) has been developed to allow intraoperative 3D imaging with sub-millimeter spatial resolution and soft-tissue visibility. Image quality and radiation dose were evaluated in spinal surgery, commonly relying on lower-performance image intensifier based mobile C-arms. Scan protocols were developed for task-specific imaging at minimum dose, in-room exposure was evaluated, and integration of the imaging system with a surgical guidance system was demonstrated in preclinical studies of minimally invasive spine surgery. Methods: Radiation dose was assessed as a function of kilovolt (peak) (80-120 kVp) and milliampere second using thoracic andmore » lumbar spine dosimetry phantoms. In-room radiation exposure was measured throughout the operating room for various CBCT scan protocols. Image quality was assessed using tissue-equivalent inserts in chest and abdomen phantoms to evaluate bone and soft-tissue contrast-to-noise ratio as a function of dose, and task-specific protocols (i.e., visualization of bone or soft-tissues) were defined. Results were applied in preclinical studies using a cadaveric torso simulating minimally invasive, transpedicular surgery. Results: Task-specific CBCT protocols identified include: thoracic bone visualization (100 kVp; 60 mAs; 1.8 mGy); lumbar bone visualization (100 kVp; 130 mAs; 3.2 mGy); thoracic soft-tissue visualization (100 kVp; 230 mAs; 4.3 mGy); and lumbar soft-tissue visualization (120 kVp; 460 mAs; 10.6 mGy) - each at (0.3 x 0.3 x 0.9 mm{sup 3}) voxel size. Alternative lower-dose, lower-resolution soft-tissue visualization protocols were identified (100 kVp; 230 mAs; 5.1 mGy) for the lumbar region at (0.3 x 0.3 x 1.5 mm{sup 3}) voxel size. Half-scan orbit of the C-arm (x-ray tube traversing under the table) was dosimetrically advantageous (prepatient attenuation) with a nonuniform dose distribution ({approx}2 x higher at the entrance side than at isocenter, and {approx}3-4 lower at the exit side). The in-room dose (microsievert) per unit scan dose (milligray) ranged from {approx}21 {mu}Sv/mGy on average at tableside to {approx}0.1 {mu}Sv/mGy at 2.0 m distance to isocenter. All protocols involve surgical staff stepping behind a shield wall for each CBCT scan, therefore imparting {approx}zero dose to staff. Protocol implementation in preclinical cadaveric studies demonstrate integration of the C-arm with a navigation system for spine surgery guidance-specifically, minimally invasive vertebroplasty in which the system provided accurate guidance and visualization of needle placement and bone cement distribution. Cumulative dose including multiple intraoperative scans was {approx}11.5 mGy for CBCT-guided thoracic vertebroplasty and {approx}23.2 mGy for lumbar vertebroplasty, with dose to staff at tableside reduced to {approx}1 min of fluoroscopy time ({approx}40-60 {mu}Sv), compared to 5-11 min for the conventional approach. Conclusions: Intraoperative CBCT using a high-performance mobile C-arm prototype demonstrates image quality suitable to guidance of spine surgery, with task-specific protocols providing an important basis for minimizing radiation dose, while maintaining image quality sufficient for surgical guidance. Images demonstrate a significant advance in spatial resolution and soft-tissue visibility, and CBCT guidance offers the potential to reduce fluoroscopy reliance, reducing cumulative dose to patient and staff. Integration with a surgical guidance system demonstrates precise tracking and visualization in up-to-date images (alleviating reliance on preoperative images only), including detection of errors or suboptimal surgical outcomes in the operating room.« less

A new method to evaluate image quality of CBCT images quantitatively without observers

PubMed Central

Shimizu, Mayumi; Okamura, Kazutoshi; Yoshida, Shoko; Weerawanich, Warangkana; Tokumori, Kenji; Jasa, Gainer R; Yoshiura, Kazunori

2017-01-01

Objectives: To develop an observer-free method for quantitatively evaluating the image quality of CBCT images by applying just-noticeable difference (JND). Methods: We used two test objects: (1) a Teflon (polytetrafluoroethylene) plate phantom attached to a dry human mandible; and (2) a block phantom consisting of a Teflon step phantom and an aluminium step phantom. These phantoms had holes with different depths. They were immersed in water and scanned with a CB MercuRay (Hitachi Medical Corporation, Tokyo, Japan) at tube voltages of 120 kV, 100 kV, 80 kV and 60 kV. Superimposed images of the phantoms with holes were used for evaluation. The number of detectable holes was used as an index of image quality. In detecting holes quantitatively, the threshold grey value (ΔG), which differentiated holes from the background, was calculated using a specific threshold (the JND), and we extracted the holes with grey values above ΔG. The indices obtained by this quantitative method (the extracted hole values) were compared with the observer evaluations (the observed hole values). In addition, the contrast-to-noise ratio (CNR) of the shallowest detectable holes and the deepest undetectable holes were measured to evaluate the contribution of CNR to detectability. Results: The results of this evaluation method corresponded almost exactly with the evaluations made by observers. The extracted hole values reflected the influence of different tube voltages. All extracted holes had an area with a CNR of ≥1.5. Conclusions: This quantitative method of evaluating CBCT image quality may be more useful and less time-consuming than evaluation by observation. PMID:28045343

Assessment of female breast dose for thoracic cone-beam CT using MOSFET dosimeters

PubMed Central

Qiu, Bo; Liang, Jian; Xie, Weihao; Deng, Xiaowu; Qi, Zhenyu

2017-01-01

Objective: To assess the breast dose during a routine thoracic cone-beam CT (CBCT) check with the efforts to explore the possible dose reduction strategy. Materials and Methods: Metal oxide semiconductor field-effect transistor (MOSFET) dosimeters were used to measure breast surface doses during a thorax kV CBCT scan in an anthropomorphic phantom. Breast doses for different scanning protocols and breast sizes were compared. Dose reduction was attempted by using partial arc CBCT scan with bowtie filter. The impact of this dose reduction strategy on image registration accuracy was investigated. Results: The average breast surface doses were 20.02 mGy and 11.65 mGy for thoracic CBCT without filtration and with filtration, respectively. This indicates a dose reduction of 41.8% by use of bowtie filter. It was found 220° partial arc scanning significantly reduced the dose to contralateral breast (44.4% lower than ipsilateral breast), while the image registration accuracy was not compromised. Conclusions: Breast dose reduction can be achieved by using ipsilateral 220° partial arc scan with bowtie filter. This strategy also provides sufficient image quality for thorax image registration in daily patient positioning verification. PMID:28423624

SU-F-J-211: Scatter Correction for Clinical Cone-Beam CT System Using An Optimized Stationary Beam Blocker with a Single Scan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liang, X; Zhang, Z; Xie, Y

Purpose: X-ray scatter photons result in significant image quality degradation of cone-beam CT (CBCT). Measurement based algorithms using beam blocker directly acquire the scatter samples and achieve significant improvement on the quality of CBCT image. Within existing algorithms, single-scan and stationary beam blocker proposed previously is promising due to its simplicity and practicability. Although demonstrated effectively on tabletop system, the blocker fails to estimate the scatter distribution on clinical CBCT system mainly due to the gantry wobble. In addition, the uniform distributed blocker strips in our previous design results in primary data loss in the CBCT system and leads tomore » the image artifacts due to data insufficiency. Methods: We investigate the motion behavior of the beam blocker in each projection and design an optimized non-uniform blocker strip distribution which accounts for the data insufficiency issue. An accurate scatter estimation is then achieved from the wobble modeling. Blocker wobble curve is estimated using threshold-based segmentation algorithms in each projection. In the blocker design optimization, the quality of final image is quantified using the number of the primary data loss voxels and the mesh adaptive direct search algorithm is applied to minimize the objective function. Scatter-corrected CT images are obtained using the optimized blocker. Results: The proposed method is evaluated using Catphan@504 phantom and a head patient. On the Catphan©504, our approach reduces the average CT number error from 115 Hounsfield unit (HU) to 11 HU in the selected regions of interest, and improves the image contrast by a factor of 1.45 in the high-contrast regions. On the head patient, the CT number error is reduced from 97 HU to 6 HU in the soft tissue region and image spatial non-uniformity is decreased from 27% to 5% after correction. Conclusion: The proposed optimized blocker design is practical and attractive for CBCT guided radiation therapy. This work is supported by grants from Guangdong Innovative Research Team Program of China (Grant No. 2011S013), National 863 Programs of China (Grant Nos. 2012AA02A604 and 2015AA043203), the National High-tech R&D Program for Young Scientists by the Ministry of Science and Technology of China (Grant No. 2015AA020917)« less

Accuracy of radiotherapy dose calculations based on cone-beam CT: comparison of deformable registration and image correction based methods

NASA Astrophysics Data System (ADS)

Marchant, T. E.; Joshi, K. D.; Moore, C. J.

2018-03-01

Radiotherapy dose calculations based on cone-beam CT (CBCT) images can be inaccurate due to unreliable Hounsfield units (HU) in the CBCT. Deformable image registration of planning CT images to CBCT, and direct correction of CBCT image values are two methods proposed to allow heterogeneity corrected dose calculations based on CBCT. In this paper we compare the accuracy and robustness of these two approaches. CBCT images for 44 patients were used including pelvis, lung and head & neck sites. CBCT HU were corrected using a ‘shading correction’ algorithm and via deformable registration of planning CT to CBCT using either Elastix or Niftyreg. Radiotherapy dose distributions were re-calculated with heterogeneity correction based on the corrected CBCT and several relevant dose metrics for target and OAR volumes were calculated. Accuracy of CBCT based dose metrics was determined using an ‘override ratio’ method where the ratio of the dose metric to that calculated on a bulk-density assigned version of the same image is assumed to be constant for each patient, allowing comparison to the patient’s planning CT as a gold standard. Similar performance is achieved by shading corrected CBCT and both deformable registration algorithms, with mean and standard deviation of dose metric error less than 1% for all sites studied. For lung images, use of deformed CT leads to slightly larger standard deviation of dose metric error than shading corrected CBCT with more dose metric errors greater than 2% observed (7% versus 1%).

Evidence supporting the use of cone-beam computed tomography in orthodontics.

PubMed

van Vlijmen, Olivier J C; Kuijpers, Mette A R; Bergé, Stefaan J; Schols, Jan G J H; Maal, Thomas J J; Breuning, Hero; Kuijpers-Jagtman, Anne Marie

2012-03-01

The authors conducted a systematic review of cone-beam computed tomography (CBCT) applications in orthodontics and evaluated the level of evidence to determine whether the use of CBCT is justified in orthodontics. The authors identified articles by searching the Cochrane Library, PubMed, MEDLINE, Embase, Scopus and Cumulative Index to Nursing and Allied Health Literature databases. They searched the articles' reference lists manually for additional articles and had no language limitations. They did not search the gray literature. Inclusion criteria were CBCT use in orthodontics and that the participants be human. The lowest level of evidence accepted for inclusion was a case series with five or more participants. The authors evaluated the studies' methodological quality according to 13 criteria related to study design, measurements and statistical analysis. The authors identified 550 articles, and 50 met the inclusion criteria. Study topics included temporary anchorage devices, cephalometry, combined orthodontic and surgical treatment, airway measurements, root resorption and tooth impactions, and cleft lip and palate. The methodological quality averaged 53 percent (range, 15-77 percent) of the maximum score. The authors found no high-quality evidence regarding the benefits of CBCT use in orthodontics. Limited evidence shows that CBCT offers better diagnostic potential, leads to better treatment planning or results in better treatment outcome than do conventional imaging modalities. Only the results of studies on airway diagnostics provided sound scientific data suggesting that CBCT use has added value. The additional radiation exposure should be weighed against possible benefits of CBCT, which have not been supported in the literature. In future studies, investigators should evaluate the effects of CBCT on treatment procedures, progression and outcome quantitatively.

Diagnostic methods for assessing maxillary skeletal and dental transverse deficiencies: A systematic review

PubMed Central

Sawchuk, Dena; Currie, Kris; Vich, Manuel Lagravere; Palomo, Juan Martin

2016-01-01

Objective To evaluate the accuracy and reliability of the diagnostic tools available for assessing maxillary transverse deficiencies. Methods An electronic search of three databases was performed from their date of establishment to April 2015, with manual searching of reference lists of relevant articles. Articles were considered for inclusion if they reported the accuracy or reliability of a diagnostic method or evaluation technique for maxillary transverse dimensions in mixed or permanent dentitions. Risk of bias was assessed in the included articles, using the Quality Assessment of Diagnostic Accuracy Studies tool-2. Results Nine articles were selected. The studies were heterogeneous, with moderate to low methodological quality, and all had a high risk of bias. Four suggested that the use of arch width prediction indices with dental cast measurements is unreliable for use in diagnosis. Frontal cephalograms derived from cone-beam computed tomography (CBCT) images were reportedly more reliable for assessing intermaxillary transverse discrepancies than posteroanterior cephalograms. Two studies proposed new three-dimensional transverse analyses with CBCT images that were reportedly reliable, but have not been validated for clinical sensitivity or specificity. No studies reported sensitivity, specificity, positive or negative predictive values or likelihood ratios, or ROC curves of the methods for the diagnosis of transverse deficiencies. Conclusions Current evidence does not enable solid conclusions to be drawn, owing to a lack of reliable high quality diagnostic studies evaluating maxillary transverse deficiencies. CBCT images are reportedly more reliable for diagnosis, but further validation is required to confirm CBCT's accuracy and diagnostic superiority. PMID:27668196

Physics and Computational Methods for X-ray Scatter Estimation and Correction in Cone-Beam Computed Tomography

NASA Astrophysics Data System (ADS)

Bootsma, Gregory J.

X-ray scatter in cone-beam computed tomography (CBCT) is known to reduce image quality by introducing image artifacts, reducing contrast, and limiting computed tomography (CT) number accuracy. The extent of the effect of x-ray scatter on CBCT image quality is determined by the shape and magnitude of the scatter distribution in the projections. A method to allay the effects of scatter is imperative to enable application of CBCT to solve a wider domain of clinical problems. The work contained herein proposes such a method. A characterization of the scatter distribution through the use of a validated Monte Carlo (MC) model is carried out. The effects of imaging parameters and compensators on the scatter distribution are investigated. The spectral frequency components of the scatter distribution in CBCT projection sets are analyzed using Fourier analysis and found to reside predominately in the low frequency domain. The exact frequency extents of the scatter distribution are explored for different imaging configurations and patient geometries. Based on the Fourier analysis it is hypothesized the scatter distribution can be represented by a finite sum of sine and cosine functions. The fitting of MC scatter distribution estimates enables the reduction of the MC computation time by diminishing the number of photon tracks required by over three orders of magnitude. The fitting method is incorporated into a novel scatter correction method using an algorithm that simultaneously combines multiple MC scatter simulations. Running concurrent MC simulations while simultaneously fitting the results allows for the physical accuracy and flexibility of MC methods to be maintained while enhancing the overall efficiency. CBCT projection set scatter estimates, using the algorithm, are computed on the order of 1--2 minutes instead of hours or days. Resulting scatter corrected reconstructions show a reduction in artifacts and improvement in tissue contrast and voxel value accuracy.

Technical aspects of dental CBCT: state of the art

PubMed Central

Araki, K; Siewerdsen, J H; Thongvigitmanee, S S

2015-01-01

As CBCT is widely used in dental and maxillofacial imaging, it is important for users as well as referring practitioners to understand the basic concepts of this imaging modality. This review covers the technical aspects of each part of the CBCT imaging chain. First, an overview is given of the hardware of a CBCT device. The principles of cone beam image acquisition and image reconstruction are described. Optimization of imaging protocols in CBCT is briefly discussed. Finally, basic and advanced visualization methods are illustrated. Certain topics in these review are applicable to all types of radiographic imaging (e.g. the principle and properties of an X-ray tube), others are specific for dental CBCT imaging (e.g. advanced visualization techniques). PMID:25263643

Diagnostic Accuracy of Periapical Radiography and Cone-beam Computed Tomography in Identifying Root Canal Configuration of Human Premolars.

PubMed

Sousa, Thiago Oliveira; Haiter-Neto, Francisco; Nascimento, Eduarda Helena Leandro; Peroni, Leonardo Vieira; Freitas, Deborah Queiroz; Hassan, Bassam

2017-07-01

The aim of this study was to assess the diagnostic accuracy of periapical radiography (PR) and cone-beam computed tomographic (CBCT) imaging in the detection of the root canal configuration (RCC) of human premolars. PR and CBCT imaging of 114 extracted human premolars were evaluated by 2 oral radiologists. RCC was recorded according to Vertucci's classification. Micro-computed tomographic imaging served as the gold standard to determine RCC. Accuracy, sensitivity, specificity, and predictive values were calculated. The Friedman test compared both PR and CBCT imaging with the gold standard. CBCT imaging showed higher values for all diagnostic tests compared with PR. Accuracy was 0.55 and 0.89 for PR and CBCT imaging, respectively. There was no difference between CBCT imaging and the gold standard, whereas PR differed from both CBCT and micro-computed tomographic imaging (P < .0001). CBCT imaging was more accurate than PR for evaluating different types of RCC individually. Canal configuration types III, VII, and "other" were poorly identified on CBCT imaging with a detection accuracy of 50%, 0%, and 43%, respectively. With PR, all canal configurations except type I were poorly visible. PR presented low performance in the detection of RCC in premolars, whereas CBCT imaging showed no difference compared with the gold standard. Canals with complex configurations were less identifiable using both imaging methods, especially PR. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

SU-E-I-40: Phantom Research On Monochromatic Images Taken by Dual CBCT with Multiple Energy Sets

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gao, R; Shandong University, Jinan, Shandong; Wang, H

Purpose: To evaluate the quality of monochromatic images at the same virtual monochromatic energy using dual cone-beam computed tomography (CBCT) with either kV/kV or MV/kV or MV/MV energy sets. Methods: CT images of Catphan 504 phantom were acquired using four different KV and MV settings: 80kV, 140kV, 4MV, 6MV. Three sets of monochromatic images were calculated: 80kV-140kV, 140kV-4MV and 4MV-6MV. Each set of CBCT images were reconstructed from the same selected virtual monochromatic energy of 1MeV. Contrast-to-Noise Ratios (CNRs) were calculated and compared between each pair of images with different energy sets. Results: Between kV/MV and MV/MV images, the CNRsmore » are comparable for all inserts. However, differences of CNRs were observed between the kV/kV and kV/MV images. Delrin’s CNR ratio between kV/kV image and kV/MV image is 1.634. LDPE’s (Low-Density Polyethylene) CNR ratio between kV/kV and kV/MV images is 0.509. Polystyrene’s CNR ratio between kV/kV image and kV/MV image is 2.219. Conclusion: Preliminary results indicated that the CNRs calculated from CBCT images reconstructed from either kV/MV projections or MV/MV projections for the same selected virtual monochromatic energy may be comparable.« less

Evaluation of lens absorbed dose with Cone Beam IGRT procedures.

PubMed

Palomo, R; Pujades, M C; Gimeno-Olmos, J; Carmona, V; Lliso, F; Candela-Juan, C; Vijande, J; Ballester, F; Perez-Calatayud, J

2015-12-01

The purpose of this work is to evaluate the absorbed dose to the eye lenses due to the cone beam computed tomography (CBCT) system used to accurately position the patient during head-and-neck image guided procedures. The on-board imaging (OBI) systems (v.1.5) of Clinac iX and TrueBeam (Varian) accelerators were used to evaluate the imparted dose to the eye lenses and some additional points of the head. All CBCT scans were acquired with the Standard-Dose Head protocol from Varian. Doses were measured using thermoluminescence dosimeters (TLDs) placed in an anthropomorphic phantom. TLDs were calibrated at the beam quality used to reduce their energy dependence. Average dose to the lens due to the OBI systems of the Clinac iX and the TrueBeam were 0.71  ±  0.07 mGy/CBCT and 0.70  ±  0.08 mGy/CBCT, respectively. The extra absorbed dose received by the eye lenses due to one CBCT acquisition with the studied protocol is far below the 500 mGy threshold established by ICRP for cataract formation (ICRP 2011 Statement on Tissue Reactions). However, the incremental effect of several CBCT acquisitions during the whole treatment should be taken into account.

A methodology for on‐board CBCT imaging dose using optically stimulated luminescence detectors

PubMed Central

Yusuf, Muhammad; Alothmany, Nazeeh; Kinsara, A. Abdulrahman; Abdulkhaliq, Fahad; Ghamdi, Suliman M.; Saoudi, Abdelhamid

2016-01-01

Cone‐beam computed tomography CBCT systems are used in radiation therapy for patient alignment and positioning. The CBCT imaging procedure for patient setup adds substantial radiation dose to patient's normal tissue. This study presents a complete procedure for the CBCT dosimetry using the InLight optically‐stimulated‐luminescence (OSL) nanoDots. We report five dose parameters: the mean slice dose (DMSD); the cone beam dose index (CBDIW); the mean volume dose (DMVD); point‐dose profile, D(FOV); and the off‐field Dose. In addition, CBCT skin doses for seven pelvic tumor patients are reported. CBCT‐dose measurement was performed on a custom‐made cylindrical acrylic body phantom (50 cm length, 32 cm diameter). We machined 25 circular disks (2 cm thick) with grooves and holes to hold OSL‐nanoDots. OSLs that showed similar sensitivities were selected and calibrated against a Farmer‐type ionization‐chamber (0.6 CT) before being inserted into the grooves and holes. For the phantom scan, a standard CBCT‐imaging protocol (pelvic sites: 125 kVp, 80 mA and 25 ms) was used. Five dose parameters were quantified: DMSD, CBDIW, DMVD, D(FOV), and the off‐field dose. The DMSD for the central slice was 31.1±0.85 mGy, and CBDIW was 34.5±0.6 mGy at 16 cm FOV. The DMVD was 25.6±1.1 mGy. The off‐field dose was 10.5 mGy. For patients, the anterior and lateral skin doses attributable to CBCT imaging were 39.04±4.4 and 27.1±1.3 mGy, respectively. OSL nanoDots were convenient to use in measuring CBCT dose. The method of selecting the nanoDots greatly reduced uncertainty in the OSL measurements. Our detailed calibration procedure and CBCT dose measurements and calculations could prove useful in developing OSL routines for CBCT quality assessment, which in turn gives them the property of high spatial resolution, meaning that they have the potential for measurement of dose in regions of severe dose‐gradients. PACS number(s): 87.57.‐s, 87.57.Q, 87.57.uq PMID:27685143

Optimization-based image reconstruction from sparse-view data in offset-detector CBCT

NASA Astrophysics Data System (ADS)

Bian, Junguo; Wang, Jiong; Han, Xiao; Sidky, Emil Y.; Shao, Lingxiong; Pan, Xiaochuan

2013-01-01

The field of view (FOV) of a cone-beam computed tomography (CBCT) unit in a single-photon emission computed tomography (SPECT)/CBCT system can be increased by offsetting the CBCT detector. Analytic-based algorithms have been developed for image reconstruction from data collected at a large number of densely sampled views in offset-detector CBCT. However, the radiation dose involved in a large number of projections can be of a health concern to the imaged subject. CBCT-imaging dose can be reduced by lowering the number of projections. As analytic-based algorithms are unlikely to reconstruct accurate images from sparse-view data, we investigate and characterize in the work optimization-based algorithms, including an adaptive steepest descent-weighted projection onto convex sets (ASD-WPOCS) algorithms, for image reconstruction from sparse-view data collected in offset-detector CBCT. Using simulated data and real data collected from a physical pelvis phantom and patient, we verify and characterize properties of the algorithms under study. Results of our study suggest that optimization-based algorithms such as ASD-WPOCS may be developed for yielding images of potential utility from a number of projections substantially smaller than those used currently in clinical SPECT/CBCT imaging, thus leading to a dose reduction in CBCT imaging.

Imaging a moving lung tumor with megavoltage cone beam computed tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gayou, Olivier, E-mail: ogayou@wpahs.org; Colonias, Athanasios

2015-05-15

Purpose: Respiratory motion may affect the accuracy of image guidance of radiation treatment of lung cancer. A cone beam computed tomography (CBCT) image spans several breathing cycles, resulting in a blurred object with a theoretical size equal to the sum of tumor size and breathing motion. However, several factors may affect this theoretical relationship. The objective of this study was to analyze the effect of tumor motion on megavoltage (MV)-CBCT images, by comparing target sizes on simulation and pretreatment images of a large cohort of lung cancer patients. Methods: Ninety-three MV-CBCT images from 17 patients were analyzed. Internal target volumesmore » were contoured on each MV-CBCT dataset [internal target volume (ITV{sub CB})]. Their extent in each dimension was compared to that of two volumes contoured on simulation 4-dimensional computed tomography (4D-CT) images: the combination of the tumor contours of each phase of the 4D-CT (ITV{sub 4D}) and the volume contoured on the average CT calculated from the 4D-CT phases (ITV{sub ave}). Tumor size and breathing amplitude were assessed by contouring the tumor on each CBCT raw projection where it could be unambiguously identified. The effect of breathing amplitude on the quality of the MV-CBCT image reconstruction was analyzed. Results: The mean differences between the sizes of ITV{sub CB} and ITV{sub 4D} were −1.6 ± 3.3 mm (p < 0.001), −2.4 ± 3.1 mm (p < 0.001), and −7.2 ± 5.3 mm (p < 0.001) in the anterior/posterior (AP), left/right (LR), and superior/inferior (SI) directions, respectively, showing that MV-CBCT underestimates the full target size. The corresponding mean differences between ITV{sub CB} and ITV{sub ave} were 0.3 ± 2.6 mm (p = 0.307), 0.0 ± 2.4 mm (p = 0.86), and −4.0 ± 4.3 mm (p < 0.001), indicating that the average CT image is more representative of what is visible on MV-CBCT in the AP and LR directions. In the SI directions, differences between ITV{sub CB} and ITV{sub ave} could be separated into two groups based on tumor motion: −3.2 ± 3.2 mm for tumor motion less than 15 mm and −10.9 ± 6.3 mm for tumor motion greater than 15 mm. Deviations of measured target extents from their theoretical values derived from tumor size and motion were correlated with motion amplitude similarly for both MV-CBCT and average CT images, suggesting that the two images were subject to similar motion artifacts for motion less than 15 mm. Conclusions: MV-CBCT images are affected by tumor motion and tend to under-represent the full target volume. For tumor motion up to 15 mm, the volume contoured on average CT is comparable to that contoured on the MV-CBCT. Therefore, the average CT should be used in image registration for localization purposes, and the standard 5 mm PTV margin seems adequate. For tumor motion greater than 15 mm, an additional setup margin may need to be used to account for the increased uncertainty in tumor localization.« less

High quality 4D cone-beam CT reconstruction using motion-compensated total variation regularization

NASA Astrophysics Data System (ADS)

Zhang, Hua; Ma, Jianhua; Bian, Zhaoying; Zeng, Dong; Feng, Qianjin; Chen, Wufan

2017-04-01

Four dimensional cone-beam computed tomography (4D-CBCT) has great potential clinical value because of its ability to describe tumor and organ motion. But the challenge in 4D-CBCT reconstruction is the limited number of projections at each phase, which result in a reconstruction full of noise and streak artifacts with the conventional analytical algorithms. To address this problem, in this paper, we propose a motion compensated total variation regularization approach which tries to fully explore the temporal coherence of the spatial structures among the 4D-CBCT phases. In this work, we additionally conduct motion estimation/motion compensation (ME/MC) on the 4D-CBCT volume by using inter-phase deformation vector fields (DVFs). The motion compensated 4D-CBCT volume is then viewed as a pseudo-static sequence, of which the regularization function was imposed on. The regularization used in this work is the 3D spatial total variation minimization combined with 1D temporal total variation minimization. We subsequently construct a cost function for a reconstruction pass, and minimize this cost function using a variable splitting algorithm. Simulation and real patient data were used to evaluate the proposed algorithm. Results show that the introduction of additional temporal correlation along the phase direction can improve the 4D-CBCT image quality.

Accuracy of imaging methods for detection of bone tissue invasion in patients with oral squamous cell carcinoma

PubMed Central

Uribe, S; Rojas, LA; Rosas, CF

2013-01-01

The objective of this review is to evaluate the diagnostic accuracy of imaging methods for detection of mandibular bone tissue invasion by squamous cell carcinoma (SCC). A systematic review was carried out of studies in MEDLINE, SciELO and ScienceDirect, published between 1960 and 2012, in English, Spanish or German, which compared detection of mandibular bone tissue invasion via different imaging tests against a histopathology reference standard. Sensitivity and specificity data were extracted from each study. The outcome measure was diagnostic accuracy. We found 338 articles, of which 5 fulfilled the inclusion criteria. Tests included were: CT (four articles), MRI (four articles), panoramic radiography (one article), positron emission tomography (PET)/CT (one article) and cone beam CT (CBCT) (one article). The quality of articles was low to moderate and the evidence showed that all tests have a high diagnostic accuracy for detection of mandibular bone tissue invasion by SCC, with sensitivity values of 94% (MRI), 91% (CBCT), 83% (CT) and 55% (panoramic radiography), and specificity values of 100% (CT, MRI, CBCT), 97% (PET/CT) and 91.7% (panoramic radiography). Available evidence is scarce and of only low to moderate quality. However, it is consistently shown that current imaging methods give a moderate to high diagnostic accuracy for the detection of mandibular bone tissue invasion by SCC. Recommendations are given for improving the quality of future reports, in particular provision of a detailed description of the patients' conditions, the imaging instrument and both imaging and histopathological invasion criteria. PMID:23420854

Scatter correction in cone-beam CT via a half beam blocker technique allowing simultaneous acquisition of scatter and image information

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Ho; Xing Lei; Lee, Rena

2012-05-15

Purpose: X-ray scatter incurred to detectors degrades the quality of cone-beam computed tomography (CBCT) and represents a problem in volumetric image guided and adaptive radiation therapy. Several methods using a beam blocker for the estimation and subtraction of scatter have been proposed. However, due to missing information resulting from the obstruction of the blocker, such methods require dual scanning or dynamically moving blocker to obtain a complete volumetric image. Here, we propose a half beam blocker-based approach, in conjunction with a total variation (TV) regularized Feldkamp-Davis-Kress (FDK) algorithm, to correct scatter-induced artifacts by simultaneously acquiring image and scatter information frommore » a single-rotation CBCT scan. Methods: A half beam blocker, comprising lead strips, is used to simultaneously acquire image data on one side of the projection data and scatter data on the other half side. One-dimensional cubic B-Spline interpolation/extrapolation is applied to derive patient specific scatter information by using the scatter distributions on strips. The estimated scatter is subtracted from the projection image acquired at the opposite view. With scatter-corrected projections where this subtraction is completed, the FDK algorithm based on a cosine weighting function is performed to reconstruct CBCT volume. To suppress the noise in the reconstructed CBCT images produced by geometric errors between two opposed projections and interpolated scatter information, total variation regularization is applied by a minimization using a steepest gradient descent optimization method. The experimental studies using Catphan504 and anthropomorphic phantoms were carried out to evaluate the performance of the proposed scheme. Results: The scatter-induced shading artifacts were markedly suppressed in CBCT using the proposed scheme. Compared with CBCT without a blocker, the nonuniformity value was reduced from 39.3% to 3.1%. The root mean square error relative to values inside the regions of interest selected from a benchmark scatter free image was reduced from 50 to 11.3. The TV regularization also led to a better contrast-to-noise ratio. Conclusions: An asymmetric half beam blocker-based FDK acquisition and reconstruction technique has been established. The proposed scheme enables simultaneous detection of patient specific scatter and complete volumetric CBCT reconstruction without additional requirements such as prior images, dual scans, or moving strips.« less

Integration of Digital Dental Casts in Cone-Beam Computed Tomography Scans

PubMed Central

Rangel, Frits A.; Maal, Thomas J. J.; Bergé, Stefaan J.; Kuijpers-Jagtman, Anne Marie

2012-01-01

Cone-beam computed tomography (CBCT) is widely used in maxillofacial surgery. The CBCT image of the dental arches, however, is of insufficient quality to use in digital planning of orthognathic surgery. Several authors have described methods to integrate digital dental casts into CBCT scans, but all reported methods have drawbacks. The aim of this feasibility study is to present a new simplified method to integrate digital dental casts into CBCT scans. In a patient scheduled for orthognathic surgery, titanium markers were glued to the gingiva. Next, a CBCT scan and dental impressions were made. During the impression-taking procedure, the titanium markers were transferred to the impression. The impressions were scanned, and all CBCT datasets were exported in DICOM format. The two datasets were matched, and the dentition derived from the scanned impressions was transferred to the CBCT of the patient. After matching the two datasets, the average distance between the corresponding markers was 0.1 mm. This novel method allows for the integration of digital dental casts into CBCT scans, overcoming problems such as unwanted extra radiation exposure, distortion of soft tissues due to the use of bite jigs, and time-consuming digital data handling. PMID:23050159

Architecture of a high-performance surgical guidance system based on C-arm cone-beam CT: software platform for technical integration and clinical translation

NASA Astrophysics Data System (ADS)

Uneri, Ali; Schafer, Sebastian; Mirota, Daniel; Nithiananthan, Sajendra; Otake, Yoshito; Reaungamornrat, Sureerat; Yoo, Jongheun; Stayman, J. Webster; Reh, Douglas; Gallia, Gary L.; Khanna, A. Jay; Hager, Gregory; Taylor, Russell H.; Kleinszig, Gerhard; Siewerdsen, Jeffrey H.

2011-03-01

Intraoperative imaging modalities are becoming more prevalent in recent years, and the need for integration of these modalities with surgical guidance is rising, creating new possibilities as well as challenges. In the context of such emerging technologies and new clinical applications, a software architecture for cone-beam CT (CBCT) guided surgery has been developed with emphasis on binding open-source surgical navigation libraries and integrating intraoperative CBCT with novel, application-specific registration and guidance technologies. The architecture design is focused on accelerating translation of task-specific technical development in a wide range of applications, including orthopaedic, head-and-neck, and thoracic surgeries. The surgical guidance system is interfaced with a prototype mobile C-arm for high-quality CBCT and through a modular software architecture, integration of different tools and devices consistent with surgical workflow in each of these applications is realized. Specific modules are developed according to the surgical task, such as: 3D-3D rigid or deformable registration of preoperative images, surgical planning data, and up-to-date CBCT images; 3D-2D registration of planning and image data in real-time fluoroscopy and/or digitally reconstructed radiographs (DRRs); compatibility with infrared, electromagnetic, and video-based trackers used individually or in hybrid arrangements; augmented overlay of image and planning data in endoscopic or in-room video; real-time "virtual fluoroscopy" computed from GPU-accelerated DRRs; and multi-modality image display. The platform aims to minimize offline data processing by exposing quantitative tools that analyze and communicate factors of geometric precision. The system was translated to preclinical phantom and cadaver studies for assessment of fiducial (FRE) and target registration error (TRE) showing sub-mm accuracy in targeting and video overlay within intraoperative CBCT. The work culminates in the development of a CBCT guidance system (reported here for the first time) that leverages the technical developments in Carm CBCT and associated technologies for realizing a high-performance system for translation to clinical studies.

SU-F-J-81: Evaluation of Automated Deformable Registration Between Planning Computed Tomography (CT) and Daily Cone Beam CT Images Over the Course of Prostate Cancer Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matney, J; Hammers, J; Kaidar-Person, O

2016-06-15

Purpose: To compute daily dose delivered during radiotherapy, deformable registration needs to be relatively fast, automated, and accurate. The aim of this study was to evaluate the performance of commercial deformable registration software for deforming between two modalities: planning computed tomography (pCT) images acquired for treatment planning and cone beam (CB) CT images acquired prior to each fraction of prostate cancer radiotherapy. Methods: A workflow was designed using MIM Software™ that aligned and deformed pCT into daily CBCT images in two steps: (1) rigid shifts applied after daily CBCT imaging to align patient anatomy to the pCT and (2) normalizedmore » intensity-based deformable registration to account for interfractional anatomical variations. The physician-approved CTV and organ and risk (OAR) contours were deformed from the pCT to daily CBCT over the course of treatment. The same structures were delineated on each daily CBCT by a radiation oncologist. Dice similarity coefficient (DSC) mean and standard deviations were calculated to quantify the deformable registration quality for prostate, bladder, rectum and femoral heads. Results: To date, contour comparisons have been analyzed for 31 daily fractions of 2 of 10 of the cohort. Interim analysis shows that right and left femoral head contours demonstrate the highest agreement (DSC: 0.96±0.02) with physician contours. Additionally, deformed bladder (DSC: 0.81±0.09) and prostate (DSC: 0.80±0.07) have good agreement with physician-defined daily contours. Rectum contours have the highest variations (DSC: 0.66±0.10) between the deformed and physician-defined contours on daily CBCT imaging. Conclusion: For structures with relatively high contrast boundaries on CBCT, the MIM automated deformable registration provided accurate representations of the daily contours during treatment delivery. These findings will permit subsequent investigations to automate daily dose computation from CBCT. However, improved methods need to be investigated to improve deformable results for rectum contours.« less

Morphometric analysis - Cone beam computed tomography to predict bone quality and quantity.

PubMed

Hohlweg-Majert, B; Metzger, M C; Kummer, T; Schulze, D

2011-07-01

Modified quantitative computed tomography is a method used to predict bone quality and quantify the bone mass of the jaw. The aim of this study was to determine whether bone quantity or quality was detected by cone beam computed tomography (CBCT) combined with image analysis. MATERIALS AND PROCEDURES: Different measurements recorded on two phantoms (Siemens phantom, Comac phantom) were evaluated on images taken with the Somatom VolumeZoom (Siemens Medical Solutions, Erlangen, Germany) and the NewTom 9000 (NIM s.r.l., Verona, Italy) in order to calculate a calibration curve. The spatial relationships of six sample cylinders and the repositioning from four pig skull halves relative to adjacent defined anatomical structures were assessed by means of three-dimensional visualization software. The calibration curves for computer tomography (CT) and cone beam computer tomography (CBCT) using the Siemens phantom showed linear correlation in both modalities between the Hounsfield Units (HU) and bone morphology. A correction factor for CBCT was calculated. Exact information about the micromorphology of the bone cylinders was only available using of micro computer tomography. Cone-beam computer tomography is a suitable choice for analysing bone mass, but, it does not give any information about bone quality. 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Motion-compensated cone beam computed tomography using a conjugate gradient least-squares algorithm and electrical impedance tomography imaging motion data.

PubMed

Pengpen, T; Soleimani, M

2015-06-13

Cone beam computed tomography (CBCT) is an imaging modality that has been used in image-guided radiation therapy (IGRT). For applications such as lung radiation therapy, CBCT images are greatly affected by the motion artefacts. This is mainly due to low temporal resolution of CBCT. Recently, a dual modality of electrical impedance tomography (EIT) and CBCT has been proposed, in which the high temporal resolution EIT imaging system provides motion data to a motion-compensated algebraic reconstruction technique (ART)-based CBCT reconstruction software. High computational time associated with ART and indeed other variations of ART make it less practical for real applications. This paper develops a motion-compensated conjugate gradient least-squares (CGLS) algorithm for CBCT. A motion-compensated CGLS offers several advantages over ART-based methods, including possibilities for explicit regularization, rapid convergence and parallel computations. This paper for the first time demonstrates motion-compensated CBCT reconstruction using CGLS and reconstruction results are shown in limited data CBCT considering only a quarter of the full dataset. The proposed algorithm is tested using simulated motion data in generic motion-compensated CBCT as well as measured EIT data in dual EIT-CBCT imaging. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

A quality assurance framework for the fully automated and objective evaluation of image quality in cone-beam computed tomography.

PubMed

Steiding, Christian; Kolditz, Daniel; Kalender, Willi A

2014-03-01

Thousands of cone-beam computed tomography (CBCT) scanners for vascular, maxillofacial, neurological, and body imaging are in clinical use today, but there is no consensus on uniform acceptance and constancy testing for image quality (IQ) and dose yet. The authors developed a quality assurance (QA) framework for fully automated and time-efficient performance evaluation of these systems. In addition, the dependence of objective Fourier-based IQ metrics on direction and position in 3D volumes was investigated for CBCT. The authors designed a dedicated QA phantom 10 cm in length consisting of five compartments, each with a diameter of 10 cm, and an optional extension ring 16 cm in diameter. A homogeneous section of water-equivalent material allows measuring CT value accuracy, image noise and uniformity, and multidimensional global and local noise power spectra (NPS). For the quantitative determination of 3D high-contrast spatial resolution, the modulation transfer function (MTF) of centrally and peripherally positioned aluminum spheres was computed from edge profiles. Additional in-plane and axial resolution patterns were used to assess resolution qualitatively. The characterization of low-contrast detectability as well as CT value linearity and artifact behavior was tested by utilizing sections with soft-tissue-equivalent and metallic inserts. For an automated QA procedure, a phantom detection algorithm was implemented. All tests used in the dedicated QA program were initially verified in simulation studies and experimentally confirmed on a clinical dental CBCT system. The automated IQ evaluation of volume data sets of the dental CBCT system was achieved with the proposed phantom requiring only one scan for the determination of all desired parameters. Typically, less than 5 min were needed for phantom set-up, scanning, and data analysis. Quantitative evaluation of system performance over time by comparison to previous examinations was also verified. The maximum percentage interscan variation of repeated measurements was less than 4% and 1.7% on average for all investigated quality criteria. The NPS-based image noise differed by less than 5% from the conventional standard deviation approach and spatially selective 10% MTF values were well comparable to subjective results obtained with 3D resolution pattern. Determining only transverse spatial resolution and global noise behavior in the central field of measurement turned out to be insufficient. The proposed framework transfers QA routines employed in conventional CT in an advanced version to CBCT for fully automated and time-efficient evaluation of technical equipment. With the modular phantom design, a routine as well as an expert version for assessing IQ is provided. The QA program can be used for arbitrary CT units to evaluate 3D imaging characteristics automatically.

A quality assurance framework for the fully automated and objective evaluation of image quality in cone-beam computed tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Steiding, Christian; Kolditz, Daniel; Kalender, Willi A., E-mail: willi.kalender@imp.uni-erlangen.de

Purpose: Thousands of cone-beam computed tomography (CBCT) scanners for vascular, maxillofacial, neurological, and body imaging are in clinical use today, but there is no consensus on uniform acceptance and constancy testing for image quality (IQ) and dose yet. The authors developed a quality assurance (QA) framework for fully automated and time-efficient performance evaluation of these systems. In addition, the dependence of objective Fourier-based IQ metrics on direction and position in 3D volumes was investigated for CBCT. Methods: The authors designed a dedicated QA phantom 10 cm in length consisting of five compartments, each with a diameter of 10 cm, andmore » an optional extension ring 16 cm in diameter. A homogeneous section of water-equivalent material allows measuring CT value accuracy, image noise and uniformity, and multidimensional global and local noise power spectra (NPS). For the quantitative determination of 3D high-contrast spatial resolution, the modulation transfer function (MTF) of centrally and peripherally positioned aluminum spheres was computed from edge profiles. Additional in-plane and axial resolution patterns were used to assess resolution qualitatively. The characterization of low-contrast detectability as well as CT value linearity and artifact behavior was tested by utilizing sections with soft-tissue-equivalent and metallic inserts. For an automated QA procedure, a phantom detection algorithm was implemented. All tests used in the dedicated QA program were initially verified in simulation studies and experimentally confirmed on a clinical dental CBCT system. Results: The automated IQ evaluation of volume data sets of the dental CBCT system was achieved with the proposed phantom requiring only one scan for the determination of all desired parameters. Typically, less than 5 min were needed for phantom set-up, scanning, and data analysis. Quantitative evaluation of system performance over time by comparison to previous examinations was also verified. The maximum percentage interscan variation of repeated measurements was less than 4% and 1.7% on average for all investigated quality criteria. The NPS-based image noise differed by less than 5% from the conventional standard deviation approach and spatially selective 10% MTF values were well comparable to subjective results obtained with 3D resolution pattern. Determining only transverse spatial resolution and global noise behavior in the central field of measurement turned out to be insufficient. Conclusions: The proposed framework transfers QA routines employed in conventional CT in an advanced version to CBCT for fully automated and time-efficient evaluation of technical equipment. With the modular phantom design, a routine as well as an expert version for assessing IQ is provided. The QA program can be used for arbitrary CT units to evaluate 3D imaging characteristics automatically.« less

TU-H-CAMPUS-JeP1-05: Dose Deformation Error Associated with Deformable Image Registration Pathways

DOE Office of Scientific and Technical Information (OSTI.GOV)

Surucu, M; Woerner, A; Roeske, J

Purpose: To evaluate errors associated with using different deformable image registration (DIR) pathways to deform dose from planning CT (pCT) to cone-beam CT (CBCT). Methods: Deforming dose is controversial because of the lack of quality assurance tools. We previously proposed a novel metric to evaluate dose deformation error (DDE) by warping dose information using two methods, via dose and contour deformation. First, isodose lines of the pCT were converted into structures and then deformed to the CBCT using an image based deformation map (dose/structure/deform). Alternatively, the dose matrix from the pCT was deformed to CBCT using the same deformation map,more » and then the same isodose lines of the deformed dose were converted into structures (dose/deform/structure). The doses corresponding to each structure were queried from the deformed dose and full-width-half-maximums were used to evaluate the dose dispersion. The difference between the FWHM of each isodose level structure is defined as the DDE. Three head-and-neck cancer patients were identified. For each patient, two DIRs were performed between the pCT and CBCT, either deforming pCT-to-CBCT or CBCT-to-pCT. We evaluated the errors associated by using either of these pathways to deform dose. A commercially available, Demons based DIR was used for this study, and 10 isodose levels (20% to 105%) were used to evaluate the errors in various dose levels. Results: The prescription dose for all patients was 70 Gy. The mean DDE for CT-to-CBCT deformation was 1.0 Gy (range: 0.3–2.0 Gy) and this was increased to 4.3 Gy (range: 1.5–6.4 Gy) for CBCT-to-CT deformation. The mean increase in DDE between the two deformations was 3.3 Gy (range: 1.0–5.4 Gy). Conclusion: The proposed DDF was used to quantitatively estimate dose deformation errors caused by different pathways to perform DIR. Deforming dose using CBCT-to-CT deformation produced greater error than CT-to-CBCT deformation.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, J; Zhang, W; Lu, J

Purpose: To investigate the accuracy and feasibility of dose calculations using kilovoltage cone beam computed tomography in cervical cancer radiotherapy using a correction algorithm. Methods: The Hounsfield units (HU) and electron density (HU-density) curve was obtained for both planning CT (pCT) and kilovoltage cone beam CT (CBCT) using a CIRS-062 calibration phantom. The pCT and kV-CBCT images have different HU values, and if the HU-density curve of CBCT was directly used to calculate dose in CBCT images may have a deviation on dose distribution. It is necessary to normalize the different HU values between pCT and CBCT. A HU correctionmore » algorithm was used for CBCT images (cCBCT). Fifteen intensity-modulated radiation therapy (IMRT) plans of cervical cancer were chosen, and the plans were transferred to the pCT and cCBCT data sets without any changes for dose calculations. Phantom and patient studies were carried out. The dose differences and dose distributions were compared between cCBCT plan and pCT plan. Results: The HU number of CBCT was measured by several times, and the maximum change was less than 2%. To compare with pCT, the CBCT and cCBCT has a discrepancy, the dose differences in CBCT and cCBCT images were 2.48%±0.65% (range: 1.3%∼3.8%) and 0.48%±0.21% (range: 0.1%∼0.82%) for phantom study, respectively. For dose calculation in patient images, the dose differences were 2.25%±0.43% (range: 1.4%∼3.4%) and 0.63%±0.35% (range: 0.13%∼0.97%), respectively. And for the dose distributions, the passing rate of cCBCT was higher than the CBCTs. Conclusion: The CBCT image for dose calculation is feasible in cervical cancer radiotherapy, and the correction algorithm offers acceptable accuracy. It will become a useful tool for adaptive radiation therapy.« less

C-arm Cone Beam Computed Tomography: A New Tool in the Interventional Suite.

PubMed

Raj, Santhosh; Irani, Farah Gillan; Tay, Kiang Hiong; Tan, Bien Soo

2013-11-01

C-arm Cone Beam CT (CBCT) is a technology that is being integrated into many of the newer angiography systems in the interventional suite. Due to its ability to provide cross sectional imaging, it has opened a myriad of opportunities for creating new clinical applications. We review the technical aspects, current reported clinical applications and potential benefits of this technology. Searches were made via PubMed using the string "CBCT", "Cone Beam CT", "Cone Beam Computed Tomography" and "C-arm Cone Beam Computed Tomography". All relevant articles in the results were reviewed. CBCT clinical applications have been reported in both vascular and non-vascular interventions. They encompass many aspects of a procedure including preprocedural planning, intraprocedural guidance and postprocedural assessment. As a result, they have allowed the interventionalist to be safer and more accurate in performing image guided procedures. There are however several technical limitations. The quality of images produced is not comparable to conventional computed tomography (CT). Radiation doses are also difficult to quantify when compared to CT and fluoroscopy. CBCT technology in the interventional suite has contributed significant benefits to the patient despite its current limitations. It is a tool that will evolve and potentially become an integral part of imaging guidance for intervention.

SU-F-J-41: Experimental Validation of a Cascaded Linear System Model for MVCBCT with a Multi-Layer EPID

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu, Y; Rottmann, J; Myronakis, M

2016-06-15

Purpose: The purpose of this study was to validate the use of a cascaded linear system model for MV cone-beam CT (CBCT) using a multi-layer (MLI) electronic portal imaging device (EPID) and provide experimental insight into image formation. A validated 3D model provides insight into salient factors affecting reconstructed image quality, allowing potential for optimizing detector design for CBCT applications. Methods: A cascaded linear system model was developed to investigate the potential improvement in reconstructed image quality for MV CBCT using an MLI EPID. Inputs to the three-dimensional (3D) model include projection space MTF and NPS. Experimental validation was performedmore » on a prototype MLI detector installed on the portal imaging arm of a Varian TrueBeam radiotherapy system. CBCT scans of up to 898 projections over 360 degrees were acquired at exposures of 16 and 64 MU. Image volumes were reconstructed using a Feldkamp-type (FDK) filtered backprojection (FBP) algorithm. Flat field images and scans of a Catphan model 604 phantom were acquired. The effect of 2×2 and 4×4 detector binning was also examined. Results: Using projection flat fields as an input, examination of the modeled and measured NPS in the axial plane exhibits good agreement. Binning projection images was shown to improve axial slice SDNR by a factor of approximately 1.4. This improvement is largely driven by a decrease in image noise of roughly 20%. However, this effect is accompanied by a subsequent loss in image resolution. Conclusion: The measured axial NPS shows good agreement with the theoretical calculation using a linear system model. Binning of projection images improves SNR of large objects on the Catphan phantom by decreasing noise. Specific imaging tasks will dictate the implementation image binning to two-dimensional projection images. The project was partially supported by a grant from Varian Medical Systems, Inc. and grant No. R01CA188446-01 from the National Cancer Institute.« less

Intraoperative imaging for patient safety and QA: detection of intracranial hemorrhage using C-arm cone-beam CT

NASA Astrophysics Data System (ADS)

Schafer, Sebastian; Wang, Adam; Otake, Yoshito; Stayman, J. W.; Zbijewski, Wojciech; Kleinszig, Gerhard; Xia, Xuewei; Gallia, Gary L.; Siewerdsen, Jeffrey H.

2013-03-01

Intraoperative imaging could improve patient safety and quality assurance (QA) via the detection of subtle complications that might otherwise only be found hours after surgery. Such capability could therefore reduce morbidity and the need for additional intervention. Among the severe adverse events that could be more quickly detected by high-quality intraoperative imaging is acute intracranial hemorrhage (ICH), conventionally assessed using post-operative CT. A mobile C-arm capable of high-quality cone-beam CT (CBCT) in combination with advanced image reconstruction techniques is reported as a means of detecting ICH in the operating room. The system employs an isocentric C-arm with a flat-panel detector in dual gain mode, correction of x-ray scatter and beam-hardening, and a penalized likelihood (PL) iterative reconstruction method. Performance in ICH detection was investigated using a quantitative phantom focusing on (non-contrast-enhanced) blood-brain contrast, an anthropomorphic head phantom, and a porcine model with injection of fresh blood bolus. The visibility of ICH was characterized in terms of contrast-to-noise ratio (CNR) and qualitative evaluation of images by a neurosurgeon. Across a range of size and contrast of the ICH as well as radiation dose from the CBCT scan, the CNR was found to increase from ~2.2-3.7 for conventional filtered backprojection (FBP) to ~3.9-5.4 for PL at equivalent spatial resolution. The porcine model demonstrated superior ICH detectability for PL. The results support the role of high-quality mobile C-arm CBCT employing advanced reconstruction algorithms for detecting subtle complications in the operating room at lower radiation dose and lower cost than intraoperative CT scanners and/or fixedroom C-arms. Such capability could present a potentially valuable aid to patient safety and QA.

Sensitivity and specificity of cone beam computed tomography in thin bony structures in maxillofacial surgery – A clinical trial.

PubMed

Thönissen, P; Ermer, M A; Schmelzeisen, R; Gutwald, R; Metzger, M C; Bittermann, G

2015-09-01

Cone-Beam Computed Tomography (CBCT) has become widely used in dentistry and maxillofacial surgery. Accuracy, sensitivity and specificity of thin bony structures below 0.5 mm have been subject of some in vitro studies. This prospective in vivo study investigates the correlation between preoperative CBCT-imaging and intraoperative clinical examination of thin bony structures. We hereby present results from daily clinical routine. A total number of 80 sites in 64 patients has been examined to differentiate between preoperative 3D imaging and clinical measurements on cystic lesions in maxilla and mandible. Different CBCT-devices with a voxel size ranging from 0.08 mm to 0.4 mm were used. Overall-specificity found for detecting thin bony structures of the human jaw is 13.89%, overall sensitivity is 100%, positive predictive value (PPV) is 58.67% and negative predictive value (NPV) is 100%. Image quality is the key to make use of additional information CBCT provides and depends on spatial, temporal and contrast resolution. CBCT does not depict reliably thin bony structures of the jaw, even if high voxel resolution is used. In selected cases using high resolution protocols should be considered despite affecting the patient with higher doses of radiation. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Assessment of contrast enhanced respiration managed cone-beam CT for image guided radiotherapy of intrahepatic tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jensen, Nikolaj K. G., E-mail: nkyj@regionsjaelland.dk; Stewart, Errol; Imaging Research Lab, Robarts Research Institute, London, Ontario N6A 5B7

2014-05-15

Purpose: Contrast enhancement and respiration management are widely used during image acquisition for radiotherapy treatment planning of liver tumors along with respiration management at the treatment unit. However, neither respiration management nor intravenous contrast is commonly used during cone-beam CT (CBCT) image acquisition for alignment prior to radiotherapy. In this study, the authors investigate the potential gains of injecting an iodinated contrast agent in combination with respiration management during CBCT acquisition for liver tumor radiotherapy. Methods: Five rabbits with implanted liver tumors were subjected to CBCT with and without motion management and contrast injection. The acquired CBCT images were registeredmore » to the planning CT to determine alignment accuracy and dosimetric impact. The authors developed a simulation tool for simulating contrast-enhanced CBCT images from dynamic contrast enhanced CT imaging (DCE-CT) to determine optimal contrast injection protocols. The tool was validated against contrast-enhanced CBCT of the rabbit subjects and was used for five human patients diagnosed with hepatocellular carcinoma. Results: In the rabbit experiment, when neither motion management nor contrast was used, tumor centroid misalignment between planning image and CBCT was 9.2 mm. This was reduced to 2.8 mm when both techniques were employed. Tumors were not visualized in clinical CBCT images of human subjects. Simulated contrast-enhanced CBCT was found to improve tumor contrast in all subjects. Different patients were found to require different contrast injections to maximize tumor contrast. Conclusions: Based on the authors’ animal study, respiration managed contrast enhanced CBCT improves IGRT significantly. Contrast enhanced CBCT benefits from patient specific tracer kinetics determined from DCE-CT.« less

Comparison of the accuracy of 3-dimensional cone-beam computed tomography and micro-computed tomography reconstructions by using different voxel sizes.

PubMed

Maret, Delphine; Peters, Ove A; Galibourg, Antoine; Dumoncel, Jean; Esclassan, Rémi; Kahn, Jean-Luc; Sixou, Michel; Telmon, Norbert

2014-09-01

Cone-beam computed tomography (CBCT) data are, in principle, metrically exact. However, clinicians need to consider the precision of measurements of dental morphology as well as other hard tissue structures. CBCT spatial resolution, and thus image reconstruction quality, is restricted by the acquisition voxel size. The aim of this study was to assess geometric discrepancies among 3-dimensional CBCT reconstructions relative to the micro-CT reference. A total of 37 permanent teeth from 9 mandibles were scanned with CBCT 9500 and 9000 3D and micro-CT. After semiautomatic segmentation, reconstructions were obtained from CBCT acquisitions (voxel sizes 76, 200, and 300 μm) and from micro-CT (voxel size 41 μm). All reconstructions were positioned in the same plane by image registration. The topography of the geometric discrepancies was displayed by using a color map allowing the maximum differences to be located. The maximum differences were mainly found at the cervical margins and on the cusp tips or incisal edges. Geometric reconstruction discrepancies were significant at 300-μm resolution (P = .01, Wilcoxon test). To study hard tissue morphology, CBCT acquisitions require voxel sizes smaller than 300 μm. This experimental study will have to be complemented by studies in vivo that consider the conditions of clinical practice. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparison between cone-beam and multislice computed tomography depicting mandibular neurovascular canal structures.

PubMed

Naitoh, Munetaka; Nakahara, Kino; Suenaga, Yutaka; Gotoh, Kenichi; Kondo, Shintaro; Ariji, Eiichiro

2010-01-01

The most common diagnostic imaging modalities for cross-sectional imaging in dental implant planning are currently cone-beam computed tomography (CBCT) and multislice CT (MSCT). However, clinical differences between CBCT and MSCT in this task have not been fully clarified. In this investigation, the detection of fine anatomical structures in the mandible was assessed and compared between CBCT and MSCT images. The sample consisted of 28 patients who had undergone CBCT and MSCT. The bifid mandibular canal in the mandibular ramus, accessory mental and buccal foramina, and median and lateral lingual bony canals were observed in 2-D images, and the findings were compared between CBCT and MSCT. Four of 19 canals observed in CBCT were not observed in MSCT images. Three accessory mental foramina in 2 patients and 28 lateral lingual bony canals in 18 patients were observed consistently using the two methods. Depiction of fine anatomic features in the mandible associated with neurovascular structures is consistent between CBCT and MSCT images. Copyright 2010 Mosby, Inc. All rights reserved.

Volume-of-Change Cone-Beam CT for Image-Guided Surgery

PubMed Central

Lee, Junghoon; Stayman, J. Webster; Otake, Yoshito; Schafer, Sebastian; Zbijewski, Wojciech; Khanna, A. Jay; Prince, Jerry L.; Siewerdsen, Jeffrey H.

2012-01-01

C-arm cone-beam CT (CBCT) can provide intraoperative 3D imaging capability for surgical guidance, but workflow and radiation dose are the significant barriers to broad utilization. One main reason is that each 3D image acquisition requires a complete scan with a full radiation dose to present a completely new 3D image every time. In this paper, we propose to utilize patient-specific CT or CBCT as prior knowledge to accurately reconstruct the aspects of the region that have changed by the surgical procedure from only a sparse set of x-rays. The proposed methods consist of a 3D-2D registration between the prior volume and a sparse set of intraoperative x-rays, creating digitally reconstructed radiographs (DRR) from the registered prior volume, computing difference images by subtracting DRRs from the intraoperative x-rays, a penalized likelihood reconstruction of the volume of change (VOC) from the difference images, and finally a fusion of VOC reconstruction with the prior volume to visualize the entire surgical field. When the surgical changes are local and relatively small, the VOC reconstruction involves only a small volume size and a small number of projections, allowing less computation and lower radiation dose than is needed to reconstruct the entire surgical field. We applied this approach to sacroplasty phantom data obtained from a CBCT test bench and vertebroplasty data with a fresh cadaver acquired from a C-arm CBCT system with a flat-panel detector (FPD). The VOCs were reconstructed from varying number of images (10–66 images) and compared to the CBCT ground truth using four different metrics (mean squared error, correlation coefficient, structural similarity index, and perceptual difference model). The results show promising reconstruction quality with structural similarity to the ground truth close to 1 even when only 15–20 images were used, allowing dose reduction by the factor of 10–20. PMID:22801026

[Prospective economic evaluation of image-guided radiation therapy for prostate cancer in the framework of the national programme for innovative and costly therapies assessment].

PubMed

Pommier, P; Morelle, M; Perrier, L; de Crevoisier, R; Laplanche, A; Dudouet, P; Mahé, M-A; Chauvet, B; Nguyen, T-D; Créhange, G; Zawadi, A; Chapet, O; Latorzeff, I; Bossi, A; Beckendorf, V; Touboul, E; Muracciole, X; Bachaud, J-M; Supiot, S; Lagrange, J-L

2012-09-01

The main objective of the economical study was to prospectively and randomly assess the additional costs of daily versus weekly patient positioning quality control in image-guided radiotherapy (IGRT), taking into account the modalities of the 3D-imaging: tomography (CBCT) or gold seeds implants. A secondary objective was to prospectively assess the additional costs of 3D versus 2D imaging with portal imaging for patient positioning controls. Economics data are issued from a multicenter randomized medico-economics trial comparing the two frequencies of patient positioning control during prostate IGRT. A prospective cohort with patient positioning control with PI (control group) was constituted for the cost comparison between 3D (IGRT) versus 2D imaging. The economical evaluation was focused to the radiotherapy direct costs, adopting the hospital's point of view and using a microcosting method applied to the parameters that may lead to cost differences between evaluated strategies. The economical analysis included a total of 241 patients enrolled between 2007 and 2011 in seven centres, 183 in the randomized study (128 with CBCT and 55 with fiducial markers) and 58 in the control group. Compared to weekly controls, the average additional cost per patient of daily controls was €847 (CBCT) and €179 (markers). Compared to PI, the average additional cost per patient was €1392 (CBCT) and €997 (fiducial markers) for daily controls; €545 (CBCT) and €818 (markers) in case of weekly controls. A daily frequency for image control in IGRT and 3D images patient positioning control (IGRT) for prostate cancer lead to significant additional cost compared to weekly control and 2D imaging (PI). Long-term clinical assessment will permit to assess the medico-economical ratio of these innovative radiotherapy modalities. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Volume-of-change cone-beam CT for image-guided surgery

NASA Astrophysics Data System (ADS)

Lee, Junghoon; Webster Stayman, J.; Otake, Yoshito; Schafer, Sebastian; Zbijewski, Wojciech; Khanna, A. Jay; Prince, Jerry L.; Siewerdsen, Jeffrey H.

2012-08-01

C-arm cone-beam CT (CBCT) can provide intraoperative 3D imaging capability for surgical guidance, but workflow and radiation dose are the significant barriers to broad utilization. One main reason is that each 3D image acquisition requires a complete scan with a full radiation dose to present a completely new 3D image every time. In this paper, we propose to utilize patient-specific CT or CBCT as prior knowledge to accurately reconstruct the aspects of the region that have changed by the surgical procedure from only a sparse set of x-rays. The proposed methods consist of a 3D-2D registration between the prior volume and a sparse set of intraoperative x-rays, creating digitally reconstructed radiographs (DRRs) from the registered prior volume, computing difference images by subtracting DRRs from the intraoperative x-rays, a penalized likelihood reconstruction of the volume of change (VOC) from the difference images, and finally a fusion of VOC reconstruction with the prior volume to visualize the entire surgical field. When the surgical changes are local and relatively small, the VOC reconstruction involves only a small volume size and a small number of projections, allowing less computation and lower radiation dose than is needed to reconstruct the entire surgical field. We applied this approach to sacroplasty phantom data obtained from a CBCT test bench and vertebroplasty data with a fresh cadaver acquired from a C-arm CBCT system with a flat-panel detector. The VOCs were reconstructed from a varying number of images (10-66 images) and compared to the CBCT ground truth using four different metrics (mean squared error, correlation coefficient, structural similarity index and perceptual difference model). The results show promising reconstruction quality with structural similarity to the ground truth close to 1 even when only 15-20 images were used, allowing dose reduction by the factor of 10-20.

Cone beam CT of the musculoskeletal system: clinical applications.

PubMed

Posadzy, Magdalena; Desimpel, Julie; Vanhoenacker, Filip

2018-02-01

The aim of this pictorial review is to illustrate the use of CBCT in a broad spectrum of musculoskeletal disorders and to compare its diagnostic merit with other imaging modalities, such as conventional radiography (CR), Multidetector Computed Tomography (MDCT) and Magnetic Resonance Imaging. Cone Beam Computed Tomography (CBCT) has been widely used for dental imaging for over two decades. Current CBCT equipment allows use for imaging of various musculoskeletal applications. Because of its low cost and relatively low irradiation, CBCT may have an emergent role in making a more precise diagnosis, assessment of local extent and follow-up of fractures and dislocations of small bones and joints. Due to its exquisite high spatial resolution, CBCT in combination with arthrography may be the preferred technique for detection and local staging of cartilage lesions in small joints. Evaluation of degenerative joint disorders may be facilitated by CBCT compared to CR, particularly in those anatomical areas in which there is much superposition of adjacent bony structures. The use of CBCT in evaluation of osteomyelitis is restricted to detection of sequestrum formation in chronic osteomyelitis. Miscellaneous applications include assessment of (symptomatic) variants, detection and characterization of tumour and tumour-like conditions of bone. • Review the spectrum of MSK disorders in which CBCT may be complementary to other imaging techniques. • Compare the advantages and drawbacks of CBCT compared to other imaging techniques. • Define the present and future role of CBCT in musculoskeletal imaging.

Evaluation of tumor localization in respiration motion-corrected cone-beam CT: Prospective study in lung

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dzyubak, Oleksandr; Kincaid, Russell; Hertanto, Agung

Purpose: Target localization accuracy of cone-beam CT (CBCT) images used in radiation treatment of respiratory disease sites is affected by motion artifacts (blurring and streaking). The authors have previously reported on a method of respiratory motion correction in thoracic CBCT at end expiration (EE). The previous retrospective study was limited to examination of reducing motion artifacts in a small number of patient cases. They report here on a prospective study in a larger group of lung cancer patients to evaluate respiratory motion-corrected (RMC)-CBCT ability to improve lung tumor localization accuracy and reduce motion artifacts in Linac-mounted CBCT images. A secondmore » study goal examines whether the motion correction derived from a respiration-correlated CT (RCCT) at simulation yields similar tumor localization accuracy at treatment. Methods: In an IRB-approved study, 19 lung cancer patients (22 tumors) received a RCCT at simulation, and on one treatment day received a RCCT, a respiratory-gated CBCT at end expiration, and a 1-min CBCT. A respiration monitor of abdominal displacement was used during all scans. In addition to a CBCT reconstruction without motion correction, the motion correction method was applied to the same 1-min scan. Projection images were sorted into ten bins based on abdominal displacement, and each bin was reconstructed to produce ten intermediate CBCT images. Each intermediate CBCT was deformed to the end expiration state using a motion model derived from RCCT. The deformed intermediate CBCT images were then added to produce a final RMC-CBCT. In order to evaluate the second study goal, the CBCT was corrected in two ways, one using a model derived from the RCCT at simulation [RMC-CBCT(sim)], the other from the RCCT at treatment [RMC-CBCT(tx)]. Image evaluation compared uncorrected CBCT, RMC-CBCT(sim), and RMC-CBCT(tx). The gated CBCT at end expiration served as the criterion standard for comparison. Using automatic rigid image registration, each CBCT was registered twice to the gated CBCT, first aligned to spine, second to tumor in lung. Localization discrepancy was defined as the difference between tumor and spine registration. Agreement in tumor localization with the gated CBCT was further evaluated by calculating a normalized cross correlation (NCC) of pixel intensities within a volume-of-interest enclosing the tumor in lung. Results: Tumor localization discrepancy was reduced with RMC-CBCT(tx) in 17 out of 22 cases relative to no correction. If one considers cases in which tumor motion is 5 mm or more in the RCCT, tumor localization discrepancy is reduced with RMC-CBCT(tx) in 14 out of 17 cases (p = 0.04), and with RMC-CBCT(sim) in 13 out of 17 cases (p = 0.05). Differences in localization discrepancy between correction models [RMC-CBCT(sim) vs RMC-CBCT(tx)] were less than 2 mm. In 21 out of 22 cases, improvement in NCC was higher with RMC-CBCT(tx) relative to no correction (p < 0.0001). Differences in NCC between RMC-CBCT(sim) and RMC-CBCT(tx) were small. Conclusions: Motion-corrected CBCT improves lung tumor localization accuracy and reduces motion artifacts in nearly all cases. Motion correction at end expiration using RCCT acquired at simulation yields similar results to that using a RCCT on the treatment day (2–3 weeks after simulation)« less

Evaluation of tumor localization in respiration motion-corrected cone-beam CT: prospective study in lung.

PubMed

Dzyubak, Oleksandr; Kincaid, Russell; Hertanto, Agung; Hu, Yu-Chi; Pham, Hai; Rimner, Andreas; Yorke, Ellen; Zhang, Qinghui; Mageras, Gig S

2014-10-01

Target localization accuracy of cone-beam CT (CBCT) images used in radiation treatment of respiratory disease sites is affected by motion artifacts (blurring and streaking). The authors have previously reported on a method of respiratory motion correction in thoracic CBCT at end expiration (EE). The previous retrospective study was limited to examination of reducing motion artifacts in a small number of patient cases. They report here on a prospective study in a larger group of lung cancer patients to evaluate respiratory motion-corrected (RMC)-CBCT ability to improve lung tumor localization accuracy and reduce motion artifacts in Linac-mounted CBCT images. A second study goal examines whether the motion correction derived from a respiration-correlated CT (RCCT) at simulation yields similar tumor localization accuracy at treatment. In an IRB-approved study, 19 lung cancer patients (22 tumors) received a RCCT at simulation, and on one treatment day received a RCCT, a respiratory-gated CBCT at end expiration, and a 1-min CBCT. A respiration monitor of abdominal displacement was used during all scans. In addition to a CBCT reconstruction without motion correction, the motion correction method was applied to the same 1-min scan. Projection images were sorted into ten bins based on abdominal displacement, and each bin was reconstructed to produce ten intermediate CBCT images. Each intermediate CBCT was deformed to the end expiration state using a motion model derived from RCCT. The deformed intermediate CBCT images were then added to produce a final RMC-CBCT. In order to evaluate the second study goal, the CBCT was corrected in two ways, one using a model derived from the RCCT at simulation [RMC-CBCT(sim)], the other from the RCCT at treatment [RMC-CBCT(tx)]. Image evaluation compared uncorrected CBCT, RMC-CBCT(sim), and RMC-CBCT(tx). The gated CBCT at end expiration served as the criterion standard for comparison. Using automatic rigid image registration, each CBCT was registered twice to the gated CBCT, first aligned to spine, second to tumor in lung. Localization discrepancy was defined as the difference between tumor and spine registration. Agreement in tumor localization with the gated CBCT was further evaluated by calculating a normalized cross correlation (NCC) of pixel intensities within a volume-of-interest enclosing the tumor in lung. Tumor localization discrepancy was reduced with RMC-CBCT(tx) in 17 out of 22 cases relative to no correction. If one considers cases in which tumor motion is 5 mm or more in the RCCT, tumor localization discrepancy is reduced with RMC-CBCT(tx) in 14 out of 17 cases (p = 0.04), and with RMC-CBCT(sim) in 13 out of 17 cases (p = 0.05). Differences in localization discrepancy between correction models [RMC-CBCT(sim) vs RMC-CBCT(tx)] were less than 2 mm. In 21 out of 22 cases, improvement in NCC was higher with RMC-CBCT(tx) relative to no correction (p < 0.0001). Differences in NCC between RMC-CBCT(sim) and RMC-CBCT(tx) were small. Motion-corrected CBCT improves lung tumor localization accuracy and reduces motion artifacts in nearly all cases. Motion correction at end expiration using RCCT acquired at simulation yields similar results to that using a RCCT on the treatment day (2-3 weeks after simulation).

Bone quality evaluation at dental implant site using multislice CT, micro-CT, and cone beam CT.

PubMed

Parsa, Azin; Ibrahim, Norliza; Hassan, Bassam; van der Stelt, Paul; Wismeijer, Daniel

2015-01-01

The first purpose of this study was to analyze the correlation between bone volume fraction (BV/TV) and calibrated radiographic bone density Hounsfield units (HU) in human jaws, derived from micro-CT and multislice computed tomography (MSCT), respectively. The second aim was to assess the accuracy of cone beam computed tomography (CBCT) in evaluating trabecular bone density and microstructure using MSCT and micro-CT, respectively, as reference gold standards. Twenty partially edentulous human mandibular cadavers were scanned by three types of CT modalities: MSCT (Philips, Best, the Netherlands), CBCT (3D Accuitomo 170, J Morita, Kyoto, Japan), and micro-CT (SkyScan 1173, Kontich, Belgium). Image analysis was performed using Amira (v4.1, Visage Imaging Inc., Carlsbad, CA, USA), 3Diagnosis (v5.3.1, 3diemme, Cantu, Italy), Geomagic (studio(®) 2012, Morrisville, NC, USA), and CTAn (v1.11, SkyScan). MSCT, CBCT, and micro-CT scans of each mandible were matched to select the exact region of interest (ROI). MSCT HU, micro-CT BV/TV, and CBCT gray value and bone volume fraction of each ROI were derived. Statistical analysis was performed to assess the correlations between corresponding measurement parameters. Strong correlations were observed between CBCT and MSCT density (r = 0.89) and between CBCT and micro-CT BV/TV measurements (r = 0.82). Excellent correlation was observed between MSCT HU and micro-CT BV/TV (r = 0.91). However, significant differences were found between all comparisons pairs (P < 0.001) except for mean measurement between CBCT BV/TV and micro-CT BV/TV (P = 0.147). An excellent correlation exists between bone volume fraction and bone density as assessed on micro-CT and MSCT, respectively. This suggests that bone density measurements could be used to estimate bone microstructural parameters. A strong correlation also was found between CBCT gray values and BV/TV and their gold standards, suggesting the potential of this modality in bone quality assessment at implant site. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Investigation on Beam-Blocker-Based Scatter Correction Method for Improving CT Number Accuracy

NASA Astrophysics Data System (ADS)

Lee, Hoyeon; Min, Jonghwan; Lee, Taewon; Pua, Rizza; Sabir, Sohail; Yoon, Kown-Ha; Kim, Hokyung; Cho, Seungryong

2017-03-01

Cone-beam computed tomography (CBCT) is gaining widespread use in various medical and industrial applications but suffers from substantially larger amount of scatter than that in the conventional diagnostic CT resulting in relatively poor image quality. Various methods that can reduce and/or correct for the scatter in the CBCT have therefore been developed. Scatter correction method that uses a beam-blocker has been considered a direct measurement-based approach providing accurate scatter estimation from the data in the shadows of the beam-blocker. To the best of our knowledge, there has been no record reporting the significance of the scatter from the beam-blocker itself in such correction methods. In this paper, we identified the scatter from the beam-blocker that is detected in the object-free projection data investigated its influence on the image accuracy of CBCT reconstructed images, and developed a scatter correction scheme that takes care of this scatter as well as the scatter from the scanned object.

SU-E-T-416: VMAT Dose Calculations Using Cone Beam CT Images: A Preliminary Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, S; Sehgal, V; Kuo, J

Purpose: Cone beam CT (CBCT) images have been used routinely for patient positioning throughout the treatment course. However, use of CBCT for dose calculation is still investigational. The purpose of this study is to assess the utility of CBCT images for Volumetric Modulated Arc Therapy (VMAT) plan dose calculation. Methods: A CATPHAN 504 phantom (The Phantom Laboratory, Salem, NY) was used to compare the dosimetric and geometric accuracy between conventional CT and CBCT (in both full and half fan modes). Hounsfield units (HU) profiles at different density areas were evaluated. A C shape target that surrounds a central avoidance structuremore » was created and a VMAT plan was generated on the CT images and copied to the CBCT phantom images. Patient studies included three brain patients, and one head and neck (H'N) patient. VMAT plans generated on the patients treatment planning CT was applied to CBCT images obtained during the first treatment. Isodose distributions and dosevolume- histograms (DVHs) were compared. Results: For the phantom study, the HU difference between CT and CBCT is within 100 (maximum 96 HU for Teflon CBCT images in full fan mode). The impact of these differences on the calculated dose distributions was clinically insignificant. In both phantom and patient studies, target DVHs based on CBCT images were in excellent agreement with those based on planning CT images. Mean, Median, near minimum (D98%), and near maximum (D2%) doses agreed within 0-2.5%. A slightly larger discrepancy is observed in the patient studies compared to that seen in the phantom study, (0-1% vs. 0 - 2.5%). Conclusion: CBCT images can be used to accurately predict dosimetric results, without any HU correction. It is feasible to use CBCT to evaluate the actual dose delivered at each fraction. The dosimetric consequences resulting from tumor response and patient geometry changes could be monitored.« less

An in vitro comparison of subjective image quality of panoramic views acquired via 2D or 3D imaging.

PubMed

Pittayapat, P; Galiti, D; Huang, Y; Dreesen, K; Schreurs, M; Souza, P Couto; Rubira-Bullen, I R F; Westphalen, F H; Pauwels, R; Kalema, G; Willems, G; Jacobs, R

2013-01-01

The objective of this study is to compare subjective image quality and diagnostic validity of cone-beam CT (CBCT) panoramic reformatting with digital panoramic radiographs. Four dry human skulls and two formalin-fixed human heads were scanned using nine different CBCTs, one multi-slice CT (MSCT) and one standard digital panoramic device. Panoramic views were generated from CBCTs in four slice thicknesses. Seven observers scored image quality and visibility of 14 anatomical structures. Four observers repeated the observation after 4 weeks. Digital panoramic radiographs showed significantly better visualization of anatomical structures except for the condyle. Statistical analysis of image quality showed that the 3D imaging modalities (CBCTs and MSCT) were 7.3 times more likely to receive poor scores than the 2D modality. Yet, image quality from NewTom VGi® and 3D Accuitomo 170® was almost equivalent to that of digital panoramic radiographs with respective odds ratio estimates of 1.2 and 1.6 at 95% Wald confidence limits. A substantial overall agreement amongst observers was found. Intra-observer agreement was moderate to substantial. While 2D-panoramic images are significantly better for subjective diagnosis, 2/3 of the 3D-reformatted panoramic images are moderate or good for diagnostic purposes. Panoramic reformattings from particular CBCTs are comparable to digital panoramic images concerning the overall image quality and visualization of anatomical structures. This clinically implies that a 3D-derived panoramic view can be generated for diagnosis with a recommended 20-mm slice thickness, if CBCT data is a priori available for other purposes.

SU-F-BRF-14: Increasing the Accuracy of Dose Calculation On Cone-Beam Imaging Using Deformable Image Registration in the Case of Prostate Translation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fillion, O; Gingras, L; Departement de physique, de genie physique et d'optique, Universite Laval, Quebec, Quebec

2014-06-15

Purpose: Artifacts can reduce the quality of dose re-calculations on CBCT scans during a treatment. The aim of this project is to correct the CBCT images in order to allow for more accurate and exact dose calculations in the case of a translation of the tumor in prostate cancer. Methods: Our approach is to develop strategies based on deformable image registration algorithms using the elastix software (Klein et al., 2010) to register the treatment planning CT on a daily CBCT scan taken during treatment. Sets of images are provided by a 3D deformable phantom and comprise two CT and twomore » CBCT scans: one of both with the reference anatomy and the others with known deformations (i.e. translations of the prostate). The reference CT is registered onto the deformed CBCT and the deformed CT serves as the control for dose calculation accuracy. The planned treatment used for the evaluation of dose calculation is a 2-Gy fraction prescribed at the location of the reference prostate and assigned to 7 rectangular fields. Results: For a realistic 0.5-cm translation of the prostate, the relative dose discrepancy between the CBCT and the CT control scan at the prostate's centroid is 8.9 ± 0.8 % while dose discrepancy between the registered CT and the control scan lessens to −2.4 ± 0.8 %. For a 2-cm translation, clinical indices like the V90 and the D100 are more accurate by 0.7 ± 0.3 % and 8.0 ± 0.5 cGy respectively when using registered CT than when using CBCT for dose calculation. Conclusion: The results show that this strategy gives doses in agreement within a few percents with those from calculations on actual CT scans. In the future, various deformations of the phantom anatomy will allow a thorough characterization of the registration strategies needed for more complex anatomies.« less

Metal Artifact Suppression in Dental Cone Beam Computed Tomography Images Using Image Processing Techniques.

PubMed

Johari, Masoumeh; Abdollahzadeh, Milad; Esmaeili, Farzad; Sakhamanesh, Vahideh

2018-01-01

Dental cone beam computed tomography (CBCT) images suffer from severe metal artifacts. These artifacts degrade the quality of acquired image and in some cases make it unsuitable to use. Streaking artifacts and cavities around teeth are the main reason of degradation. In this article, we have proposed a new artifact reduction algorithm which has three parallel components. The first component extracts teeth based on the modeling of image histogram with a Gaussian mixture model. Striking artifact reduction component reduces artifacts using converting image into the polar domain and applying morphological filtering. The third component fills cavities through a simple but effective morphological filtering operation. Finally, results of these three components are combined into a fusion step to create a visually good image which is more compatible to human visual system. Results show that the proposed algorithm reduces artifacts of dental CBCT images and produces clean images.

Metal Artifact Suppression in Dental Cone Beam Computed Tomography Images Using Image Processing Techniques

PubMed Central

Johari, Masoumeh; Abdollahzadeh, Milad; Esmaeili, Farzad; Sakhamanesh, Vahideh

2018-01-01

Background: Dental cone beam computed tomography (CBCT) images suffer from severe metal artifacts. These artifacts degrade the quality of acquired image and in some cases make it unsuitable to use. Streaking artifacts and cavities around teeth are the main reason of degradation. Methods: In this article, we have proposed a new artifact reduction algorithm which has three parallel components. The first component extracts teeth based on the modeling of image histogram with a Gaussian mixture model. Striking artifact reduction component reduces artifacts using converting image into the polar domain and applying morphological filtering. The third component fills cavities through a simple but effective morphological filtering operation. Results: Finally, results of these three components are combined into a fusion step to create a visually good image which is more compatible to human visual system. Conclusions: Results show that the proposed algorithm reduces artifacts of dental CBCT images and produces clean images. PMID:29535920

Shading correction for cone-beam CT in radiotherapy: validation of dose calculation accuracy using clinical images

NASA Astrophysics Data System (ADS)

Marchant, T. E.; Joshi, K. D.; Moore, C. J.

2017-03-01

Cone-beam CT (CBCT) images are routinely acquired to verify patient position in radiotherapy (RT), but are typically not calibrated in Hounsfield Units (HU) and feature non-uniformity due to X-ray scatter and detector persistence effects. This prevents direct use of CBCT for re-calculation of RT delivered dose. We previously developed a prior-image based correction method to restore HU values and improve uniformity of CBCT images. Here we validate the accuracy with which corrected CBCT can be used for dosimetric assessment of RT delivery, using CBCT images and RT plans for 45 patients including pelvis, lung and head sites. Dose distributions were calculated based on each patient's original RT plan and using CBCT image values for tissue heterogeneity correction. Clinically relevant dose metrics were calculated (e.g. median and minimum target dose, maximum organ at risk dose). Accuracy of CBCT based dose metrics was determined using an "override ratio" method where the ratio of the dose metric to that calculated on a bulk-density assigned version of the image is assumed to be constant for each patient, allowing comparison to "gold standard" CT. For pelvis and head images the proportion of dose errors >2% was reduced from 40% to 1.3% after applying shading correction. For lung images the proportion of dose errors >3% was reduced from 66% to 2.2%. Application of shading correction to CBCT images greatly improves their utility for dosimetric assessment of RT delivery, allowing high confidence that CBCT dose calculations are accurate within 2-3%.

Non-rigid CT/CBCT to CBCT registration for online external beam radiotherapy guidance

NASA Astrophysics Data System (ADS)

Zachiu, Cornel; de Senneville, Baudouin Denis; Tijssen, Rob H. N.; Kotte, Alexis N. T. J.; Houweling, Antonetta C.; Kerkmeijer, Linda G. W.; Lagendijk, Jan J. W.; Moonen, Chrit T. W.; Ries, Mario

2018-01-01

Image-guided external beam radiotherapy (EBRT) allows radiation dose deposition with a high degree of accuracy and precision. Guidance is usually achieved by estimating the displacements, via image registration, between cone beam computed tomography (CBCT) and computed tomography (CT) images acquired at different stages of the therapy. The resulting displacements are then used to reposition the patient such that the location of the tumor at the time of treatment matches its position during planning. Moreover, ongoing research aims to use CBCT-CT image registration for online plan adaptation. However, CBCT images are usually acquired using a small number of x-ray projections and/or low beam intensities. This often leads to the images being subject to low contrast, low signal-to-noise ratio and artifacts, which ends-up hampering the image registration process. Previous studies addressed this by integrating additional image processing steps into the registration procedure. However, these steps are usually designed for particular image acquisition schemes, therefore limiting their use on a case-by-case basis. In the current study we address CT to CBCT and CBCT to CBCT registration by the means of the recently proposed EVolution registration algorithm. Contrary to previous approaches, EVolution does not require the integration of additional image processing steps in the registration scheme. Moreover, the algorithm requires a low number of input parameters, is easily parallelizable and provides an elastic deformation on a point-by-point basis. Results have shown that relative to a pure CT-based registration, the intrinsic artifacts present in typical CBCT images only have a sub-millimeter impact on the accuracy and precision of the estimated deformation. In addition, the algorithm has low computational requirements, which are compatible with online image-based guidance of EBRT treatments.

Clinical Evaluation of positioning verification using digital tomosynthesis (DTS) based on bony anatomy and soft tissues for prostate image-guided radiation therapy (IGRT)

PubMed Central

Yoo, Sua; Wu, Q. Jackie; Godfrey, Devon; Yan, Hui; Ren, Lei; Das, Shiva; Lee, William R.; Yin, Fang-Fang

2008-01-01

Purpose To evaluate on-board digital tomosynthesis (DTS) for patient positioning in comparison with 2D-radiographs and 3D-CBCT. Methods and Materials A total of 92 image sessions from 9 prostate cancer patients were analyzed. An on-board image set was registered to a corresponding reference image set. Four pairs of image sets were used; DRR vs. on-board orthogonal paired radiograph for the 2D method, coronal-reference-DTS (RDTS) vs. on-board coronal-DTS for the coronal-DTS method, sagittal-RDTS vs. on-board sagittal-DTS for the sagittal-DTS method, and planning CT vs. CBCT for the CBCT method. Registration results were compared. Results The systematic errors in all methods were less than 1 mm/1°. When registering bony anatomy, the mean vector differences were 0.21±0.11 cm between 2D and CBCT, 0.11±0.08 cm between CBCT and coronal-DTS, and 0.14±0.07 cm between CBCT and sagittal-DTS. The correlation of CBCT to DTS was stronger (coefficients=0.92–0.95) than the correlation between 2D and CBCT or DTS (coefficients=0.81–0.83). When registering soft tissue, the mean vector differences were 0.18±0.11 cm between CBCT and coronal-DTS and 0.29±0.17 cm between CBCT and sagittal-DTS. The correlation coefficients of CBCT to sagittal-DTS and to coronal-DTS were 0.84 and 0.92, respectively. Conclusions DTS could provide equivalent results to CBCT when bony anatomy is used as landmarks for prostate IGRT. For soft tissue-based positioning verification, coronal-DTS produced equivalent results to CBCT and sagittal-DTS alone was insufficient. DTS could allow comparable soft tissue-based target localization with faster scanning time and less imaging dose compared to CBCT. PMID:19100923

4D cone-beam computed tomography (CBCT) using a moving blocker for simultaneous radiation dose reduction and scatter correction

NASA Astrophysics Data System (ADS)

Zhao, Cong; Zhong, Yuncheng; Duan, Xinhui; Zhang, You; Huang, Xiaokun; Wang, Jing; Jin, Mingwu

2018-06-01

Four-dimensional (4D) x-ray cone-beam computed tomography (CBCT) is important for a precise radiation therapy for lung cancer. Due to the repeated use and 4D acquisition over a course of radiotherapy, the radiation dose becomes a concern. Meanwhile, the scatter contamination in CBCT deteriorates image quality for treatment tasks. In this work, we propose the use of a moving blocker (MB) during the 4D CBCT acquisition (‘4D MB’) and to combine motion-compensated reconstruction to address these two issues simultaneously. In 4D MB CBCT, the moving blocker reduces the x-ray flux passing through the patient and collects the scatter information in the blocked region at the same time. The scatter signal is estimated from the blocked region for correction. Even though the number of projection views and projection data in each view are not complete for conventional reconstruction, 4D reconstruction with a total-variation (TV) constraint and a motion-compensated temporal constraint can utilize both spatial gradient sparsity and temporal correlations among different phases to overcome the missing data problem. The feasibility simulation studies using the 4D NCAT phantom showed that 4D MB with motion-compensated reconstruction with 1/3 imaging dose reduction could produce satisfactory images and achieve 37% improvement on structural similarity (SSIM) index and 55% improvement on root mean square error (RMSE), compared to 4D reconstruction at the regular imaging dose without scatter correction. For the same 4D MB data, 4D reconstruction outperformed 3D TV reconstruction by 28% on SSIM and 34% on RMSE. A study of synthetic patient data also demonstrated the potential of 4D MB to reduce the radiation dose by 1/3 without compromising the image quality. This work paves the way for more comprehensive studies to investigate the dose reduction limit offered by this novel 4D MB method using physical phantom experiments and real patient data based on clinical relevant metrics.

4D cone-beam computed tomography (CBCT) using a moving blocker for simultaneous radiation dose reduction and scatter correction.

PubMed

Zhao, Cong; Zhong, Yuncheng; Duan, Xinhui; Zhang, You; Huang, Xiaokun; Wang, Jing; Jin, Mingwu

2018-05-03

Four-dimensional (4D) X-ray cone-beam computed tomography (CBCT) is important for a precise radiation therapy for lung cancer. Due to the repeated use and 4D acquisition over a course of radiotherapy, the radiation dose becomes a concern. Meanwhile, the scatter contamination in CBCT deteriorates image quality for treatment tasks. In this work, we propose to use a moving blocker (MB) during the 4D CBCT acquisition ("4D MB") and to combine motion-compensated reconstruction to address these two issues simultaneously. In 4D MB CBCT, the moving blocker reduces the X-ray flux passing through the patient and collects the scatter information in the blocked region at the same time. The scatter signal is estimated from the blocked region for correction. Even though the number of projection views and projection data in each view are not complete for conventional reconstruction, 4D reconstruction with a total-variation (TV) constraint and a motion-compensated temporal constraint can utilize both spatial gradient sparsity and temporal correlations among different phases to overcome the missing data problem. The feasibility simulation studies using the 4D NCAT phantom showed that 4D MB with motion-compensated reconstruction with 1/3 imaging dose reduction could produce satisfactory images and achieve 37% improvement on structural similarity (SSIM) index and 55% improvement on root mean square error (RMSE), compared to 4D reconstruction at the regular imaging dose without scatter correction. For the same 4D MB data, 4D reconstruction outperformed 3D TV reconstruction by 28% on SSIM and 34% on RMSE. A study of synthetic patient data also demonstrated the potential of 4D MB to reduce the radiation dose by 1/3 without compromising the image quality. This work paves the way for more comprehensive studies to investigate the dose reduction limit offered by this novel 4D MB method using physical phantom experiments and real patient data based on clinical relevant metrics. © 2018 Institute of Physics and Engineering in Medicine.

SU-F-J-34: Automatic Target-Based Patient Positioning Framework for Image-Guided Radiotherapy in Prostate Cancer Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sasahara, M; Arimura, H; Hirose, T

Purpose: Current image-guided radiotherapy (IGRT) procedure is bonebased patient positioning, followed by subjective manual correction using cone beam computed tomography (CBCT). This procedure might cause the misalignment of the patient positioning. Automatic target-based patient positioning systems achieve the better reproducibility of patient setup. Our aim of this study was to develop an automatic target-based patient positioning framework for IGRT with CBCT images in prostate cancer treatment. Methods: Seventy-three CBCT images of 10 patients and 24 planning CT images with digital imaging and communications in medicine for radiotherapy (DICOM-RT) structures were used for this study. Our proposed framework started from themore » generation of probabilistic atlases of bone and prostate from 24 planning CT images and prostate contours, which were made in the treatment planning. Next, the gray-scale histograms of CBCT values within CTV regions in the planning CT images were obtained as the occurrence probability of the CBCT values. Then, CBCT images were registered to the atlases using a rigid registration with mutual information. Finally, prostate regions were estimated by applying the Bayesian inference to CBCT images with the probabilistic atlases and CBCT value occurrence probability. The proposed framework was evaluated by calculating the Euclidean distance of errors between two centroids of prostate regions determined by our method and ground truths of manual delineations by a radiation oncologist and a medical physicist on CBCT images for 10 patients. Results: The average Euclidean distance between the centroids of extracted prostate regions determined by our proposed method and ground truths was 4.4 mm. The average errors for each direction were 1.8 mm in anteroposterior direction, 0.6 mm in lateral direction and 2.1 mm in craniocaudal direction. Conclusion: Our proposed framework based on probabilistic atlases and Bayesian inference might be feasible to automatically determine prostate regions on CBCT images.« less

SU-D-207-03: Development of 4D-CBCT Imaging System with Dual Source KV X-Ray Tubes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nakamura, M; Ishihara, Y; Matsuo, Y

Purpose: The purposes of this work are to develop 4D-CBCT imaging system with orthogonal dual source kV X-ray tubes, and to determine the imaging doses from 4D-CBCT scans. Methods: Dual source kV X-ray tubes were used for the 4D-CBCT imaging. The maximum CBCT field of view was 200 mm in diameter and 150 mm in length, and the imaging parameters were 110 kV, 160 mA and 5 ms. The rotational angle was 105°, the rotational speed of the gantry was 1.5°/s, the gantry rotation time was 70 s, and the image acquisition interval was 0.3°. The observed amplitude of infraredmore » marker motion during respiration was used to sort each image into eight respiratory phase bins. The EGSnrc/BEAMnrc and EGSnrc/DOSXYZnrc packages were used to simulate kV X-ray dose distributions of 4D-CBCT imaging. The kV X-ray dose distributions were calculated for 9 lung cancer patients based on the planning CT images with dose calculation grid size of 2.5 x 2.5 x 2.5 mm. The dose covering a 2-cc volume of skin (D2cc), defined as the inner 5 mm of the skin surface with the exception of bone structure, was assessed. Results: A moving object was well identified on 4D-CBCT images in a phantom study. Given a gantry rotational angle of 105° and the configuration of kV X-ray imaging subsystems, both kV X-ray fields overlapped at a part of skin surface. The D2cc for the 4D-CBCT scans was in the range 73.8–105.4 mGy. Linear correlation coefficient between the 1000 minus averaged SSD during CBCT scanning and D2cc was −0.65 (with a slope of −0.17) for the 4D-CBCT scans. Conclusion: We have developed 4D-CBCT imaging system with dual source kV X-ray tubes. The total imaging dose with 4D-CBCT scans was up to 105.4 mGy.« less

SU-E-I-59: Image Quality and Dose Measurement for Partial Cone-Beam CT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abouei, E; Ford, N

Purpose: To characterize performance of cone beam CT (CBCT) used in dentistry investigating quantitatively the image quality and radiation dose during dental CBCT over different settings for partial rotation of the x-ray tube. Methods: Image quality and dose measurements were done on a variable field of view (FOV) dental CBCT (Carestream 9300). X-ray parameters for clinical settings were adjustable for 2–10 mA, 60–90 kVp, and two optional voxel size values, but time was fixed for each FOV. Image quality was assessed by scanning cylindrical poly-methyl methacrylate (PMMA) image quality phantom (SEDENTEXCT IQ), and then the images were analyzed using ImageJmore » to calculate image quality parameters such as noise, uniformity, and contrast to noise ratio (CNR). A protocol proposed by SEDENTEXCT, dose index 1 (DI1), was applied to dose measurements obtained using a thimble ionization chamber and cylindrical PMMA dose index phantom (SEDENTEXCT DI). Dose distributions were obtained using Gafchromic film. The phantoms were positioned in the FOV to imitate a clinical positioning. Results: The image noise was 6–12.5% which, when normalized to the difference of mean voxel value of PMMA and air, was comparable between different FOVs. Uniformity was 93.5ß 99.7% across the images. CNR was 1.7–4.2 and 6.3–14.3 for LDPE and Aluminum, respectively. Dose distributions were symmetric about the rotation angle's bisector. For large and medium FOVs at 4 mA and 80–90 kVp, DI1 values were in the range of 1.26–3.23 mGy. DI1 values were between 1.01–1.93 mGy for small FOV (5×5 cm{sup 2}) at 4–5 mA and 75–84 kVp. Conclusion: Noise decreased by increasing kVp, and the CNR increased for each FOV. When FOV size increased, image noise increased and CNR decreased. DI1 values were increased by increasing tube current (mA), tube voltage (kVp), and/or FOV. Funding for this project from NSERC Discovery grant, UBC Faculty of Dentistry Research Equipment Grant and UBC Faculty of Dentistry S. Wah Leung Endowment Fund.« less

SU-F-I-09: Improvement of Image Registration Using Total-Variation Based Noise Reduction Algorithms for Low-Dose CBCT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mukherjee, S; Farr, J; Merchant, T

Purpose: To study the effect of total-variation based noise reduction algorithms to improve the image registration of low-dose CBCT for patient positioning in radiation therapy. Methods: In low-dose CBCT, the reconstructed image is degraded by excessive quantum noise. In this study, we developed a total-variation based noise reduction algorithm and studied the effect of the algorithm on noise reduction and image registration accuracy. To study the effect of noise reduction, we have calculated the peak signal-to-noise ratio (PSNR). To study the improvement of image registration, we performed image registration between volumetric CT and MV- CBCT images of different head-and-neck patientsmore » and calculated the mutual information (MI) and Pearson correlation coefficient (PCC) as a similarity metric. The PSNR, MI and PCC were calculated for both the noisy and noise-reduced CBCT images. Results: The algorithms were shown to be effective in reducing the noise level and improving the MI and PCC for the low-dose CBCT images tested. For the different head-and-neck patients, a maximum improvement of PSNR of 10 dB with respect to the noisy image was calculated. The improvement of MI and PCC was 9% and 2% respectively. Conclusion: Total-variation based noise reduction algorithm was studied to improve the image registration between CT and low-dose CBCT. The algorithm had shown promising results in reducing the noise from low-dose CBCT images and improving the similarity metric in terms of MI and PCC.« less

Quantification of the kV X-ray imaging dose during real-time tumor tracking and from three- and four-dimensional cone-beam computed tomography in lung cancer patients using a Monte Carlo simulation.

PubMed

Nakamura, Mitsuhiro; Ishihara, Yoshitomo; Matsuo, Yukinori; Iizuka, Yusuke; Ueki, Nami; Iramina, Hiraku; Hirashima, Hideaki; Mizowaki, Takashi

2018-03-01

Knowledge of the imaging doses delivered to patients and accurate dosimetry of the radiation to organs from various imaging procedures is becoming increasingly important for clinicians. The purposes of this study were to calculate imaging doses delivered to the organs of lung cancer patients during real-time tumor tracking (RTTT) with three-dimensional (3D), and four-dimensional (4D) cone-beam computed tomography (CBCT), using Monte Carlo techniques to simulate kV X-ray dose distributions delivered using the Vero4DRT. Imaging doses from RTTT, 3D-CBCT and 4D-CBCT were calculated with the planning CT images for nine lung cancer patients who underwent stereotactic body radiotherapy (SBRT) with RTTT. With RTTT, imaging doses from correlation modeling and from monitoring of imaging during beam delivery were calculated. With CBCT, doses from 3D-CBCT and 4D-CBCT were also simulated. The doses covering 2-cc volumes (D2cc) in correlation modeling were up to 9.3 cGy for soft tissues and 48.4 cGy for bone. The values from correlation modeling and monitoring were up to 11.0 cGy for soft tissues and 59.8 cGy for bone. Imaging doses in correlation modeling were larger with RTTT. On a single 4D-CBCT, the skin and bone D2cc values were in the ranges of 7.4-10.5 cGy and 33.5-58.1 cGy, respectively. The D2cc from 4D-CBCT was approximately double that from 3D-CBCT. Clinicians should Figure that the imaging dose increases the cumulative doses to organs.

Quantification of the kV X-ray imaging dose during real-time tumor tracking and from three- and four-dimensional cone-beam computed tomography in lung cancer patients using a Monte Carlo simulation

PubMed Central

Nakamura, Mitsuhiro; Ishihara, Yoshitomo; Matsuo, Yukinori; Iizuka, Yusuke; Ueki, Nami; Iramina, Hiraku; Hirashima, Hideaki; Mizowaki, Takashi

2018-01-01

Abstract Knowledge of the imaging doses delivered to patients and accurate dosimetry of the radiation to organs from various imaging procedures is becoming increasingly important for clinicians. The purposes of this study were to calculate imaging doses delivered to the organs of lung cancer patients during real-time tumor tracking (RTTT) with three-dimensional (3D), and four-dimensional (4D) cone-beam computed tomography (CBCT), using Monte Carlo techniques to simulate kV X-ray dose distributions delivered using the Vero4DRT. Imaging doses from RTTT, 3D-CBCT and 4D-CBCT were calculated with the planning CT images for nine lung cancer patients who underwent stereotactic body radiotherapy (SBRT) with RTTT. With RTTT, imaging doses from correlation modeling and from monitoring of imaging during beam delivery were calculated. With CBCT, doses from 3D-CBCT and 4D-CBCT were also simulated. The doses covering 2-cc volumes (D2cc) in correlation modeling were up to 9.3 cGy for soft tissues and 48.4 cGy for bone. The values from correlation modeling and monitoring were up to 11.0 cGy for soft tissues and 59.8 cGy for bone. Imaging doses in correlation modeling were larger with RTTT. On a single 4D-CBCT, the skin and bone D2cc values were in the ranges of 7.4–10.5 cGy and 33.5–58.1 cGy, respectively. The D2cc from 4D-CBCT was approximately double that from 3D-CBCT. Clinicians should Figure that the imaging dose increases the cumulative doses to organs. PMID:29385514

High quantum efficiency megavoltage imaging with thick scintillator detectors for image guided radiation therapy

NASA Astrophysics Data System (ADS)

Gopal, Arun

In image guided radiation therapy (IGRT), imaging devices serve as guidance systems to aid patient set-up and tumor volume localization. Traditionally, 2-D megavoltage x-ray imagers, referred to as electronic portal imaging devices (EPIDs), have been used for planar target localization, and have recently been extended to perform 3-D volumetric reconstruction via cone-beam computed tomography (CBCT). However, current EPIDs utilize thin and inefficient phosphor screen detectors and are subsequently limited by poor soft tissue visualization, which limits their use for CBCT. Therefore, the use of thick scintillation media as megavoltage x-ray detectors for greater x-ray sensitivity and enhanced image quality has recently been of significant interest. In this research, two candidates for thick scintillators: CsI(Tl) and terbium doped scintillation glass were investigated in separate imaging configurations. In the first configuration, a thick scintillation crystal (TSC) consisting of a thick, monolithic slab of CsI(Tl) was coupled to a mirror-lens-camera system. The second configuration is based on a fiber-optic scintillation glass array (FOSGA), wherein the scintillation glass is drawn into long fiber-optic conduits, inserted into a grid-type housing constructed out of polymer-tungsten alloy, and coupled to an array of photodiodes for digital read-out. The imaging prototypes were characterized using theoretical studies and imaging measurements to obtain fundamental metrics of imaging performance. Spatial resolution was measured based on a modulation transfer function (MTF), noise was evaluated in terms of a noise power spectrum (NPS), and overall contrast was characterized in the form of detective quantum efficiency (DQE). The imaging studies were used to optimize the TSC and FOSGA imagers and propose prototype configurations for order-of-magnitude improvements in overall image quality. In addition, a fast and simple technique was developed to measure the MTF, NPS, and DQE metrics for clinical EPID and CBCT systems based on a novel adaptation of a traditional line-pair resolution bar-pattern. This research provides two significant benefits to radiotherapy: the characterization of a new generation of thick scintillator based megavoltage x-ray imagers for CBCT based IGRT, and the novel adaptation of fundamental imaging metrics from imaging research to routine clinical performance monitoring.

Low-dose 4D cone-beam CT via joint spatiotemporal regularization of tensor framelet and nonlocal total variation

NASA Astrophysics Data System (ADS)

Han, Hao; Gao, Hao; Xing, Lei

2017-08-01

Excessive radiation exposure is still a major concern in 4D cone-beam computed tomography (4D-CBCT) due to its prolonged scanning duration. Radiation dose can be effectively reduced by either under-sampling the x-ray projections or reducing the x-ray flux. However, 4D-CBCT reconstruction under such low-dose protocols is prone to image artifacts and noise. In this work, we propose a novel joint regularization-based iterative reconstruction method for low-dose 4D-CBCT. To tackle the under-sampling problem, we employ spatiotemporal tensor framelet (STF) regularization to take advantage of the spatiotemporal coherence of the patient anatomy in 4D images. To simultaneously suppress the image noise caused by photon starvation, we also incorporate spatiotemporal nonlocal total variation (SNTV) regularization to make use of the nonlocal self-recursiveness of anatomical structures in the spatial and temporal domains. Under the joint STF-SNTV regularization, the proposed iterative reconstruction approach is evaluated first using two digital phantoms and then using physical experiment data in the low-dose context of both under-sampled and noisy projections. Compared with existing approaches via either STF or SNTV regularization alone, the presented hybrid approach achieves improved image quality, and is particularly effective for the reconstruction of low-dose 4D-CBCT data that are not only sparse but noisy.

SU-E-J-114: A Practical Hybrid Method for Improving the Quality of CT-CBCT Deformable Image Registration for Head and Neck Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, C; Kumarasiri, A; Chetvertkov, M

2015-06-15

Purpose: Accurate deformable image registration (DIR) between CT and CBCT in H&N is challenging. In this study, we propose a practical hybrid method that uses not only the pixel intensities but also organ physical properties, structure volume of interest (VOI), and interactive local registrations. Methods: Five oropharyngeal cancer patients were selected retrospectively. For each patient, the planning CT was registered to the last fraction CBCT, where the anatomy difference was largest. A three step registration strategy was tested; Step1) DIR using pixel intensity only, Step2) DIR with additional use of structure VOI and rigidity penalty, and Step3) interactive local correction.more » For Step1, a public-domain open-source DIR algorithm was used (cubic B-spline, mutual information, steepest gradient optimization, and 4-level multi-resolution). For Step2, rigidity penalty was applied on bony anatomies and brain, and a structure VOI was used to handle the body truncation such as the shoulder cut-off on CBCT. Finally, in Step3, the registrations were reviewed on our in-house developed software and the erroneous areas were corrected via a local registration using level-set motion algorithm. Results: After Step1, there were considerable amount of registration errors in soft tissues and unrealistic stretching in the posterior to the neck and near the shoulder due to body truncation. The brain was also found deformed to a measurable extent near the superior border of CBCT. Such errors could be effectively removed by using a structure VOI and rigidity penalty. The rest of the local soft tissue error could be corrected using the interactive software tool. The estimated interactive correction time was approximately 5 minutes. Conclusion: The DIR using only the image pixel intensity was vulnerable to noise and body truncation. A corrective action was inevitable to achieve good quality of registrations. We found the proposed three-step hybrid method efficient and practical for CT/CBCT registrations in H&N. My department receives grant support from Industrial partners: (a) Varian Medical Systems, Palo Alto, CA, and (b) Philips HealthCare, Best, Netherlands.« less

How I Do It: Cone-Beam CT during Transarterial Chemoembolization for Liver Cancer

PubMed Central

Tacher, Vania; Radaelli, Alessandro; Lin, MingDe

2015-01-01

Cone-beam computed tomography (CBCT) is an imaging technique that provides computed tomographic (CT) images from a rotational scan acquired with a C-arm equipped with a flat panel detector. Utilizing CBCT images during interventional procedures bridges the gap between the world of diagnostic imaging (typically three-dimensional imaging but performed separately from the procedure) and that of interventional radiology (typically two-dimensional imaging). CBCT is capable of providing more information than standard two-dimensional angiography in localizing and/or visualizing liver tumors (“seeing” the tumor) and targeting tumors though precise microcatheter placement in close proximity to the tumors (“reaching” the tumor). It can also be useful in evaluating treatment success at the time of procedure (“assessing” treatment success). CBCT technology is rapidly evolving along with the development of various contrast material injection protocols and multiphasic CBCT techniques. The purpose of this article is to provide a review of the principles of CBCT imaging, including purpose and clinical evidence of the different techniques, and to introduce a decision-making algorithm as a guide for the routine utilization of CBCT during transarterial chemoembolization of liver cancer. © RSNA, 2015 Online supplemental material is available for this article. PMID:25625741

4D cone-beam CT imaging for guidance in radiation therapy: setup verification by use of implanted fiducial markers

NASA Astrophysics Data System (ADS)

Jin, Peng; van Wieringen, Niek; Hulshof, Maarten C. C. M.; Bel, Arjan; Alderliesten, Tanja

2016-03-01

The use of 4D cone-beam computed tomography (CBCT) and fiducial markers for guidance during radiation therapy of mobile tumors is challenging due to the trade-off between image quality, imaging dose, and scanning time. We aimed to investigate the visibility of markers and the feasibility of marker-based 4D registration and manual respiration-induced marker motion quantification for different CBCT acquisition settings. A dynamic thorax phantom and a patient with implanted gold markers were included. For both the phantom and patient, the peak-to-peak amplitude of marker motion in the cranial-caudal direction ranged from 5.3 to 14.0 mm, which did not affect the marker visibility and the associated marker-based registration feasibility. While using a medium field of view (FOV) and the same total imaging dose as is applied for 3D CBCT scanning in our clinic, it was feasible to attain an improved marker visibility by reducing the imaging dose per projection and increasing the number of projection images. For a small FOV with a shorter rotation arc but similar total imaging dose, streak artifacts were reduced due to using a smaller sampling angle. Additionally, the use of a small FOV allowed reducing total imaging dose and scanning time (~2.5 min) without losing the marker visibility. In conclusion, by using 4D CBCT with identical or lower imaging dose and a reduced gantry speed, it is feasible to attain sufficient marker visibility for marker-based 4D setup verification. Moreover, regardless of the settings, manual marker motion quantification can achieve a high accuracy with the error <1.2 mm.

SU-E-J-26: Analysis of Image Quality in CBCT QA Using a Treatment Planning System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, M

2014-06-01

Purpose: The objective of this study is to propose an alternative QA technique that analyzes imaging quality(IQ) in CBCT-QA processing. Methods: A catphan phantom was used to take CT imaging data set that were imported into a treatment planning system - Eclipse. The image quality was analyzed in terms of in-slice geometry resolution, Hounsfield numbers(HU) accuracy, mean-slice thickness, edge-to-center uniformity, low contrast resolution, and high contrast spatial resolution in Eclipse workstation. The CBCT-QA was also analyzed by OBI-workstation and a commercial software. Comparison was made to evaluation feasibility in a TPS environment. Results: The analysis of IQ was conducted inmore » Eclipse v10.0 TPS. In-slice geometric resolution was measured between 2-rods in section CTP404 and repeated for all 4 rods with the difference between expected and measured values less than +/−0.1 cm. For HU, the difference between expected and measured values in HU was found much less than +/−40. Mean slice thickness measured by a distance on the wire proportional to scanner increment multiplying by a factor of 0.42. After repeating measurements to 4 wires, the average difference between expected and measured values was less +/−0.124 mm in slice thickness. HU uniformity was measured in section CTP486 with the tolerance less than +/−40 HU. Low contrast resolution in section CTP515 and high contrast resolution in section CTP528 were found to be 7 disks in diameter of 4 mm and 6 lp/cm, respectively. Eclipse TPS results indicated a good agreement to those obtained in OBI workstation and ImagePro software for major parameters. Conclusion: An analysis of IQ was proposed as an alternative CBCT QA processing. Based upon measured data assessment, proposed method was accurate and consistent to IQ evaluation and TG142 guideline. The approach was to utilize TPS resource, which can be valuable to re-planning, verification, and delivery in adaptive therapy.« less

Directional sinogram interpolation for sparse angular acquisition in cone-beam computed tomography.

PubMed

Zhang, Hua; Sonke, Jan-Jakob

2013-01-01

Cone-beam (CB) computed tomography (CT) is widely used in the field of medical imaging for guidance. Inspired by Betram's directional interpolation (BDI) methods, directional sinogram interpolation (DSI) was implemented to generate more CB projections by optimized (iterative) double-orientation estimation in sinogram space and directional interpolation. A new CBCT was subsequently reconstructed with the Feldkamp algorithm using both the original and interpolated CB projections. The proposed method was evaluated on both phantom and clinical data, and image quality was assessed by correlation ratio (CR) between the interpolated image and a gold standard obtained from full measured projections. Additionally, streak artifact reduction and image blur were assessed. In a CBCT reconstructed by 40 acquired projections over an arc of 360 degree, streak artifacts dropped 20.7% and 6.7% in a thorax phantom, when our method was compared to linear interpolation (LI) and BDI methods. Meanwhile, image blur was assessed by a head-and-neck phantom, where image blur of DSI was 20.1% and 24.3% less than LI and BDI. When our method was compared to LI and DI methods, CR increased by 4.4% and 3.1%. Streak artifacts of sparsely acquired CBCT were decreased by our method and image blur induced by interpolation was constrained to below other interpolation methods.

Impact of cone beam computed tomography (CBCT) on diagnostic thinking in endodontics of posterior teeth: A before- after study.

PubMed

Al-Salehi, S K; Horner, K

2016-10-01

The aim of this study was to evaluate the impact of limited volume CBCT upon diagnosis as part of endodontic management of posterior teeth. The null hypothesis that CBCT does not make any difference in endodontic diagnosis was tested. A single-centre "before-after" study was conducted in a secondary healthcare establishment. Eligible patients were all adults aged 18 years or over who were referred to a specialist endodontic unit. Further inclusion criteria were that the cases were either re-treatment or de novo root canal treatment where the anatomy was judged to be complex. Exclusion criteria included vulnerable groups and de novo endodontic treatment with uncomplicated root canal anatomy. As well as a full history and clinical examination, a high quality colour photographic intraoral image, two paralleling technique periapical radiographs and limited volume CBCT examination were carried out for each patient. All components, except the CBCT dataset, were combined into a Powerpoint presentation and assessed by 4 observers. A questionnaire was designed for the observers as part of the study. CBCT information only changed the radiological findings and the final diagnosis in a minority of cases. There was no clear evidence that CBCT increases the confidence of observers or that CBCT was helpful in making a diagnosis. Routine use of CBCT cannot not be justified on the basis of a change in diagnosis and carefully selected use is appropriate. CBCT is being increasingly used in the field of endodontics. The benefits gained from the use of CBCT must be carefully balanced against the increased radiation dosage. Determination of selection criteria for the use of CBCT in endodontics is, therefore, essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

SU-F-J-23: Field-Of-View Expansion in Cone-Beam CT Reconstruction by Use of Prior Information

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haga, A; Magome, T; Nakano, M

Purpose: Cone-beam CT (CBCT) has become an integral part of online patient setup in an image-guided radiation therapy (IGRT). In addition, the utility of CBCT for dose calculation has actively been investigated. However, the limited size of field-of-view (FOV) and resulted CBCT image with a lack of peripheral area of patient body prevents the reliability of dose calculation. In this study, we aim to develop an FOV expanded CBCT in IGRT system to allow the dose calculation. Methods: Three lung cancer patients were selected in this study. We collected the cone-beam projection images in the CBCT-based IGRT system (X-ray volumemore » imaging unit, ELEKTA), where FOV size of the provided CBCT with these projections was 410 × 410 mm{sup 2} (normal FOV). Using these projections, CBCT with a size of 728 × 728 mm{sup 2} was reconstructed by a posteriori estimation algorithm including a prior image constrained compressed sensing (PICCS). The treatment planning CT was used as a prior image. To assess the effectiveness of FOV expansion, a dose calculation was performed on the expanded CBCT image with region-of-interest (ROI) density mapping method, and it was compared with that of treatment planning CT as well as that of CBCT reconstructed by filtered back projection (FBP) algorithm. Results: A posteriori estimation algorithm with PICCS clearly visualized an area outside normal FOV, whereas the FBP algorithm yielded severe streak artifacts outside normal FOV due to under-sampling. The dose calculation result using the expanded CBCT agreed with that using treatment planning CT very well; a maximum dose difference was 1.3% for gross tumor volumes. Conclusion: With a posteriori estimation algorithm, FOV in CBCT can be expanded. Dose comparison results suggested that the use of expanded CBCTs is acceptable for dose calculation in adaptive radiation therapy. This study has been supported by KAKENHI (15K08691).« less

Motion vector field phase-to-amplitude resampling for 4D motion-compensated cone-beam CT

NASA Astrophysics Data System (ADS)

Sauppe, Sebastian; Kuhm, Julian; Brehm, Marcus; Paysan, Pascal; Seghers, Dieter; Kachelrieß, Marc

2018-02-01

We propose a phase-to-amplitude resampling (PTAR) method to reduce motion blurring in motion-compensated (MoCo) 4D cone-beam CT (CBCT) image reconstruction, without increasing the computational complexity of the motion vector field (MVF) estimation approach. PTAR is able to improve the image quality in reconstructed 4D volumes, including both regular and irregular respiration patterns. The PTAR approach starts with a robust phase-gating procedure for the initial MVF estimation and then switches to a phase-adapted amplitude gating method. The switch implies an MVF-resampling, which makes them amplitude-specific. PTAR ensures that the MVFs, which have been estimated on phase-gated reconstructions, are still valid for all amplitude-gated reconstructions. To validate the method, we use an artificially deformed clinical CT scan with a realistic breathing pattern and several patient data sets acquired with a TrueBeamTM integrated imaging system (Varian Medical Systems, Palo Alto, CA, USA). Motion blurring, which still occurs around the area of the diaphragm or at small vessels above the diaphragm in artifact-specific cyclic motion compensation (acMoCo) images based on phase-gating, is significantly reduced by PTAR. Also, small lung structures appear sharper in the images. This is demonstrated both for simulated and real patient data. A quantification of the sharpness of the diaphragm confirms these findings. PTAR improves the image quality of 4D MoCo reconstructions compared to conventional phase-gated MoCo images, in particular for irregular breathing patterns. Thus, PTAR increases the robustness of MoCo reconstructions for CBCT. Because PTAR does not require any additional steps for the MVF estimation, it is computationally efficient. Our method is not restricted to CBCT but could rather be applied to other image modalities.

WE-G-18A-03: Cone Artifacts Correction in Iterative Cone Beam CT Reconstruction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yan, H; Folkerts, M; Jiang, S

Purpose: For iterative reconstruction (IR) in cone-beam CT (CBCT) imaging, data truncation along the superior-inferior (SI) direction causes severe cone artifacts in the reconstructed CBCT volume images. Not only does it reduce the effective SI coverage of the reconstructed volume, it also hinders the IR algorithm convergence. This is particular a problem for regularization based IR, where smoothing type regularization operations tend to propagate the artifacts to a large area. It is our purpose to develop a practical cone artifacts correction solution. Methods: We found it is the missing data residing in the truncated cone area that leads to inconsistencymore » between the calculated forward projections and measured projections. We overcome this problem by using FDK type reconstruction to estimate the missing data and design weighting factors to compensate the inconsistency caused by the missing data. We validate the proposed methods in our multi-GPU low-dose CBCT reconstruction system on multiple patients' datasets. Results: Compared to the FDK reconstruction with full datasets, while IR is able to reconstruct CBCT images using a subset of projection data, the severe cone artifacts degrade overall image quality. For head-neck case under a full-fan mode, 13 out of 80 slices are contaminated. It is even more severe in pelvis case under half-fan mode, where 36 out of 80 slices are affected, leading to inferior soft-tissue delineation. By applying the proposed method, the cone artifacts are effectively corrected, with a mean intensity difference decreased from ∼497 HU to ∼39HU for those contaminated slices. Conclusion: A practical and effective solution for cone artifacts correction is proposed and validated in CBCT IR algorithm. This study is supported in part by NIH (1R01CA154747-01)« less

Cone beam CT imaging with limited angle of projections and prior knowledge for volumetric verification of non-coplanar beam radiation therapy: a proof of concept study

NASA Astrophysics Data System (ADS)

Meng, Bowen; Xing, Lei; Han, Bin; Koong, Albert; Chang, Daniel; Cheng, Jason; Li, Ruijiang

2013-11-01

Non-coplanar beams are important for treatment of both cranial and noncranial tumors. Treatment verification of such beams with couch rotation/kicks, however, is challenging, particularly for the application of cone beam CT (CBCT). In this situation, only limited and unconventional imaging angles are feasible to avoid collision between the gantry, couch, patient, and on-board imaging system. The purpose of this work is to develop a CBCT verification strategy for patients undergoing non-coplanar radiation therapy. We propose an image reconstruction scheme that integrates a prior image constrained compressed sensing (PICCS) technique with image registration. Planning CT or CBCT acquired at the neutral position is rotated and translated according to the nominal couch rotation/translation to serve as the initial prior image. Here, the nominal couch movement is chosen to have a rotational error of 5° and translational error of 8 mm from the ground truth in one or more axes or directions. The proposed reconstruction scheme alternates between two major steps. First, an image is reconstructed using the PICCS technique implemented with total-variation minimization and simultaneous algebraic reconstruction. Second, the rotational/translational setup errors are corrected and the prior image is updated by applying rigid image registration between the reconstructed image and the previous prior image. The PICCS algorithm and rigid image registration are alternated iteratively until the registration results fall below a predetermined threshold. The proposed reconstruction algorithm is evaluated with an anthropomorphic digital phantom and physical head phantom. The proposed algorithm provides useful volumetric images for patient setup using projections with an angular range as small as 60°. It reduced the translational setup errors from 8 mm to generally <1 mm and the rotational setup errors from 5° to <1°. Compared with the PICCS algorithm alone, the integration of rigid registration significantly improved the reconstructed image quality, with a reduction of mostly 2-3 folds (up to 100) in root mean square image error. The proposed algorithm provides a remedy for solving the problem of non-coplanar CBCT reconstruction from limited angle of projections by combining the PICCS technique and rigid image registration in an iterative framework. In this proof of concept study, non-coplanar beams with couch rotations of 45° can be effectively verified with the CBCT technique.

Observer Evaluation of a Metal Artifact Reduction Algorithm Applied to Head and Neck Cone Beam Computed Tomographic Images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Korpics, Mark; Surucu, Murat; Mescioglu, Ibrahim

Purpose and Objectives: To quantify, through an observer study, the reduction in metal artifacts on cone beam computed tomographic (CBCT) images using a projection-interpolation algorithm, on images containing metal artifacts from dental fillings and implants in patients treated for head and neck (H&N) cancer. Methods and Materials: An interpolation-substitution algorithm was applied to H&N CBCT images containing metal artifacts from dental fillings and implants. Image quality with respect to metal artifacts was evaluated subjectively and objectively. First, 6 independent radiation oncologists were asked to rank randomly sorted blinded images (before and after metal artifact reduction) using a 5-point rating scalemore » (1 = severe artifacts; 5 = no artifacts). Second, the standard deviation of different regions of interest (ROI) within each image was calculated and compared with the mean rating scores. Results: The interpolation-substitution technique successfully reduced metal artifacts in 70% of the cases. From a total of 60 images from 15 H&N cancer patients undergoing image guided radiation therapy, the mean rating score on the uncorrected images was 2.3 ± 1.1, versus 3.3 ± 1.0 for the corrected images. The mean difference in ranking score between uncorrected and corrected images was 1.0 (95% confidence interval: 0.9-1.2, P<.05). The standard deviation of each ROI significantly decreased after artifact reduction (P<.01). Moreover, a negative correlation between the mean rating score for each image and the standard deviation of the oral cavity and bilateral cheeks was observed. Conclusion: The interpolation-substitution algorithm is efficient and effective for reducing metal artifacts caused by dental fillings and implants on CBCT images, as demonstrated by the statistically significant increase in observer image quality ranking and by the decrease in ROI standard deviation between uncorrected and corrected images.« less

Cone beam computed tomography radiation dose and image quality assessments.

PubMed

Lofthag-Hansen, Sara

2010-01-01

Diagnostic radiology has undergone profound changes in the last 30 years. New technologies are available to the dental field, cone beam computed tomography (CBCT) as one of the most important. CBCT is a catch-all term for a technology comprising a variety of machines differing in many respects: patient positioning, volume size (FOV), radiation quality, image capturing and reconstruction, image resolution and radiation dose. When new technology is introduced one must make sure that diagnostic accuracy is better or at least as good as the one it can be expected to replace. The CBCT brand tested was two versions of Accuitomo (Morita, Japan): 3D Accuitomo with an image intensifier as detector, FOV 3 cm x 4 cm and 3D Accuitomo FPD with a flat panel detector, FOVs 4 cm x 4 cm and 6 cm x 6 cm. The 3D Accuitomo was compared with intra-oral radiography for endodontic diagnosis in 35 patients with 46 teeth analyzed, of which 41 were endodontically treated. Three observers assessed the images by consensus. The result showed that CBCT imaging was superior with a higher number of teeth diagnosed with periapical lesions (42 vs 32 teeth). When evaluating 3D Accuitomo examinations in the posterior mandible in 30 patients, visibility of marginal bone crest and mandibular canal, important anatomic structures for implant planning, was high with good observer agreement among seven observers. Radiographic techniques have to be evaluated concerning radiation dose, which requires well-defined and easy-to-use methods. Two methods: CT dose index (CTDI), prevailing method for CT units, and dose-area product (DAP) were evaluated for calculating effective dose (E) for both units. An asymmetric dose distribution was revealed when a clinical situation was simulated. Hence, the CTDI method was not applicable for these units with small FOVs. Based on DAP values from 90 patient examinations effective dose was estimated for three diagnostic tasks: implant planning in posterior mandible and examinations of impacted lower third molars and retained upper cuspids. It varied between 11-77 microSv. Radiation dose should be evaluated together with image quality. Images of a skull phantom were obtained with both units varying tube voltage, tube current, degree of rotation and FOVs. Seven observers assessed subjective image quality using a six-point rating scale for two diagnostic tasks: periapical diagnosis and implant planning in the posterior part of the jaws. Intra-observer agreement was good and inter-observer agreement moderate. Periapical diagnosis was found to, regardless of jaw, require higher exposure parameters compared to implant planning. Implant planning in the lower jaw required higher exposure parameters compared to upper jaw. Substantial dose reduction could be made without loss of diagnostic information by using a rotation of 180 degrees, in particular implant planning in upper jaw. CBCT with small FOVs was found to be well-suited for periapical diagnosis and implant planning. The CTDI method is not applicable estimating effective dose for these units. Based on DAP values effective dose varied between 11-77 microSv (ICRP 60, 1991) in a retrospectively selected patient material. Adaptation of exposure parameters to diagnostic task can give substantial dose reduction.

Effect of object location on the density measurement in cone-beam computed tomography versus multislice computed tomography

PubMed Central

Eskandarloo, Amir; Abdinian, Mehrdad; Salemi, Fatemeh; Hashemzadeh, Zahra; Safaei, Mehran

2012-01-01

Background: Bone density measurement in a radiographic view is a valuable method for evaluating the density of bone quality before performing some dental procedures such as, dental implant placements. It seems that Cone-Beam Computed Tomography (CBCT) can be used as a diagnostic tool for evaluating the density of the bone, prior to any treatment, as the reported radiation dose in this method is minimal. The aim of this study is to investigate the effect of object location on the density measurement in CBCT versus Multislice computed tomography (CT). Materials and Methods: In an experimental study, three samples with similar dimensions, but different compositions, different densities (Polyethylene, Polyamide, Polyvinyl Chloride), and three bone pieces of different parts of the mandibular bone were imaged in three different positions by CBCT and Multislice CT sets. The average density value was computed for each sample in each position. Then the data obtained from each CBCT was converted to a Hounsfield unit and evaluated using a single variable T analysis. A P value <0.05 was considered to be significant. Results: The density in a Multislice CT is stable in the form of a Hounsfield Number, but this density is variable in the images acquired through CBCT, and the change in the position results in significant changes in the density. In this study, a statistically significant difference (P value = 0.000) has been observed for the position of the sample and its density in CBCT in comparison to Multislice CT. Conclusions: Density values in CBCT are not real because they are affected by the position of the object in the machine. PMID:23814567

Relationship between Hounsfield unit in CT scan and gray scale in CBCT

NASA Astrophysics Data System (ADS)

Kamaruddin, Noorshaida; Rajion, Zainul Ahmad; Yusof, Asilah; Aziz, Mohd Ezane

2016-12-01

Cone-beam computed tomography (CBCT) is an imaging system which has advantages over computed tomography (CT). Recently, CBCT has become widely used for oral and maxillofacial imaging. In CT scan, Hounsfield Unit (HU) is proportional to the degree of x-ray attenuation by the tissue. In CBCT, the degree of x-ray attenuation is shown by gray scale (voxel value). The aim of the present (in vitro) study was to investigate the relationship between gray scale in CBCT and HU in CT scan. In this descriptive study, the anthropomorphic head phantom was scanned with CBCT and CT scanner. Gray scales and HUs were detected on images at the crown of the teeth, trabecular and cortical bone of mandible. The images were analyzed to obtain the gray scale value and HU value. The obtained value then used to investigate the relationship between CBCT gray scales and HUs. For the statistical analysis, t-test, Pearson's correlation and regression analysis were used. The differences between the gray scale of CBCT and HU of CT were statistically not significant, whereas the Pearson's correlation coefficients demonstrated a statistically significant correlation between gray scale of CBCT and HU of CT values. Considering the fact that gray scale in CBCT is important in pre assessment evaluation of bone density before implant treatments, it is recommended because of the lower dose and cost compared to CT scan.

Accelerating an Ordered-Subset Low-Dose X-Ray Cone Beam Computed Tomography Image Reconstruction with a Power Factor and Total Variation Minimization.

PubMed

Huang, Hsuan-Ming; Hsiao, Ing-Tsung

2016-01-01

In recent years, there has been increased interest in low-dose X-ray cone beam computed tomography (CBCT) in many fields, including dentistry, guided radiotherapy and small animal imaging. Despite reducing the radiation dose, low-dose CBCT has not gained widespread acceptance in routine clinical practice. In addition to performing more evaluation studies, developing a fast and high-quality reconstruction algorithm is required. In this work, we propose an iterative reconstruction method that accelerates ordered-subsets (OS) reconstruction using a power factor. Furthermore, we combine it with the total-variation (TV) minimization method. Both simulation and phantom studies were conducted to evaluate the performance of the proposed method. Results show that the proposed method can accelerate conventional OS methods, greatly increase the convergence speed in early iterations. Moreover, applying the TV minimization to the power acceleration scheme can further improve the image quality while preserving the fast convergence rate.

Accelerating an Ordered-Subset Low-Dose X-Ray Cone Beam Computed Tomography Image Reconstruction with a Power Factor and Total Variation Minimization

PubMed Central

Huang, Hsuan-Ming; Hsiao, Ing-Tsung

2016-01-01

In recent years, there has been increased interest in low-dose X-ray cone beam computed tomography (CBCT) in many fields, including dentistry, guided radiotherapy and small animal imaging. Despite reducing the radiation dose, low-dose CBCT has not gained widespread acceptance in routine clinical practice. In addition to performing more evaluation studies, developing a fast and high-quality reconstruction algorithm is required. In this work, we propose an iterative reconstruction method that accelerates ordered-subsets (OS) reconstruction using a power factor. Furthermore, we combine it with the total-variation (TV) minimization method. Both simulation and phantom studies were conducted to evaluate the performance of the proposed method. Results show that the proposed method can accelerate conventional OS methods, greatly increase the convergence speed in early iterations. Moreover, applying the TV minimization to the power acceleration scheme can further improve the image quality while preserving the fast convergence rate. PMID:27073853

Comparison of hand and semiautomatic tracing methods for creating maxillofacial artificial organs using sequences of computed tomography (CT) and cone beam computed tomography (CBCT) images.

PubMed

Szabo, Bence T; Aksoy, Seçil; Repassy, Gabor; Csomo, Krisztian; Dobo-Nagy, Csaba; Orhan, Kaan

2017-06-09

The aim of this study was to compare the paranasal sinus volumes obtained by manual and semiautomatic imaging software programs using both CT and CBCT imaging. 121 computed tomography (CT) and 119 cone beam computed tomography (CBCT) examinations were selected from the databases of the authors' institutes. The Digital Imaging and Communications in Medicine (DICOM) images were imported into 3-dimensonal imaging software, in which hand mode and semiautomatic tracing methods were used to measure the volumes of both maxillary sinuses and the sphenoid sinus. The determined volumetric means were compared to previously published averages. Isometric CBCT-based volume determination results were closer to the real volume conditions, whereas the non-isometric CT-based volume measurements defined coherently lower volumes. By comparing the 2 volume measurement modes, the values gained from hand mode were closer to the literature data. Furthermore, CBCT-based image measurement results corresponded to the known averages. Our results suggest that CBCT images provide reliable volumetric information that can be depended on for artificial organ construction, and which may aid the guidance of the operator prior to or during the intervention.

SU-E-J-11: Measurement of Eye Lens Dose for Varian On-Board Imaging with Different CBCT Acquisition Techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deshpande, S; Dhote, D; Kumar, R

Purpose: To measure actual patient eye lens dose for different cone beam computed tomography (CBCT) acquisition protocol of Varian’s On Board Imagining (OBI) system using Optically Stimulated Luminescence (OSL) dosimeter and study the eye lens dose with patient geometry and distance of isocenter to the eye lens Methods: OSL dosimeter was used to measure eye lens dose of patient. OSL dosimeter was placed on patient forehead center during CBCT image acquisition to measure eye lens dose. For three different cone beam acquisition protocol (standard dose head, low dose head and high quality head) of Varian On-Board Imaging, eye lens dosesmore » were measured. Measured doses were correlated with patient geometry and distance between isocenter to eye lens. Results: Measured eye lens dose for standard dose head was in the range of 1.8 mGy to 3.2 mGy, for high quality head protocol dose was in range of 4.5mGy to 9.9 mGy whereas for low dose head was in the range of 0.3mGy to 0.7mGy. Dose to eye lens is depends upon position of isocenter. For posterioraly located tumor eye lens dose is less. Conclusion: From measured doses it can be concluded that by proper selection of imagining protocol and frequency of imaging, it is possible to restrict the eye lens dose below the new limit set by ICRP. However, undoubted advantages of imaging system should be counter balanced by careful consideration of imaging protocol especially for very intense imaging sequences for Adoptive Radiotherapy or IMRT.« less

Association between the Presence of Apical Periodontitis and Clinical Symptoms in Endodontic Patients Using Cone-beam Computed Tomography and Periapical Radiographs.

PubMed

Weissman, Jake; Johnson, James D; Anderson, Melissa; Hollender, Lars; Huson, Tim; Paranjpe, Avina; Patel, Shanon; Cohenca, Nestor

2015-11-01

Cone-beam computed tomographic (CBCT) imaging is a valuable adjunct to endodontic practice. Among the endodontic applications of CBCT imaging, it aids in the diagnosis of apical periodontitis, often in cases in which there is no evidence of pathosis identified by conventional imaging. The purpose of this study was to correlate the presence of apical periodontitis of teeth evaluated with 2-dimensional periapical (PA) radiographs and 3-dimensional CBCT volumes with clinical signs and symptoms. Clinical records were reviewed from patients examined at the graduate endodontics clinic. The examination included clinical examination, sensibility tests, PA radiographs, and limited field-of-view CBCT scans. Of 498 cases, 67 fulfilled the inclusion criteria and were evaluated for apical periodontitis and symptomology. CBCT slices and PA radiographs were evaluated by 2 board-certified endodontists and a board-certified oral and maxillofacial radiologist for the presence of apical periodontitis. Thirty eight of 67 teeth showed the presence of apical radiolucencies on PA radiographs and on CBCT imaging, whereas 14 teeth had no evidence of apical radiolucencies on either imaging modality. Fifteen cases showed the presence of apical radiolucencies visible on CBCT imaging that were not visible on PA radiographic images. The presence of apical radiolucencies on CBCT slices and PA radiographic images was correlated with clinical signs and symptoms, including the chief complaint. This research has important implications to prevent overexposure to radiation and to provide treatment for those patients with persistent symptoms lacking proper diagnosis based on conventional (2D) radiographs. Copyright © 2015. Published by Elsevier Inc.

Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses.

PubMed

Almatani, Turki; Hugtenburg, Richard P; Lewis, Ryan D; Barley, Susan E; Edwards, Mark A

2016-10-01

Cone beam CT (CBCT) images contain more scatter than a conventional CT image and therefore provide inaccurate Hounsfield units (HUs). Consequently, CBCT images cannot be used directly for radiotherapy dose calculation. The aim of this study is to enable dose calculations to be performed with the use of CBCT images taken during radiotherapy and evaluate the necessity of replanning. A patient with prostate cancer with bilateral metallic prosthetic hip replacements was imaged using both CT and CBCT. The multilevel threshold (MLT) algorithm was used to categorize pixel values in the CBCT images into segments of homogeneous HU. The variation in HU with position in the CBCT images was taken into consideration. This segmentation method relies on the operator dividing the CBCT data into a set of volumes where the variation in the relationship between pixel values and HUs is small. An automated MLT algorithm was developed to reduce the operator time associated with the process. An intensity-modulated radiation therapy plan was generated from CT images of the patient. The plan was then copied to the segmented CBCT (sCBCT) data sets with identical settings, and the doses were recalculated and compared. Gamma evaluation showed that the percentage of points in the rectum with γ < 1 (3%/3 mm) were 98.7% and 97.7% in the sCBCT using MLT and the automated MLT algorithms, respectively. Compared with the planning CT (pCT) plan, the MLT algorithm showed -0.46% dose difference with 8 h operator time while the automated MLT algorithm showed -1.3%, which are both considered to be clinically acceptable, when using collapsed cone algorithm. The segmentation of CBCT images using the method in this study can be used for dose calculation. For a patient with prostate cancer with bilateral hip prostheses and the associated issues with CT imaging, the MLT algorithms achieved a sufficient dose calculation accuracy that is clinically acceptable. The automated MLT algorithm reduced the operator time associated with implementing the MLT algorithm to achieve clinically acceptable accuracy. This saved time makes the automated MLT algorithm superior and easier to implement in the clinical setting. The MLT algorithm has been extended to the complex example of a patient with bilateral hip prostheses, which with the introduction of automation is feasible for use in adaptive radiotherapy, as an alternative to obtaining a new pCT and reoutlining the structures.

Possibilities and limits of imaging endodontic structures with CBCT.

PubMed

Weber, Marie-Theres; Stratz, Nadja; Fleiner, Jonathan; Schulze, Dirk; Hannig, Christian

2015-01-01

An adequate portrayal of the root canal anatomy by diagnostic imaging is a prerequisite for a successful diagnosis and therapy in endodontics. The introduction of dental cone beam computed tomography (CBCT) has considerably expanded the scope of imaging diagnostics. The aim of the following study was to evaluate the imaging of endodontic structures with CBCT. One hundred and twenty teeth were examined with a CBCT device (ProMax 3D). Subsequently, the findings of the three-dimensional images were evaluated and compared to those of dental radiographs and tangential section preparations of the examined teeth. Results with high prevalence, such as existing roots and root canals, as well as results with low prevalence, e.g., extremely fine anatomical structures of the endodontic tissue, could be visualized precisely by dental CBCT; side canals, ramifications, communications, pulp stones, and obliterations could also be detected. Additionally, the length of curved root canals could be determined accurately. Likewise, root fractures were visualized reliably with CBCT. However, carious lesions could not be diagnosed adequately, and the evaluation of fillings and prosthetic restorations was complicated due to scattered X-ray artifacts. CBCT datasets qualify to visualize and diagnose small anatomical structures of the endodontic tissue.

Investigating CT to CBCT image registration for head and neck proton therapy as a tool for daily dose recalculation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Landry, Guillaume, E-mail: g.landry@lmu.de; Nijhuis, Reinoud; Thieke, Christian

2015-03-15

Purpose: Intensity modulated proton therapy (IMPT) of head and neck (H and N) cancer patients may be improved by plan adaptation. The decision to adapt the treatment plan based on a dose recalculation on the current anatomy requires a diagnostic quality computed tomography (CT) scan of the patient. As gantry-mounted cone beam CT (CBCT) scanners are currently being offered by vendors, they may offer daily or weekly updates of patient anatomy. CBCT image quality may not be sufficient for accurate proton dose calculation and it is likely necessary to perform CBCT CT number correction. In this work, the authors investigatedmore » deformable image registration (DIR) of the planning CT (pCT) to the CBCT to generate a virtual CT (vCT) to be used for proton dose recalculation. Methods: Datasets of six H and N cancer patients undergoing photon intensity modulated radiation therapy were used in this study to validate the vCT approach. Each dataset contained a CBCT acquired within 3 days of a replanning CT (rpCT), in addition to a pCT. The pCT and rpCT were delineated by a physician. A Morphons algorithm was employed in this work to perform DIR of the pCT to CBCT following a rigid registration of the two images. The contours from the pCT were deformed using the vector field resulting from DIR to yield a contoured vCT. The DIR accuracy was evaluated with a scale invariant feature transform (SIFT) algorithm comparing automatically identified matching features between vCT and CBCT. The rpCT was used as reference for evaluation of the vCT. The vCT and rpCT CT numbers were converted to stopping power ratio and the water equivalent thickness (WET) was calculated. IMPT dose distributions from treatment plans optimized on the pCT were recalculated with a Monte Carlo algorithm on the rpCT and vCT for comparison in terms of gamma index, dose volume histogram (DVH) statistics as well as proton range. The DIR generated contours on the vCT were compared to physician-drawn contours on the rpCT. Results: The DIR accuracy was better than 1.4 mm according to the SIFT evaluation. The mean WET differences between vCT (pCT) and rpCT were below 1 mm (2.6 mm). The amount of voxels passing 3%/3 mm gamma criteria were above 95% for the vCT vs rpCT. When using the rpCT contour set to derive DVH statistics from dose distributions calculated on the rpCT and vCT the differences, expressed in terms of 30 fractions of 2 Gy, were within [−4, 2 Gy] for parotid glands (D{sub mean}), spinal cord (D{sub 2%}), brainstem (D{sub 2%}), and CTV (D{sub 95%}). When using DIR generated contours for the vCT, those differences ranged within [−8, 11 Gy]. Conclusions: In this work, the authors generated CBCT based stopping power distributions using DIR of the pCT to a CBCT scan. DIR accuracy was below 1.4 mm as evaluated by the SIFT algorithm. Dose distributions calculated on the vCT agreed well to those calculated on the rpCT when using gamma index evaluation as well as DVH statistics based on the same contours. The use of DIR generated contours introduced variability in DVH statistics.« less

Systematic calibration of an integrated x-ray and optical tomography system for preclinical radiation research

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Yidong, E-mail: yidongyang@med.miami.edu; Wang, Ken Kang-Hsin; Wong, John W.

2015-04-15

Purpose: The cone beam computed tomography (CBCT) guided small animal radiation research platform (SARRP) has been developed for focal tumor irradiation, allowing laboratory researchers to test basic biological hypotheses that can modify radiotherapy outcomes in ways that were not feasible previously. CBCT provides excellent bone to soft tissue contrast, but is incapable of differentiating tumors from surrounding soft tissue. Bioluminescence tomography (BLT), in contrast, allows direct visualization of even subpalpable tumors and quantitative evaluation of tumor response. Integration of BLT with CBCT offers complementary image information, with CBCT delineating anatomic structures and BLT differentiating luminescent tumors. This study is tomore » develop a systematic method to calibrate an integrated CBCT and BLT imaging system which can be adopted onboard the SARRP to guide focal tumor irradiation. Methods: The integrated imaging system consists of CBCT, diffuse optical tomography (DOT), and BLT. The anatomy acquired from CBCT and optical properties acquired from DOT serve as a priori information for the subsequent BLT reconstruction. Phantoms were designed and procedures were developed to calibrate the CBCT, DOT/BLT, and the entire integrated system. Geometrical calibration was performed to calibrate the CBCT system. Flat field correction was performed to correct the nonuniform response of the optical imaging system. Absolute emittance calibration was performed to convert the camera readout to the emittance at the phantom or animal surface, which enabled the direct reconstruction of the bioluminescence source strength. Phantom and mouse imaging were performed to validate the calibration. Results: All calibration procedures were successfully performed. Both CBCT of a thin wire and a euthanized mouse revealed no spatial artifact, validating the accuracy of the CBCT calibration. The absolute emittance calibration was validated with a 650 nm laser source, resulting in a 3.0% difference between simulated and measured signal. The calibration of the entire system was confirmed through the CBCT and BLT reconstruction of a bioluminescence source placed inside a tissue-simulating optical phantom. Using a spatial region constraint, the source position was reconstructed with less than 1 mm error and the source strength reconstructed with less than 24% error. Conclusions: A practical and systematic method has been developed to calibrate an integrated x-ray and optical tomography imaging system, including the respective CBCT and optical tomography system calibration and the geometrical calibration of the entire system. The method can be modified and adopted to calibrate CBCT and optical tomography systems that are operated independently or hybrid x-ray and optical tomography imaging systems.« less

Systematic calibration of an integrated x-ray and optical tomography system for preclinical radiation research

PubMed Central

Yang, Yidong; Wang, Ken Kang-Hsin; Eslami, Sohrab; Iordachita, Iulian I.; Patterson, Michael S.; Wong, John W.

2015-01-01

Purpose: The cone beam computed tomography (CBCT) guided small animal radiation research platform (SARRP) has been developed for focal tumor irradiation, allowing laboratory researchers to test basic biological hypotheses that can modify radiotherapy outcomes in ways that were not feasible previously. CBCT provides excellent bone to soft tissue contrast, but is incapable of differentiating tumors from surrounding soft tissue. Bioluminescence tomography (BLT), in contrast, allows direct visualization of even subpalpable tumors and quantitative evaluation of tumor response. Integration of BLT with CBCT offers complementary image information, with CBCT delineating anatomic structures and BLT differentiating luminescent tumors. This study is to develop a systematic method to calibrate an integrated CBCT and BLT imaging system which can be adopted onboard the SARRP to guide focal tumor irradiation. Methods: The integrated imaging system consists of CBCT, diffuse optical tomography (DOT), and BLT. The anatomy acquired from CBCT and optical properties acquired from DOT serve as a priori information for the subsequent BLT reconstruction. Phantoms were designed and procedures were developed to calibrate the CBCT, DOT/BLT, and the entire integrated system. Geometrical calibration was performed to calibrate the CBCT system. Flat field correction was performed to correct the nonuniform response of the optical imaging system. Absolute emittance calibration was performed to convert the camera readout to the emittance at the phantom or animal surface, which enabled the direct reconstruction of the bioluminescence source strength. Phantom and mouse imaging were performed to validate the calibration. Results: All calibration procedures were successfully performed. Both CBCT of a thin wire and a euthanized mouse revealed no spatial artifact, validating the accuracy of the CBCT calibration. The absolute emittance calibration was validated with a 650 nm laser source, resulting in a 3.0% difference between simulated and measured signal. The calibration of the entire system was confirmed through the CBCT and BLT reconstruction of a bioluminescence source placed inside a tissue-simulating optical phantom. Using a spatial region constraint, the source position was reconstructed with less than 1 mm error and the source strength reconstructed with less than 24% error. Conclusions: A practical and systematic method has been developed to calibrate an integrated x-ray and optical tomography imaging system, including the respective CBCT and optical tomography system calibration and the geometrical calibration of the entire system. The method can be modified and adopted to calibrate CBCT and optical tomography systems that are operated independently or hybrid x-ray and optical tomography imaging systems. PMID:25832060

SU-E-J-28: Gantry Speed Significantly Affects Image Quality and Imaging Dose for 4D Cone-Beam Computed Tomography On the Varian Edge Platform

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santoso, A; Song, K; Gardner, S

Purpose: 4D-CBCT facilitates assessment of tumor motion at treatment position. We investigated the effect of gantry speed on 4D-CBCT image quality and dose using the Varian Edge On-Board Imager (OBI). Methods: A thoracic protocol was designed using a 125 kVp spectrum. Image quality parameters were obtained via 4D acquisition using a Catphan phantom with a gating system. A sinusoidal waveform was executed with a five second period and superior-inferior motion. 4D-CBCT scans were sorted into 4 and 10 phases. Image quality metrics included spatial resolution, contrast-to-noise ratio (CNR), uniformity index (UI), Hounsfield unit (HU) sensitivity, and RMS error (RMSE) ofmore » motion amplitude. Dosimetry was accomplished using Gafchromic XR-QA2 films within a CIRS Thorax phantom. This was placed on the gating phantom using the same motion waveform. Results: High contrast resolution decreased linearly from 5.93 to 4.18 lp/cm, 6.54 to 4.18 lp/cm, and 5.19 to 3.91 lp/cm for averaged, 4 phase, and 10 phase 4DCBCT volumes respectively as gantry speed increased from 1.0 to 6.0 degs/sec. CNRs decreased linearly from 4.80 to 1.82 as the gantry speed increased from 1.0 to 6.0 degs/sec, respectively. No significant variations in UIs, HU sensitivities, or RMSEs were observed with variable gantry speed. Ion chamber measurements compared to film yielded small percent differences in plastic water regions (0.1–9.6%), larger percent differences in lung equivalent regions (7.5–34.8%), and significantly larger percent differences in bone equivalent regions (119.1–137.3%). Ion chamber measurements decreased from 17.29 to 2.89 cGy with increasing gantry speed from 1.0 to 6.0 degs/sec. Conclusion: Maintaining technique factors while changing gantry speed changes the number of projections used for reconstruction. Increasing the number of projections by decreasing gantry speed decreases noise, however, dose is increased. The future of 4DCBCT’s clinical utility relies on further investigation of image optimization.« less

Tailoring four-dimensional cone-beam CT acquisition settings for fiducial marker-based image guidance in radiation therapy.

PubMed

Jin, Peng; van Wieringen, Niek; Hulshof, Maarten C C M; Bel, Arjan; Alderliesten, Tanja

2018-04-01

Use of four-dimensional cone-beam CT (4D-CBCT) and fiducial markers for image guidance during radiation therapy (RT) of mobile tumors is challenging due to the trade-off among image quality, imaging dose, and scanning time. This study aimed to investigate different 4D-CBCT acquisition settings for good visibility of fiducial markers in 4D-CBCT. Using these 4D-CBCTs, the feasibility of marker-based 4D registration for RT setup verification and manual respiration-induced motion quantification was investigated. For this, we applied a dynamic phantom with three different breathing motion amplitudes and included two patients with implanted markers. Irrespective of the motion amplitude, for a medium field of view (FOV), marker visibility was improved by reducing the imaging dose per projection and increasing the number of projection images; however, the scanning time was 4 to 8 min. For a small FOV, the total imaging dose and the scanning time were reduced (62.5% of the dose using a medium FOV, 2.5 min) without losing marker visibility. However, the body contour could be missing for a small FOV, which is not preferred in RT. The marker-based 4D setup verification was feasible for both the phantom and patient data. Moreover, manual marker motion quantification can achieve a high accuracy with a mean error of [Formula: see text].

SU-E-J-34: Setup Accuracy in Spine SBRT Using CBCT 6D Image Guidance in Comparison with 6D ExacTrac

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han, Z; Yip, S; Lewis, J

2015-06-15

Purpose Volumetric information of the spine captured on CBCT can potentially improve the accuracy in spine SBRT setup that has been commonly performed through 2D radiographs. This work evaluates the setup accuracy in spine SBRT using 6D CBCT image guidance that recently became available on Varian systems. Methods ExacTrac radiographs have been commonly used for Spine SBRT setup. The setup process involves first positioning patients with lasers followed by localization imaging, registration, and repositioning. Verification images are then taken providing the residual errors (ExacTracRE) before beam on. CBCT verification is also acquired in our institute. The availability of both ExacTracmore » and CBCT verifications allows a comparison study. 41 verification CBCT of 16 patients were retrospectively registered with the planning CT enabling 6D corrections, giving CBCT residual errors (CBCTRE) which were compared with ExacTracRE. Results The RMS discrepancies between CBCTRE and ExacTracRE are 1.70mm, 1.66mm, 1.56mm in vertical, longitudinal and lateral directions and 0.27°, 0.49°, 0.35° in yaw, roll and pitch respectively. The corresponding mean discrepancies (and standard deviation) are 0.62mm (1.60mm), 0.00mm (1.68mm), −0.80mm (1.36mm) and 0.05° (0.58°), 0.11° (0.48°), −0.16° (0.32°). Of the 41 CBCT, 17 had high-Z surgical implants. No significant difference in ExacTrac-to-CBCT discrepancy was observed between patients with and without the implants. Conclusion Multiple factors can contribute to the discrepancies between CBCT and ExacTrac: 1) the imaging iso-centers of the two systems, while calibrated to coincide, can be different; 2) the ROI used for registration can be different especially if ribs were included in ExacTrac images; 3) small patient motion can occur between the two verification image acquisitions; 4) the algorithms can be different between CBCT (volumetric) and ExacTrac (radiographic) registrations.« less

Binary moving-blocker-based scatter correction in cone-beam computed tomography with width-truncated projections: proof of concept.

PubMed

Lee, Ho; Fahimian, Benjamin P; Xing, Lei

2017-03-21

This paper proposes a binary moving-blocker (BMB)-based technique for scatter correction in cone-beam computed tomography (CBCT). In concept, a beam blocker consisting of lead strips, mounted in front of the x-ray tube, moves rapidly in and out of the beam during a single gantry rotation. The projections are acquired in alternating phases of blocked and unblocked cone beams, where the blocked phase results in a stripe pattern in the width direction. To derive the scatter map from the blocked projections, 1D B-Spline interpolation/extrapolation is applied by using the detected information in the shaded regions. The scatter map of the unblocked projections is corrected by averaging two scatter maps that correspond to their adjacent blocked projections. The scatter-corrected projections are obtained by subtracting the corresponding scatter maps from the projection data and are utilized to generate the CBCT image by a compressed-sensing (CS)-based iterative reconstruction algorithm. Catphan504 and pelvis phantoms were used to evaluate the method's performance. The proposed BMB-based technique provided an effective method to enhance the image quality by suppressing scatter-induced artifacts, such as ring artifacts around the bowtie area. Compared to CBCT without a blocker, the spatial nonuniformity was reduced from 9.1% to 3.1%. The root-mean-square error of the CT numbers in the regions of interest (ROIs) was reduced from 30.2 HU to 3.8 HU. In addition to high resolution, comparable to that of the benchmark image, the CS-based reconstruction also led to a better contrast-to-noise ratio in seven ROIs. The proposed technique enables complete scatter-corrected CBCT imaging with width-truncated projections and allows reducing the acquisition time to approximately half. This work may have significant implications for image-guided or adaptive radiation therapy, where CBCT is often used.

Binary moving-blocker-based scatter correction in cone-beam computed tomography with width-truncated projections: proof of concept

NASA Astrophysics Data System (ADS)

Lee, Ho; Fahimian, Benjamin P.; Xing, Lei

2017-03-01

This paper proposes a binary moving-blocker (BMB)-based technique for scatter correction in cone-beam computed tomography (CBCT). In concept, a beam blocker consisting of lead strips, mounted in front of the x-ray tube, moves rapidly in and out of the beam during a single gantry rotation. The projections are acquired in alternating phases of blocked and unblocked cone beams, where the blocked phase results in a stripe pattern in the width direction. To derive the scatter map from the blocked projections, 1D B-Spline interpolation/extrapolation is applied by using the detected information in the shaded regions. The scatter map of the unblocked projections is corrected by averaging two scatter maps that correspond to their adjacent blocked projections. The scatter-corrected projections are obtained by subtracting the corresponding scatter maps from the projection data and are utilized to generate the CBCT image by a compressed-sensing (CS)-based iterative reconstruction algorithm. Catphan504 and pelvis phantoms were used to evaluate the method’s performance. The proposed BMB-based technique provided an effective method to enhance the image quality by suppressing scatter-induced artifacts, such as ring artifacts around the bowtie area. Compared to CBCT without a blocker, the spatial nonuniformity was reduced from 9.1% to 3.1%. The root-mean-square error of the CT numbers in the regions of interest (ROIs) was reduced from 30.2 HU to 3.8 HU. In addition to high resolution, comparable to that of the benchmark image, the CS-based reconstruction also led to a better contrast-to-noise ratio in seven ROIs. The proposed technique enables complete scatter-corrected CBCT imaging with width-truncated projections and allows reducing the acquisition time to approximately half. This work may have significant implications for image-guided or adaptive radiation therapy, where CBCT is often used.

Generation of intra-oral-like images from cone beam computed tomography volumes for dental forensic image comparison.

PubMed

Trochesset, Denise A; Serchuk, Richard B; Colosi, Dan C

2014-03-01

Identification of unknown individuals using dental comparison is well established in the forensic setting. The identification technique can be time and resource consuming if many individuals need to be identified at once. Medical CT (MDCT) for dental profiling has had limited success, mostly due to artifact from metal-containing dental restorations and implants. The authors describe a CBCT reformatting technique that creates images, which closely approximate conventional dental images. Using a i-CAT Platinum CBCT unit and standard issue i-CAT Vision software, a protocol is developed to reproducibly and reliably reformat CBCT volumes. The reformatted images are presented with conventional digital images from the same anatomic area for comparison. The authors conclude that images derived from CBCT volumes following this protocol are similar enough to conventional dental radiographs to allow for dental forensic comparison/identification and that CBCT offers a superior option over MDCT for this purpose. © 2013 American Academy of Forensic Sciences.

2D–3D radiograph to cone-beam computed tomography (CBCT) registration for C-arm image-guided robotic surgery

PubMed Central

Liu, Wen Pei; Otake, Yoshito; Azizian, Mahdi; Wagner, Oliver J.; Sorger, Jonathan M.; Armand, Mehran; Taylor, Russell H.

2015-01-01

Purpose C-arm radiographs are commonly used for intraoperative image guidance in surgical interventions. Fluoroscopy is a cost-effective real-time modality, although image quality can vary greatly depending on the target anatomy. Cone-beam computed tomography (CBCT) scans are sometimes available, so 2D–3D registration is needed for intra-procedural guidance. C-arm radiographs were registered to CBCT scans and used for 3D localization of peritumor fiducials during a minimally invasive thoracic intervention with a da Vinci Si robot. Methods Intensity-based 2D–3D registration of intraoperative radiographs to CBCT was performed. The feasible range of X-ray projections achievable by a C-arm positioned around a da Vinci Si surgical robot, configured for robotic wedge resection, was determined using phantom models. Experiments were conducted on synthetic phantoms and animals imaged with an OEC 9600 and a Siemens Artis zeego, representing the spectrum of different C-arm systems currently available for clinical use. Results The image guidance workflow was feasible using either an optically tracked OEC 9600 or a Siemens Artis zeego C-arm, resulting in an angular difference of Δθ : ~ 30°. The two C-arm systems provided TREmean ≤ 2.5 mm and TREmean ≤ 2.0 mm, respectively (i.e., comparable to standard clinical intraoperative navigation systems). Conclusions C-arm 3D localization from dual 2D–3D registered radiographs was feasible and applicable for intraoperative image guidance during da Vinci robotic thoracic interventions using the proposed workflow. Tissue deformation and in vivo experiments are required before clinical evaluation of this system. PMID:25503592

SU-E-J-06: A Time Dependence Analysis of CBCT Image Quality and Mechanical Stability.

PubMed

Oves, S; Stenbeck, J; Gebreamlak, W; Alkhatib, H

2012-06-01

To quantify the change, if any, in flexmap correction factors and image quality with the XVI system over a course of several years and from these results, assess their clinical impact. Flexmap, a calibration procedure which corrects for imperfect gantry rotation for cone-beam CT reconstruction, and image quality tests were performed on three Elekta Synergy linacs equipped with XVI. Data was collected per month over three years. U and V values, corresponding to lateral and longitudinal shifts respectively, were acquired through the XVI software. Image quality parameters were obtained through CT imaging of the Catphan 500®. For each reconstruction, pixel values for low density polyethylene (LDPE) and polystyrene materials were recorded. For all three linacs, analysis of the flexmap showed a significant change in the U factor for both month-to-month comparisons and comparisons between machines. The V correction factor exhibited a small variation month to month, and showed a slight, gradual increase over time (0.2 +/-0.08 mm). Image quality analysis showed a near consistent decrease (5-10%) in LDPE and polystyrene. Despite this decrease in pixel values, the ratio of the two pixel values remained constant, thus a similar decreasing trend in contrast was not observed. Analysis of monthly flexmap calibration showed the general monthly change in correction shifts and their general trend over several years. For image quality, our research exhibited roughly 0.5% per month decrease in pixel values of the Catphan®. Our results imply that CBCT images obtained from XVI are not appropriate for treatment planning and despite the decrease in panel response over time, image quality with respect to contrast will remain within acceptable clinical standards. Future studies may be carried out to assess any correlation between image quality and XVI source strength. © 2012 American Association of Physicists in Medicine.

Dose calculation accuracy of different image value to density tables for cone-beam CT planning in head & neck and pelvic localizations.

PubMed

Barateau, Anaïs; Garlopeau, Christopher; Cugny, Audrey; De Figueiredo, Bénédicte Henriques; Dupin, Charles; Caron, Jérôme; Antoine, Mikaël

2015-03-01

We aimed to identify the most accurate combination of phantom and protocol for image value to density table (IVDT) on volume-modulated arc therapy (VMAT) dose calculation based on kV-Cone-beam CT imaging, for head and neck (H&N) and pelvic localizations. Three phantoms (Catphan(®)600, CIRS(®)062M (inner phantom for head and outer phantom for body), and TomoTherapy(®) "Cheese" phantom) were used to create IVDT curves of CBCT systems with two different CBCT protocols (Standard-dose Head and Standard Pelvis). Hounsfield Unit (HU) time stability and repeatability for a single On-Board-Imager (OBI) and compatibility of two distinct devices were assessed with Catphan(®)600. Images from the anthropomorphic phantom CIRS ATOM(®) for both CT and CBCT modalities were used for VMAT dose calculation from different IVDT curves. Dosimetric indices from CT and CBCT imaging were compared. IVDT curves from CBCT images were highly different depending on phantom used (up to 1000 HU for high densities) and protocol applied (up to 200 HU for high densities). HU time stability was verified over seven weeks. A maximum difference of 3% on the dose calculation indices studied was found between CT and CBCT VMAT dose calculation across the two localizations using appropriate IVDT curves. One IVDT curve per localization can be established with a bi-monthly verification of IVDT-CBCT. The IVDT-CBCTCIRS-Head phantom with the Standard-dose Head protocol was the most accurate combination for dose calculation on H&N CBCT images. For pelvic localizations, the IVDT-CBCTCheese established with the Standard Pelvis protocol provided the best accuracy. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Evaluation of three imaging techniques for the detection of vertical root fractures in the absence and presence of gutta-percha root fillings.

PubMed

Khedmat, S; Rouhi, N; Drage, N; Shokouhinejad, N; Nekoofar, M H

2012-11-01

To compare the accuracy of digital radiography (DR), multidetector computed tomography (MDCT) and cone beam computed tomography (CBCT) in detecting vertical root fractures (VRF) in the absence and presence of gutta-percha root filling. The root canals of 100 extracted human single-rooted teeth were prepared and randomly divided into four groups: two experimental groups with artificially fractured root and two intact groups as controls. In one experimental and one control group, a size 40, 0.04 taper gutta-percha cone was inserted in the root canals. Then DR, MDCT and CBCT were performed and the images evaluated. Statistical analyses of sensitivity, specificity and accuracy of each imaging technique in the presence and absence of gutta-percha were calculated and compared. In the absence of gutta-percha, the specificity of DR, MDCT and CBCT was similar. CBCT was the most accurate and sensitive imaging technique (P < 0 .05). In the presence of gutta-percha, the accuracy of MDCT was higher than the other imaging techniques (P < 0.05). The sensitivity of CBCT and MDCT was significantly higher than that of DR (P < 0.05), whereas CBCT was the least specific technique. Under the conditions of this ex vivo study, CBCT was the most sensitive imaging technique in detecting vertical root fracture. The presence of gutta-percha reduced the accuracy, sensitivity and specificity of CBCT but not MDCT. The sensitivity of DR was reduced in the presence of gutta-percha. The use of MDCT as an alternative technique may be recommended when VRF are suspected in root filled teeth. However, as the radiation dose of MDCT is higher than CBCT, the technique could be considered at variance with the principles of ALARA. © 2012 International Endodontic Journal.

SU-E-J-243: Possibility of Exposure Dose Reduction of Cone-Beam Computed Tomography in An Image Guided Patient Positioning System by Using Various Noise Suppression Filters

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kamezawa, H; Fujimoto General Hospital, Miyakonojo, Miyazaki; Arimura, H

Purpose: To investigate the possibility of exposure dose reduction of the cone-beam computed tomography (CBCT) in an image guided patient positioning system by using 6 noise suppression filters. Methods: First, a reference dose (RD) and low-dose (LD)-CBCT (X-ray volume imaging system, Elekta Co.) images were acquired with a reference dose of 86.2 mGy (weighted CT dose index: CTDIw) and various low doses of 1.4 to 43.1 mGy, respectively. Second, an automated rigid registration for three axes was performed for estimating setup errors between a planning CT image and the LD-CBCT images, which were processed by 6 noise suppression filters, i.e.,more » averaging filter (AF), median filter (MF), Gaussian filter (GF), bilateral filter (BF), edge preserving smoothing filter (EPF) and adaptive partial median filter (AMF). Third, residual errors representing the patient positioning accuracy were calculated as an Euclidean distance between the setup error vectors estimated using the LD-CBCT image and RD-CBCT image. Finally, the relationships between the residual error and CTDIw were obtained for 6 noise suppression filters, and then the CTDIw for LD-CBCT images processed by the noise suppression filters were measured at the same residual error, which was obtained with the RD-CBCT. This approach was applied to an anthropomorphic pelvic phantom and two cancer patients. Results: For the phantom, the exposure dose could be reduced from 61% (GF) to 78% (AMF) by applying the noise suppression filters to the CBCT images. The exposure dose in a prostate cancer case could be reduced from 8% (AF) to 61% (AMF), and the exposure dose in a lung cancer case could be reduced from 9% (AF) to 37% (AMF). Conclusion: Using noise suppression filters, particularly an adaptive partial median filter, could be feasible to decrease the additional exposure dose to patients in image guided patient positioning systems.« less

Performance of cone beam computed tomography in comparison to conventional imaging techniques for the detection of bone invasion in oral cancer.

PubMed

Linz, C; Müller-Richter, U D A; Buck, A K; Mottok, A; Ritter, C; Schneider, P; Metzen, D; Heuschmann, P; Malzahn, U; Kübler, A C; Herrmann, K; Bluemel, C

2015-01-01

Detecting bone invasion in oral cancer is crucial for therapy planning and the prognosis. The present study evaluated cone beam computed tomography (CBCT) for detecting bone invasion in comparison to standard imaging techniques. A total of 197 patients with diagnoses of oral cancer underwent CBCT as part of preoperative staging between January 2007 and April 2013. The sensitivity, specificity, and accuracy of CBCT were compared with panoramic radiography (PR), multi-slice computed tomography (CT) or magnetic resonance imaging (MRI), and bone scintigraphy (BS) using McNemar's test. Histopathology and clinical follow-up served as references for the presence of bone invasion. CBCT and BS (84.8% and 89.3%, respectively), as well as CBCT and CT/MRI (83.2%), showed comparable accuracy (P = 0.188 and P = 0.771). CBCT was significantly superior to PR, which was reconstructed based on a CBCT dataset (74.1%, P = 0.002). In detecting bone invasion, CBCT was significantly more accurate than PR and was comparable to BS and CT/MRI. However, each method has certain advantages, and the best combination of imaging methods must be evaluated in prospective clinic trials. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Target volume motion during anal cancer image guided radiotherapy using cone-beam computed tomography.

PubMed

Brooks, Corrinne J; Bernier, Laurence; Hansen, Vibeke N; Tait, Diana M

2018-05-01

Literature regarding image-guidance and interfractional motion of the anal canal (AC) during anal cancer radiotherapy is sparse. This study investigates interfractional AC motion during anal cancer radiotherapy. Bone matched cone beam CT (CBCT) images were acquired for 20 patients receiving anal cancer radiotherapy allowing population systematic and random error calculations. 12 were selected to investigate interfractional AC motion. Primary anal gross tumour volume and clinical target volume (CTVa) were contoured on each CBCT. CBCT CTVa volumes were compared to planning CTVa. CBCT CTVa volumes were combined into a CBCT-CTVa envelope for each patient. Maximum distortion between each orthogonal border of the planning CTVa and CBCT-CTVa envelope was measured. Frequency, volume and location of CBCT-CTVa envelope beyond the planning target volume (PTVa) was analysed. Population systematic and random errors were 1 and 3 mm respectively. 112 CBCTs were analysed in the interfractional motion study. CTVa varied between each imaging session particularly T location patients of anorectal origin. CTVa border expansions ≥ 1 cm were seen inferiorly, anteriorly, posteriorly and left direction. The CBCT-CTVa envelope fell beyond the PTVa ≥ 50% imaging sessions (n = 5). Of these CBCT CTVa distortions beyond PTVa, 44% and 32% were in the upper and lower thirds of PTVa respectively. The AC is susceptible to volume changes and shape deformations. Care must be taken when calculating or considering reducing the PTV margin to the anus. Advances in knowledge: Within a limited field of research, this study provides further knowledge of how the AC deforms during anal cancer radiotherapy.

Robust scatter correction method for cone-beam CT using an interlacing-slit plate

NASA Astrophysics Data System (ADS)

Huang, Kui-Dong; Xu, Zhe; Zhang, Ding-Hua; Zhang, Hua; Shi, Wen-Long

2016-06-01

Cone-beam computed tomography (CBCT) has been widely used in medical imaging and industrial nondestructive testing, but the presence of scattered radiation will cause significant reduction of image quality. In this article, a robust scatter correction method for CBCT using an interlacing-slit plate (ISP) is carried out for convenient practice. Firstly, a Gaussian filtering method is proposed to compensate the missing data of the inner scatter image, and simultaneously avoid too-large values of calculated inner scatter and smooth the inner scatter field. Secondly, an interlacing-slit scan without detector gain correction is carried out to enhance the practicality and convenience of the scatter correction method. Finally, a denoising step for scatter-corrected projection images is added in the process flow to control the noise amplification The experimental results show that the improved method can not only make the scatter correction more robust and convenient, but also achieve a good quality of scatter-corrected slice images. Supported by National Science and Technology Major Project of the Ministry of Industry and Information Technology of China (2012ZX04007021), Aeronautical Science Fund of China (2014ZE53059), and Fundamental Research Funds for Central Universities of China (3102014KYJD022)

Task-based statistical image reconstruction for high-quality cone-beam CT

NASA Astrophysics Data System (ADS)

Dang, Hao; Webster Stayman, J.; Xu, Jennifer; Zbijewski, Wojciech; Sisniega, Alejandro; Mow, Michael; Wang, Xiaohui; Foos, David H.; Aygun, Nafi; Koliatsos, Vassilis E.; Siewerdsen, Jeffrey H.

2017-11-01

Task-based analysis of medical imaging performance underlies many ongoing efforts in the development of new imaging systems. In statistical image reconstruction, regularization is often formulated in terms to encourage smoothness and/or sharpness (e.g. a linear, quadratic, or Huber penalty) but without explicit formulation of the task. We propose an alternative regularization approach in which a spatially varying penalty is determined that maximizes task-based imaging performance at every location in a 3D image. We apply the method to model-based image reconstruction (MBIR—viz., penalized weighted least-squares, PWLS) in cone-beam CT (CBCT) of the head, focusing on the task of detecting a small, low-contrast intracranial hemorrhage (ICH), and we test the performance of the algorithm in the context of a recently developed CBCT prototype for point-of-care imaging of brain injury. Theoretical predictions of local spatial resolution and noise are computed via an optimization by which regularization (specifically, the quadratic penalty strength) is allowed to vary throughout the image to maximize local task-based detectability index ({{d}\\prime} ). Simulation studies and test-bench experiments were performed using an anthropomorphic head phantom. Three PWLS implementations were tested: conventional (constant) penalty; a certainty-based penalty derived to enforce constant point-spread function, PSF; and the task-based penalty derived to maximize local detectability at each location. Conventional (constant) regularization exhibited a fairly strong degree of spatial variation in {{d}\\prime} , and the certainty-based method achieved uniform PSF, but each exhibited a reduction in detectability compared to the task-based method, which improved detectability up to ~15%. The improvement was strongest in areas of high attenuation (skull base), where the conventional and certainty-based methods tended to over-smooth the data. The task-driven reconstruction method presents a promising regularization method in MBIR by explicitly incorporating task-based imaging performance as the objective. The results demonstrate improved ICH conspicuity and support the development of high-quality CBCT systems.

An image quality comparison study between XVI and OBI CBCT systems.

PubMed

Kamath, Srijit; Song, William; Chvetsov, Alexei; Ozawa, Shuichi; Lu, Haibin; Samant, Sanjiv; Liu, Chihray; Li, Jonathan G; Palta, Jatinder R

2011-02-04

The purpose of this study is to evaluate and compare image quality characteristics for two commonly used and commercially available CBCT systems: the X-ray Volumetric Imager and the On-Board Imager. A commonly used CATPHAN image quality phantom was used to measure various image quality parameters, namely, pixel value stability and accuracy, noise, contrast to noise ratio (CNR), high-contrast resolution, low contrast resolution and image uniformity. For the XVI unit, we evaluated the image quality for four manufacturer-supplied protocols as a function of mAs. For the OBI unit, we did the same for the full-fan and half-fan scanning modes, which were respectively used with the full bow-tie and half bow-tie filters. For XVI, the mean pixel values of regions of interest were found to generally decrease with increasing mAs for all protocols, while they were relatively stable with mAs for OBI. Noise was slightly lower on XVI and was seen to decrease with increasing mAs, while CNR increased with mAs for both systems. For XVI and OBI, the high-contrast resolution was approximately limited by the pixel resolution of the reconstructed image. On OBI images, up to 6 and 5 discs of 1% and 0.5% contrast, respectively, were visible for a high mAs setting using the full-fan mode, while none of the discs were clearly visible on the XVI images for various mAs settings when the medium resolution reconstruction was used. In conclusion, image quality parameters for XVI and OBI have been quantified and compared for clinical protocols under various mAs settings. These results need to be viewed in the context of a recent study that reported the dose-mAs relationship for the two systems and found that OBI generally delivered higher imaging doses than XVI.

Evaluation of stability of stereotactic space defined by cone-beam CT for the Leksell Gamma Knife Icon.

PubMed

AlDahlawi, Ismail; Prasad, Dheerendra; Podgorsak, Matthew B

2017-05-01

The Gamma Knife Icon comes with an integrated cone-beam CT (CBCT) for image-guided stereotactic treatment deliveries. The CBCT can be used for defining the Leksell stereotactic space using imaging without the need for the traditional invasive frame system, and this allows also for frameless thermoplastic mask stereotactic treatments (single or fractionated) with the Gamma Knife unit. In this study, we used an in-house built marker tool to evaluate the stability of the CBCT-based stereotactic space and its agreement with the standard frame-based stereotactic space. We imaged the tool with a CT indicator box using our CT-simulator at the beginning, middle, and end of the study period (6 weeks) for determining the frame-based stereotactic space. The tool was also scanned with the Icon's CBCT on a daily basis throughout the study period, and the CBCT images were used for determining the CBCT-based stereotactic space. The coordinates of each marker were determined in each CT and CBCT scan using the Leksell GammaPlan treatment planning software. The magnitudes of vector difference between the means of each marker in frame-based and CBCT-based stereotactic space ranged from 0.21 to 0.33 mm, indicating good agreement of CBCT-based and frame-based stereotactic space definition. Scanning 4-month later showed good prolonged stability of the CBCT-based stereotactic space definition. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Accurate tracking of tumor volume change during radiotherapy by CT-CBCT registration with intensity correction

NASA Astrophysics Data System (ADS)

Park, Seyoun; Robinson, Adam; Quon, Harry; Kiess, Ana P.; Shen, Colette; Wong, John; Plishker, William; Shekhar, Raj; Lee, Junghoon

2016-03-01

In this paper, we propose a CT-CBCT registration method to accurately predict the tumor volume change based on daily cone-beam CTs (CBCTs) during radiotherapy. CBCT is commonly used to reduce patient setup error during radiotherapy, but its poor image quality impedes accurate monitoring of anatomical changes. Although physician's contours drawn on the planning CT can be automatically propagated to daily CBCTs by deformable image registration (DIR), artifacts in CBCT often cause undesirable errors. To improve the accuracy of the registration-based segmentation, we developed a DIR method that iteratively corrects CBCT intensities by local histogram matching. Three popular DIR algorithms (B-spline, demons, and optical flow) with the intensity correction were implemented on a graphics processing unit for efficient computation. We evaluated their performances on six head and neck (HN) cancer cases. For each case, four trained scientists manually contoured the nodal gross tumor volume (GTV) on the planning CT and every other fraction CBCTs to which the propagated GTV contours by DIR were compared. The performance was also compared with commercial image registration software based on conventional mutual information (MI), VelocityAI (Varian Medical Systems Inc.). The volume differences (mean±std in cc) between the average of the manual segmentations and automatic segmentations are 3.70+/-2.30 (B-spline), 1.25+/-1.78 (demons), 0.93+/-1.14 (optical flow), and 4.39+/-3.86 (VelocityAI). The proposed method significantly reduced the estimation error by 9% (B-spline), 38% (demons), and 51% (optical flow) over the results using VelocityAI. Although demonstrated only on HN nodal GTVs, the results imply that the proposed method can produce improved segmentation of other critical structures over conventional methods.

Dental MRI using wireless intraoral coils

NASA Astrophysics Data System (ADS)

Ludwig, Ute; Eisenbeiss, Anne-Katrin; Scheifele, Christian; Nelson, Katja; Bock, Michael; Hennig, Jürgen; von Elverfeldt, Dominik; Herdt, Olga; Flügge, Tabea; Hövener, Jan-Bernd

2016-03-01

Currently, the gold standard for dental imaging is projection radiography or cone-beam computed tomography (CBCT). These methods are fast and cost-efficient, but exhibit poor soft tissue contrast and expose the patient to ionizing radiation (X-rays). The need for an alternative imaging modality e.g. for soft tissue management has stimulated a rising interest in dental magnetic resonance imaging (MRI) which provides superior soft tissue contrast. Compared to X-ray imaging, however, so far the spatial resolution of MRI is lower and the scan time is longer. In this contribution, we describe wireless, inductively-coupled intraoral coils whose local sensitivity enables high resolution MRI of dental soft tissue. In comparison to CBCT, a similar image quality with complementary contrast was obtained ex vivo. In-vivo, a voxel size of the order of 250•250•500 μm3 was achieved in 4 min only. Compared to dental MRI acquired with clinical equipment, the quality of the images was superior in the sensitive volume of the coils and is expected to improve the planning of interventions and monitoring thereafter. This method may enable a more accurate dental diagnosis and avoid unnecessary interventions, improving patient welfare and bringing MRI a step closer to becoming a radiation-free alternative for dental imaging.

SU-F-T-40: Can CBCT Images Be Used for Volume Studies of Prostate Seed Implants for Boost Treatment?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, H; Lee, S; Diwanji, T

Purpose: In our clinic, the planning CT is used for definitive and boost low-dose-rate (LDR) brachytherapy treatments to determine the ultrasound volume in the operating room (OR) at the time of the implant. While the CT overestimation of OR volume is known, a larger estimation discrepancy has been observed for boost treatments. A possible reason is the prostate size reduction during EBRT for boost patients. Since cone-beam CT (CBCT) is often used as routine imaging guidance of EBRT, this prostate volume change may be captured. This study investigates if CBCT taken during EBRT includes the volume change information and thereforemore » beats CT in estimating the prostate OR volumes. Methods: 9 prostate patients treated with EBRT (45Gy in 1.8Gy per fractions to the whole pelvis) and I-125 seed implants (108Gy) were involved in this study. During EBRT, CBCT image guidance was performed on a weekly basis. For each patient, the prostate volumes on the first and the last available CBCT images were manually contoured by a physician. These volumes were then compared to each other and with the contoured volumes from the planning CT and from the ultrasound images in the OR. Results: The first and the last CBCT images did not show significant prostate volume change. Their average +/− standard deviation of prostate volumes were 24.4cc+/−14.6cc and 29.9cc+/−16.1cc, respectively (T-test p=0.68). The ratio of the OR volume to the last CBCT (0.71+/−0.21) was not significantly different from the ratio of OR volumes to the planning CT (0.61+/−0.13) (p=0.25). Conclusion: In this study, CBCT does not show significant prostate volume changes during EBRT. CBCT and CT volumes are quite consistent and no improvement of volume estimation using CBCT is observed. The advantage of CBCT as a replacement of CT for volume study of boost LDR brachytherapy is limited.« less

Automated segmentation of dental CBCT image with prior-guided sequential random forests

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Li; Gao, Yaozong; Shi, Feng

Purpose: Cone-beam computed tomography (CBCT) is an increasingly utilized imaging modality for the diagnosis and treatment planning of the patients with craniomaxillofacial (CMF) deformities. Accurate segmentation of CBCT image is an essential step to generate 3D models for the diagnosis and treatment planning of the patients with CMF deformities. However, due to the image artifacts caused by beam hardening, imaging noise, inhomogeneity, truncation, and maximal intercuspation, it is difficult to segment the CBCT. Methods: In this paper, the authors present a new automatic segmentation method to address these problems. Specifically, the authors first employ a majority voting method to estimatemore » the initial segmentation probability maps of both mandible and maxilla based on multiple aligned expert-segmented CBCT images. These probability maps provide an important prior guidance for CBCT segmentation. The authors then extract both the appearance features from CBCTs and the context features from the initial probability maps to train the first-layer of random forest classifier that can select discriminative features for segmentation. Based on the first-layer of trained classifier, the probability maps are updated, which will be employed to further train the next layer of random forest classifier. By iteratively training the subsequent random forest classifier using both the original CBCT features and the updated segmentation probability maps, a sequence of classifiers can be derived for accurate segmentation of CBCT images. Results: Segmentation results on CBCTs of 30 subjects were both quantitatively and qualitatively validated based on manually labeled ground truth. The average Dice ratios of mandible and maxilla by the authors’ method were 0.94 and 0.91, respectively, which are significantly better than the state-of-the-art method based on sparse representation (p-value < 0.001). Conclusions: The authors have developed and validated a novel fully automated method for CBCT segmentation.« less

Poster — Thur Eve — 10: Partial kV CBCT, complete kV CBCT and EPID in breast treatment: a dose comparison study for skin, breasts, heart and lungs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roussin, E; Archambault, L K; Wierzbicki, W

The advantages of kilovoltage cone beam CT (kV CBCT) imaging over electronic portal imaging device (EPID) such as accurate 3D anatomy, soft tissue visualization, fast rigid registration and enhanced precision on patient positioning has lead to its increasing use in clinics. The benefits of this imaging technique are at the cost of increasing the dose to healthy surrounding organs. Our center has moved toward the use of daily partial rotation kV CBCT to restrict the dose to healthy tissues. This study aims to better quantify radiation doses from different image-guidance techniques such as tangential EPID, complete and partial kV CBCTmore » for breast treatments. Cross-calibrated ionization chambers and kV calibrated Gafchromic films were used to measure the dose to the heart, lungs, breasts and skin. It was found that performing partial kV CBCT decreases the heart dose by about 36%, the lungs dose by 31%, the contralateral breast dose by 41% and the ipsilateral breast dose by 43% when compared to a full rotation CBCT. The skin dose measured for a full rotation CBCT was about 0.8 cGy for the contralateral breast and about 0.3 cGy for the ipsilateral breast. The study is still ongoing and results on skin doses for partial rotation kV CBCT as well as for tangential EPID images are upcoming.« less

Low-dose megavoltage cone-beam computed tomography for lung tumors using a high-efficiency image receptor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sillanpaa, Jussi; Chang Jenghwa; Mageras, Gikas

2006-09-15

We report on the capabilities of a low-dose megavoltage cone-beam computed tomography (MV CBCT) system. The high-efficiency image receptor consists of a photodiode array coupled to a scintillator composed of individual CsI crystals. The CBCT system uses the 6 MV beam from a linear accelerator. A synchronization circuit allows us to limit the exposure to one beam pulse [0.028 monitor units (MU)] per projection image. 150-500 images (4.2-13.9 MU total) are collected during a one-minute scan and reconstructed using a filtered backprojection algorithm. Anthropomorphic and contrast phantoms are imaged and the contrast-to-noise ratio of the reconstruction is studied as amore » function of the number of projections and the error in the projection angles. The detector dose response is linear (R{sup 2} value 0.9989). A 2% electron density difference is discernible using 460 projection images and a total exposure of 13 MU (corresponding to a maximum absorbed dose of about 12 cGy in a patient). We present first patient images acquired with this system. Tumors in lung are clearly visible and skeletal anatomy is observed in sufficient detail to allow reproducible registration with the planning kV CT images. The MV CBCT system is shown to be capable of obtaining good quality three-dimensional reconstructions at relatively low dose and to be clinically usable for improving the accuracy of radiotherapy patient positioning.« less

SU-D-206-07: CBCT Scatter Correction Based On Rotating Collimator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, G; Feng, Z; Yin, Y

2016-06-15

Purpose: Scatter correction in cone-beam computed tomography (CBCT) has obvious effect on the removal of image noise, the cup artifact and the increase of image contrast. Several methods using a beam blocker for the estimation and subtraction of scatter have been proposed. However, the inconvenience of mechanics and propensity to residual artifacts limited the further evolution of basic and clinical research. Here, we propose a rotating collimator-based approach, in conjunction with reconstruction based on a discrete Radon transform and Tchebichef moments algorithm, to correct scatter-induced artifacts. Methods: A rotating-collimator, comprising round tungsten alloy strips, was mounted on a linear actuator.more » The rotating-collimator is divided into 6 portions equally. The round strips space is evenly spaced on each portion but staggered between different portions. A step motor connected to the rotating collimator drove the blocker to around x-ray source during the CBCT acquisition. The CBCT reconstruction based on a discrete Radon transform and Tchebichef moments algorithm is performed. Experimental studies using water phantom and Catphan504 were carried out to evaluate the performance of the proposed scheme. Results: The proposed algorithm was tested on both the Monte Carlo simulation and actual experiments with the Catphan504 phantom. From the simulation result, the mean square error of the reconstruction error decreases from 16% to 1.18%, the cupping (τcup) from 14.005% to 0.66%, and the peak signal-to-noise ratio increase from 16.9594 to 31.45. From the actual experiments, the induced visual artifacts are significantly reduced. Conclusion: We conducted an experiment on CBCT imaging system with a rotating collimator to develop and optimize x-ray scatter control and reduction technique. The proposed method is attractive in applications where a high CBCT image quality is critical, for example, dose calculation in adaptive radiation therapy. We want to thank Dr. Lei Xing and Dr. Yong Yang in the Stanford University School of Medicine for this work. This work was jointly supported by NSFC (61471226), Natural Science Foundation for Distinguished Young Scholars of Shandong Province (JQ201516), and China Postdoctoral Science Foundation (2015T80739, 2014M551949).« less

Using gamma index to flag changes in anatomy during image-guided radiation therapy of head and neck cancer.

PubMed

Schaly, Bryan; Kempe, Jeff; Venkatesan, Varagur; Mitchell, Sylvia; Battista, Jerry J

2017-11-01

During radiation therapy of head and neck cancer, the decision to consider replanning a treatment because of anatomical changes has significant resource implications. We developed an algorithm that compares cone-beam computed tomography (CBCT) image pairs and provides an automatic alert as to when remedial action may be required. Retrospective CBCT data from ten head and neck cancer patients that were replanned during their treatment was used to train the algorithm on when to recommend a repeat CT simulation (re-CT). An additional 20 patients (replanned and not replanned) were used to validate the predictive power of the algorithm. CBCT images were compared in 3D using the gamma index, combining Hounsfield Unit (HU) difference with distance-to-agreement (DTA), where the CBCT study acquired on the first fraction is used as the reference. We defined the match quality parameter (MQP x ) as a difference between the x th percentiles of the failed-pixel histograms calculated from the reference gamma comparison and subsequent comparisons, where the reference gamma comparison is taken from the first two CBCT images acquired during treatment. The decision to consider re-CT was based on three consecutive MQP values being less than or equal to a threshold value, such that re-CT recommendations were within ±3 fractions of the actual re-CT order date for the training cases. Receiver-operator characteristic analysis showed that the best trade-off in sensitivity and specificity was achieved using gamma criteria of 3 mm DTA and 30 HU difference, and the 80 th percentile of the failed-pixel histogram. A sensitivity of 82% and 100% was achieved in the training and validation cases, respectively, with a false positive rate of ~30%. We have demonstrated that gamma analysis of CBCT-acquired anatomy can be used to flag patients for possible replanning in a manner consistent with local clinical practice guidelines. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

A Questionnaire Cross-Sectional Study on Application of CBCT in Dental Postgraduate Students.

PubMed

Lavanya, Reddy; Babu, D B Gandhi; Waghray, Shefali; Chaitanya, Nallan C S K; Mamatha, Boring; Nithika, Madhireddy

2016-01-01

CBCT is a new emerging imaging technique which uses a cone-shaped radiation beam that is centered on a 2D detector. It is now routinely evaluated for oral and para-oral disorders. It has been widely accepted in practice in radiology in academic and hospital settings and included in the curricula of some countries. The present study aimed to evaluate the awareness of and knowledge on CBCT among postgraduates. After obtaining permission and ethical clearance from concerned authorities, an anonymous survey on CBCT was conducted in a dental college by using a close-ended validated questionnaire to get to know the knowledge on CBCT among postgraduates in a dental college in India. A total of 100 volunteers participated but only 88 postgraduates responded to the questionnaire. Among the respondents, 54.5% were not using CBCT for diagnostic purposes at their work place. A total of 68.2% of respondents were partially aware of common terminologies used in CBCT. Most of the respondents were unsure about radiation exposure of CBCT when compared to other types of imaging. Almost nobody had any idea on relative importance of image characteristics. Only half of the respondents were willing to attend a hands-on course on CBCT interpretations versus pathology. In the present study it was apparent that most of the respondents were lacking adequate knowledge on CBCT. Hence, there is an urgent need for more training programs on CBCT which would result in better diagnosis and treatment planning.

Segmentation of facial bone surfaces by patch growing from cone beam CT volumes

PubMed Central

Lilja, Mikko; Kalke, Martti

2016-01-01

Objectives: The motivation behind this work was to design an automatic algorithm capable of segmenting the exterior of the dental and facial bones including the mandible, teeth, maxilla and zygomatic bone with an open surface (a surface with a boundary) from CBCT images for the anatomy-based reconstruction of radiographs. Such an algorithm would provide speed, consistency and improved image quality for clinical workflows, for example, in planning of implants. Methods: We used CBCT images from two studies: first to develop (n = 19) and then to test (n = 30) a segmentation pipeline. The pipeline operates by parameterizing the topology and shape of the target, searching for potential points on the facial bone–soft tissue edge, reconstructing a triangular mesh by growing patches on from the edge points with good contrast and regularizing the result with a surface polynomial. This process is repeated for convergence. Results: The output of the algorithm was benchmarked against a hand-drawn reference and reached a 0.50 ± 1.0-mm average and 1.1-mm root mean squares error in Euclidean distance from the reference to our automatically segmented surface. These results were achieved with images affected by inhomogeneity, noise and metal artefacts that are typical for dental CBCT. Conclusions: Previously, this level of accuracy and precision in dental CBCT has been reported in segmenting only the mandible, a much easier target. The segmentation results were consistent throughout the data set and the pipeline was found fast enough (<1-min average computation time) to be considered for clinical use. PMID:27482878

A Clinical Evaluation of Cone Beam Computed Tomography

DTIC Science & Technology

2013-07-31

body of literature lacks in vivo studies comparing CBCT images with clinical findings. The purpose of this descriptive case series was to...All (18/18) bone measurements were underrepresented on CBCT images in this study . This case series also identified limitations in accuracy when... study was to compare pre-surgical CBCT images against the actual clinical presentation of the hard tissues. METHOD: Eleven patients requiring

SU-E-J-47: Comparison of Online Image Registrations of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac Imaging Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, J; Shi, W; Andrews, D

2015-06-15

Purpose To compare online image registrations of TrueBeam cone-beam CT (CBCT) and BrainLab ExacTrac imaging systems. Methods Tests were performed on a Varian TrueBeam STx linear accelerator (Version 2.0), which is integrated with a BrainLab ExacTrac imaging system (Version 6.0.5). The study was focused on comparing the online image registrations for translational shifts. A Rando head phantom was placed on treatment couch and immobilized with a BrainLab mask. The phantom was shifted by moving the couch translationally for 8 mm with a step size of 1 mm, in vertical, longitudinal, and lateral directions, respectively. At each location, the phantom wasmore » imaged with CBCT and ExacTrac x-ray. CBCT images were registered with TrueBeam and ExacTrac online registration algorithms, respectively. And ExacTrac x-ray image registrations were performed. Shifts calculated from different registrations were compared with nominal couch shifts. Results The averages and ranges of absolute differences between couch shifts and calculated phantom shifts obtained from ExacTrac x-ray registration, ExacTrac CBCT registration with default window, ExaxTrac CBCT registration with adjusted window (bone), Truebeam CBCT registration with bone window, and Truebeam CBCT registration with soft tissue window, were: 0.07 (0.02–0.14), 0.14 (0.01–0.35), 0.12 (0.02–0.28), 0.09 (0–0.20), and 0.06 (0–0.10) mm, in vertical direction; 0.06 (0.01–0.12), 0.27 (0.07–0.57), 0.23 (0.02–0.48), 0.04 (0–0.10), and 0.08 (0– 0.20) mm, in longitudinal direction; 0.05 (0.01–0.21), 0.35 (0.14–0.80), 0.25 (0.01–0.56), 0.19 (0–0.40), and 0.20 (0–0.40) mm, in lateral direction. Conclusion The shifts calculated from ExacTrac x-ray and TrueBeam CBCT registrations were close to each other (the differences between were less than 0.40 mm in any direction), and had better agreements with couch shifts than those from ExacTrac CBCT registrations. There were no significant differences between TrueBeam CBCT registrations using different windows. In ExacTrac CBCT registrations, using bone window led to better agreements than using default window.« less

Definition and visualisation of regions of interest in post-prostatectomy image-guided intensity modulated radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bell, Linda J, E-mail: linda.bell1@health.nsw.gov.au; Cox, Jennifer; Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales

2014-09-15

Standard post-prostatectomy radiotherapy (PPRT) image verification uses bony anatomy alignment. However, the prostate bed (PB) moves independently of bony anatomy. Cone beam computed tomography (CBCT) can be used to soft tissue match, so radiation therapists (RTs) must understand pelvic anatomy and PPRT clinical target volumes (CTV). The aims of this study are to define regions of interest (ROI) to be used in soft tissue matching image guidance and determine their visibility on planning CT (PCT) and CBCT. Published CTV guidelines were used to select ROIs. The PCT scans (n = 23) and CBCT scans (n = 105) of 23 post-prostatectomymore » patients were reviewed. Details on ROI identification were recorded. Eighteen patients had surgical clips. All ROIs were identified on PCTs at least 90% of the time apart from mesorectal fascia (MF) (87%) due to superior image quality. When surgical clips are present, the seminal vesicle bed (SVB) was only seen in 2.3% of CBCTs and MF was unidentifiable. Most other structures were well identified on CBCT. The anterior rectal wall (ARW) was identified in 81.4% of images and penile bulb (PB) in 68.6%. In the absence of surgical clips, the MF and SVB were always identified; the ARW was identified in 89.5% of CBCTs and PB in 73.7%. Surgical clips should be used as ROIs when present to define SVB and MF. In the absence of clips, SVB, MF and ARW can be used. RTs must have a strong knowledge of soft tissue anatomy and PPRT CTV to ensure coverage and enable soft tissue matching.« less

MRI and CBCT image registration of temporomandibular joint: a systematic review.

PubMed

Al-Saleh, Mohammed A Q; Alsufyani, Noura A; Saltaji, Humam; Jaremko, Jacob L; Major, Paul W

2016-05-10

The purpose of the present review is to systematically and critically analyze the available literature regarding the importance, applicability, and practicality of (MRI), computerized tomography (CT) or cone-beam CT (CBCT) image registration for TMJ anatomy and assessment. A systematic search of 4 databases; MEDLINE, EMBASE, EBM reviews and Scopus, was conducted by 2 reviewers. An additional manual search of the bibliography was performed. All articles discussing the magnetic resonance imaging MRI and CT or CBCT image registration for temporomandibular joint (TMJ) visualization or assessment were included. Only 3 articles satisfied the inclusion criteria. All included articles were published within the last 7 years. Two articles described MRI to CT multimodality image registration as a complementary tool to visualize TMJ. Both articles used images of one patient only to introduce the complementary concept of MRI-CT fused image. One article assessed the reliability of using MRI-CBCT registration to evaluate the TMJ disc position and osseous pathology for 10 temporomandibular disorder (TMD) patients. There are very limited studies of MRI-CT/CBCT registration to reach a conclusion regarding its accuracy or clinical use in the temporomandibular joints.

Evaluating the four-dimensional cone beam computed tomography with varying gantry rotation speed

PubMed Central

Maria Das, K J; Mohamed Ali, Shajahan; Agarwal, Arpita; Mishra, Surendra P; Kumar, Shaleen

2016-01-01

Objective: The purpose of this work was to evaluate the four-dimensional cone beam CT (4DCBCT) imaging with different gantry rotation speed. Methods: All the 4DCBCT image acquisitions were carried out in Elekta XVI Symmetry™ system (Elekta AB, Stockholm, Sweden). A dynamic thorax phantom with tumour mimicking inserts of diameter 1, 2 and 3 cm was programmed to simulate the respiratory motion (4 s) of the target. 4DCBCT images were acquired with different gantry rotation speeds (36°, 50°, 75°, 100°, 150° and 200° min−1). Owing to the technical limitation of 4DCBCT system, average cone beam CT (CBCT) images derived from the 10 phases of 4DCBCT were used for the internal target volume (ITV) contouring. ITVs obtained from average CBCT were compared with the four-dimensional CT (4DCT). In addition, the image quality of 4DCBCT was also evaluated for various gantry rotation speeds using Catphan® 600 (The Phantom Laboratory Inc., Salem, NY). Results: Compared to 4DCT, the average CBCT underestimated the ITV. The ITV deviation increased with increasing gantry speed (−10.8% vs −17.8% for 36° and 200° min−1 in 3-cm target) and decreasing target size (−17.8% vs −26.8% for target diameter 3 and 1 cm in 200° min−1). Similarly, the image quality indicators such as spatial resolution, contrast-to-noise ratio and uniformity also degraded with increasing gantry rotation speed. Conclusion: The impact of gantry rotation speed has to be considered when using 4DCBCT for ITV definition. The phantom study demonstrated that 4DCBCT with slow gantry rotation showed better image quality and less ITV deviation. Advances in knowledge: Usually, the gantry rotation period of Elekta 4DCBCT system is kept constant at 4 min (50° min−1) for acquisition, and any attempt of decreasing/increasing the acquisition duration requires careful investigation. In this study, the 4DCBCT images with different gantry rotation speed were evaluated. PMID:26916281

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, C; Zhang, H; Chen, Y

Purpose: Recently, compressed sensing (CS) based iterative reconstruction (IR) method is receiving attentions to reconstruct high quality cone beam computed tomography (CBCT) images using sparsely sampled or noisy projections. The aim of this study is to develop a novel baseline algorithm called Mask Guided Image Reconstruction (MGIR), which can provide superior image quality for both low-dose 3DCBCT and 4DCBCT under single mathematical framework. Methods: In MGIR, the unknown CBCT volume was mathematically modeled as a combination of two regions where anatomical structures are 1) within the priori-defined mask and 2) outside the mask. Then we update each part of imagesmore » alternatively thorough solving minimization problems based on CS type IR. For low-dose 3DCBCT, the former region is defined as the anatomically complex region where it is focused to preserve edge information while latter region is defined as contrast uniform, and hence aggressively updated to remove noise/artifact. In 4DCBCT, the regions are separated as the common static part and moving part. Then, static volume and moving volumes were updated with global and phase sorted projection respectively, to optimize the image quality of both moving and static part simultaneously. Results: Examination of MGIR algorithm showed that high quality of both low-dose 3DCBCT and 4DCBCT images can be reconstructed without compromising the image resolution and imaging dose or scanning time respectively. For low-dose 3DCBCT, a clinical viable and high resolution head-and-neck image can be obtained while cutting the dose by 83%. In 4DCBCT, excellent quality 4DCBCT images could be reconstructed while requiring no more projection data and imaging dose than a typical clinical 3DCBCT scan. Conclusion: The results shown that the image quality of MGIR was superior compared to other published CS based IR algorithms for both 4DCBCT and low-dose 3DCBCT. This makes our MGIR algorithm potentially useful in various on-line clinical applications. Provisional Patent: UF#15476; WGS Ref. No. U1198.70067US00.« less

SU-E-J-50: An Evaluation of the Stability of Image Quality Parameters of the Elekta XVI and IView Imaging Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stanley, D; Papanikolaou, N; Gutierrez, A

2015-06-15

Introduction Quality assurance of the image quality for image guided localization systems is crucial to ensure accurate visualization and localization of target volumes. In this study, the long term stability of selected image parameters was assessed and evaluated for CBCT mode, planar radiographic kV mode and MV mode. Methods and Materials: The CATPHAN, QckV-1 and QC-3 phantoms were used to evaluate the image quality parameters. The planar radiographic images were analyzed in PIPSpro™ with spatial resolution (f30, f40, f50) being recorded. For XVI CBCT, Head and Neck Small20 (S20) and Pelvis Medium20 (M20) standard acquisition modes were evaluated for Uniformity,more » Noise, Spatial Resolution and HU constancy. Dose and kVp for the XVI were recorded using the Unfors RaySafe Xi system with the R/F Low Detector for the kV planar radiographic mode. Results A total of 20 and 10 measurements were acquired for the planar radiographic and CBCT systems respectively over a two month period. Values were normalized to the mean and the standard deviations (STD) were recorded. For the planar radiographic spatial resolution, the STD for f30, f40, f50 were 0.004, 0.002, 0.002 and 0.005, 0.007, 0.008 for the kV and MV, respectively. The average recorded dose for kV was 38.7±2.7 μGy. The STD of the evaluated metrics for the S20 acquisition were: 0.444(f30), 0.067(f40), 0.062(f50), 0.018(Water/poly-HU constancy), 0.028(uniformity) and 0.106(noise). The standard deviations for the M20 acquisition were: 0.108(f30), 0.073(f40), 0.091(f50), 0.008(Water/poly-HU constancy), 0.005(uniformity) and 0.005(noise). Using these, tolerances can be reported as a warning and action threshold of 1σ and 2σ. Conclusion A study was performed to assess the stability of the basic image quality parameters recommended by TG-142 for the Elekta XVI and iView imaging systems. Consistent imaging and dosimetric properties over the evaluated time frame were noted. This work was funded in part by the Cancer Prevention Research Institute of Texas Pre doctoral fellowship training grant (RP140105) to Dennis N. Stanley M.Sc.« less

3D exemplar-based random walks for tooth segmentation from cone-beam computed tomography images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pei, Yuru, E-mail: peiyuru@cis.pku.edu.cn; Ai, Xin

Purpose: Tooth segmentation is an essential step in acquiring patient-specific dental geometries from cone-beam computed tomography (CBCT) images. Tooth segmentation from CBCT images is still a challenging task considering the comparatively low image quality caused by the limited radiation dose, as well as structural ambiguities from intercuspation and nearby alveolar bones. The goal of this paper is to present and discuss the latest accomplishments in semisupervised tooth segmentation with adaptive 3D shape constraints. Methods: The authors propose a 3D exemplar-based random walk method of tooth segmentation from CBCT images. The proposed method integrates semisupervised label propagation and regularization by 3Dmore » exemplar registration. To begin with, the pure random walk method is to get an initial segmentation of the teeth, which tends to be erroneous because of the structural ambiguity of CBCT images. And then, as an iterative refinement, the authors conduct a regularization by using 3D exemplar registration, as well as label propagation by random walks with soft constraints, to improve the tooth segmentation. In the first stage of the iteration, 3D exemplars with well-defined topologies are adapted to fit the tooth contours, which are obtained from the random walks based segmentation. The soft constraints on voxel labeling are defined by shape-based foreground dentine probability acquired by the exemplar registration, as well as the appearance-based probability from a support vector machine (SVM) classifier. In the second stage, the labels of the volume-of-interest (VOI) are updated by the random walks with soft constraints. The two stages are optimized iteratively. Instead of the one-shot label propagation in the VOI, an iterative refinement process can achieve a reliable tooth segmentation by virtue of exemplar-based random walks with adaptive soft constraints. Results: The proposed method was applied for tooth segmentation of twenty clinically captured CBCT images. Three metrics, including the Dice similarity coefficient (DSC), the Jaccard similarity coefficient (JSC), and the mean surface deviation (MSD), were used to quantitatively analyze the segmentation of anterior teeth including incisors and canines, premolars, and molars. The segmentation of the anterior teeth achieved a DSC up to 98%, a JSC of 97%, and an MSD of 0.11 mm compared with manual segmentation. For the premolars, the average values of DSC, JSC, and MSD were 98%, 96%, and 0.12 mm, respectively. The proposed method yielded a DSC of 95%, a JSC of 89%, and an MSD of 0.26 mm for molars. Aside from the interactive definition of label priors by the user, automatic tooth segmentation can be achieved in an average of 1.18 min. Conclusions: The proposed technique enables an efficient and reliable tooth segmentation from CBCT images. This study makes it clinically practical to segment teeth from CBCT images, thus facilitating pre- and interoperative uses of dental morphologies in maxillofacial and orthodontic treatments.« less

3D exemplar-based random walks for tooth segmentation from cone-beam computed tomography images.

PubMed

Pei, Yuru; Ai, Xingsheng; Zha, Hongbin; Xu, Tianmin; Ma, Gengyu

2016-09-01

Tooth segmentation is an essential step in acquiring patient-specific dental geometries from cone-beam computed tomography (CBCT) images. Tooth segmentation from CBCT images is still a challenging task considering the comparatively low image quality caused by the limited radiation dose, as well as structural ambiguities from intercuspation and nearby alveolar bones. The goal of this paper is to present and discuss the latest accomplishments in semisupervised tooth segmentation with adaptive 3D shape constraints. The authors propose a 3D exemplar-based random walk method of tooth segmentation from CBCT images. The proposed method integrates semisupervised label propagation and regularization by 3D exemplar registration. To begin with, the pure random walk method is to get an initial segmentation of the teeth, which tends to be erroneous because of the structural ambiguity of CBCT images. And then, as an iterative refinement, the authors conduct a regularization by using 3D exemplar registration, as well as label propagation by random walks with soft constraints, to improve the tooth segmentation. In the first stage of the iteration, 3D exemplars with well-defined topologies are adapted to fit the tooth contours, which are obtained from the random walks based segmentation. The soft constraints on voxel labeling are defined by shape-based foreground dentine probability acquired by the exemplar registration, as well as the appearance-based probability from a support vector machine (SVM) classifier. In the second stage, the labels of the volume-of-interest (VOI) are updated by the random walks with soft constraints. The two stages are optimized iteratively. Instead of the one-shot label propagation in the VOI, an iterative refinement process can achieve a reliable tooth segmentation by virtue of exemplar-based random walks with adaptive soft constraints. The proposed method was applied for tooth segmentation of twenty clinically captured CBCT images. Three metrics, including the Dice similarity coefficient (DSC), the Jaccard similarity coefficient (JSC), and the mean surface deviation (MSD), were used to quantitatively analyze the segmentation of anterior teeth including incisors and canines, premolars, and molars. The segmentation of the anterior teeth achieved a DSC up to 98%, a JSC of 97%, and an MSD of 0.11 mm compared with manual segmentation. For the premolars, the average values of DSC, JSC, and MSD were 98%, 96%, and 0.12 mm, respectively. The proposed method yielded a DSC of 95%, a JSC of 89%, and an MSD of 0.26 mm for molars. Aside from the interactive definition of label priors by the user, automatic tooth segmentation can be achieved in an average of 1.18 min. The proposed technique enables an efficient and reliable tooth segmentation from CBCT images. This study makes it clinically practical to segment teeth from CBCT images, thus facilitating pre- and interoperative uses of dental morphologies in maxillofacial and orthodontic treatments.

TH-A-18C-09: Ultra-Fast Monte Carlo Simulation for Cone Beam CT Imaging of Brain Trauma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sisniega, A; Zbijewski, W; Stayman, J

Purpose: Application of cone-beam CT (CBCT) to low-contrast soft tissue imaging, such as in detection of traumatic brain injury, is challenged by high levels of scatter. A fast, accurate scatter correction method based on Monte Carlo (MC) estimation is developed for application in high-quality CBCT imaging of acute brain injury. Methods: The correction involves MC scatter estimation executed on an NVIDIA GTX 780 GPU (MC-GPU), with baseline simulation speed of ~1e7 photons/sec. MC-GPU is accelerated by a novel, GPU-optimized implementation of variance reduction (VR) techniques (forced detection and photon splitting). The number of simulated tracks and projections is reduced formore » additional speed-up. Residual noise is removed and the missing scatter projections are estimated via kernel smoothing (KS) in projection plane and across gantry angles. The method is assessed using CBCT images of a head phantom presenting a realistic simulation of fresh intracranial hemorrhage (100 kVp, 180 mAs, 720 projections, source-detector distance 700 mm, source-axis distance 480 mm). Results: For a fixed run-time of ~1 sec/projection, GPU-optimized VR reduces the noise in MC-GPU scatter estimates by a factor of 4. For scatter correction, MC-GPU with VR is executed with 4-fold angular downsampling and 1e5 photons/projection, yielding 3.5 minute run-time per scan, and de-noised with optimized KS. Corrected CBCT images demonstrate uniformity improvement of 18 HU and contrast improvement of 26 HU compared to no correction, and a 52% increase in contrast-tonoise ratio in simulated hemorrhage compared to “oracle” constant fraction correction. Conclusion: Acceleration of MC-GPU achieved through GPU-optimized variance reduction and kernel smoothing yields an efficient (<5 min/scan) and accurate scatter correction that does not rely on additional hardware or simplifying assumptions about the scatter distribution. The method is undergoing implementation in a novel CBCT dedicated to brain trauma imaging at the point of care in sports and military applications. Research grant from Carestream Health. JY is an employee of Carestream Health.« less

An interprojection sensor fusion approach to estimate blocked projection signal in synchronized moving grid-based CBCT system.

PubMed

Zhang, Hong; Ren, Lei; Kong, Vic; Giles, William; Zhang, You; Jin, Jian-Yue

2016-01-01

A preobject grid can reduce and correct scatter in cone beam computed tomography (CBCT). However, half of the signal in each projection is blocked by the grid. A synchronized moving grid (SMOG) has been proposed to acquire two complimentary projections at each gantry position and merge them into one complete projection. That approach, however, suffers from increased scanning time and the technical difficulty of accurately merging the two projections per gantry angle. Herein, the authors present a new SMOG approach which acquires a single projection per gantry angle, with complimentary grid patterns for any two adjacent projections, and use an interprojection sensor fusion (IPSF) technique to estimate the blocked signal in each projection. The method may have the additional benefit of reduced imaging dose due to the grid blocking half of the incident radiation. The IPSF considers multiple paired observations from two adjacent gantry angles as approximations of the blocked signal and uses a weighted least square regression of these observations to finally determine the blocked signal. The method was first tested with a simulated SMOG on a head phantom. The signal to noise ratio (SNR), which represents the difference of the recovered CBCT image to the original image without the SMOG, was used to evaluate the ability of the IPSF in recovering the missing signal. The IPSF approach was then tested using a Catphan phantom on a prototype SMOG assembly installed in a bench top CBCT system. In the simulated SMOG experiment, the SNRs were increased from 15.1 and 12.7 dB to 35.6 and 28.9 dB comparing with a conventional interpolation method (inpainting method) for a projection and the reconstructed 3D image, respectively, suggesting that IPSF successfully recovered most of blocked signal. In the prototype SMOG experiment, the authors have successfully reconstructed a CBCT image using the IPSF-SMOG approach. The detailed geometric features in the Catphan phantom were mostly recovered according to visual evaluation. The scatter related artifacts, such as cupping artifacts, were almost completely removed. The IPSF-SMOG is promising in reducing scatter artifacts and improving image quality while reducing radiation dose.

Dose Calculation on KV Cone Beam CT Images: An Investigation of the Hu-Density Conversion Stability and Dose Accuracy Using the Site-Specific Calibration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rong Yi, E-mail: rong@humonc.wisc.ed; Smilowitz, Jennifer; Tewatia, Dinesh

2010-10-01

Precise calibration of Hounsfield units (HU) to electron density (HU-density) is essential to dose calculation. On-board kV cone beam computed tomography (CBCT) imaging is used predominantly for patients' positioning, but will potentially be used for dose calculation. The impacts of varying 3 imaging parameters (mAs, source-imager distance [SID], and cone angle) and phantom size on the HU number accuracy and HU-density calibrations for CBCT imaging were studied. We proposed a site-specific calibration method to achieve higher accuracy in CBCT image-based dose calculation. Three configurations of the Computerized Imaging Reference Systems (CIRS) water equivalent electron density phantom were used to simulatemore » sites including head, lungs, and lower body (abdomen/pelvis). The planning computed tomography (CT) scan was used as the baseline for comparisons. CBCT scans of these phantom configurations were performed using Varian Trilogy{sup TM} system in a precalibrated mode with fixed tube voltage (125 kVp), but varied mAs, SID, and cone angle. An HU-density curve was generated and evaluated for each set of scan parameters. Three HU-density tables generated using different phantom configurations with the same imaging parameter settings were selected for dose calculation on CBCT images for an accuracy comparison. Changing mAs or SID had small impact on HU numbers. For adipose tissue, the HU discrepancy from the baseline was 20 HU in a small phantom, but 5 times lager in a large phantom. Yet, reducing the cone angle significantly decreases the HU discrepancy. The HU-density table was also affected accordingly. By performing dose comparison between CT and CBCT image-based plans, results showed that using the site-specific HU-density tables to calibrate CBCT images of different sites improves the dose accuracy to {approx}2%. Our phantom study showed that CBCT imaging can be a feasible option for dose computation in adaptive radiotherapy approach if the site-specific calibration is applied.« less

Physics considerations in MV-CBCT multi-layer imager design.

PubMed

Hu, Yue-Houng; Fueglistaller, Rony; Myronakis, Marios E; Rottmann, Joerg; Wang, Adam; Shedlock, Daniel; Morf, Daniel; Baturin, Paul; Huber, Pascal; Star-Lack, Josh M; Berbeco, Ross I

2018-05-30

Megavoltage (MV) cone-beam computed tomography (CBCT) using an electronic portal imaging (EPID) offers advantageous features, including 3D mapping, treatment beam registration, high-z artifact suppression, and direct radiation dose calculation. Adoption has been slowed by image quality limitations and concerns about imaging dose. Developments in imager design, including pixelated scintillators, structured phosphors, inexpensive scintillation materials, and multi-layer imager (MLI) architecture have been explored to improve EPID image quality and reduce imaging dose. The present study employs a hybrid Monte Carlo and linear systems model to determine the effect of detector design elements, such as multi-layer architecture and scintillation materials. We follow metrics of image quality including modulation transfer function (MTF) and noise power spectrum (NPS) from projection images to 3D reconstructions to in-plane slices and apply a task based figure-of-merit, the ideal observer signal-to-noise ratio (d') to determine the effect of detector design on object detectability. Generally, detectability was limited by detector noise performance. Deploying an MLI imager with a single scintillation material for all layers yields improvement in noise performance and d' linear with the number of layers. In general, improving x-ray absorption using thicker scintillators results in improved DQE(0). However, if light yield is low, performance will be affected by electronic noise at relatively high doses, resulting in rapid image quality degradation. Maximizing image quality in a heterogenous MLI detector (i.e. multiple different scintillation materials) is most affected by limiting imager noise. However, while a second-order effect, maximizing total spatial resolution of the MLI detector is a balance between the intensity contribution of each layer against its individual MTF. So, while a thinner scintillator may yield a maximal individual-layer MTF, its quantum efficiency will be relatively low in comparison to a thicker scintillator and thus, intensity contribution may be insufficient to noticeably improve the total detector MTF. © 2018 Institute of Physics and Engineering in Medicine.

High-fidelity artifact correction for cone-beam CT imaging of the brain

NASA Astrophysics Data System (ADS)

Sisniega, A.; Zbijewski, W.; Xu, J.; Dang, H.; Stayman, J. W.; Yorkston, J.; Aygun, N.; Koliatsos, V.; Siewerdsen, J. H.

2015-02-01

CT is the frontline imaging modality for diagnosis of acute traumatic brain injury (TBI), involving the detection of fresh blood in the brain (contrast of 30-50 HU, detail size down to 1 mm) in a non-contrast-enhanced exam. A dedicated point-of-care imaging system based on cone-beam CT (CBCT) could benefit early detection of TBI and improve direction to appropriate therapy. However, flat-panel detector (FPD) CBCT is challenged by artifacts that degrade contrast resolution and limit application in soft-tissue imaging. We present and evaluate a fairly comprehensive framework for artifact correction to enable soft-tissue brain imaging with FPD CBCT. The framework includes a fast Monte Carlo (MC)-based scatter estimation method complemented by corrections for detector lag, veiling glare, and beam hardening. The fast MC scatter estimation combines GPU acceleration, variance reduction, and simulation with a low number of photon histories and reduced number of projection angles (sparse MC) augmented by kernel de-noising to yield a runtime of ~4 min per scan. Scatter correction is combined with two-pass beam hardening correction. Detector lag correction is based on temporal deconvolution of the measured lag response function. The effects of detector veiling glare are reduced by deconvolution of the glare response function representing the long range tails of the detector point-spread function. The performance of the correction framework is quantified in experiments using a realistic head phantom on a testbench for FPD CBCT. Uncorrected reconstructions were non-diagnostic for soft-tissue imaging tasks in the brain. After processing with the artifact correction framework, image uniformity was substantially improved, and artifacts were reduced to a level that enabled visualization of ~3 mm simulated bleeds throughout the brain. Non-uniformity (cupping) was reduced by a factor of 5, and contrast of simulated bleeds was improved from ~7 to 49.7 HU, in good agreement with the nominal blood contrast of 50 HU. Although noise was amplified by the corrections, the contrast-to-noise ratio (CNR) of simulated bleeds was improved by nearly a factor of 3.5 (CNR = 0.54 without corrections and 1.91 after correction). The resulting image quality motivates further development and translation of the FPD-CBCT system for imaging of acute TBI.

Segmentation of large periapical lesions toward dental computer-aided diagnosis in cone-beam CT scans

NASA Astrophysics Data System (ADS)

Rysavy, Steven; Flores, Arturo; Enciso, Reyes; Okada, Kazunori

2008-03-01

This paper presents an experimental study for assessing the applicability of general-purpose 3D segmentation algorithms for analyzing dental periapical lesions in cone-beam computed tomography (CBCT) scans. In the field of Endodontics, clinical studies have been unable to determine if a periapical granuloma can heal with non-surgical methods. Addressing this issue, Simon et al. recently proposed a diagnostic technique which non-invasively classifies target lesions using CBCT. Manual segmentation exploited in their study, however, is too time consuming and unreliable for real world adoption. On the other hand, many technically advanced algorithms have been proposed to address segmentation problems in various biomedical and non-biomedical contexts, but they have not yet been applied to the field of dentistry. Presented in this paper is a novel application of such segmentation algorithms to the clinically-significant dental problem. This study evaluates three state-of-the-art graph-based algorithms: a normalized cut algorithm based on a generalized eigen-value problem, a graph cut algorithm implementing energy minimization techniques, and a random walks algorithm derived from discrete electrical potential theory. In this paper, we extend the original 2D formulation of the above algorithms to segment 3D images directly and apply the resulting algorithms to the dental CBCT images. We experimentally evaluate quality of the segmentation results for 3D CBCT images, as well as their 2D cross sections. The benefits and pitfalls of each algorithm are highlighted.

Fusion of cone-beam CT and 3D photographic images for soft tissue simulation in maxillofacial surgery

NASA Astrophysics Data System (ADS)

Chung, Soyoung; Kim, Joojin; Hong, Helen

2016-03-01

During maxillofacial surgery, prediction of the facial outcome after surgery is main concern for both surgeons and patients. However, registration of the facial CBCT images and 3D photographic images has some difficulties that regions around the eyes and mouth are affected by facial expressions or the registration speed is low due to their dense clouds of points on surfaces. Therefore, we propose a framework for the fusion of facial CBCT images and 3D photos with skin segmentation and two-stage surface registration. Our method is composed of three major steps. First, to obtain a CBCT skin surface for the registration with 3D photographic surface, skin is automatically segmented from CBCT images and the skin surface is generated by surface modeling. Second, to roughly align the scale and the orientation of the CBCT skin surface and 3D photographic surface, point-based registration with four corresponding landmarks which are located around the mouth is performed. Finally, to merge the CBCT skin surface and 3D photographic surface, Gaussian-weight-based surface registration is performed within narrow-band of 3D photographic surface.

A Comparative Evaluation of Mixed Dentition Analysis on Reliability of Cone Beam Computed Tomography Image Compared to Plaster Model.

PubMed

Gowd, Snigdha; Shankar, T; Dash, Samarendra; Sahoo, Nivedita; Chatterjee, Suravi; Mohanty, Pritam

2017-01-01

The aim of the study was to evaluate the reliability of cone beam computed tomography (CBCT) obtained image over plaster model for the assessment of mixed dentition analysis. Thirty CBCT-derived images and thirty plaster models were derived from the dental archives, and Moyer's and Tanaka-Johnston analyses were performed. The data obtained were interpreted and analyzed statistically using SPSS 10.0/PC (SPSS Inc., Chicago, IL, USA). Descriptive and analytical analysis along with Student's t -test was performed to qualitatively evaluate the data and P < 0.05 was considered statistically significant. Statistically, significant results were obtained on data comparison between CBCT-derived images and plaster model; the mean for Moyer's analysis in the left and right lower arch for CBCT and plaster model was 21.2 mm, 21.1 mm and 22.5 mm, 22.5 mm, respectively. CBCT-derived images were less reliable as compared to data obtained directly from plaster model for mixed dentition analysis.

Impact of Image Filters and Observations Parameters in CBCT for Identification of Mandibular Osteolytic Lesions

PubMed Central

Monteiro, Bruna Moraes; Nobrega Filho, Denys Silveira; Lopes, Patrícia de Medeiros Loureiro; de Sales, Marcelo Augusto Oliveira

2012-01-01

The aim of this study was to analyze the influence of filters (algorithms) to improve the image of Cone Beam Computed Tomography (CBCT) in diagnosis of osteolytic lesions of the mandible, in order to establish the protocols for viewing images more suitable for CBCT diagnostics. 15 dry mandibles in which perforations were performed, simulating lesions, were submitted to CBCT examination. Two examiners analyzed the images, using filters to improve image Hard, Normal, and Very Sharp, contained in the iCAT Vision software, and protocols for assessment: axial; sagittal and coronal; and axial, sagittal and coronal planes simultaneously (MPR), on two occasions. The sensitivity and specificity (validity) of the cone beam computed tomography (CBCT) have been demonstrated as the values achieved were above 75% for sensitivity and above 85% for specificity, reaching around 95.5% of sensitivity and 99% of specificity when we used the appropriate observation protocol. It was concluded that the use of filters (algorithms) to improve the CBCT image influences the diagnosis, due to the fact that all measured values were correspondingly higher when it was used the filter Very Sharp, which justifies its use for clinical activities, followed by Hard and Normal filters, in order of decreasing values. PMID:22956955

Impact of Image Filters and Observations Parameters in CBCT for Identification of Mandibular Osteolytic Lesions.

PubMed

Monteiro, Bruna Moraes; Nobrega Filho, Denys Silveira; Lopes, Patrícia de Medeiros Loureiro; de Sales, Marcelo Augusto Oliveira

2012-01-01

The aim of this study was to analyze the influence of filters (algorithms) to improve the image of Cone Beam Computed Tomography (CBCT) in diagnosis of osteolytic lesions of the mandible, in order to establish the protocols for viewing images more suitable for CBCT diagnostics. 15 dry mandibles in which perforations were performed, simulating lesions, were submitted to CBCT examination. Two examiners analyzed the images, using filters to improve image Hard, Normal, and Very Sharp, contained in the iCAT Vision software, and protocols for assessment: axial; sagittal and coronal; and axial, sagittal and coronal planes simultaneously (MPR), on two occasions. The sensitivity and specificity (validity) of the cone beam computed tomography (CBCT) have been demonstrated as the values achieved were above 75% for sensitivity and above 85% for specificity, reaching around 95.5% of sensitivity and 99% of specificity when we used the appropriate observation protocol. It was concluded that the use of filters (algorithms) to improve the CBCT image influences the diagnosis, due to the fact that all measured values were correspondingly higher when it was used the filter Very Sharp, which justifies its use for clinical activities, followed by Hard and Normal filters, in order of decreasing values.

Accuracy and reliability of stitched cone-beam computed tomography images.

PubMed

Egbert, Nicholas; Cagna, David R; Ahuja, Swati; Wicks, Russell A

2015-03-01

This study was performed to evaluate the linear distance accuracy and reliability of stitched small field of view (FOV) cone-beam computed tomography (CBCT) reconstructed images for the fabrication of implant surgical guides. Three gutta percha points were fixed on the inferior border of a cadaveric mandible to serve as control reference points. Ten additional gutta percha points, representing fiduciary markers, were scattered on the buccal and lingual cortices at the level of the proposed complete denture flange. A digital caliper was used to measure the distance between the reference points and fiduciary markers, which represented the anatomic linear dimension. The mandible was scanned using small FOV CBCT, and the images were then reconstructed and stitched using the manufacturer's imaging software. The same measurements were then taken with the CBCT software. The anatomic linear dimension measurements and stitched small FOV CBCT measurements were statistically evaluated for linear accuracy. The mean difference between the anatomic linear dimension measurements and the stitched small FOV CBCT measurements was found to be 0.34 mm with a 95% confidence interval of +0.24 - +0.44 mm and a mean standard deviation of 0.30 mm. The difference between the control and the stitched small FOV CBCT measurements was insignificant within the parameters defined by this study. The proven accuracy of stitched small FOV CBCT data sets may allow image-guided fabrication of implant surgical stents from such data sets.

Investigation of cone-beam CT image quality trade-off for image-guided radiation therapy

NASA Astrophysics Data System (ADS)

Bian, Junguo; Sharp, Gregory C.; Park, Yang-Kyun; Ouyang, Jinsong; Bortfeld, Thomas; El Fakhri, Georges

2016-05-01

It is well-known that projections acquired over an angular range slightly over 180° (so-called short scan) are sufficient for fan-beam reconstruction. However, due to practical imaging conditions (projection data and reconstruction image discretization, physical factors, and data noise), the short-scan reconstructions may have different appearances and properties from the full-scan (scans over 360°) reconstructions. Nevertheless, short-scan configurations have been used in applications such as cone-beam CT (CBCT) for head-neck-cancer image-guided radiation therapy (IGRT) that only requires a small field of view due to the potential reduced imaging time and dose. In this work, we studied the image quality trade-off for full, short, and full/short scan configurations with both conventional filtered-backprojection (FBP) reconstruction and iterative reconstruction algorithms based on total-variation (TV) minimization for head-neck-cancer IGRT. Anthropomorphic and Catphan phantoms were scanned at different exposure levels with a clinical scanner used in IGRT. Both visualization- and numerical-metric-based evaluation studies were performed. The results indicate that the optimal exposure level and number of views are in the middle range for both FBP and TV-based iterative algorithms and the optimization is object-dependent and task-dependent. The optimal view numbers decrease with the total exposure levels for both FBP and TV-based algorithms. The results also indicate there are slight differences between FBP and TV-based iterative algorithms for the image quality trade-off: FBP seems to be more in favor of larger number of views while the TV-based algorithm is more robust to different data conditions (number of views and exposure levels) than the FBP algorithm. The studies can provide a general guideline for image-quality optimization for CBCT used in IGRT and other applications.

Investigation of cone-beam CT image quality trade-off for image-guided radiation therapy.

PubMed

Bian, Junguo; Sharp, Gregory C; Park, Yang-Kyun; Ouyang, Jinsong; Bortfeld, Thomas; El Fakhri, Georges

2016-05-07

It is well-known that projections acquired over an angular range slightly over 180° (so-called short scan) are sufficient for fan-beam reconstruction. However, due to practical imaging conditions (projection data and reconstruction image discretization, physical factors, and data noise), the short-scan reconstructions may have different appearances and properties from the full-scan (scans over 360°) reconstructions. Nevertheless, short-scan configurations have been used in applications such as cone-beam CT (CBCT) for head-neck-cancer image-guided radiation therapy (IGRT) that only requires a small field of view due to the potential reduced imaging time and dose. In this work, we studied the image quality trade-off for full, short, and full/short scan configurations with both conventional filtered-backprojection (FBP) reconstruction and iterative reconstruction algorithms based on total-variation (TV) minimization for head-neck-cancer IGRT. Anthropomorphic and Catphan phantoms were scanned at different exposure levels with a clinical scanner used in IGRT. Both visualization- and numerical-metric-based evaluation studies were performed. The results indicate that the optimal exposure level and number of views are in the middle range for both FBP and TV-based iterative algorithms and the optimization is object-dependent and task-dependent. The optimal view numbers decrease with the total exposure levels for both FBP and TV-based algorithms. The results also indicate there are slight differences between FBP and TV-based iterative algorithms for the image quality trade-off: FBP seems to be more in favor of larger number of views while the TV-based algorithm is more robust to different data conditions (number of views and exposure levels) than the FBP algorithm. The studies can provide a general guideline for image-quality optimization for CBCT used in IGRT and other applications.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arai, K; Tohoku University Graduate School of Medicine, Sendal, Miyagi; Kadoya, N

Purpose: The aim of this study was to confirm On-Board Imager cone-beam computed tomography (CBCT) using a histogram-matching algorithm as a useful method for proton dose calculation in head and neck radiotherapy. Methods: We studied one head and neck phantom and ten patients with head and neck cancer treated using intensity-modulated radiation therapy (IMRT) and proton beam therapy. We modified Hounsfield unit (HU) values of CBCT (mCBCT) using a histogram-matching algorithm. In order to evaluate the accuracy of the proton dose calculation, we compared dose differences in dosimetric parameters (Dmean) for clinical target volume (CTV), planning target volume (PTV) andmore » left parotid and proton ranges (PR) between the planning CT (reference) and CBCT or mCBCT, and gamma passing rates of CBCT and mCBCT. To minimize the effect of organ deformation, we also performed image registration. Results: For patients, the average differences in Dmean for CTV, PTV, and left parotid between planning CT and CBCT were 1.63 ± 2.34%, 3.30 ± 1.02%, and 5.42 ± 3.06%, respectively. Similarly, the average differences between planning CT and mCBCT were 0.20 ± 0.19%, 0.58 ±0.43%, and 3.53 ±2.40%, respectively. The average differences in PR between planning CT and CBCT or mCBCT of a 50° beam for ten patients were 2.1 ± 2.1 mm and 0.3 ± 0.5 mm, respectively. Similarly, the average differences in PR of a 120° beam were 2.9 ± 2.6 mm and 1.1 ± 0.9 mm, respectively. The average dose and PR differences of mCBCT were smaller than those of CBCT. Additionally, the average gamma passing rates of mCBCT were larger than those of CBCT. Conclusion: We evaluated the accuracy of the proton dose calculation in CBCT and mCBCT with the image registration for ten patients. Our results showed that HU modification using a histogram-matching algorithm could improve the accuracy of the proton dose calculation.« less

SU-G-IeP2-06: Evaluation of Registration Accuracy for Cone-Beam CT Reconstruction Techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, J; Wang, P; Zhang, H

2016-06-15

Purpose: Cone-beam (CB) computed tomography (CT) is used for image guidance during radiotherapy treatment delivery. Conventional Feldkamp and compressed sensing (CS) based CBCT recon-struction techniques are compared for image registration. This study is to evaluate the image registration accuracy of conventional and CS CBCT for head-and-neck (HN) patients. Methods: Ten HN patients with oropharyngeal tumors were retrospectively selected. Each HN patient had one planning CT (CTP) and three CBCTs were acquired during an adaptive radiotherapy proto-col. Each CBCT was reconstructed by both the conventional (CBCTCON) and compressed sens-ing (CBCTCS) methods. Two oncologists manually labeled 23 landmarks of normal tissue andmore » implanted gold markers on both the CTP and CBCTCON. Subsequently, landmarks on CTp were propagated to CBCTs, using a b-spline-based deformable image registration (DIR) and rigid registration (RR). The errors of these registration methods between two CBCT methods were calcu-lated. Results: For DIR, the mean distance between the propagated and the labeled landmarks was 2.8 mm ± 0.52 for CBCTCS, and 3.5 mm ± 0.75 for CBCTCON. For RR, the mean distance between the propagated and the labeled landmarks was 6.8 mm ± 0.92 for CBCTCS, and 8.7 mm ± 0.95 CBCTCON. Conclusion: This study has demonstrated that CS CBCT is more accurate than conventional CBCT in image registration by both rigid and non-rigid methods. It is potentially suggested that CS CBCT is an improved image modality for image guided adaptive applications.« less

Analytic image reconstruction from partial data for a single-scan cone-beam CT with scatter correction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Min, Jonghwan; Pua, Rizza; Cho, Seungryong, E-mail: scho@kaist.ac.kr

Purpose: A beam-blocker composed of multiple strips is a useful gadget for scatter correction and/or for dose reduction in cone-beam CT (CBCT). However, the use of such a beam-blocker would yield cone-beam data that can be challenging for accurate image reconstruction from a single scan in the filtered-backprojection framework. The focus of the work was to develop an analytic image reconstruction method for CBCT that can be directly applied to partially blocked cone-beam data in conjunction with the scatter correction. Methods: The authors developed a rebinned backprojection-filteration (BPF) algorithm for reconstructing images from the partially blocked cone-beam data in amore » circular scan. The authors also proposed a beam-blocking geometry considering data redundancy such that an efficient scatter estimate can be acquired and sufficient data for BPF image reconstruction can be secured at the same time from a single scan without using any blocker motion. Additionally, scatter correction method and noise reduction scheme have been developed. The authors have performed both simulation and experimental studies to validate the rebinned BPF algorithm for image reconstruction from partially blocked cone-beam data. Quantitative evaluations of the reconstructed image quality were performed in the experimental studies. Results: The simulation study revealed that the developed reconstruction algorithm successfully reconstructs the images from the partial cone-beam data. In the experimental study, the proposed method effectively corrected for the scatter in each projection and reconstructed scatter-corrected images from a single scan. Reduction of cupping artifacts and an enhancement of the image contrast have been demonstrated. The image contrast has increased by a factor of about 2, and the image accuracy in terms of root-mean-square-error with respect to the fan-beam CT image has increased by more than 30%. Conclusions: The authors have successfully demonstrated that the proposed scanning method and image reconstruction algorithm can effectively estimate the scatter in cone-beam projections and produce tomographic images of nearly scatter-free quality. The authors believe that the proposed method would provide a fast and efficient CBCT scanning option to various applications particularly including head-and-neck scan.« less

Cone-Beam Computed Tomography for Image-Guided Radiation Therapy of Prostate Cancer

DTIC Science & Technology

2008-01-01

forexa t volumetri image re onstru tion. As a onsequense, images re onstru ted by approx-imate algorithms, mostly based on the Feldkamp algorithm...patient dose from CBCT. Reverse heli al CBCT has been developed for exa tre onstru tion of volumetri images, region-of-interest (ROI) re onstru tion...algorithm with a priori informa-tion in few-view CBCT for IGRT. We expe t the proposed algorithm an redu e the numberof proje tions needed for volumetri

Scatter measurement and correction method for cone-beam CT based on single grating scan

NASA Astrophysics Data System (ADS)

Huang, Kuidong; Shi, Wenlong; Wang, Xinyu; Dong, Yin; Chang, Taoqi; Zhang, Hua; Zhang, Dinghua

2017-06-01

In cone-beam computed tomography (CBCT) systems based on flat-panel detector imaging, the presence of scatter significantly reduces the quality of slices. Based on the concept of collimation, this paper presents a scatter measurement and correction method based on single grating scan. First, according to the characteristics of CBCT imaging, the scan method using single grating and the design requirements of the grating are analyzed and figured out. Second, by analyzing the composition of object projection images and object-and-grating projection images, the processing method for the scatter image at single projection angle is proposed. In addition, to avoid additional scan, this paper proposes an angle interpolation method of scatter images to reduce scan cost. Finally, the experimental results show that the scatter images obtained by this method are accurate and reliable, and the effect of scatter correction is obvious. When the additional object-and-grating projection images are collected and interpolated at intervals of 30 deg, the scatter correction error of slices can still be controlled within 3%.

SU-E-E-11: Novel Matching Module for Respiration-Gated Motion Tumor of Cone-Beam Computed Tomography (CBCT) to 4DCT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, P; Tsai, Y; Nien, H

2015-06-15

Purpose: Four dimensional computed tomography (4DCT) scans reliably record whole respiratory phase and generate internal target volumes (ITV) for radiotherapy planning. However, image guiding with cone-beam computed tomography (CBCT) cannot acquire all or specific respiratory phases. This study was designed to investigate the correlation between average CT and Maximum Intensity Projection (MIP) from 4DCT and CBCT. Methods: Retrospective respiratory gating were performed by GE Discovery CT590 RT. 4DCT and CBCT data from CRIS Dynamic Thorax Phantom with simulated breathing mode were analyzed. The lung tissue equivalent material encompassed 3 cm sphere tissue equivalent material. Simulated breathing cycle period was setmore » as 4 seconds, 5 seconds and 6 seconds for representing variation of patient breathing cycle time, and the sphere material moved toward inferior and superior direction with 1 cm amplitude simulating lung tumor motion during respiration. Results: Under lung window, the volume ratio of CBCT scans to ITVs derived from 10 phases average scans was 1.00 ± 0.02, and 1.03 ± 0.03 for ratio of CBCT scans to MIP scans. Under abdomen window, the ratio of CBCT scans to ITVs derived from 10 phases average scans was 0.39 ± 0.06, and 0.06 ± 0.00 for ratio of CBCT scans to MIP scans. There was a significant difference between lung window Result and abdomen window Result. For reducing image guiding uncertainty, CBCT window was set with width 500 and level-250. The ratio of CBCT scans to ITVs derived from 4 phases average scans with abdomen window was 1.19 ± 0.02, and 1.06 ± 0.01 for ratio of CBCT to MIP scans. Conclusion: CBCT images with suitable window width and level can efficiently reduce image guiding uncertainty for patient with mobile tumor. By our setting, we can match motion tumor to gating tumor location on planning CT more accurately neglecting other motion artifacts during CBCT scans.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

MacFarlane, Michael; Battista, Jerry; Chen, Jeff

Purpose: To develop a radiotherapy dose tracking and plan evaluation technique using cone-beam computed tomography (CBCT) images. Methods: We developed a patient-specific method of calibrating CBCT image sets for dose calculation. The planning CT was first registered with the CBCT using deformable image registration (DIR). A scatter plot was generated between the CT numbers of the planning CT and CBCT for each slice. The CBCT calibration curve was obtained by least-square fitting of the data, and applied to each CBCT slice. The calibrated CBCT was then merged with original planning CT to extend the small field of view of CBCT.more » Finally, the treatment plan was copied to the merged CT for dose tracking and plan evaluation. The proposed patient-specific calibration method was also compared to two methods proposed in literature. To evaluate the accuracy of each technique, 15 head-and-neck patients requiring plan adaptation were arbitrarily selected from our institution. The original plan was calculated on each method’s data set, including a second planning CT acquired within 48 hours of the CBCT (serving as gold standard). Clinically relevant dose metrics and 3D gamma analysis of dose distributions were compared between the different techniques. Results: Compared to the gold standard of using planning CTs, the patient-specific CBCT calibration method was shown to provide promising results with gamma pass rates above 95% and average dose metric agreement within 2.5%. Conclusions: The patient-specific CBCT calibration method could potentially be used for on-line dose tracking and plan evaluation, without requiring a re-planning CT session.« less

Influence of cone-beam computed tomography image artifacts on the determination of dental arch measurements.

PubMed

Gamba, Thiago O; Oliveira, Matheus L; Flores, Isadora L; Cruz, Adriana D; Almeida, Solange M; Haiter-Neto, Francisco; Lopes, Sérgio L P C

2014-03-01

To compare dental plaster model (DPM) and cone-beam computed tomography (CBCT) in the measurement of the dental arches, and investigate whether CBCT image artifacts compromise the reliability of such measurements. Twenty patients were divided into two groups based on the presence or absence of metallic restorations in the posterior teeth. Both dental arches of the patients were scanned with the CBCT unit i-CAT, and DPMs were obtained. Two examiners obtained eight arch measurements on the CBCT images and DPMs and repeated this procedure 15 days later. The arch measurements of each patient group were compared separately by the Wilcoxon rank sum (Mann-Whitney U) test, with a significance level of 5% (α  =  .05). Intraclass correlation measured the level of intraobserver agreement. Patients with healthy teeth showed no significant difference between all DPM and CBCT arch measurements (P > .05). Patients with metallic restoration showed significant difference between DPM and CBCT for the majority of the arch measurements (P > .05). The two examiners showed excellent intraobserver agreement for both measuring methods with intraclass correlation coefficient higher than 0.95. CBCT provided the same accuracy as DPM in the measurement of the dental arches, and was negatively influenced by the presence of image artifacts.

CT to Cone-beam CT Deformable Registration With Simultaneous Intensity Correction

PubMed Central

Zhen, Xin; Gu, Xuejun; Yan, Hao; Zhou, Linghong; Jia, Xun; Jiang, Steve B.

2012-01-01

Computed tomography (CT) to cone-beam computed tomography (CBCT) deformable image registration (DIR) is a crucial step in adaptive radiation therapy. Current intensity-based registration algorithms, such as demons, may fail in the context of CT-CBCT DIR because of inconsistent intensities between the two modalities. In this paper, we propose a variant of demons, called Deformation with Intensity Simultaneously Corrected (DISC), to deal with CT-CBCT DIR. DISC distinguishes itself from the original demons algorithm by performing an adaptive intensity correction step on the CBCT image at every iteration step of the demons registration. Specifically, the intensity correction of a voxel in CBCT is achieved by matching the first and the second moments of the voxel intensities inside a patch around the voxel with those on the CT image. It is expected that such a strategy can remove artifacts in the CBCT image, as well as ensuring the intensity consistency between the two modalities. DISC is implemented on computer graphics processing units (GPUs) in compute unified device architecture (CUDA) programming environment. The performance of DISC is evaluated on a simulated patient case and six clinical head-and-neck cancer patient data. It is found that DISC is robust against the CBCT artifacts and intensity inconsistency and significantly improves the registration accuracy when compared with the original demons. PMID:23032638

Impact of voxel size variation on CBCT-based diagnostic outcome in dentistry: a systematic review.

PubMed

Spin-Neto, Rubens; Gotfredsen, Erik; Wenzel, Ann

2013-08-01

The objective of this study was to make a systematic review on the impact of voxel size in cone beam computed tomography (CBCT)-based image acquisition, retrieving evidence regarding the diagnostic outcome of those images. The MEDLINE bibliographic database was searched from 1950 to June 2012 for reports comparing diverse CBCT voxel sizes. The search strategy was limited to English-language publications using the following combined terms in the search strategy: (voxel or FOV or field of view or resolution) and (CBCT or cone beam CT). The results from the review identified 20 publications that qualitatively or quantitatively assessed the influence of voxel size on CBCT-based diagnostic outcome, and in which the methodology/results comprised at least one of the expected parameters (image acquisition, reconstruction protocols, type of diagnostic task, and presence of a gold standard). The diagnostic task assessed in the studies was diverse, including the detection of root fractures, the detection of caries lesions, and accuracy of 3D surface reconstruction and of bony measurements, among others. From the studies assessed, it is clear that no general protocol can be yet defined for CBCT examination of specific diagnostic tasks in dentistry. Rationale in this direction is an important step to define the utility of CBCT imaging.

Radiographic signs of pathology determining removal of an impacted mandibular third molar assessed in a panoramic image or CBCT

PubMed Central

Schropp, Lars; Spin-Neto, Rubens; Wenzel, Ann

2017-01-01

Objectives: To (1) compare pathological findings related to the mandibular third molar in panoramic images (PAN) and CBCT; (2) estimate the frequency of removals if pathological findings were indicative; and (3) assess factors in PAN associated with resorption and marginal bone loss at the second molar as observed in CBCT. Methods: 379 mandibular third molars were examined with PAN and CBCT. Four observers registered resorption and marginal bone loss at the second molar and increased periodontal space at the third molar in both imaging modalities. Agreement between PAN and CBCT, frequency of removals based on pathological findings in either of the two modalities and interobserver reproducibility was calculated. Logistic regression analyses assessed factors in PAN, which could predict marginal bone loss and resorption observed in CBCT. Results: Agreement between PAN and CBCT: resorption 54–74%; marginal bone loss 66–85%; and increased periodontal space 92–97%. Removals based on CBCT and PAN: 58–71% and 36–65%. Interobserver percentage accordance and kappa values ranged from 57 to 98% and 0.10–0.91 for PAN and 61–97% and 0.22–0.78 for CBCT, respectively. Mesioangulated/horizontally positioned third molars were associated with marginal bone loss [odds ratio (OR) = 7.0–31.3; p < 0.001] and resorption (OR = 2.9–35.6; p < 0.001) in CBCT. Overprojection between the third and the second molars in PAN predicted resorption observed in CBCT (OR = 5.6–21.2; p < 0.001). Conclusions: Pathology associated with the third molar is more often observed in CBCT than in PAN. More third molars would be removed if pathological findings are based on CBCT. Mesioangulated/horizontally positioned third molars overprojecting the cervical/root part of the second molar in PAN are strongly associated with pathology observed in CBCT. PMID:27681861

Radiographic signs of pathology determining removal of an impacted mandibular third molar assessed in a panoramic image or CBCT.

PubMed

Matzen, Louise H; Schropp, Lars; Spin-Neto, Rubens; Wenzel, Ann

2017-01-01

To (1) compare pathological findings related to the mandibular third molar in panoramic images (PAN) and CBCT; (2) estimate the frequency of removals if pathological findings were indicative; and (3) assess factors in PAN associated with resorption and marginal bone loss at the second molar as observed in CBCT. 379 mandibular third molars were examined with PAN and CBCT. Four observers registered resorption and marginal bone loss at the second molar and increased periodontal space at the third molar in both imaging modalities. Agreement between PAN and CBCT, frequency of removals based on pathological findings in either of the two modalities and interobserver reproducibility was calculated. Logistic regression analyses assessed factors in PAN, which could predict marginal bone loss and resorption observed in CBCT. Agreement between PAN and CBCT: resorption 54-74%; marginal bone loss 66-85%; and increased periodontal space 92-97%. Removals based on CBCT and PAN: 58-71% and 36-65%. Interobserver percentage accordance and kappa values ranged from 57 to 98% and 0.10-0.91 for PAN and 61-97% and 0.22-0.78 for CBCT, respectively. Mesioangulated/horizontally positioned third molars were associated with marginal bone loss [odds ratio (OR) = 7.0-31.3; p < 0.001] and resorption (OR = 2.9-35.6; p < 0.001) in CBCT. Overprojection between the third and the second molars in PAN predicted resorption observed in CBCT (OR = 5.6-21.2; p < 0.001). Pathology associated with the third molar is more often observed in CBCT than in PAN. More third molars would be removed if pathological findings are based on CBCT. Mesioangulated/horizontally positioned third molars overprojecting the cervical/root part of the second molar in PAN are strongly associated with pathology observed in CBCT.

Deformable planning CT to cone-beam CT image registration in head-and-neck cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hou Jidong; Guerrero, Mariana; Chen, Wenjuan

2011-04-15

Purpose: The purpose of this work was to implement and validate a deformable CT to cone-beam computed tomography (CBCT) image registration method in head-and-neck cancer to eventually facilitate automatic target delineation on CBCT. Methods: Twelve head-and-neck cancer patients underwent a planning CT and weekly CBCT during the 5-7 week treatment period. The 12 planning CT images (moving images) of these patients were registered to their weekly CBCT images (fixed images) via the symmetric force Demons algorithm and using a multiresolution scheme. Histogram matching was used to compensate for the intensity difference between the two types of images. Using nine knownmore » anatomic points as registration targets, the accuracy of the registration was evaluated using the target registration error (TRE). In addition, region-of-interest (ROI) contours drawn on the planning CT were morphed to the CBCT images and the volume overlap index (VOI) between registered contours and manually delineated contours was evaluated. Results: The mean TRE value of the nine target points was less than 3.0 mm, the slice thickness of the planning CT. Of the 369 target points evaluated for registration accuracy, the average TRE value was 2.6{+-}0.6 mm. The mean TRE for bony tissue targets was 2.4{+-}0.2 mm, while the mean TRE for soft tissue targets was 2.8{+-}0.2 mm. The average VOI between the registered and manually delineated ROI contours was 76.2{+-}4.6%, which is consistent with that reported in previous studies. Conclusions: The authors have implemented and validated a deformable image registration method to register planning CT images to weekly CBCT images in head-and-neck cancer cases. The accuracy of the TRE values suggests that they can be used as a promising tool for automatic target delineation on CBCT.« less

SU-E-I-06: Measurement of Skin Dose from Dental Cone-Beam CT Scans.

PubMed

Akyalcin, S; English, J; Abramovitch, K; Rong, J

2012-06-01

To directly measure skin dose using point-dosimeters from dental cone-beam CT (CBCT) scans. To compare the results among three different dental CBCT scanners and compare the CBCT results with those from a conventional panoramic and cephalomic dental imaging system. A head anthropomorphic phantom was used with nanoDOT dosimeters attached to specified anatomic landmarks of selected radiosensitive tissues of interest. To ensure reliable measurement results, three dosimeters were used for each location. The phantom was scanned under various modes of operation and scan protocols for typical dental exams on three dental CBCT systems plus a conventional dental imaging system. The Landauer OSL nanoDOT dosimeters were calibrated under the same imaging condition as the head phantom scan protocols, and specifically for each of the imaging systems. Using nanoDOT dosimeters, skin doses at several positions on the surface of an adult head anthropomorphic phantom were measured for clinical dental imaging. The measured skin doses ranged from 0.04 to 4.62mGy depending on dosimeter positions and imaging systems. The highest dose location was at the parotid surface for all three CBCT scanners. The surface doses to the locations of the eyes were ∼4.0mGy, well below the 500mGy threshold for possibly causing cataract development. The results depend on x-ray tube output (kVp and mAs) and also are sensitive to SFOV. Comparing to the conventional dental imaging system operated in panoramic and cephalometric modes, doses from all three CBCT systems were at least an order of magnitude higher. No image artifact was caused by presence of nanoDOT dosimeters in the head phantom images. Direct measurements of skin dose using nanoDOT dosimeters provided accurate skin dose values without any image artifacts. The results of skin dose measurements serve as dose references in guiding future dose optimization efforts in dental CBCT imaging. © 2012 American Association of Physicists in Medicine.

MO-FG-CAMPUS-JeP1-05: Water Equivalent Path Length Calculations Using Scatter-Corrected Head and Neck CBCT Images to Evaluate Patients for Adaptive Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, J; Park, Y; Sharp, G

Purpose: To establish a method to evaluate the dosimetric impact of anatomic changes in head and neck patients during proton therapy by using scatter-corrected cone-beam CT (CBCT) images. Methods: The water equivalent path length (WEPL) was calculated to the distal edge of PTV contours by using tomographic images available for six head and neck patients received photon therapy. The proton range variation was measured by calculating the difference between the distal WEPLs calculated with the planning CT and weekly treatment CBCT images. By performing an automatic rigid registration, six degrees-of-freedom (DOF) correction was made to the CBCT images to accountmore » for the patient setup uncertainty. For accurate WEPL calculations, an existing CBCT scatter correction algorithm, whose performance was already proven for phantom images, was calibrated for head and neck patient images. Specifically, two different image similarity measures, mutual information (MI) and mean square error (MSE), were tested for the deformable image registration (DIR) in the CBCT scatter correction algorithm. Results: The impact of weight loss was reflected in the distal WEPL differences with the aid of the automatic rigid registration reducing the influence of patient setup uncertainty on the WEPL calculation results. The WEPL difference averaged over distal area was 2.9 ± 2.9 (mm) across all fractions of six patients and its maximum, mostly found at the last available fraction, was 6.2 ± 3.4 (mm). The MSE-based DIR successfully registered each treatment CBCT image to the planning CT image. On the other hand, the MI-based DIR deformed the skin voxels in the planning CT image to the immobilization mask in the treatment CBCT image, most of which was cropped out of the planning CT image. Conclusion: The dosimetric impact of anatomic changes was evaluated by calculating the distal WEPL difference with the existing scatter-correction algorithm appropriately calibrated. Jihun Kim, Yang-Kyun Park, Gregory Sharp, and Brian Winey have received grant support from the NCI Federal Share of program income earned by Massachusetts General Hospital on C06 CA059267, Proton Therapy Research and Treatment Center.« less

Demons deformable registration of CT and cone-beam CT using an iterative intensity matching approach.

PubMed

Nithiananthan, Sajendra; Schafer, Sebastian; Uneri, Ali; Mirota, Daniel J; Stayman, J Webster; Zbijewski, Wojciech; Brock, Kristy K; Daly, Michael J; Chan, Harley; Irish, Jonathan C; Siewerdsen, Jeffrey H

2011-04-01

A method of intensity-based deformable registration of CT and cone-beam CT (CBCT) images is described, in which intensity correction occurs simultaneously within the iterative registration process. The method preserves the speed and simplicity of the popular Demons algorithm while providing robustness and accuracy in the presence of large mismatch between CT and CBCT voxel values ("intensity"). A variant of the Demons algorithm was developed in which an estimate of the relationship between CT and CBCT intensity values for specific materials in the image is computed at each iteration based on the set of currently overlapping voxels. This tissue-specific intensity correction is then used to estimate the registration output for that iteration and the process is repeated. The robustness of the method was tested in CBCT images of a cadaveric head exhibiting a broad range of simulated intensity variations associated with x-ray scatter, object truncation, and/or errors in the reconstruction algorithm. The accuracy of CT-CBCT registration was also measured in six real cases, exhibiting deformations ranging from simple to complex during surgery or radiotherapy guided by a CBCT-capable C-arm or linear accelerator, respectively. The iterative intensity matching approach was robust against all levels of intensity variation examined, including spatially varying errors in voxel value of a factor of 2 or more, as can be encountered in cases of high x-ray scatter. Registration accuracy without intensity matching degraded severely with increasing magnitude of intensity error and introduced image distortion. A single histogram match performed prior to registration alleviated some of these effects but was also prone to image distortion and was quantifiably less robust and accurate than the iterative approach. Within the six case registration accuracy study, iterative intensity matching Demons reduced mean TRE to (2.5 +/- 2.8) mm compared to (3.5 +/- 3.0) mm with rigid registration. A method was developed to iteratively correct CT-CBCT intensity disparity during Demons registration, enabling fast, intensity-based registration in CBCT-guided procedures such as surgery and radiotherapy, in which CBCT voxel values may be inaccurate. Accurate CT-CBCT registration in turn facilitates registration of multimodality preoperative image and planning data to intraoperative CBCT by way of the preoperative CT, thereby linking the intraoperative frame of reference to a wealth of preoperative information that could improve interventional guidance.

SU-E-J-246: A Deformation-Field Map Based Liver 4D CBCT Reconstruction Method Using Gold Nanoparticles as Constraints

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harris, W; Zhang, Y; Ren, L

2014-06-01

Purpose: To investigate the feasibility of using nanoparticle markers to validate liver tumor motion together with a deformation field map-based four dimensional (4D) cone-beam computed tomography (CBCT) reconstruction method. Methods: A technique for lung 4D-CBCT reconstruction has been previously developed using a deformation field map (DFM)-based strategy. In this method, each phase of the 4D-CBCT is considered as a deformation of a prior CT volume. The DFM is solved by a motion modeling and free-form deformation (MM-FD) technique, using a data fidelity constraint and the deformation energy minimization. For liver imaging, there is low contrast of a liver tumor inmore » on-board projections. A validation of liver tumor motion using implanted gold nanoparticles, along with the MM-FD deformation technique is implemented to reconstruct onboard 4D CBCT liver radiotherapy images. These nanoparticles were placed around the liver tumor to reflect the tumor positions in both CT simulation and on-board image acquisition. When reconstructing each phase of the 4D-CBCT, the migrations of the gold nanoparticles act as a constraint to regularize the deformation field, along with the data fidelity and the energy minimization constraints. In this study, multiple tumor diameters and positions were simulated within the liver for on-board 4D-CBCT imaging. The on-board 4D-CBCT reconstructed by the proposed method was compared with the “ground truth” image. Results: The preliminary data, which uses reconstruction for lung radiotherapy suggests that the advanced reconstruction algorithm including the gold nanoparticle constraint will Resultin volume percentage differences (VPD) between lesions in reconstructed images by MM-FD and “ground truth” on-board images of 11.5% (± 9.4%) and a center of mass shift of 1.3 mm (± 1.3 mm) for liver radiotherapy. Conclusion: The advanced MM-FD technique enforcing the additional constraints from gold nanoparticles, results in improved accuracy for reconstructing on-board 4D-CBCT of liver tumor. Varian medical systems research grant.« less

Simultaneous calibration phantom commission and geometry calibration in cone beam CT

NASA Astrophysics Data System (ADS)

Xu, Yuan; Yang, Shuai; Ma, Jianhui; Li, Bin; Wu, Shuyu; Qi, Hongliang; Zhou, Linghong

2017-09-01

Geometry calibration is a vital step for describing the geometry of a cone beam computed tomography (CBCT) system and is a prerequisite for CBCT reconstruction. In current methods, calibration phantom commission and geometry calibration are divided into two independent tasks. Small errors in ball-bearing (BB) positioning in the phantom-making step will severely degrade the quality of phantom calibration. To solve this problem, we propose an integrated method to simultaneously realize geometry phantom commission and geometry calibration. Instead of assuming the accuracy of the geometry phantom, the integrated method considers BB centers in the phantom as an optimized parameter in the workflow. Specifically, an evaluation phantom and the corresponding evaluation contrast index are used to evaluate geometry artifacts for optimizing the BB coordinates in the geometry phantom. After utilizing particle swarm optimization, the CBCT geometry and BB coordinates in the geometry phantom are calibrated accurately and are then directly used for the next geometry calibration task in other CBCT systems. To evaluate the proposed method, both qualitative and quantitative studies were performed on simulated and realistic CBCT data. The spatial resolution of reconstructed images using dental CBCT can reach up to 15 line pair cm-1. The proposed method is also superior to the Wiesent method in experiments. This paper shows that the proposed method is attractive for simultaneous and accurate geometry phantom commission and geometry calibration.

Clinical implementation of intraoperative cone-beam CT in head and neck surgery

NASA Astrophysics Data System (ADS)

Daly, M. J.; Chan, H.; Nithiananthan, S.; Qiu, J.; Barker, E.; Bachar, G.; Dixon, B. J.; Irish, J. C.; Siewerdsen, J. H.

2011-03-01

A prototype mobile C-arm for cone-beam CT (CBCT) has been translated to a prospective clinical trial in head and neck surgery. The flat-panel CBCT C-arm was developed in collaboration with Siemens Healthcare, and demonstrates both sub-mm spatial resolution and soft-tissue visibility at low radiation dose (e.g., <1/5th of a typical diagnostic head CT). CBCT images are available ~15 seconds after scan completion (~1 min acquisition) and reviewed at bedside using custom 3D visualization software based on the open-source Image-Guided Surgery Toolkit (IGSTK). The CBCT C-arm has been successfully deployed in 15 head and neck cases and streamlined into the surgical environment using human factors engineering methods and expert feedback from surgeons, nurses, and anesthetists. Intraoperative imaging is implemented in a manner that maintains operating field sterility, reduces image artifacts (e.g., carbon fiber OR table) and minimizes radiation exposure. Image reviews conducted with surgical staff indicate bony detail and soft-tissue visualization sufficient for intraoperative guidance, with additional artifact management (e.g., metal, scatter) promising further improvements. Clinical trial deployment suggests a role for intraoperative CBCT in guiding complex head and neck surgical tasks, including planning mandible and maxilla resection margins, guiding subcranial and endonasal approaches to skull base tumours, and verifying maxillofacial reconstruction alignment. Ongoing translational research into complimentary image-guidance subsystems include novel methods for real-time tool tracking, fusion of endoscopic video and CBCT, and deformable registration of preoperative volumes and planning contours with intraoperative CBCT.

Dual source and dual detector arrays tetrahedron beam computed tomography for image guided radiotherapy.

PubMed

Kim, Joshua; Lu, Weiguo; Zhang, Tiezhi

2014-02-07

Cone-beam computed tomography (CBCT) is an important online imaging modality for image guided radiotherapy. But suboptimal image quality and the lack of a real-time stereoscopic imaging function limit its implementation in advanced treatment techniques, such as online adaptive and 4D radiotherapy. Tetrahedron beam computed tomography (TBCT) is a novel online imaging modality designed to improve on the image quality provided by CBCT. TBCT geometry is flexible, and multiple detector and source arrays can be used for different applications. In this paper, we describe a novel dual source-dual detector TBCT system that is specially designed for LINAC radiation treatment machines. The imaging system is positioned in-line with the MV beam and is composed of two linear array x-ray sources mounted aside the electrical portal imaging device and two linear arrays of x-ray detectors mounted below the machine head. The detector and x-ray source arrays are orthogonal to each other, and each pair of source and detector arrays forms a tetrahedral volume. Four planer images can be obtained from different view angles at each gantry position at a frame rate as high as 20 frames per second. The overlapped regions provide a stereoscopic field of view of approximately 10-15 cm. With a half gantry rotation, a volumetric CT image can be reconstructed having a 45 cm field of view. Due to the scatter rejecting design of the TBCT geometry, the system can potentially produce high quality 2D and 3D images with less radiation exposure. The design of the dual source-dual detector system is described, and preliminary results of studies performed on numerical phantoms and simulated patient data are presented.

Dual source and dual detector arrays tetrahedron beam computed tomography for image guided radiotherapy

NASA Astrophysics Data System (ADS)

Kim, Joshua; Lu, Weiguo; Zhang, Tiezhi

2014-02-01

Cone-beam computed tomography (CBCT) is an important online imaging modality for image guided radiotherapy. But suboptimal image quality and the lack of a real-time stereoscopic imaging function limit its implementation in advanced treatment techniques, such as online adaptive and 4D radiotherapy. Tetrahedron beam computed tomography (TBCT) is a novel online imaging modality designed to improve on the image quality provided by CBCT. TBCT geometry is flexible, and multiple detector and source arrays can be used for different applications. In this paper, we describe a novel dual source-dual detector TBCT system that is specially designed for LINAC radiation treatment machines. The imaging system is positioned in-line with the MV beam and is composed of two linear array x-ray sources mounted aside the electrical portal imaging device and two linear arrays of x-ray detectors mounted below the machine head. The detector and x-ray source arrays are orthogonal to each other, and each pair of source and detector arrays forms a tetrahedral volume. Four planer images can be obtained from different view angles at each gantry position at a frame rate as high as 20 frames per second. The overlapped regions provide a stereoscopic field of view of approximately 10-15 cm. With a half gantry rotation, a volumetric CT image can be reconstructed having a 45 cm field of view. Due to the scatter rejecting design of the TBCT geometry, the system can potentially produce high quality 2D and 3D images with less radiation exposure. The design of the dual source-dual detector system is described, and preliminary results of studies performed on numerical phantoms and simulated patient data are presented.

Accuracy and reliability of stitched cone-beam computed tomography images

PubMed Central

Egbert, Nicholas; Cagna, David R.; Wicks, Russell A.

2015-01-01

Purpose This study was performed to evaluate the linear distance accuracy and reliability of stitched small field of view (FOV) cone-beam computed tomography (CBCT) reconstructed images for the fabrication of implant surgical guides. Materials and Methods Three gutta percha points were fixed on the inferior border of a cadaveric mandible to serve as control reference points. Ten additional gutta percha points, representing fiduciary markers, were scattered on the buccal and lingual cortices at the level of the proposed complete denture flange. A digital caliper was used to measure the distance between the reference points and fiduciary markers, which represented the anatomic linear dimension. The mandible was scanned using small FOV CBCT, and the images were then reconstructed and stitched using the manufacturer's imaging software. The same measurements were then taken with the CBCT software. Results The anatomic linear dimension measurements and stitched small FOV CBCT measurements were statistically evaluated for linear accuracy. The mean difference between the anatomic linear dimension measurements and the stitched small FOV CBCT measurements was found to be 0.34 mm with a 95% confidence interval of +0.24 - +0.44 mm and a mean standard deviation of 0.30 mm. The difference between the control and the stitched small FOV CBCT measurements was insignificant within the parameters defined by this study. Conclusion The proven accuracy of stitched small FOV CBCT data sets may allow image-guided fabrication of implant surgical stents from such data sets. PMID:25793182

SU-F-P-32: A Phantom Study of Accuracy of Four-Dimensional Cone-Beam CT (4D-CBCT) Vs. Three-Dimensional Cone Beam CT (3D-CBCT) in Image Guided Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

He, R; Morris, B; Duggar, N

2016-06-15

Purpose: SymmetryTM 4D IGRT system of Elekta has been installed at our institution, which offers the 4D CBCT registration option. This study is to evaluate the accuracy of 4D CBCT system by using the CIRS 4D motion phantom and to perform a feasibility study on the implementation of 4D-CBCT as image guidance for SBRT treatment. Methods: The 3D and 4D CT image data sets are acquired using the CIRS motion phantom on a Philips large bore CT simulator. The motion was set as 0.5 cm superior and inferior directions with 6 seconds recycle time. The 4D CT data were sortedmore » as 10 phases. One identifiable part of the 4D CT QA insert from CIRS phantom was used as the target. The ITV MIP was drawn based on maximum intensity projection (MIP) and transferred as a planning structure into 4D CBCT system. Then the 3D CBCT and 4D CBCT images were taken and registered with the free breath (3D), MIP (4D) and average intensity projection (AIP)(4D) reference data sets. The couch shifts (X, Y, Z) are recorded and compared. Results: Table 1 listed the twelve couch shifts based on the registration of MIP, AIP and free breath CT data sets with 3D CBCT and 4D CBCT for both whole body and local registration. X, Y and Z represent couch shifts in the direction of the right-left, superior-inferior and anterior-posterior. The biggest differences of 0.73 cm and 0.57 cm are noted in the free breath CT data with 4D CBCT and 3D CBCT data registration. Fig. 1 and Fig. 2 are the shift analysis in diagram. Fig. 3 shows the registration. Conclusion: Significant differences exist in the shifts corresponding with the direction of target motion. Further investigations are ongoing.« less

SU-F-J-48: Effect of Scan Length On Magnitude of Imaging Dose in KV CBCT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deshpande, S; Naidu, S; Sutar, A

Purpose: To study effect of scan length on magnitude of imaging dose deposition in Varian kV CBCT for head & neck and pelvis CBCT. Methods: To study effect of scan length we measured imaging dose at depth of 8 cm for head and neck Cone Beam Computed Tomography (CBCT) acquisition ( X ray beam energy is used 100kV and 200 degree of gantry rotation) and at 16 cm depth for pelvis CBCT acquisition ( X ray beam energy used is 125 kV and 360 degree of gantry rotation) in specially designed phantom. We used farmer chamber which was calibrated inmore » kV X ray range for measurements .Dose was measured with default field size, and reducing field size along y direction to 10 cm and 5 cm. Results: As the energy of the beam decreases the scattered radiation increases and this contributes significantly to the dose deposited in the patient. By reducing the scan length to 10 Cm from default 20.6 cm we found a dose reduction of 14% for head and neck CBCT protocol and a reduction of 26% for pelvis CBCT protocol. Similarly for a scan length of 5cm compared to default the dose reduction in head and neck CBCT protocol is 36% while in the pelvis CBCT protocol the dose reduction is 50%. Conclusion: By limiting the scan length we can control the scatter radiation generated and hence the dose to the patient. However the variation in dose reduction for same length used in two protocols is because of the scan geometry. The pelvis CBCT protocol uses a full rotation and head and neck CBCT protocol uses partial rotation.« less

A Comparative Evaluation of Mixed Dentition Analysis on Reliability of Cone Beam Computed Tomography Image Compared to Plaster Model

PubMed Central

Gowd, Snigdha; Shankar, T; Dash, Samarendra; Sahoo, Nivedita; Chatterjee, Suravi; Mohanty, Pritam

2017-01-01

Aims and Objective: The aim of the study was to evaluate the reliability of cone beam computed tomography (CBCT) obtained image over plaster model for the assessment of mixed dentition analysis. Materials and Methods: Thirty CBCT-derived images and thirty plaster models were derived from the dental archives, and Moyer's and Tanaka-Johnston analyses were performed. The data obtained were interpreted and analyzed statistically using SPSS 10.0/PC (SPSS Inc., Chicago, IL, USA). Descriptive and analytical analysis along with Student's t-test was performed to qualitatively evaluate the data and P < 0.05 was considered statistically significant. Results: Statistically, significant results were obtained on data comparison between CBCT-derived images and plaster model; the mean for Moyer's analysis in the left and right lower arch for CBCT and plaster model was 21.2 mm, 21.1 mm and 22.5 mm, 22.5 mm, respectively. Conclusion: CBCT-derived images were less reliable as compared to data obtained directly from plaster model for mixed dentition analysis. PMID:28852639

SU-E-P-41: Imaging Coordination of Cone Beam CT, On-Board Image Conjunction with Optical Image Guidance for SBRT Treatment with Respiratory Motion Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Y; Campbell, J

2015-06-15

Purpose: To spare normal tissue for SBRT lung/liver patients, especially for patients with significant tumor motion, image guided respiratory motion management has been widely implemented in clinical practice. The purpose of this study was to evaluate imaging coordination of cone beam CT, on-board X-ray image conjunction with optical image guidance for SBRT treatment with motion management. Methods: Currently in our clinic a Varian Novlis Tx was utilized for treating SBRT patients implementing CBCT. A BrainLAB X-ray ExacTrac imaging system in conjunction with optical guidance was primarily used for SRS patients. CBCT and X-ray imaging system were independently calibrated with 1.0more » mm tolerance. For SBRT lung/liver patients, the magnitude of tumor motion was measured based-on 4DCT and the measurement was analyzed to determine if patients would be beneficial with respiratory motion management. For patients eligible for motion management, an additional CT with breath holding would be scanned and used as primary planning CT and as reference images for Cone beam CT. During the SBRT treatment, a CBCT with pause and continuing technology would be performed with patients holding breath, which may require 3–4 partially scanned CBCT to combine as a whole CBCT depending on how long patients capable of holding breath. After patients being setup by CBCT images, the ExactTrac X-ray imaging system was implemented with patients’ on-board X-ray images compared to breath holding CT-based DRR. Results: For breath holding patients SBRT treatment, after initially localizing patients with CBCT, we then position patients with ExacTrac X-ray and optical imaging system. The observed deviations of real-time optical guided position average at 3.0, 2.5 and 1.5 mm in longitudinal, vertical and lateral respectively based on 35 treatments. Conclusion: The respiratory motion management clinical practice improved our physician confidence level to give tighter tumor margin for sparing normal tissue for SBRT lung/liver patients.« less

Evaluation of On-Board kV Cone Beam Computed Tomography–Based Dose Calculation With Deformable Image Registration Using Hounsfield Unit Modifications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Onozato, Yusuke; Kadoya, Noriyuki, E-mail: kadoya.n@rad.med.tohoku.ac.jp; Fujita, Yukio

2014-06-01

Purpose: The purpose of this study was to estimate the accuracy of the dose calculation of On-Board Imager (Varian, Palo Alto, CA) cone beam computed tomography (CBCT) with deformable image registration (DIR), using the multilevel-threshold (MLT) algorithm and histogram matching (HM) algorithm in pelvic radiation therapy. Methods and Materials: One pelvis phantom and 10 patients with prostate cancer treated with intensity modulated radiation therapy were studied. To minimize the effect of organ deformation and different Hounsfield unit values between planning CT (PCT) and CBCT, we modified CBCT (mCBCT) with DIR by using the MLT (mCBCT{sub MLT}) and HM (mCBCT{sub HM})more » algorithms. To evaluate the accuracy of the dose calculation, we compared dose differences in dosimetric parameters (mean dose [D{sub mean}], minimum dose [D{sub min}], and maximum dose [D{sub max}]) for planning target volume, rectum, and bladder between PCT (reference) and CBCTs or mCBCTs. Furthermore, we investigated the effect of organ deformation compared with DIR and rigid registration (RR). We determined whether dose differences between PCT and mCBCTs were significantly lower than in CBCT by using Student t test. Results: For patients, the average dose differences in all dosimetric parameters of CBCT with DIR were smaller than those of CBCT with RR (eg, rectum; 0.54% for DIR vs 1.24% for RR). For the mCBCTs with DIR, the average dose differences in all dosimetric parameters were less than 1.0%. Conclusions: We evaluated the accuracy of the dose calculation in CBCT, mCBCT{sub MLT}, and mCBCT{sub HM} with DIR for 10 patients. The results showed that dose differences in D{sub mean}, D{sub min}, and D{sub max} in mCBCTs were within 1%, which were significantly better than those in CBCT, especially for the rectum (P<.05). Our results indicate that the mCBCT{sub MLT} and mCBCT{sub HM} can be useful for improving the dose calculation for adaptive radiation therapy.« less

Validation of CBCT for the computation of textural biomarkers

NASA Astrophysics Data System (ADS)

Paniagua, Beatriz; Ruellas, Antonio C.; Benavides, Erika; Marron, Steve; Wolford, Larry; Cevidanes, Lucia

2015-03-01

Osteoarthritis (OA) is associated with significant pain and 42.6% of patients with TMJ disorders present with evidence of TMJ OA. However, OA diagnosis and treatment remain controversial, since there are no clear symptoms of the disease. The subchondral bone in the TMJ is believed to play a major role in the progression of OA. We hypothesize that the textural imaging biomarkers computed in high resolution Conebeam CT (hr- CBCT) and μCT scans are comparable. The purpose of this study is to test the feasibility of computing textural imaging biomarkers in-vivo using hr-CBCT, compared to those computed in μCT scans as our Gold Standard. Specimens of condylar bones obtained from condylectomies were scanned using μCT and hr- CBCT. Nine different textural imaging biomarkers (four co-occurrence features and five run-length features) from each pair of μCT and hr-CBCT were computed and compared. Pearson correlation coefficients were computed to compare textural biomarkers values of μCT and hr-CBCT. Four of the nine computed textural biomarkers showed a strong positive correlation between biomarkers computed in μCT and hr-CBCT. Higher correlations in Energy and Contrast, and in GLN (grey-level non-uniformity) and RLN (run length non-uniformity) indicate quantitative texture features can be computed reliably in hr-CBCT, when compared with μCT. The textural imaging biomarkers computed in-vivo hr-CBCT have captured the structure, patterns, contrast between neighboring regions and uniformity of healthy and/or pathologic subchondral bone. The ability to quantify bone texture non-invasively now makes it possible to evaluate the progression of subchondral bone alterations, in TMJ OA.

Validation of CBCT for the computation of textural biomarkers

PubMed Central

Paniagua, Beatriz; Ruellas, Antonio Carlos; Benavides, Erika; Marron, Steve; Woldford, Larry; Cevidanes, Lucia

2015-01-01

Osteoarthritis (OA) is associated with significant pain and 42.6% of patients with TMJ disorders present with evidence of TMJ OA. However, OA diagnosis and treatment remain controversial, since there are no clear symptoms of the disease. The subchondral bone in the TMJ is believed to play a major role in the progression of OA. We hypothesize that the textural imaging biomarkers computed in high resolution Conebeam CT (hr-CBCT) and μCT scans are comparable. The purpose of this study is to test the feasibility of computing textural imaging biomarkers in-vivo using hr-CBCT, compared to those computed in μCT scans as our Gold Standard. Specimens of condylar bones obtained from condylectomies were scanned using μCT and hr-CBCT. Nine different textural imaging biomarkers (four co-occurrence features and five run-length features) from each pair of μCT and hr-CBCT were computed and compared. Pearson correlation coefficients were computed to compare textural biomarkers values of μCT and hr-CBCT. Four of the nine computed textural biomarkers showed a strong positive correlation between biomarkers computed in μCT and hr-CBCT. Higher correlations in Energy and Contrast, and in GLN (grey-level non-uniformity) and RLN (run length non-uniformity) indicate quantitative texture features can be computed reliably in hr-CBCT, when compared with μCT. The textural imaging biomarkers computed in-vivo hr-CBCT have captured the structure, patterns, contrast between neighboring regions and uniformity of healthy and/or pathologic subchondral bone. The ability to quantify bone texture non-invasively now makes it possible to evaluate the progression of subchondral bone alterations, in TMJ OA. PMID:26085710

Validation of CBCT for the computation of textural biomarkers.

PubMed

Paniagua, Beatriz; Ruellas, Antonio Carlos; Benavides, Erika; Marron, Steve; Woldford, Larry; Cevidanes, Lucia

2015-03-17

Osteoarthritis (OA) is associated with significant pain and 42.6% of patients with TMJ disorders present with evidence of TMJ OA. However, OA diagnosis and treatment remain controversial, since there are no clear symptoms of the disease. The subchondral bone in the TMJ is believed to play a major role in the progression of OA. We hypothesize that the textural imaging biomarkers computed in high resolution Conebeam CT (hr-CBCT) and μCT scans are comparable. The purpose of this study is to test the feasibility of computing textural imaging biomarkers in-vivo using hr-CBCT, compared to those computed in μCT scans as our Gold Standard. Specimens of condylar bones obtained from condylectomies were scanned using μCT and hr-CBCT. Nine different textural imaging biomarkers (four co-occurrence features and five run-length features) from each pair of μCT and hr-CBCT were computed and compared. Pearson correlation coefficients were computed to compare textural biomarkers values of μCT and hr-CBCT. Four of the nine computed textural biomarkers showed a strong positive correlation between biomarkers computed in μCT and hr-CBCT. Higher correlations in Energy and Contrast, and in GLN (grey-level non-uniformity) and RLN (run length non-uniformity) indicate quantitative texture features can be computed reliably in hr-CBCT, when compared with μCT. The textural imaging biomarkers computed in-vivo hr-CBCT have captured the structure, patterns, contrast between neighboring regions and uniformity of healthy and/or pathologic subchondral bone. The ability to quantify bone texture non-invasively now makes it possible to evaluate the progression of subchondral bone alterations, in TMJ OA.

SU-E-J-145: Geometric Uncertainty in CBCT Extrapolation for Head and Neck Adaptive Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, C; Kumarasiri, A; Chetvertkov, M

2014-06-01

Purpose: One primary limitation of using CBCT images for H'N adaptive radiotherapy (ART) is the limited field of view (FOV) range. We propose a method to extrapolate the CBCT by using a deformed planning CT for the dose of the day calculations. The aim was to estimate the geometric uncertainty of our extrapolation method. Methods: Ten H'N patients, each with a planning CT (CT1) and a subsequent CT (CT2) taken, were selected. Furthermore, a small FOV CBCT (CT2short) was synthetically created by cropping CT2 to the size of a CBCT image. Then, an extrapolated CBCT (CBCTextrp) was generated by deformablymore » registering CT1 to CT2short and resampling with a wider FOV (42mm more from the CT2short borders), where CT1 is deformed through translation, rigid, affine, and b-spline transformations in order. The geometric error is measured as the distance map ||DVF|| produced by a deformable registration between CBCTextrp and CT2. Mean errors were calculated as a function of the distance away from the CBCT borders. The quality of all the registrations was visually verified. Results: Results were collected based on the average numbers from 10 patients. The extrapolation error increased linearly as a function of the distance (at a rate of 0.7mm per 1 cm) away from the CBCT borders in the S/I direction. The errors (μ±σ) at the superior and inferior boarders were 0.8 ± 0.5mm and 3.0 ± 1.5mm respectively, and increased to 2.7 ± 2.2mm and 5.9 ± 1.9mm at 4.2cm away. The mean error within CBCT borders was 1.16 ± 0.54mm . The overall errors within 4.2cm error expansion were 2.0 ± 1.2mm (sup) and 4.5 ± 1.6mm (inf). Conclusion: The overall error in inf direction is larger due to more large unpredictable deformations in the chest. The error introduced by extrapolation is plan dependent. The mean error in the expanded region can be large, and must be considered during implementation. This work is supported in part by Varian Medical Systems, Palo Alto, CA.« less

SU-G-BRA-11: Tumor Tracking in An Iterative Volume of Interest Based 4D CBCT Reconstruction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martin, R; Pan, T; Ahmad, M

2016-06-15

Purpose: 4D CBCT can allow evaluation of tumor motion immediately prior to radiation therapy, but suffers from heavy artifacts that limit its ability to track tumors. Various iterative and compressed sensing reconstructions have been proposed to reduce these artifacts, but are costly time-wise and can degrade the image quality of bony anatomy for alignment with regularization. We have previously proposed an iterative volume of interest (I4D VOI) method which minimizes reconstruction time and maintains image quality of bony anatomy by focusing a 4D reconstruction within a VOI. The purpose of this study is to test the tumor tracking accuracy ofmore » this method compared to existing methods. Methods: Long scan (8–10 mins) CBCT data with corresponding RPM data was collected for 12 lung cancer patients. The full data set was sorted into 8 phases and reconstructed using FDK cone beam reconstruction to serve as a gold standard. The data was reduced in way that maintains a normal breathing pattern and used to reconstruct 4D images using FDK, low and high regularization TV minimization (λ=2,10), and the proposed I4D VOI method with PTVs used for the VOI. Tumor trajectories were found using rigid registration within the VOI for each reconstruction and compared to the gold standard. Results: The root mean square error (RMSE) values were 2.70mm for FDK, 2.50mm for low regularization TV, 1.48mm for high regularization TV, and 2.34mm for I4D VOI. Streak artifacts in I4D VOI were reduced compared to FDK and images were less blurred than TV reconstructed images. Conclusion: I4D VOI performed at least as well as existing methods in tumor tracking, with the exception of high regularization TV minimization. These results along with the reconstruction time and outside VOI image quality advantages suggest I4D VOI to be an improvement over existing methods. Funding support provided by CPRIT grant RP110562-P2-01.« less

SU-F-R-33: Can CT and CBCT Be Used Simultaneously for Radiomics Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Luo, R; Wang, J; Zhong, H

2016-06-15

Purpose: To investigate whether CBCT and CT can be used in radiomics analysis simultaneously. To establish a batch correction method for radiomics in two similar image modalities. Methods: Four sites including rectum, bladder, femoral head and lung were considered as region of interest (ROI) in this study. For each site, 10 treatment planning CT images were collected. And 10 CBCT images which came from same site of same patient were acquired at first radiotherapy fraction. 253 radiomics features, which were selected by our test-retest study at rectum cancer CT (ICC>0.8), were calculated for both CBCT and CT images in MATLAB.more » Simple scaling (z-score) and nonlinear correction methods were applied to the CBCT radiomics features. The Pearson Correlation Coefficient was calculated to analyze the correlation between radiomics features of CT and CBCT images before and after correction. Cluster analysis of mixed data (for each site, 5 CT and 5 CBCT data are randomly selected) was implemented to validate the feasibility to merge radiomics data from CBCT and CT. The consistency of clustering result and site grouping was verified by a chi-square test for different datasets respectively. Results: For simple scaling, 234 of the 253 features have correlation coefficient ρ>0.8 among which 154 features haveρ>0.9 . For radiomics data after nonlinear correction, 240 of the 253 features have ρ>0.8 among which 220 features have ρ>0.9. Cluster analysis of mixed data shows that data of four sites was almost precisely separated for simple scaling(p=1.29 * 10{sup −7}, χ{sup 2} test) and nonlinear correction (p=5.98 * 10{sup −7}, χ{sup 2} test), which is similar to the cluster result of CT data (p=4.52 * 10{sup −8}, χ{sup 2} test). Conclusion: Radiomics data from CBCT can be merged with those from CT by simple scaling or nonlinear correction for radiomics analysis.« less

Cone Beam CT vs. Fan Beam CT: A Comparison of Image Quality and Dose Delivered Between Two Differing CT Imaging Modalities.

PubMed

Lechuga, Lawrence; Weidlich, Georg A

2016-09-12

A comparison of image quality and dose delivered between two differing computed tomography (CT) imaging modalities-fan beam and cone beam-was performed. A literature review of quantitative analyses for various image quality aspects such as uniformity, signal-to-noise ratio, artifact presence, spatial resolution, modulation transfer function (MTF), and low contrast resolution was generated. With these aspects quantified, cone beam computed tomography (CBCT) shows a superior spatial resolution to that of fan beam, while fan beam shows a greater ability to produce clear and anatomically correct images with better soft tissue differentiation. The results indicate that fan beam CT produces superior images to that of on-board imaging (OBI) cone beam CT systems, while providing a considerably less dose to the patient.

Cone Beam CT vs. Fan Beam CT: A Comparison of Image Quality and Dose Delivered Between Two Differing CT Imaging Modalities

PubMed Central

Weidlich, Georg A.

2016-01-01

A comparison of image quality and dose delivered between two differing computed tomography (CT) imaging modalities—fan beam and cone beam—was performed. A literature review of quantitative analyses for various image quality aspects such as uniformity, signal-to-noise ratio, artifact presence, spatial resolution, modulation transfer function (MTF), and low contrast resolution was generated. With these aspects quantified, cone beam computed tomography (CBCT) shows a superior spatial resolution to that of fan beam, while fan beam shows a greater ability to produce clear and anatomically correct images with better soft tissue differentiation. The results indicate that fan beam CT produces superior images to that of on-board imaging (OBI) cone beam CT systems, while providing a considerably less dose to the patient. PMID:27752404

Data consistency-driven scatter kernel optimization for x-ray cone-beam CT

NASA Astrophysics Data System (ADS)

Kim, Changhwan; Park, Miran; Sung, Younghun; Lee, Jaehak; Choi, Jiyoung; Cho, Seungryong

2015-08-01

Accurate and efficient scatter correction is essential for acquisition of high-quality x-ray cone-beam CT (CBCT) images for various applications. This study was conducted to demonstrate the feasibility of using the data consistency condition (DCC) as a criterion for scatter kernel optimization in scatter deconvolution methods in CBCT. As in CBCT, data consistency in the mid-plane is primarily challenged by scatter, we utilized data consistency to confirm the degree of scatter correction and to steer the update in iterative kernel optimization. By means of the parallel-beam DCC via fan-parallel rebinning, we iteratively optimized the scatter kernel parameters, using a particle swarm optimization algorithm for its computational efficiency and excellent convergence. The proposed method was validated by a simulation study using the XCAT numerical phantom and also by experimental studies using the ACS head phantom and the pelvic part of the Rando phantom. The results showed that the proposed method can effectively improve the accuracy of deconvolution-based scatter correction. Quantitative assessments of image quality parameters such as contrast and structure similarity (SSIM) revealed that the optimally selected scatter kernel improves the contrast of scatter-free images by up to 99.5%, 94.4%, and 84.4%, and of the SSIM in an XCAT study, an ACS head phantom study, and a pelvis phantom study by up to 96.7%, 90.5%, and 87.8%, respectively. The proposed method can achieve accurate and efficient scatter correction from a single cone-beam scan without need of any auxiliary hardware or additional experimentation.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, H; Kong, V; Jin, J

Purpose: A synchronized moving grid (SMOG) has been proposed to reduce scatter and lag artifacts in cone beam computed tomography (CBCT). However, information is missing in each projection because certain areas are blocked by the grid. A previous solution to this issue is acquiring 2 complimentary projections at each position, which increases scanning time. This study reports our first Result using an inter-projection sensor fusion (IPSF) method to estimate missing projection in our prototype SMOG-based CBCT system. Methods: An in-house SMOG assembling with a 1:1 grid of 3 mm gap has been installed in a CBCT benchtop. The grid movesmore » back and forth in a 3-mm amplitude and up-to 20-Hz frequency. A control program in LabView synchronizes the grid motion with the platform rotation and x-ray firing so that the grid patterns for any two neighboring projections are complimentary. A Catphan was scanned with 360 projections. After scatter correction, the IPSF algorithm was applied to estimate missing signal for each projection using the information from the 2 neighboring projections. Feldkamp-Davis-Kress (FDK) algorithm was applied to reconstruct CBCT images. The CBCTs were compared to those reconstructed using normal projections without applying the SMOG system. Results: The SMOG-IPSF method may reduce image dose by half due to the blocked radiation by the grid. The method almost completely removed scatter related artifacts, such as the cupping artifacts. The evaluation of line pair patterns in the CatPhan suggested that the spatial resolution degradation was minimal. Conclusion: The SMOG-IPSF is promising in reducing scatter artifacts and improving image quality while reducing radiation dose.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanabe, S; Utsunomiya, S; Abe, E

Purpose: To assess an accuracy of fiducial maker-based setup using ExacTrac (ExT-based setup) as compared with soft tissue-based setup using Cone-beam CT (CBCT-based setup) for patients with prostate cancer receiving intensity-modulated radiation therapy (IMRT) for the purpose of investigating whether ExT-based setup can be an alternative to CBCT-based setup. Methods: The setup accuracy was analyzed prospectively for 7 prostate cancer patients with implanted three fiducial markers received IMRT. All patients were treated after CBCT-based setup was performed and corresponding shifts were recorded. ExacTrac images were obtained before and after CBCT-based setup. The fiducial marker-based shifts were calculated based on thosemore » two images and recorded on the assumption that the setup correction was carried out by fiducial marker-based auto correction. Mean and standard deviation of absolute differences and the correlation between CBCT and ExT shifts were estimated. Results: A total of 178 image dataset were analyzed. On the differences between CBCT and ExT shifts, 133 (75%) of 178 image dataset resulted in smaller differences than 3 mm in all dimensions. Mean differences in the anterior-posterior (AP), superior-inferior (SI), and left-right (LR) dimensions were 1.8 ± 1.9 mm, 0.7 ± 1.9 mm, and 0.6 ± 0.8 mm, respectively. The percentages of shift agreements within ±3 mm were 76% for AP, 90% for SI, and 100% for LR. The Pearson coefficient of correlation for CBCT and ExT shifts were 0.80 for AP, 0.80 for SI, and 0.65 for LR. Conclusion: This work showed that the accuracy of ExT-based setup was correlated with that of CBCT-based setup, implying that ExT-based setup has a potential ability to be an alternative to CBCT-based setup. The further work is to specify the conditions that ExT-based setup can provide the accuracy comparable to CBCT-based setup.« less

Two- versus three-dimensional imaging in subjects with unerupted maxillary canines.

PubMed

Botticelli, Susanna; Verna, Carlalberta; Cattaneo, Paolo M; Heidmann, Jens; Melsen, Birte

2011-08-01

The aim of this study was to evaluate whether there is any difference in the diagnostic information provided by conventional two-dimensional (2D) images or by three-dimensional (3D) cone beam computed tomography (CBCT) in subjects with unerupted maxillary canines. Twenty-seven patients (17 females and 10 males, mean age 11.8 years) undergoing orthodontic treatment with 39 impacted or retained maxillary canines were included. For each canine, two different digital image sets were obtained: (1) A 2D image set including a panoramic radiograph, a lateral cephalogram, and the available periapical radiographs with different projections and (2) A 3D image set obtained with CBCT. Both sets of images were submitted, in a single-blind randomized order, to eight dentists. A questionnaire was used to assess the position of the canine, the presence of root resorption, the difficulty of the case, treatment choice options, and the quality of the images. Data analysis was performed using the McNemar-Bowker test for paired data, Kappa statistics, and paired t-tests. The findings demonstrated a difference in the localization of the impacted canines between the two techniques, which can be explained by factors affecting the conventional 2D radiographs such as distortion, magnification, and superimposition of anatomical structures situated in different planes of space. The increased precision in the localization of the canines and the improved estimation of the space conditions in the arch obtained with CBCT resulted in a difference in diagnosis and treatment planning towards a more clinically orientated approach.

An evaluation of the periapical status of teeth with necrotic pulps using periapical radiography and cone-beam computed tomography.

PubMed

Abella, F; Patel, S; Durán-Sindreu, F; Mercadé, M; Bueno, R; Roig, M

2014-04-01

To evaluate the presence or absence of periapical (PA) radiolucencies on individual roots of teeth with necrotic pulps, as assessed with digital PA radiographs and cone-beam computed tomography (CBCT). Digital PA radiographs and CBCT scans were taken from 161 endodontically untreated teeth (from 155 patients) diagnosed with non-vital pulps (pulp necrosis with normal PA tissue, symptomatic apical periodontitis, asymptomatic apical periodontitis, acute apical abscess and chronic apical abscess). Images were assessed by two calibrated endodontists to analyse the radiographic PA status of the teeth. A consensus was reached in the event of any disagreement. The data were analysed using a McNemar's test, and significance was set at P ≤ 0.05. Three hundred and forty paired images of roots were assessed with both digital PA radiographs and CBCT images. Fifteen additional roots were identified with CBCT. PA radiolucencies were present in 132 (38.8%) roots when assessed with PA radiographs, and in 196 (57.6%) roots when assessed with CBCT. This difference was statistically significant (P < 0.05). In teeth diagnosed with pulp necrosis, symptomatic apical periodontitis or acute apical abscess, CBCT images revealed a statistically larger number of PA radiolucencies than did PA radiographs (P < 0.05). No statistical differences were observed between PA radiographs and CBCT in teeth classified with asymptomatic apical periodontitis (P = 0.31) or chronic apical abscess (P = 1). Unlike PA radiographs, CBCT revealed a higher prevalence of PA radiolucencies when endodontically untreated teeth with non-vital pulps were examined. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

WE-AB-207A-12: HLCC Based Quantitative Evaluation Method of Image Artifact in Dental CBCT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Y; Wu, S; Qi, H

Purpose: Image artifacts are usually evaluated qualitatively via visual observation of the reconstructed images, which is susceptible to subjective factors due to the lack of an objective evaluation criterion. In this work, we propose a Helgason-Ludwig consistency condition (HLCC) based evaluation method to quantify the severity level of different image artifacts in dental CBCT. Methods: Our evaluation method consists of four step: 1) Acquire Cone beam CT(CBCT) projection; 2) Convert 3D CBCT projection to fan-beam projection by extracting its central plane projection; 3) Convert fan-beam projection to parallel-beam projection utilizing sinogram-based rebinning algorithm or detail-based rebinning algorithm; 4) Obtain HLCCmore » profile by integrating parallel-beam projection per view and calculate wave percentage and variance of the HLCC profile, which can be used to describe the severity level of image artifacts. Results: Several sets of dental CBCT projections containing only one type of artifact (i.e. geometry, scatter, beam hardening, lag and noise artifact), were simulated using gDRR, a GPU tool developed for efficient, accurate, and realistic simulation of CBCT Projections. These simulated CBCT projections were used to test our proposed method. HLCC profile wave percentage and variance induced by geometry distortion are about 3∼21 times and 16∼393 times as large as that of the artifact-free projection, respectively. The increase factor of wave percentage and variance are 6 and133 times for beam hardening, 19 and 1184 times for scatter, and 4 and16 times for lag artifacts, respectively. In contrast, for noisy projection the wave percentage, variance and inconsistency level are almost the same with those of the noise-free one. Conclusion: We have proposed a quantitative evaluation method of image artifact based on HLCC theory. According to our simulation results, the severity of different artifact types is found to be in a following order: Scatter>Geometry>Beam hardening>Lag>Noise>Artifact-free in dental CBCT.« less

Cascaded systems analysis of noise and detectability in dual-energy cone-beam CT

PubMed Central

Gang, Grace J.; Zbijewski, Wojciech; Webster Stayman, J.; Siewerdsen, Jeffrey H.

2012-01-01

Purpose: Dual-energy computed tomography and dual-energy cone-beam computed tomography (DE-CBCT) are promising modalities for applications ranging from vascular to breast, renal, hepatic, and musculoskeletal imaging. Accordingly, the optimization of imaging techniques for such applications would benefit significantly from a general theoretical description of image quality that properly incorporates factors of acquisition, reconstruction, and tissue decomposition in DE tomography. This work reports a cascaded systems analysis model that includes the Poisson statistics of x rays (quantum noise), detector model (flat-panel detectors), anatomical background, image reconstruction (filtered backprojection), DE decomposition (weighted subtraction), and simple observer models to yield a task-based framework for DE technique optimization. Methods: The theoretical framework extends previous modeling of DE projection radiography and CBCT. Signal and noise transfer characteristics are propagated through physical and mathematical stages of image formation and reconstruction. Dual-energy decomposition was modeled according to weighted subtraction of low- and high-energy images to yield the 3D DE noise-power spectrum (NPS) and noise-equivalent quanta (NEQ), which, in combination with observer models and the imaging task, yields the dual-energy detectability index (d′). Model calculations were validated with NPS and NEQ measurements from an experimental imaging bench simulating the geometry of a dedicated musculoskeletal extremities scanner. Imaging techniques, including kVp pair and dose allocation, were optimized using d′ as an objective function for three example imaging tasks: (1) kidney stone discrimination; (2) iodine vs bone in a uniform, soft-tissue background; and (3) soft tissue tumor detection on power-law anatomical background. Results: Theoretical calculations of DE NPS and NEQ demonstrated good agreement with experimental measurements over a broad range of imaging conditions. Optimization results suggest a lower fraction of total dose imparted by the low-energy acquisition, a finding consistent with previous literature. The selection of optimal kVp pair reveals the combined effect of both quantum noise and contrast in the kidney stone discrimination and soft-tissue tumor detection tasks, whereas the K-edge effect of iodine was the dominant factor in determining kVp pairs in the iodine vs bone task. The soft-tissue tumor task illustrated the benefit of dual-energy imaging in eliminating anatomical background noise and improving detectability beyond that achievable by single-energy scans. Conclusions: This work established a task-based theoretical framework that is predictive of DE image quality. The model can be utilized in optimizing a broad range of parameters in image acquisition, reconstruction, and decomposition, providing a useful tool for maximizing DE-CBCT image quality and reducing dose. PMID:22894440

Accuracy and reliability of different cone beam computed tomography (CBCT) devices for structural analysis of alveolar bone in comparison with multislice CT and micro-CT.

PubMed

Van Dessel, Jeroen; Nicolielo, Laura Ferreira Pinheiro; Huang, Yan; Coudyzer, Walter; Salmon, Benjamin; Lambrichts, Ivo; Jacobs, Reinhilde

The aim of this study was to assess whether cone beam computed tomography (CBCT) may be used for clinically reliable alveolar bone quality assessment in comparison to its clinical alternatives, multislice computed tomography and the gold standard (micro-CT). Six dentate mandibular bone samples were scanned with seven CBCT devices (ProMax 3D Max, NewTom GiANO, Cranex 3D, 3D Accuitomo 170, Carestream 9300, Scanora 3D, I-CAT Next generation), one micro-CT scanner (SkyScan 1174) and one MSCT machine (Somatom Definition Flash) using two protocols (standard and high-resolution). MSCT and CBCT images were automatically spatially aligned on the micro-CT scan of the corresponding sample. A volume of interest was manually delineated on the micro-CT image and overlaid on the other scanning devices. Alveolar bone structures were automatically extracted using the adaptive thresholding algorithm. Based on the resulting binary images, an automatic 3D morphometric quantification was performed in a CT-Analyser (Bruker, Kontich, Belgium). The reliability and measurement errors were calculated for each modality compared to the gold standard micro-CT. Both MSCT and CBCT were associated with a clinically and statistically (P <0.05) significant measurement error. Bone quantity-related morphometric indices (bone volume fraction 8.41% min to 17.90% max, bone surface density -0.47 mm-1 min to 0.16 mm-1 max and trabecular thickness 0.15 mm min to 0.31 mm max) were significantly (P <0.05) overestimated, resulting in significantly (P <0.05) closer trabecular pores (total porosity percentage -8.41% min to -17.90% max and fractal dimension 0.08 min to 0.17 max) in all scanners compared to micro-CT. However, the structural pattern of the alveolar bone remained similar compared to that of the micro-CT for the ProMax 3D Max, NewTom GiANO, Cranex 3D, 3D Accuitomo 170 and Carestream 9300. On the other hand, the Scanora 3D, i-CAT Next Generation, standard and high-resolution MSCT displayed an overrated bone quantity and aberrant structural pattern compared to other scanning devices. The calculation of morphometric indices had an overall high reliability (intraclass correlation coefficient [ICC] 0.62 min to 0.99 max), except for the i-CAT Next Generation CBCT (ICC 0.26 min to 0.86 max) and standard resolution MSCT (ICC 0.10 min to 0.62 max). This study demonstrated that most CBCT machines may be able to quantitatively assess alveolar bone quality, with a level of accuracy and reliability that approaches micro-CT. One may therefore propose to extrapolate this to clinical CBCT imaging, certainly when there is a need for implant rehabilitation in dentate jaw bones. Conflict-of-interest statement: There is no conflict of interest to declare. Fellowship support was received from Research Foundation Flanders (FWO) from the Belgian government and from the Coordination for the Improvement of Higher Education Personnel (CAPES) programme, Science without Borders, from the Brazilian government.

SU-E-J-122: The CBCT Dose Calculation Using a Patient Specific CBCT Number to Mass Density Conversion Curve Based On a Novel Image Registration and Organ Mapping Method in Head-And-Neck Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhou, J; Lasio, G; Chen, S

2015-06-15

Purpose: To develop a CBCT HU correction method using a patient specific HU to mass density conversion curve based on a novel image registration and organ mapping method for head-and-neck radiation therapy. Methods: There are three steps to generate a patient specific CBCT HU to mass density conversion curve. First, we developed a novel robust image registration method based on sparseness analysis to register the planning CT (PCT) and the CBCT. Second, a novel organ mapping method was developed to transfer the organs at risk (OAR) contours from the PCT to the CBCT and corresponding mean HU values of eachmore » OAR were measured in both the PCT and CBCT volumes. Third, a set of PCT and CBCT HU to mass density conversion curves were created based on the mean HU values of OARs and the corresponding mass density of the OAR in the PCT. Then, we compared our proposed conversion curve with the traditional Catphan phantom based CBCT HU to mass density calibration curve. Both curves were input into the treatment planning system (TPS) for dose calculation. Last, the PTV and OAR doses, DVH and dose distributions of CBCT plans are compared to the original treatment plan. Results: One head-and-neck cases which contained a pair of PCT and CBCT was used. The dose differences between the PCT and CBCT plans using the proposed method are −1.33% for the mean PTV, 0.06% for PTV D95%, and −0.56% for the left neck. The dose differences between plans of PCT and CBCT corrected using the CATPhan based method are −4.39% for mean PTV, 4.07% for PTV D95%, and −2.01% for the left neck. Conclusion: The proposed CBCT HU correction method achieves better agreement with the original treatment plan compared to the traditional CATPhan based calibration method.« less

An automatic panoramic image reconstruction scheme from dental computed tomography images

PubMed Central

Papakosta, Thekla K; Savva, Antonis D; Economopoulos, Theodore L; Gröhndal, H G

2017-01-01

Objectives: Panoramic images of the jaws are extensively used for dental examinations and/or surgical planning because they provide a general overview of the patient's maxillary and mandibular regions. Panoramic images are two-dimensional projections of three-dimensional (3D) objects. Therefore, it should be possible to reconstruct them from 3D radiographic representations of the jaws, produced by CBCT scanning, obviating the need for additional exposure to X-rays, should there be a need of panoramic views. The aim of this article is to present an automated method for reconstructing panoramic dental images from CBCT data. Methods: The proposed methodology consists of a series of sequential processing stages for detecting a fitting dental arch which is used for projecting the 3D information of the CBCT data to the two-dimensional plane of the panoramic image. The detection is based on a template polynomial which is constructed from a training data set. Results: A total of 42 CBCT data sets of real clinical pre-operative and post-operative representations from 21 patients were used. Eight data sets were used for training the system and the rest for testing. Conclusions: The proposed methodology was successfully applied to CBCT data sets, producing corresponding panoramic images, suitable for examining pre-operatively and post-operatively the patients' maxillary and mandibular regions. PMID:28112548

A Method to Improve Electron Density Measurement of Cone-Beam CT Using Dual Energy Technique

PubMed Central

Men, Kuo; Dai, Jian-Rong; Li, Ming-Hui; Chen, Xin-Yuan; Zhang, Ke; Tian, Yuan; Huang, Peng; Xu, Ying-Jie

2015-01-01

Purpose. To develop a dual energy imaging method to improve the accuracy of electron density measurement with a cone-beam CT (CBCT) device. Materials and Methods. The imaging system is the XVI CBCT system on Elekta Synergy linac. Projection data were acquired with the high and low energy X-ray, respectively, to set up a basis material decomposition model. Virtual phantom simulation and phantoms experiments were carried out for quantitative evaluation of the method. Phantoms were also scanned twice with the high and low energy X-ray, respectively. The data were decomposed into projections of the two basis material coefficients according to the model set up earlier. The two sets of decomposed projections were used to reconstruct CBCT images of the basis material coefficients. Then, the images of electron densities were calculated with these CBCT images. Results. The difference between the calculated and theoretical values was within 2% and the correlation coefficient of them was about 1.0. The dual energy imaging method obtained more accurate electron density values and reduced the beam hardening artifacts obviously. Conclusion. A novel dual energy CBCT imaging method to calculate the electron densities was developed. It can acquire more accurate values and provide a platform potentially for dose calculation. PMID:26346510

Online geometric calibration of cone-beam computed tomography for arbitrary imaging objects.

PubMed

Meng, Yuanzheng; Gong, Hui; Yang, Xiaoquan

2013-02-01

A novel online method based on the symmetry property of the sum of projections (SOP) is proposed to obtain the geometric parameters in cone-beam computed tomography (CBCT). This method requires no calibration phantom and can be used in circular trajectory CBCT with arbitrary cone angles. An objective function is deduced to illustrate the dependence of the symmetry of SOP on geometric parameters, which will converge to its minimum when the geometric parameters achieve their true values. Thus, by minimizing the objective function, we can obtain the geometric parameters for image reconstruction. To validate this method, numerical phantom studies with different noise levels are simulated. The results show that our method is insensitive to the noise and can determine the skew (in-plane rotation angle of the detector), the roll (rotation angle around the projection of the rotation axis on the detector), and the rotation axis with high accuracy, while the mid-plane and source-to-detector distance will be obtained with slightly lower accuracy. However, our simulation studies validate that the errors of the latter two parameters brought by our method will hardly degrade the quality of reconstructed images. The small animal studies show that our method is able to deal with arbitrary imaging objects. In addition, the results of the reconstructed images in different slices demonstrate that we have achieved comparable image quality in the reconstructions as some offline methods.

Demons deformable registration of CT and cone-beam CT using an iterative intensity matching approach

PubMed Central

Nithiananthan, Sajendra; Schafer, Sebastian; Uneri, Ali; Mirota, Daniel J.; Stayman, J. Webster; Zbijewski, Wojciech; Brock, Kristy K.; Daly, Michael J.; Chan, Harley; Irish, Jonathan C.; Siewerdsen, Jeffrey H.

2011-01-01

Purpose: A method of intensity-based deformable registration of CT and cone-beam CT (CBCT) images is described, in which intensity correction occurs simultaneously within the iterative registration process. The method preserves the speed and simplicity of the popular Demons algorithm while providing robustness and accuracy in the presence of large mismatch between CT and CBCT voxel values (“intensity”). Methods: A variant of the Demons algorithm was developed in which an estimate of the relationship between CT and CBCT intensity values for specific materials in the image is computed at each iteration based on the set of currently overlapping voxels. This tissue-specific intensity correction is then used to estimate the registration output for that iteration and the process is repeated. The robustness of the method was tested in CBCT images of a cadaveric head exhibiting a broad range of simulated intensity variations associated with x-ray scatter, object truncation, and∕or errors in the reconstruction algorithm. The accuracy of CT-CBCT registration was also measured in six real cases, exhibiting deformations ranging from simple to complex during surgery or radiotherapy guided by a CBCT-capable C-arm or linear accelerator, respectively. Results: The iterative intensity matching approach was robust against all levels of intensity variation examined, including spatially varying errors in voxel value of a factor of 2 or more, as can be encountered in cases of high x-ray scatter. Registration accuracy without intensity matching degraded severely with increasing magnitude of intensity error and introduced image distortion. A single histogram match performed prior to registration alleviated some of these effects but was also prone to image distortion and was quantifiably less robust and accurate than the iterative approach. Within the six case registration accuracy study, iterative intensity matching Demons reduced mean TRE to (2.5±2.8) mm compared to (3.5±3.0) mm with rigid registration. Conclusions: A method was developed to iteratively correct CT-CBCT intensity disparity during Demons registration, enabling fast, intensity-based registration in CBCT-guided procedures such as surgery and radiotherapy, in which CBCT voxel values may be inaccurate. Accurate CT-CBCT registration in turn facilitates registration of multimodality preoperative image and planning data to intraoperative CBCT by way of the preoperative CT, thereby linking the intraoperative frame of reference to a wealth of preoperative information that could improve interventional guidance. PMID:21626913

Demons deformable registration of CT and cone-beam CT using an iterative intensity matching approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nithiananthan, Sajendra; Schafer, Sebastian; Uneri, Ali

2011-04-15

Purpose: A method of intensity-based deformable registration of CT and cone-beam CT (CBCT) images is described, in which intensity correction occurs simultaneously within the iterative registration process. The method preserves the speed and simplicity of the popular Demons algorithm while providing robustness and accuracy in the presence of large mismatch between CT and CBCT voxel values (''intensity''). Methods: A variant of the Demons algorithm was developed in which an estimate of the relationship between CT and CBCT intensity values for specific materials in the image is computed at each iteration based on the set of currently overlapping voxels. This tissue-specificmore » intensity correction is then used to estimate the registration output for that iteration and the process is repeated. The robustness of the method was tested in CBCT images of a cadaveric head exhibiting a broad range of simulated intensity variations associated with x-ray scatter, object truncation, and/or errors in the reconstruction algorithm. The accuracy of CT-CBCT registration was also measured in six real cases, exhibiting deformations ranging from simple to complex during surgery or radiotherapy guided by a CBCT-capable C-arm or linear accelerator, respectively. Results: The iterative intensity matching approach was robust against all levels of intensity variation examined, including spatially varying errors in voxel value of a factor of 2 or more, as can be encountered in cases of high x-ray scatter. Registration accuracy without intensity matching degraded severely with increasing magnitude of intensity error and introduced image distortion. A single histogram match performed prior to registration alleviated some of these effects but was also prone to image distortion and was quantifiably less robust and accurate than the iterative approach. Within the six case registration accuracy study, iterative intensity matching Demons reduced mean TRE to (2.5{+-}2.8) mm compared to (3.5{+-}3.0) mm with rigid registration. Conclusions: A method was developed to iteratively correct CT-CBCT intensity disparity during Demons registration, enabling fast, intensity-based registration in CBCT-guided procedures such as surgery and radiotherapy, in which CBCT voxel values may be inaccurate. Accurate CT-CBCT registration in turn facilitates registration of multimodality preoperative image and planning data to intraoperative CBCT by way of the preoperative CT, thereby linking the intraoperative frame of reference to a wealth of preoperative information that could improve interventional guidance.« less

SU-F-J-14: Kilovoltage Cone-Beam CT Dose Estimation of Varian On-Board Imager Using GMctdospp Monte Carlo Framework

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, S; Rangaraj, D

2016-06-15

Purpose: Although cone-beam CT (CBCT) imaging became popular in radiation oncology, its imaging dose estimation is still challenging. The goal of this study is to assess the kilovoltage CBCT doses using GMctdospp - an EGSnrc based Monte Carlo (MC) framework. Methods: Two Varian OBI x-ray tube models were implemented in the GMctpdospp framework of EGSnrc MC System. The x-ray spectrum of 125 kVp CBCT beam was acquired from an EGSnrc/BEAMnrc simulation and validated with IPEM report 78. Then, the spectrum was utilized as an input spectrum in GMctdospp dose calculations. Both full and half bowtie pre-filters of the OBI systemmore » were created by using egs-prism module. The x-ray tube MC models were verified by comparing calculated dosimetric profiles (lateral and depth) to ion chamber measurements for a static x-ray beam irradiation to a cuboid water phantom. An abdominal CBCT imaging doses was simulated in GMctdospp framework using a 5-year-old anthropomorphic phantom. The organ doses and effective dose (ED) from the framework were assessed and compared to the MOSFET measurements and convolution/superposition dose calculations. Results: The lateral and depth dose profiles in the water cuboid phantom were well matched within 6% except a few areas - left shoulder of the half bowtie lateral profile and surface of water phantom. The organ doses and ED from the MC framework were found to be closer to MOSFET measurements and CS calculations within 2 cGy and 5 mSv respectively. Conclusion: This study implemented and validated the Varian OBI x-ray tube models in the GMctdospp MC framework using a cuboid water phantom and CBCT imaging doses were also evaluated in a 5-year-old anthropomorphic phantom. In future study, various CBCT imaging protocols will be implemented and validated and consequently patient CT images will be used to estimate the CBCT imaging doses in patients.« less

Evaluation of volume change in rectum and bladder during application of image-guided radiotherapy for prostate carcinoma

NASA Astrophysics Data System (ADS)

Luna, J. A.; Rojas, J. I.

2016-07-01

All prostate cancer patients from Centro Médico Radioterapia Siglo XXI receive Volumetric Modulated Arc Therapy (VMAT). This therapy uses image-guided radiotherapy (IGRT) with the Cone Beam Computed Tomography (CBCT). This study compares the planned dose in the reference CT image against the delivered dose recalculate in the CBCT image. The purpose of this study is to evaluate the anatomic changes and related dosimetric effect based on weekly CBCT directly for patients with prostate cancer undergoing volumetric modulated arc therapy (VMAT) treatment. The collected data were analyzed using one-way ANOVA.

Validation of cone-beam computed tomography and magnetic resonance imaging of the porcine spine: a comparative study with multidetector computed tomography and anatomical specimens.

PubMed

de Freitas, Ricardo Miguel Costa; Andrade, Celi Santos; Caldas, José Guilherme Mendes Pereira; Kanas, Alexandre Fligelman; Cabral, Richard Halti; Tsunemi, Miriam Harumi; Rodríguez, Hernán Joel Cervantes; Rabbani, Said Rahnamaye

2015-05-01

New spinal interventions or implants have been tested on ex vivo or in vivo porcine spines, as they are readily available and have been accepted as a comparable model to human cadaver spines. Imaging-guided interventional procedures of the spine are mostly based on fluoroscopy or, still, on multidetector computed tomography (MDCT). Cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) are also available methods to guide interventional procedures. Although some MDCT data from porcine spines are available in the literature, validation of the measurements on CBCT and MRI is lacking. To describe and compare the anatomical measurements accomplished with MDCT, CBCT, and MRI of lumbar porcine spines to determine if CBCT and MRI are also useful methods for experimental studies. An experimental descriptive-comparative study. Sixteen anatomical measurements of an individual vertebra from six lumbar porcine spines (n=36 vertebrae) were compared with their MDCT, CBCT, and MRI equivalents. Comparisons were made for the absolute values of the parameters. Similarities were found in all imaging methods. Significant correlation (p<.05) was observed with all variables except those that included cartilaginous tissue from the end plates when the anatomical study was compared with the imaging methods. The CBCT and MRI provided imaging measurements of the lumbar porcine spines that were similar to the anatomical and MDCT data, and they can be useful for specific experimental research studies. Copyright © 2015 Elsevier Inc. All rights reserved.

Image guidance during head-and-neck cancer radiation therapy: analysis of alignment trends with in-room cone-beam computed tomography scans.

PubMed

Zumsteg, Zachary; DeMarco, John; Lee, Steve P; Steinberg, Michael L; Lin, Chun Shu; McBride, William; Lin, Kevin; Wang, Pin-Chieh; Kupelian, Patrick; Lee, Percy

2012-06-01

On-board cone-beam computed tomography (CBCT) is currently available for alignment of patients with head-and-neck cancer before radiotherapy. However, daily CBCT is time intensive and increases the overall radiation dose. We assessed the feasibility of using the average couch shifts from the first several CBCTs to estimate and correct for the presumed systematic setup error. 56 patients with head-and-neck cancer who received daily CBCT before intensity-modulated radiation therapy had recorded shift values in the medial-lateral, superior-inferior, and anterior-posterior dimensions. The average displacements in each direction were calculated for each patient based on the first five or 10 CBCT shifts and were presumed to represent the systematic setup error. The residual error after this correction was determined by subtracting the calculated shifts from the shifts obtained using daily CBCT. The magnitude of the average daily residual three-dimensional (3D) error was 4.8 ± 1.4 mm, 3.9 ± 1.3 mm, and 3.7 ± 1.1 mm for uncorrected, five CBCT corrected, and 10 CBCT corrected protocols, respectively. With no image guidance, 40.8% of fractions would have been >5 mm off target. Using the first five CBCT shifts to correct subsequent fractions, this percentage decreased to 19.0% of all fractions delivered and decreased the percentage of patients with average daily 3D errors >5 mm from 35.7% to 14.3% vs. no image guidance. Using an average of the first 10 CBCT shifts did not significantly improve this outcome. Using the first five CBCT shift measurements as an estimation of the systematic setup error improves daily setup accuracy for a subset of patients with head-and-neck cancer receiving intensity-modulated radiation therapy and primarily benefited those with large 3D correction vectors (>5 mm). Daily CBCT is still necessary until methods are developed that more accurately determine which patients may benefit from alternative imaging strategies. Copyright © 2012 Elsevier Inc. All rights reserved.

SU-F-J-186: Enabling Adaptive IMPT with CBCT-Based Dose Recalculation for H&N and Prostate Cancer Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurz, C; LMU Munich, Munich; Park, Y

2016-06-15

Purpose: To enable adaptive intensity modulated proton therapy for sites sensitive to inter-fractional changes on the basis of accurate CBCT-based proton dose calculations. To this aim two CBCT intensity correction methods are considered: planning CT (pCT) to CBCT DIR and projection correction based on pCT DIR prior. Methods: 3 H&N and 3 prostate cancer patients with CBCT images and corresponding projections were used in this study, in addition to pCT and re-planning CT (rpCT) images (H&N only). A virtual CT (vCT) was generated by pCT to CBCT DIR. In a second approach, the vCT was used as prior for scattermore » correction of the CBCT projections to yield a CBCTcor image. BEV 2D range maps of SFUD IMPT plans were compared. For the prostate cases, the geometric accuracy of the vCT was also evaluated by contour comparison to physician delineation of the CBCTcor and original CBCT. Results: SFUD dose calculations on vCT and CBCTcor were found to be within 3mm for 97% to 99% of 2D range maps. Median range differences compared to rpCT were below 0.5mm. Analysis showed that the DIR-based vCT approach exhibits inaccuracies in the pelvic region due to the very low soft-tissue contrast in the CBCT. The CBCTcor approach yielded results closer to the original CBCT in terms of DICE coefficients than the vCT (median 0.91 vs 0.81) for targets and OARs. In general, the CBCTcor approach was less affected by inaccuracies of the DIR used during the generation of the vCT prior. Conclusion: Both techniques yield 3D CBCT images with intensities equivalent to diagnostic CT and appear suitable for IMPT dose calculation for most sites. For H&N cases, no considerable differences between the two techniques were found, while improved results of the CBCTcor were observed for pelvic cases due to the reduced sensitivity to registration inaccuracies. Deutsche Forschungsgemeinschaft (MAP); Bundesministerium fur Bildung und Forschung (01IB13001)« less

Cone Beam CT Imaging Analysis of Interfractional Variations in Bladder Volume and Position During Radiotherapy for Bladder Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yee, Don, E-mail: dony@ualberta.c; Parliament, Matthew; Rathee, Satyapal

2010-03-15

Purpose: To quantify daily bladder size and position variations during bladder cancer radiotherapy. Methods and Materials: Ten bladder cancer patients underwent daily cone beam CT (CBCT) imaging of the bladder during radiotherapy. Bladder and planning target volumes (bladder/PTV) from CBCT and planning CT scans were compared with respect to bladder center-of-mass shifts in the x (lateral), y (anterior-posterior), and z (superior-inferior) coordinates, bladder/PTV size, bladder/PTV margin positions, overlapping areas, and mutually exclusive regions. Results: A total of 262 CBCT images were obtained from 10 bladder cancer patients. Bladder center of mass shifted most in the y coordinate (mean, -0.32 cm).more » The anterior bladder wall shifted the most (mean, -0.58 cm). Mean ratios of CBCT-derived bladder and PTV volumes to planning CT-derived counterparts were 0.83 and 0.88. The mean CBCT-derived bladder volume (+- standard deviation [SD]) outside the planning CT counterpart was 29.24 cm{sup 3} (SD, 29.71 cm{sup 3}). The mean planning CT-derived bladder volume outside the CBCT counterpart was 47.74 cm{sup 3} (SD, 21.64 cm{sup 3}). The mean CBCT PTV outside the planning CT-derived PTV was 47.35 cm{sup 3} (SD, 36.51 cm{sup 3}). The mean planning CT-derived PTV outside the CBCT-derived PTV was 93.16 cm{sup 3} (SD, 50.21). The mean CBCT-derived bladder volume outside the planning PTV was 2.41 cm{sup 3} (SD, 3.97 cm{sup 3}). CBCT bladder/ PTV volumes significantly differed from planning CT counterparts (p = 0.047). Conclusions: Significant variations in bladder and PTV volume and position occurred in patients in this trial.« less

An interprojection sensor fusion approach to estimate blocked projection signal in synchronized moving grid-based CBCT system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Hong; Kong, Vic; Ren, Lei

2016-01-15

Purpose: A preobject grid can reduce and correct scatter in cone beam computed tomography (CBCT). However, half of the signal in each projection is blocked by the grid. A synchronized moving grid (SMOG) has been proposed to acquire two complimentary projections at each gantry position and merge them into one complete projection. That approach, however, suffers from increased scanning time and the technical difficulty of accurately merging the two projections per gantry angle. Herein, the authors present a new SMOG approach which acquires a single projection per gantry angle, with complimentary grid patterns for any two adjacent projections, and usemore » an interprojection sensor fusion (IPSF) technique to estimate the blocked signal in each projection. The method may have the additional benefit of reduced imaging dose due to the grid blocking half of the incident radiation. Methods: The IPSF considers multiple paired observations from two adjacent gantry angles as approximations of the blocked signal and uses a weighted least square regression of these observations to finally determine the blocked signal. The method was first tested with a simulated SMOG on a head phantom. The signal to noise ratio (SNR), which represents the difference of the recovered CBCT image to the original image without the SMOG, was used to evaluate the ability of the IPSF in recovering the missing signal. The IPSF approach was then tested using a Catphan phantom on a prototype SMOG assembly installed in a bench top CBCT system. Results: In the simulated SMOG experiment, the SNRs were increased from 15.1 and 12.7 dB to 35.6 and 28.9 dB comparing with a conventional interpolation method (inpainting method) for a projection and the reconstructed 3D image, respectively, suggesting that IPSF successfully recovered most of blocked signal. In the prototype SMOG experiment, the authors have successfully reconstructed a CBCT image using the IPSF-SMOG approach. The detailed geometric features in the Catphan phantom were mostly recovered according to visual evaluation. The scatter related artifacts, such as cupping artifacts, were almost completely removed. Conclusions: The IPSF-SMOG is promising in reducing scatter artifacts and improving image quality while reducing radiation dose.« less

Demons deformable registration for CBCT-guided procedures in the head and neck: Convergence and accuracy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nithiananthan, S.; Brock, K. K.; Daly, M. J.

2009-10-15

Purpose: The accuracy and convergence behavior of a variant of the Demons deformable registration algorithm were investigated for use in cone-beam CT (CBCT)-guided procedures of the head and neck. Online use of deformable registration for guidance of therapeutic procedures such as image-guided surgery or radiation therapy places trade-offs on accuracy and computational expense. This work describes a convergence criterion for Demons registration developed to balance these demands; the accuracy of a multiscale Demons implementation using this convergence criterion is quantified in CBCT images of the head and neck. Methods: Using an open-source ''symmetric'' Demons registration algorithm, a convergence criterion basedmore » on the change in the deformation field between iterations was developed to advance among multiple levels of a multiscale image pyramid in a manner that optimized accuracy and computation time. The convergence criterion was optimized in cadaver studies involving CBCT images acquired using a surgical C-arm prototype modified for 3D intraoperative imaging. CBCT-to-CBCT registration was performed and accuracy was quantified in terms of the normalized cross-correlation (NCC) and target registration error (TRE). The accuracy and robustness of the algorithm were then tested in clinical CBCT images of ten patients undergoing radiation therapy of the head and neck. Results: The cadaver model allowed optimization of the convergence factor and initial measurements of registration accuracy: Demons registration exhibited TRE=(0.8{+-}0.3) mm and NCC=0.99 in the cadaveric head compared to TRE=(2.6{+-}1.0) mm and NCC=0.93 with rigid registration. Similarly for the patient data, Demons registration gave mean TRE=(1.6{+-}0.9) mm compared to rigid registration TRE=(3.6{+-}1.9) mm, suggesting registration accuracy at or near the voxel size of the patient images (1x1x2 mm{sup 3}). The multiscale implementation based on optimal convergence criteria completed registration in 52 s for the cadaveric head and in an average time of 270 s for the larger FOV patient images. Conclusions: Appropriate selection of convergence and multiscale parameters in Demons registration was shown to reduce computational expense without sacrificing registration performance. For intraoperative CBCT imaging with deformable registration, the ability to perform accurate registration within the stringent time requirements of the operating environment could offer a useful clinical tool allowing integration of preoperative information while accurately reflecting changes in the patient anatomy. Similarly for CBCT-guided radiation therapy, fast accurate deformable registration could further augment high-precision treatment strategies.« less

Demons deformable registration for CBCT-guided procedures in the head and neck: convergence and accuracy.

PubMed

Nithiananthan, S; Brock, K K; Daly, M J; Chan, H; Irish, J C; Siewerdsen, J H

2009-10-01

The accuracy and convergence behavior of a variant of the Demons deformable registration algorithm were investigated for use in cone-beam CT (CBCT)-guided procedures of the head and neck. Online use of deformable registration for guidance of therapeutic procedures such as image-guided surgery or radiation therapy places trade-offs on accuracy and computational expense. This work describes a convergence criterion for Demons registration developed to balance these demands; the accuracy of a multiscale Demons implementation using this convergence criterion is quantified in CBCT images of the head and neck. Using an open-source "symmetric" Demons registration algorithm, a convergence criterion based on the change in the deformation field between iterations was developed to advance among multiple levels of a multiscale image pyramid in a manner that optimized accuracy and computation time. The convergence criterion was optimized in cadaver studies involving CBCT images acquired using a surgical C-arm prototype modified for 3D intraoperative imaging. CBCT-to-CBCT registration was performed and accuracy was quantified in terms of the normalized cross-correlation (NCC) and target registration error (TRE). The accuracy and robustness of the algorithm were then tested in clinical CBCT images of ten patients undergoing radiation therapy of the head and neck. The cadaver model allowed optimization of the convergence factor and initial measurements of registration accuracy: Demons registration exhibited TRE=(0.8+/-0.3) mm and NCC =0.99 in the cadaveric head compared to TRE=(2.6+/-1.0) mm and NCC=0.93 with rigid registration. Similarly for the patient data, Demons registration gave mean TRE=(1.6+/-0.9) mm compared to rigid registration TRE=(3.6+/-1.9) mm, suggesting registration accuracy at or near the voxel size of the patient images (1 x 1 x 2 mm3). The multiscale implementation based on optimal convergence criteria completed registration in 52 s for the cadaveric head and in an average time of 270 s for the larger FOV patient images. Appropriate selection of convergence and multiscale parameters in Demons registration was shown to reduce computational expense without sacrificing registration performance. For intraoperative CBCT imaging with deformable registration, the ability to perform accurate registration within the stringent time requirements of the operating environment could offer a useful clinical tool allowing integration of preoperative information while accurately reflecting changes in the patient anatomy. Similarly for CBCT-guided radiation therapy, fast accurate deformable registration could further augment high-precision treatment strategies.

Demons deformable registration for CBCT-guided procedures in the head and neck: Convergence and accuracy

PubMed Central

Nithiananthan, S.; Brock, K. K.; Daly, M. J.; Chan, H.; Irish, J. C.; Siewerdsen, J. H.

2009-01-01

Purpose: The accuracy and convergence behavior of a variant of the Demons deformable registration algorithm were investigated for use in cone-beam CT (CBCT)-guided procedures of the head and neck. Online use of deformable registration for guidance of therapeutic procedures such as image-guided surgery or radiation therapy places trade-offs on accuracy and computational expense. This work describes a convergence criterion for Demons registration developed to balance these demands; the accuracy of a multiscale Demons implementation using this convergence criterion is quantified in CBCT images of the head and neck. Methods: Using an open-source “symmetric” Demons registration algorithm, a convergence criterion based on the change in the deformation field between iterations was developed to advance among multiple levels of a multiscale image pyramid in a manner that optimized accuracy and computation time. The convergence criterion was optimized in cadaver studies involving CBCT images acquired using a surgical C-arm prototype modified for 3D intraoperative imaging. CBCT-to-CBCT registration was performed and accuracy was quantified in terms of the normalized cross-correlation (NCC) and target registration error (TRE). The accuracy and robustness of the algorithm were then tested in clinical CBCT images of ten patients undergoing radiation therapy of the head and neck. Results: The cadaver model allowed optimization of the convergence factor and initial measurements of registration accuracy: Demons registration exhibited TRE=(0.8±0.3) mm and NCC=0.99 in the cadaveric head compared to TRE=(2.6±1.0) mm and NCC=0.93 with rigid registration. Similarly for the patient data, Demons registration gave mean TRE=(1.6±0.9) mm compared to rigid registration TRE=(3.6±1.9) mm, suggesting registration accuracy at or near the voxel size of the patient images (1×1×2 mm3). The multiscale implementation based on optimal convergence criteria completed registration in 52 s for the cadaveric head and in an average time of 270 s for the larger FOV patient images. Conclusions: Appropriate selection of convergence and multiscale parameters in Demons registration was shown to reduce computational expense without sacrificing registration performance. For intraoperative CBCT imaging with deformable registration, the ability to perform accurate registration within the stringent time requirements of the operating environment could offer a useful clinical tool allowing integration of preoperative information while accurately reflecting changes in the patient anatomy. Similarly for CBCT-guided radiation therapy, fast accurate deformable registration could further augment high-precision treatment strategies. PMID:19928106

The Diagnostic Efficacy of Cone-beam Computed Tomography in Endodontics: A Systematic Review and Analysis by a Hierarchical Model of Efficacy.

PubMed

Rosen, Eyal; Taschieri, Silvio; Del Fabbro, Massimo; Beitlitum, Ilan; Tsesis, Igor

2015-07-01

The aim of this study was to evaluate the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in endodontics based on a systematic search and analysis of the literature using an efficacy model. A systematic search of the literature was performed to identify studies evaluating the use of CBCT imaging in endodontics. The identified studies were subjected to strict inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for appraisal of the literature on the levels of efficacy of a diagnostic imaging modality. Initially, 485 possible relevant articles were identified. After title and abstract screening and a full-text evaluation, 58 articles (12%) that met the inclusion criteria were analyzed and allocated to levels of efficacy. Most eligible articles (n = 52, 90%) evaluated technical characteristics or the accuracy of CBCT imaging, which was defined in this model as low levels of efficacy. Only 6 articles (10%) proclaimed to evaluate the efficacy of CBCT imaging to support the practitioner's decision making; treatment planning; and, ultimately, the treatment outcome, which was defined as higher levels of efficacy. The expected ultimate benefit of CBCT imaging to the endodontic patient as evaluated by its level of diagnostic efficacy is unclear and is mainly limited to its technical and diagnostic accuracy efficacies. Even for these low levels of efficacy, current knowledge is limited. Therefore, a cautious and rational approach is advised when considering CBCT imaging for endodontic purposes. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The influence of dental implants in periapical and panoramic radiographs and cone beam computed tomography images: a clinical study.

PubMed

Felix, Rafael Perdomo; Shinkai, Rosemary Sadami Arai; Rockenbach, Maria Ivete Bolzan

2018-01-01

The aim of this study was to analyze the influence of dental implants on the radiographic density of the peri-implant region in tomographic and radiographic examinations. A sample of 21 dental implants from 10 patients with Brånemark-protocol prostheses was evaluated based on postoperative control images, including periapical radiography (paralleling technique), panoramic radiography, and cone beam computed tomography (CBCT). The density means of 6 defined areas near dental implants were calculated and compared considering their locations and the different imaging examinations. The CBCT examinations showed significantly different densities among the measured areas (P < 0.001), while there were no significant differences among the density means of the various areas in periapical radiographs (P = 0.430) and panoramic radiographs (P = 0.149). The highest mean densities were observed in areas closer to the implants in all the examinations: CBCT (127.88 and 120.71), panoramic (106.51 and 106.09), and periapical (120.32). The sagittal CBCT images were measured in 2 different sections, and in both sections those areas closer to implants showed mean densities that were significantly higher than means from more distant areas (P < 0.001). Means from distant areas on CBCT slice imaging were significantly lower than the densities of the same areas on periapical and panoramic examinations. The changes in mean radiographic density values in the peri-implant region confirmed the interference of dental implants in radiographic and tomographic images. CBCT images suffered the greatest interference from dental implants.

WE-AB-207A-03: A CBCT Head Scanner for Point-Of-Care Imaging of Intracranial Hemorrhage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, J; Sisniega, A; Zbijewski, W

Purpose: This work reports the design, development, and first technical assessment of a cone-beam CT (CBCT) scanner developed specifically for imaging of acute intracranial hemorrhage (ICH) at the point of care, with target applications in diagnosis and monitoring of traumatic brain injury, stroke, and postsurgical hemorrhage. Methods: System design employed a task-based image quality model to quantify the influence of factors such as additive noise and high-gain (HG) detector readout on ICH detectability. Three bowtie filters with varying bare-beam attenuation strength and curvature were designed to enable HG readout without detector saturation, and a polyenergetic gain correction was developed tomore » minimize artifacts from bowtie flood-field calibration. Image reconstruction used an iterative penalized weighted least squares (PWLS) method with artifact correction including Monte Carlo scatter estimation, Joseph-Spital beam hardening correction, and spatiotemporal deconvolution of detector glare and lag. Radiation dose was characterized for half-scan and full-scan protocols at various kV, and imaging performance was assessed in a head phantom presenting simulated ICH with diameter ranging 2–12 mm. Results: The image quality model guided system design and was validated by measurements on a CBCT imaging bench. Compared to low-gain readout without a bowtie filter, the combination of HG readout and a modest bowtie improved the contrast-to-noise ratio (CNR per unit square-root dose) by 20% in the center of the image but degraded noise performance near the periphery (20% reduction in CNR). Low-frequency bowtie artifacts (∼100 HU magnitude) were corrected by the polyenergetic gain correction. Image reconstructions on the prototype scanner demonstrate clear visibility of the smallest ICH insert (2 mm diameter) in both HG readout (with a bowtie) and dual-gain readout (without bowtie). Conclusion: Technical assessment of the prototype scanner suggests the capability for reliable visualization of small (2 mm), low-contrast (50 HU) ICH at <20 mGy dose and motivates translation to clinical studies, now underway. Xiaohui Wang and David Foos (co-authors) are employees of Carestream Health. Research funding support from Carestream Health.« less

Three-dimensional images contribute to the diagnosis of mucous retention cyst in maxillary sinus.

PubMed

Donizeth-Rodrigues, Cleomar; Fonseca-Da Silveira, Márcia; Gonçalves-De Alencar, Ana-Helena; Garcia-Santos-Silva, Maria-Alves; Francisco-De-Mendonça, Elismauro; Estrela, Carlos

2013-01-01

To evaluate the detection of mucous retention cyst of maxillary sinus (MRCMS) using panoramic radiography and cone beam computed tomography (CBCT). A digital database with 6,000 panoramic radiographs was reviewed for MRCMS. Suggestive images of MRCMS were detected on 185 radiographs, and patients were located and invited to return for follow-up. Thirty patients returned, and control panoramic radiographs were obtained 6 to 46 months after the initial radiograph. When MRCMS was found on control radiographs, CBCT scans were obtained. Cysts were measured and compared on radiographs and scans. The Wilcoxon, Spearman and Kolmorogov-Smirnov tests were used for statistical analysis. The level of significance was set at 5%. There were statistically significant differences between the two methods (p<0.05): 23 MRCMS detected on panoramic radiographs were confirmed by CBCT, but 5 MRCMS detected on CBCT images had not been identified by panoramic radiography. Eight MRCMS detected on control radiographs were not confirmed by CBCT. MRCMS size differences from initial to control panoramic radiographs and CBCT scans were not statistically significant (p= 0.617 and p= 0.626). The correlation between time and MRCMS size differences was not significant (r = -0.16, p = 0.381). CBCT scanning detect MRCMS more accurately than panoramic radiography.

WE-EF-207-03: Design and Optimization of a CBCT Head Scanner for Detection of Acute Intracranial Hemorrhage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, J; Sisniega, A; Zbijewski, W

Purpose: To design a dedicated x-ray cone-beam CT (CBCT) system suitable to deployment at the point-of-care and offering reliable detection of acute intracranial hemorrhage (ICH), traumatic brain injury (TBI), stroke, and other head and neck injuries. Methods: A comprehensive task-based image quality model was developed to guide system design and optimization of a prototype head scanner suitable to imaging of acute TBI and ICH. Previously reported models were expanded to include the effects of x-ray scatter correction necessary for detection of low contrast ICH and the contribution of bit depth (digitization noise) to imaging performance. Task-based detectablity index provided themore » objective function for optimization of system geometry, x-ray source, detector type, anti-scatter grid, and technique at 10–25 mGy dose. Optimal characteristics were experimentally validated using a custom head phantom with 50 HU contrast ICH inserts imaged on a CBCT imaging bench allowing variation of system geometry, focal spot size, detector, grid selection, and x-ray technique. Results: The model guided selection of system geometry with a nominal source-detector distance 1100 mm and optimal magnification of 1.50. Focal spot size ∼0.6 mm was sufficient for spatial resolution requirements in ICH detection. Imaging at 90 kVp yielded the best tradeoff between noise and contrast. The model provided quantitation of tradeoffs between flat-panel and CMOS detectors with respect to electronic noise, field of view, and readout speed required for imaging of ICH. An anti-scatter grid was shown to provide modest benefit in conjunction with post-acquisition scatter correction. Images of the head phantom demonstrate visualization of millimeter-scale simulated ICH. Conclusions: Performance consistent with acute TBI and ICH detection is feasible with model-based system design and robust artifact correction in a dedicated head CBCT system. Further improvements can be achieved with incorporation of model-based iterative reconstruction techniques also within the scope of the task-based optimization framework. David Foos and Xiaohui Wang are employees of Carestream Health.« less

Applicability of Cone Beam Computed Tomography to the Assessment of the Vocal Tract before and after Vocal Exercises in Normal Subjects.

PubMed

Garcia, Elisângela Zacanti; Yamashita, Hélio Kiitiro; Garcia, Davi Sousa; Padovani, Marina Martins Pereira; Azevedo, Renata Rangel; Chiari, Brasília Maria

2016-01-01

Cone beam computed tomography (CBCT), which represents an alternative to traditional computed tomography and magnetic resonance imaging, may be a useful instrument to study vocal tract physiology related to vocal exercises. This study aims to evaluate the applicability of CBCT to the assessment of variations in the vocal tract of healthy individuals before and after vocal exercises. Voice recordings and CBCT images before and after vocal exercises performed by 3 speech-language pathologists without vocal complaints were collected and compared. Each participant performed 1 type of exercise, i.e., Finnish resonance tube technique, prolonged consonant "b" technique, or chewing technique. The analysis consisted of an acoustic analysis and tomographic imaging. Modifications of the vocal tract settings following vocal exercises were properly detected by CBCT, and changes in the acoustic parameters were, for the most part, compatible with the variations detected in image measurements. CBCT was shown to be capable of properly assessing the changes in vocal tract settings promoted by vocal exercises. © 2017 S. Karger AG, Basel.

Standardized method to quantify the variation in voxel value distribution in patient-simulated CBCT data sets.

PubMed

Spin-Neto, R; Gotfredsen, E; Wenzel, A

2015-01-01

To suggest a standardized method to assess the variation in voxel value distribution in patient-simulated CBCT data sets and the effect of time between exposures (TBE). Additionally, a measurement of reproducibility, Aarhus measurement of reproducibility (AMORe), is introduced, which could be used for quality assurance purposes. Six CBCT units were tested [Cranex(®) 3D/CRAN (Soredex Oy, Tuusula, Finland); Scanora(®) 3D/SCAN (Soredex Oy); NewTom™ 5G/NEW5 (QR srl, Verona, Italy); i-CAT/ICAT (Imaging Sciences International, Hatfield, PA); 3D Accuitomo FPD80/ACCU (Morita, Kyoto, Japan); and NewTom VG/NEWV (QR srl)]. Two sets of volumetric data of a wax-imbedded dry human skull (containing a titanium implant) were acquired by each CBCT unit at two sessions on separate days. Each session consisted 21 exposures: 1 "initial" followed by a 30-min interval (initial data set), 10 acquired with 30-min TBE (data sets 1-10) and 10 acquired with 15-min TBE (data sets 11-20). CBCT data were exported as digital imaging and communications in medicine files and converted to text files containing x, y and z positions and grey shade for each voxel. Subtractions were performed voxel-by-voxel in two set-ups: (1) between two consecutive data sets and (2) between any subsequent data set and data set 1. The mean grey shade variation for each voxel was calculated for each unit/session. The largest mean grey shade variation was found in the subtraction set-up 2 (27-447 shades of grey, depending on the unit). Considering subtraction set-up 1, the highest variation was seen for NEW5, between data sets 1 and the initial. Discrepancies in voxel value distribution were found by comparing the initial examination of the day with the subsequent examinations. TBE had no predictable effect on the variation of CBCT-derived voxel values. AMORe ranged between 0 and 64.

Entrance surface dose distribution and organ dose assessment for cone-beam computed tomography using measurements and Monte Carlo simulations with voxel phantoms

NASA Astrophysics Data System (ADS)

Baptista, M.; Di Maria, S.; Vieira, S.; Vaz, P.

2017-11-01

Cone-Beam Computed Tomography (CBCT) enables high-resolution volumetric scanning of the bone and soft tissue anatomy under investigation at the treatment accelerator. This technique is extensively used in Image Guided Radiation Therapy (IGRT) for pre-treatment verification of patient position and target volume localization. When employed daily and several times per patient, CBCT imaging may lead to high cumulative imaging doses to the healthy tissues surrounding the exposed organs. This work aims at (1) evaluating the dose distribution during a CBCT scan and (2) calculating the organ doses involved in this image guiding procedure for clinically available scanning protocols. Both Monte Carlo (MC) simulations and measurements were performed. To model and simulate the kV imaging system mounted on a linear accelerator (Edge™, Varian Medical Systems) the state-of-the-art MC radiation transport program MCNPX 2.7.0 was used. In order to validate the simulation results, measurements of the Computed Tomography Dose Index (CTDI) were performed, using standard PMMA head and body phantoms, with 150 mm length and a standard pencil ionizing chamber (IC) 100 mm long. Measurements for head and pelvis scanning protocols, usually adopted in clinical environment were acquired, using two acquisition modes (full-fan and half fan). To calculate the organ doses, the implemented MC model of the CBCT scanner together with a male voxel phantom ("Golem") was used. The good agreement between the MCNPX simulations and the CTDIw measurements (differences up to 17%) presented in this work reveals that the CBCT MC model was successfully validated, taking into account the several uncertainties. The adequacy of the computational model to map dose distributions during a CBCT scan is discussed in order to identify ways to reduce the total CBCT imaging dose. The organ dose assessment highlights the need to evaluate the therapeutic and the CBCT imaging doses, in a more balanced approach, and the importance of improving awareness regarding the increased risk, arising from repeated exposures.

Volume-of-interest reconstruction from severely truncated data in dental cone-beam CT

NASA Astrophysics Data System (ADS)

Zhang, Zheng; Kusnoto, Budi; Han, Xiao; Sidky, E. Y.; Pan, Xiaochuan

2015-03-01

As cone-beam computed tomography (CBCT) has gained popularity rapidly in dental imaging applications in the past two decades, radiation dose in CBCT imaging remains a potential, health concern to the patients. It is a common practice in dental CBCT imaging that only a small volume of interest (VOI) containing the teeth of interest is illuminated, thus substantially lowering imaging radiation dose. However, this would yield data with severe truncations along both transverse and longitudinal directions. Although images within the VOI reconstructed from truncated data can be of some practical utility, they often are compromised significantly by truncation artifacts. In this work, we investigate optimization-based reconstruction algorithms for VOI image reconstruction from CBCT data of dental patients containing severe truncations. In an attempt to further reduce imaging dose, we also investigate optimization-based image reconstruction from severely truncated data collected at projection views substantially fewer than those used in clinical dental applications. Results of our study show that appropriately designed optimization-based reconstruction can yield VOI images with reduced truncation artifacts, and that, when reconstructing from only one half, or even one quarter, of clinical data, it can also produce VOI images comparable to that of clinical images.

Assessing the Accuracy and Reliability of Root Crack and Fracture Detection in Teeth Using Sweep Imaging with Fourier Transform (SWIFT) Magnetic Resonance Imaging (MRI)

NASA Astrophysics Data System (ADS)

Schuurmans, Tyler J.

Introduction: Magnetic Resonance Imaging (MRI) has the potential to aid in determining the presence and extent of cracks/fractures in teeth due to more advantageous contrast, without ionizing radiation. An MRI technique called Sweep Imaging with Fourier Transform (SWIFT) has overcome many of the inherent difficulties of conventional MRI with detecting fast-relaxing signals from densely mineralized dental tissues. The objectives of this in vitro investigation were to develop MRI criteria for root crack/fracture identification in teeth and to establish intra- and inter-rater reliabilities and corresponding sensitivity and specificity values for the detection of tooth-root cracks/fractures in SWIFT MRI and limited field of view (FOV) CBCT. Materials and Methods: MRI-based criteria for crack/fracture appearance was developed by an MRI physicist and 6 dentists, including 3 endodontists and 1 Oral and Maxillofacial (OMF) radiologist. Twenty-nine human adult teeth previously extracted following clinical diagnosis by a board-certified endodontist of a root crack/fracture were frequency-matched to 29 non-cracked controls. Crack/fracture status confirmation was performed with magnified visual inspection, transillumination and vital staining. Samples were scanned with two 3D imaging modalities: 1) SWIFT MRI (10 teeth/scan) via a custom oral radiofrequency (RF) coil and a 90cm, 4-T magnet; 2) Limited FOV CBCT (1 tooth/scan) via a Carestream (CS) 9000 (Rochester, NY). Following a training period, a blinded 4-member panel (3 endodontists, 1 OMF radiologist) evaluated the images with a proportion randomly re-tested to establish intra-rater reliability. Overall observer agreement was measured using Cohen's kappa and levels of agreement judged using the criteria of Landis and Koch. Sensitivity and specificity were computed with 95% confidence interval (CI); statistical significance was set at alpha ≤ 0.05. Results: MRI-based crack/fracture criteria were defined as 1-2 sharply-delineated, high-signal (bright/white) line shape(s) that must be visible on multiple contiguous image slices. The line shape(s) must present as: single entities, or parallel pairs in close proximity, or pairs in close proximity exhibiting convergence or divergence extending from the external boundary of the tooth to the pulpal cavity. Intra-rater reliability for MRI was fair-to-almost perfect (kappa = 0.38-1.00) and for CBCT was moderate-to-almost perfect (kappa = 0.66-1.00). Inter-rater reliability for MRI was fair (kappa = 0.21; 95% CI: 0.10-0.31; p < 0.001) and for CBCT was moderate (kappa = 0.45; 95% CI: 0.34-0.56; p < 0.001). Sensitivity: MRI = 0.59 (95% CI: 0.39-0.76; p = 0.46); CBCT = 0.59 (95% CI: 0.59-0.76; p = 0.46). Specificity: MRI = 0.83 (95% CI: 0.64-0.94; p < 0.01); CBCT = 0.90 (95% CI: 0.73-0.98; p < 0.01). Conclusions: Education and training for both imaging modalities is needed to improve reliabilities for the identification of tooth-root crack/fractures. Despite the advantages of increased contrast and absence of artifact from radio-dense materials in MRI, comparable measures of sensitivity and specificity (in relation to CBCT) suggest quality MRI improvements are needed, specifically in image acquisition and post-processing parameters. Given the early stage of technology development and multiple available pathways to optimize MR imaging of teeth, there may be a use for SWIFT MRI in detecting cracks and fractures in teeth.

Nerve damage assessment following implant placement in human cadaver jaws: an ex vivo comparative study.

PubMed

Murat, Sema; Kamburoğlu, Kıvanç; Kılıç, Cenk; Ozen, Tuncer; Gurbuz, Ayhan

2014-02-01

The present study compared the use of cone beam computerized tomography (CBCT) images and intra-oral radiographs in the placement of final implant drills in terms of nerve damage to cadaver mandibles. Twelve cadaver hemimandibles obtained from 6 cadavers were used. Right hemimandibles were imaged using peri-apical radiography and left hemimandibles using CBCT, and the images obtained were used in treatment planning for the placement of implant drills (22 for each modality, for a total of 44 final drills). Specimens were dissected, and the distances between the apex of the final implant drill and the inferior alveolar neurovascular bundle and incisive nerve were measured using a digital calliper. Nerves were assessed as damaged or not damaged, and the Chi-square test was used to compare nerve damage between modalities (P < 0.05). Nerve damage occurred with 7 final drills placed based on peri-apical radiography (31.8%) and 1 final drill placed using CBCT images (4.5%). The difference in nerve damage between imaging modalities was statistically significant (P = 0.023), with CBCT outperforming intraoral film in the placement of final implant drills ex vivo. In order to prevent nerve damage, CBCT is recommended as the principal imaging modality for pre-implant assessment.

TH-CD-207A-10: Using the Gamma Index to Flag Changes in Anatomy During Radiation Therapy of Head and Neck Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schaly, B; Battista, J; Department of Medical Biophysics, Western University, London, Ontario Canada

Purpose: This article presents a fast algorithm for comparing 3-D anatomy from Cone-Beam CT (CBCT) imaging using the gamma comparison index and to demonstrate how this can be used to flag patients for possible re-planning of treatment. Methods: CBCT scans acquired on a Varian linear accelerator during treatment were used as input to the gamma comparator using thresholds of 5 mm distance to agreement and 30 Hounsfield Unit CT number difference. The fraction 1 CBCT study was initially used as the reference. Should there be a re-plan during treatment, the reference resets to the CBCT study acquired on the daymore » 1 of the re-plan. Histograms of failing pixels (γ > 1) were generated from each 3-D gamma map. An indicator of anatomy congruence, the match quality parameter (MQP), was derived from failed pixel histograms using the 90th percentile gamma value. The MQP was plotted versus fraction number and related to actual repeat computed tomography (re-CT) order dates as decided by a radiation oncologist. From this, decision criteria were derived for the algorithm to “trigger” re-CT consideration and predictive power was scored using receiver-operator characteristic (ROC) analysis. Results: The MQP plot generally showed that the on-line match from CBCT image guidance deteriorated as the treatment progressed due to weight loss and tumor regression. The optimized MQP criteria for triggering re-CT consideration demonstrated high sensitivity and specificity, consistent with actual re-CT order dates within ± 3 fractions. Out of 20 patients that were actually re-planned, the algorithm failed to trigger a re-CT recommendation only twice and this was caused by CBCT ring artifacts. Conclusion: We have demonstrated that gamma comparisons can be used to evaluate CBCT-acquired anatomy pairs and, from this, an algorithm can be “trained” to flag patients for possible re-planning in a manner consistent with local radiation oncology practice.« less

SU-F-T-638: Is There A Need For Immobilization in SRS?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Masterova, K; Sethi, A; Anderson, D

2016-06-15

Purpose: Frameless Stereotactic radiosurgery (SRS) is increasingly used in the clinic. Cone-Beam CT (CBCT) to simulation-CT match has replaced the 3-dimensional coordinate based set up using a stereotactic localizing frame. The SRS frame however served as both a localizing and immobilizing device. We seek to measure the quality of frameless (mask based) and frame based immobilization and evaluate its impact on target dose. Methods: Each SRS patient was set up by kV on-board imaging (OBI) and then fine-tuned with CBCT. A second CBCT was done at treatment-end to ascertain intrafraction motion. We compared pre- vs post-treatment CBCT shifts for bothmore » frameless and frame based SRS patients. CBCT to sim-CT fusion was repeated for each patient off-line to assess systematic residual image registration error. Each patient was re-planned with measured shifts to assess effects on target dose. Results: We analyzed 11 patients (12 lesions) treated with frameless SRS and 6 patients (11 lesions) with a fixed frame system. Average intra-fraction iso-center positioning errors for frameless and frame-based treatments were 1.24 ± 0.57 mm and 0.28 ± 0.08 mm (mean ± s.d.) respectively. Residual error in CBCT registration was 0.24 mm. The frameless positioning uncertainties led to target dose errors in Dmin and D95 of 15.5 ± 18.4% and 6.6 ± 9.1% respectively. The corresponding errors in fixed frame SRS were much lower with Dmin and D95 reduced by 4.2 ± 6.5% and D95 2.5 ± 3.8% respectively. Conclusion: Frameless mask provides good immobilization with average patient motion of 1.2 mm during treatment. This exceeds MRI voxel dimensions (∼0.43mm) used for target delineation. Frame-based SRS provides superior patient immobilization with measureable movement no greater than the background noise of the CBCT registration. Small lesions requiring submm precision are better served with a frame based SRS.« less

Compressed sensing with gradient total variation for low-dose CBCT reconstruction

NASA Astrophysics Data System (ADS)

Seo, Chang-Woo; Cha, Bo Kyung; Jeon, Seongchae; Huh, Young; Park, Justin C.; Lee, Byeonghun; Baek, Junghee; Kim, Eunyoung

2015-06-01

This paper describes the improvement of convergence speed with gradient total variation (GTV) in compressed sensing (CS) for low-dose cone-beam computed tomography (CBCT) reconstruction. We derive a fast algorithm for the constrained total variation (TV)-based a minimum number of noisy projections. To achieve this task we combine the GTV with a TV-norm regularization term to promote an accelerated sparsity in the X-ray attenuation characteristics of the human body. The GTV is derived from a TV and enforces more efficient computationally and faster in convergence until a desired solution is achieved. The numerical algorithm is simple and derives relatively fast convergence. We apply a gradient projection algorithm that seeks a solution iteratively in the direction of the projected gradient while enforcing a non-negatively of the found solution. In comparison with the Feldkamp, Davis, and Kress (FDK) and conventional TV algorithms, the proposed GTV algorithm showed convergence in ≤18 iterations, whereas the original TV algorithm needs at least 34 iterations in reducing 50% of the projections compared with the FDK algorithm in order to reconstruct the chest phantom images. Future investigation includes improving imaging quality, particularly regarding X-ray cone-beam scatter, and motion artifacts of CBCT reconstruction.

Peripheral Quantitative CT (pQCT) Using a Dedicated Extremity Cone-Beam CT Scanner

PubMed Central

Muhit, A. A.; Arora, S.; Ogawa, M.; Ding, Y.; Zbijewski, W.; Stayman, J. W.; Thawait, G.; Packard, N.; Senn, R.; Yang, D.; Yorkston, J.; Bingham, C.O.; Means, K.; Carrino, J. A.; Siewerdsen, J. H.

2014-01-01

Purpose We describe the initial assessment of the peripheral quantitative CT (pQCT) imaging capabilities of a cone-beam CT (CBCT) scanner dedicated to musculoskeletal extremity imaging. The aim is to accurately measure and quantify bone and joint morphology using information automatically acquired with each CBCT scan, thereby reducing the need for a separate pQCT exam. Methods A prototype CBCT scanner providing isotropic, sub-millimeter spatial resolution and soft-tissue contrast resolution comparable or superior to standard multi-detector CT (MDCT) has been developed for extremity imaging, including the capability for weight-bearing exams and multi-mode (radiography, fluoroscopy, and volumetric) imaging. Assessment of pQCT performance included measurement of bone mineral density (BMD), morphometric parameters of subchondral bone architecture, and joint space analysis. Measurements employed phantoms, cadavers, and patients from an ongoing pilot study imaged with the CBCT prototype (at various acquisition, calibration, and reconstruction techniques) in comparison to MDCT (using pQCT protocols for analysis of BMD) and micro-CT (for analysis of subchondral morphometry). Results The CBCT extremity scanner yielded BMD measurement within ±2–3% error in both phantom studies and cadaver extremity specimens. Subchondral bone architecture (bone volume fraction, trabecular thickness, degree of anisotropy, and structure model index) exhibited good correlation with gold standard micro-CT (error ~5%), surpassing the conventional limitations of spatial resolution in clinical MDCT scanners. Joint space analysis demonstrated the potential for sensitive 3D joint space mapping beyond that of qualitative radiographic scores in application to non-weight-bearing versus weight-bearing lower extremities and assessment of phalangeal joint space integrity in the upper extremities. Conclusion The CBCT extremity scanner demonstrated promising initial results in accurate pQCT analysis from images acquired with each CBCT scan. Future studies will include improved x-ray scatter correction and image reconstruction techniques to further improve accuracy and to correlate pQCT metrics with known pathology. PMID:25076823

The current status of cone beam computed tomography imaging in orthodontics

PubMed Central

Kapila, S; Conley, R S; Harrell, W E

2011-01-01

Cone beam CT (CBCT) has become an increasingly important source of three dimensional (3D) volumetric data in clinical orthodontics since its introduction into dentistry in 1998. The purpose of this manuscript is to highlight the current understanding of, and evidence for, the clinical use of CBCT in orthodontics, and to review the findings to answer clinically relevant questions. Currently available information from studies using CBCT can be organized into five broad categories: 1, the assessment of CBCT technology; 2, its use in craniofacial morphometric analyses; 3, incidental and missed findings; 4, analysis of treatment outcomes; and 5, efficacy of CBCT in diagnosis and treatment planning. The findings in these topical areas are summarized, followed by current indications and protocols for the use of CBCT in specific cases. Despite the increasing popularity of CBCT in orthodontics, and its advantages over routine radiography in specific cases, the effects of information derived from these images in altering diagnosis and treatment decisions has not been demonstrated in several types of cases. It has therefore been recommended that CBCT be used in select cases in which conventional radiography cannot supply satisfactory diagnostic information; these include cleft palate patients, assessment of unerupted tooth position, supernumerary teeth, identification of root resorption and for planning orthognathic surgery. The need to image other types of cases should be made on a case-by-case basis following an assessment of benefits vs risks of scanning in these situations. PMID:21159912

TH-E-17A-06: Anatomical-Adaptive Compressed Sensing (AACS) Reconstruction for Thoracic 4-Dimensional Cone-Beam CT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shieh, C; Kipritidis, J; OBrien, R

2014-06-15

Purpose: The Feldkamp-Davis-Kress (FDK) algorithm currently used for clinical thoracic 4-dimensional (4D) cone-beam CT (CBCT) reconstruction suffers from noise and streaking artifacts due to projection under-sampling. Compressed sensing theory enables reconstruction of under-sampled datasets via total-variation (TV) minimization, but TV-minimization algorithms such as adaptive-steepest-descent-projection-onto-convex-sets (ASD-POCS) often converge slowly and are prone to over-smoothing anatomical details. These disadvantages can be overcome by incorporating general anatomical knowledge via anatomy segmentation. Based on this concept, we have developed an anatomical-adaptive compressed sensing (AACS) algorithm for thoracic 4D-CBCT reconstruction. Methods: AACS is based on the ASD-POCS framework, where each iteration consists of a TV-minimizationmore » step and a data fidelity constraint step. Prior to every AACS iteration, four major thoracic anatomical structures - soft tissue, lungs, bony anatomy, and pulmonary details - were segmented from the updated solution image. Based on the segmentation, an anatomical-adaptive weighting was applied to the TV-minimization step, so that TV-minimization was enhanced at noisy/streaky regions and suppressed at anatomical structures of interest. The image quality and convergence speed of AACS was compared to conventional ASD-POCS using an XCAT digital phantom and a patient scan. Results: For the XCAT phantom, the AACS image represented the ground truth better than the ASD-POCS image, giving a higher structural similarity index (0.93 vs. 0.84) and lower absolute difference (1.1*10{sup 4} vs. 1.4*10{sup 4}). For the patient case, while both algorithms resulted in much less noise and streaking than FDK, the AACS image showed considerably better contrast and sharpness of the vessels, tumor, and fiducial marker than the ASD-POCS image. In addition, AACS converged over 50% faster than ASD-POCS in both cases. Conclusions: The proposed AACS algorithm was shown to reconstruct thoracic 4D-CBCT images more accurately and with faster convergence compared to ASD-POCS. The superior image quality and rapid convergence makes AACS promising for future clinical use.« less

Clinical Application of Cone Beam Computed Tomography of the Rabbit Head: Part 2—Dental Disease

PubMed Central

Riggs, G. G.; Cissell, Derek D.; Arzi, Boaz; Hatcher, David C.; Kass, Philip H.; Zhen, Amy; Verstraete, Frank J. M.

2017-01-01

Domestic rabbits are increasing in popularity as household pets; therefore, veterinarians need to be familiar with the most common diseases afflicting rabbits including dental disease. Current diagnostic approaches include gross oral examination, endoscopic oral examination, skull radiography, and computed tomography (CT). Cone beam computed tomography (CBCT), a new oral and maxillofacial imaging modality that has the capability to produce high-resolution images, has not yet been described for use in evaluating dental disease in rabbits. A total of 15 client-owned rabbits had CBCT, oral examination, dental charting, and dental treatment performed under general anesthesia. Images were evaluated using transverse and custom multiplanar (MPR), 3D, and panoramic reconstructed images. The CBCT findings were grouped into abnormalities that could be detected on conscious oral examination vs. abnormalities that could not be detected by conscious oral examination. Potential associations between the two categories were examined by pairwise Fisher’s exact test with statistical significance determined by P < 0.05. The most common findings identified on CBCT images were periodontal ligament space widening (14/15), premolar and molar malocclusion (13/15), apical elongation (13/15), coronal elongation (12/15), inflammatory tooth resorption (12/15), periapical lucency (11/15), moth-eaten pattern of osteolysis of the alveolar bone (9/15), ventral mandibular border contour changes (9/15), and missing teeth (8/15). Of the CBCT abnormalities likely to be observed on oral examination, coronal elongation (detectable on oral examination) was significantly associated with apical elongation (P = 0.029). There were no other significant associations between CBCT findings that are also clinically detectable and CBCT findings that are not be detectable on oral examination. This suggests that pathology often exists that is not apparent upon oral examination. This study establishes the common CBCT findings associated with dental disease in rabbits and demonstrates the feasibility of this technology to diagnose and plan treatment in dental disorders in this species. PMID:28194401

Artifact reduction in short-scan CBCT by use of optimization-based reconstruction

PubMed Central

Zhang, Zheng; Han, Xiao; Pearson, Erik; Pelizzari, Charles; Sidky, Emil Y; Pan, Xiaochuan

2017-01-01

Increasing interest in optimization-based reconstruction in research on, and applications of, cone-beam computed tomography (CBCT) exists because it has been shown to have to potential to reduce artifacts observed in reconstructions obtained with the Feldkamp–Davis–Kress (FDK) algorithm (or its variants), which is used extensively for image reconstruction in current CBCT applications. In this work, we carried out a study on optimization-based reconstruction for possible reduction of artifacts in FDK reconstruction specifically from short-scan CBCT data. The investigation includes a set of optimization programs such as the image-total-variation (TV)-constrained data-divergency minimization, data-weighting matrices such as the Parker weighting matrix, and objects of practical interest for demonstrating and assessing the degree of artifact reduction. Results of investigative work reveal that appropriately designed optimization-based reconstruction, including the image-TV-constrained reconstruction, can reduce significant artifacts observed in FDK reconstruction in CBCT with a short-scan configuration. PMID:27046218

Accuracy of off-line bioluminescence imaging to localize targets in preclinical radiation research.

PubMed

Tuli, Richard; Armour, Michael; Surmak, Andrew; Reyes, Juvenal; Iordachita, Iulian; Patterson, Michael; Wong, John

2013-04-01

In this study, we investigated the accuracy of using off-line bioluminescence imaging (BLI) and tomography (BLT) to guide irradiation of small soft tissue targets on a small animal radiation research platform (SARRP) with on-board cone beam CT (CBCT) capability. A small glass bulb containing BL cells was implanted as a BL source in the abdomen of 11 mouse carcasses. Bioluminescence imaging and tomography were acquired for each carcass. Six carcasses were setup visually without immobilization and 5 were restrained in position with tape. All carcasses were setup in treatment position on the SARRP where the centroid position of the bulb on CBCT was taken as "truth". In the 2D visual setup, the carcass was setup by aligning the point of brightest luminescence with the vertical beam axis. In the CBCT assisted setup, the pose of the carcass on CBCT was aligned with that on the 2D BL image for setup. For both 2D setup methods, the offset of the bulb centroid on CBCT from the vertical beam axis was measured. In the BLT-CBCT fusion method, the 3D torso on BLT and CBCT was registered and the 3D offset of the respective source centroids was calculated. The setup results were independent of the carcass being immobilized or not due to the onset of rigor mortis. The 2D offset of the perceived BL source position from the CBCT bulb position was 2.3 mm ± 1.3 mm. The 3D offset between BLT and CBCT was 1.5 mm ± 0.9 mm. Given the rigidity of the carcasses, the setup results represent the best that can be achieved with off-line 2D BLI and 3D BLT. The setup uncertainty would require the use of undesirably large margin of 4-5 mm. The results compel the implementation of on-board BLT capability on the SARRP to eliminate setup error and to improve BLT accuracy.

Accuracy of Off-Line Bioluminescence Imaging to Localize Targets in Preclinical Radiation Research

PubMed Central

Tuli, Richard; Armour, Michael; Surmak, Andrew; Reyes, Juvenal; Iordachita, Iulian; Patterson, Michael; Wong, John

2013-01-01

In this study, we investigated the accuracy of using off-line bioluminescence imaging (BLI) and tomography (BLT) to guide irradiation of small soft tissue targets on a small animal radiation research platform (SARRP) with on-board cone beam CT (CBCT) capability. A small glass bulb containing BL cells was implanted as a BL source in the abdomen of 11 mouse carcasses. Bioluminescence imaging and tomography were acquired for each carcass. Six carcasses were setup visually without immobilization and 5 were restrained in position with tape. All carcasses were setup in treatment position on the SARRP where the centroid position of the bulb on CBCT was taken as “truth”. In the 2D visual setup, the carcass was setup by aligning the point of brightest luminescence with the vertical beam axis. In the CBCT assisted setup, the pose of the carcass on CBCT was aligned with that on the 2D BL image for setup. For both 2D setup methods, the offset of the bulb centroid on CBCT from the vertical beam axis was measured. In the BLT-CBCT fusion method, the 3D torso on BLT and CBCT was registered and the 3D offset of the respective source centroids was calculated. The setup results were independent of the carcass being immobilized or not due to the onset of rigor mortis. The 2D offset of the perceived BL source position from the CBCT bulb position was 2.3 mm ± 1.3 mm. The 3D offset between BLT and CBCT was 1.5 mm ± 0.9 mm. Given the rigidity of the carcasses, the setup results represent the best that can be achieved with off-line 2D BLI and 3D BLT. The setup uncertainty would require the use of undesirably large margin of 4–5 mm. The results compel the implementation of on-board BLT capability on the SARRP to eliminate setup error and to improve BLT accuracy. PMID:23578189

Intra-fraction motion of larynx radiotherapy

NASA Astrophysics Data System (ADS)

Durmus, Ismail Faruk; Tas, Bora

2018-02-01

In early stage laryngeal radiotherapy, movement is an important factor. Thyroid cartilage can move from swallowing, breathing, sound and reflexes. The effects of this motion on the target volume (PTV) during treatment were examined. In our study, the target volume movement during the treatment for this purpose was examined. Thus, setup margins are re-evaluated and patient-based PTV margins are determined. Intrafraction CBCT was scanned in 246 fractions for 14 patients. During the treatment, the amount of deviation which could be lateral, vertical and longitudinal axis was determined. ≤ ± 0.1cm deviation; 237 fractions in the lateral direction, 202 fractions in the longitudinal direction, 185 fractions in the vertical direction. The maximum deviation values were found in the longitudinal direction. Intrafraction guide in laryngeal radiotherapy; we are sure of the correctness of the treatment, the target volume is to adjust the margin and dose more precisely, we control the maximum deviation of the target volume for each fraction. Although the image quality of intrafraction-CBCT scans was lower than the image quality of planning CT, they showed sufficient contrast for this work.

TH-EF-207A-05: Feasibility of Applying SMEIR Method On Small Animal 4D Cone Beam CT Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhong, Y; Zhang, Y; Shao, Y

Purpose: Small animal cone beam CT imaging has been widely used in preclinical research. Due to the higher respiratory rate and heat beats of small animals, motion blurring is inevitable and needs to be corrected in the reconstruction. Simultaneous motion estimation and image reconstruction (SMEIR) method, which uses projection images of all phases, proved to be effective in motion model estimation and able to reconstruct motion-compensated images. We demonstrate the application of SMEIR for small animal 4D cone beam CT imaging by computer simulations on a digital rat model. Methods: The small animal CBCT imaging system was simulated with themore » source-to-detector distance of 300 mm and the source-to-object distance of 200 mm. A sequence of rat phantom were generated with 0.4 mm{sup 3} voxel size. The respiratory cycle was taken as 1.0 second and the motions were simulated with a diaphragm motion of 2.4mm and an anterior-posterior expansion of 1.6 mm. The projection images were calculated using a ray-tracing method, and 4D-CBCT were reconstructed using SMEIR and FDK methods. The SMEIR method iterates over two alternating steps: 1) motion-compensated iterative image reconstruction by using projections from all respiration phases and 2) motion model estimation from projections directly through a 2D-3D deformable registration of the image obtained in the first step to projection images of other phases. Results: The images reconstructed using SMEIR method reproduced the features in the original phantom. Projections from the same phase were also reconstructed using FDK method. Compared with the FDK results, the images from SMEIR method substantially improve the image quality with minimum artifacts. Conclusion: We demonstrate that it is viable to apply SMEIR method to reconstruct small animal 4D-CBCT images.« less

Comparison of methods for acceptance and constancy testing in dental cone-beam computed tomography.

PubMed

Steiding, C; Kolditz, D; Kalender, W

2015-04-01

The aim of this work was to implement, validate, and compare two procedures for routine image quality (IQ) assurance in dental cone-beam computed tomography (CBCT): 1. the German standard DIN 6868 - 161 introduced in 2013 and 2. the established standard IEC 61,223 - 3-5 for clinical CT x-ray equipment referenced as "DIN" and "IEC" below. The approximated in-plane modulation transfer function (MTF), the contrast-to-noise indicator (CNI), and the uniformity indicator (UI*) were determined in accordance with DIN. Image noise, the uniformity index (UI), the contrast-to-noise ratio (CNR), and the 3 D MTF were measured according to IEC 61,223 - 3-5 using a previously proposed quality assurance (QA) framework. For this, a modular phantom was used. All experiments were performed on a clinical dental CBCT unit. The severity of image artefacts was measured at different z-positions. A dedicated computer program was implemented to allow for automated QA procedure. The position and orientation of the phantoms were detected automatically in all of the measurements providing a reproducible placement of the evaluation regions and volumes. 50 % and 10 % in-plane MTF values of the approximated and the exact MTF calculation procedure were in agreement to within 5 %. With increasing axial distance from the isocentre, UI* and CNI dropped by 30 % and 19 %, respectively. Conventional IQ parameters showed higher sensitivity to image artefacts; i. e., UI and CNR were reduced by about 197 % and 37 %. The implemented automated QA routines are compatible with both the DIN and the IEC approach and offer reliable and quantitative tracking of imaging performance in dental CBCT for clinical practice. However, there is no equivalence between the DIN and the IEC metrics. In addition, direct measurements of physical IQ parameters such as image contrast and noise, uniformity, and axial resolution are not supported by the new concept according to DIN. The new DIN 6868 - 161 is not equivalent to the established IEC 61 223 - 3-5. Noise, uniformity, and contrast are well-suited to assess image artefacts. The implemented automated quality assurance program fits clinical routine. © Georg Thieme Verlag KG Stuttgart · New York.

Assessment of skeletal maturation based on cervical vertebrae in CBCT.

PubMed

Shim, Jocelyne J; Heo, Giseon; Lagravère, Manuel O

2012-12-01

Diagnosis of skeletal age in adolescents helps orthodontists select and time treatments. Currently this is done using lateral cephalometric radiographs. This study evaluates the application of the conventional method in cone-beam computer tomographic (CBCT) images to bring forth assessment of skeletal maturation in three-dimensions. Ninety-eight lateral cephalometric radiographs and CBCT scans were collected from orthodontic patients between 11 to 17 years of age over an 18-month period. CBCT scans were examined in seven sagittal slices based on cervical vertebral maturation staging (CVMS). Collected CVMS values were compared with those from corresponding lateral cephalometric radiograph. CVMS measured from CBCT and lateral cephalometric radiographs were the same on average. However, they were not consistent with each other and scored interclass correlation coefficient of 0.155 in validity test. Interoperator reliability was weak (0.581). Adaptation of cervical vertebrae maturation staging in CBCT requires further clarifications or modifications to become consistent with lateral cephalometric examinations and to become a reliable method. Alternatively, a completely new method may be developed consisting of maturational indicators or landmarks unique to CBCT imaging. Copyright © 2012. Published by Elsevier Masson SAS.

The importance of cone beam CT in the radiological detection of osteomalacia.

PubMed

Cakur, B; Sümbüllü, M A; Dagistan, S; Durna, D

2012-01-01

Although osteomalacia is one of the most common osteometabolic diseases among the elderly, there is no case in the literature that presents the effects of osteomalacia in detail using cone beam CT (CBCT). While thin and porous bones are the most common radiographic sign of the disease, the radiological hallmarks are pseudofractures (Looser's zone). We coincidentally detected osteomalacia in a 23-year-old female and we showed the pseudofracture on CBCT images. In the present case, we aim to present the images of osteomalacia that were detected by CBCT in detail. CBCT has an important value in screening for osteomalacia.

The importance of cone beam CT in the radiological detection of osteomalacia

PubMed Central

Çakur, B; Sümbüllü, M A; Dağistan, S; Durna, D

2012-01-01

Although osteomalacia is one of the most common osteometabolic diseases among the elderly, there is no case in the literature that presents the effects of osteomalacia in detail using cone beam CT (CBCT). While thin and porous bones are the most common radiographic sign of the disease, the radiological hallmarks are pseudofractures (Looser's zone). We coincidentally detected osteomalacia in a 23-year-old female and we showed the pseudofracture on CBCT images. In the present case, we aim to present the images of osteomalacia that were detected by CBCT in detail. CBCT has an important value in screening for osteomalacia. PMID:22074877

Evaluations of the setup discrepancy between BrainLAB 6D ExacTrac and cone-beam computed tomography used with the imaging guidance system Novalis-Tx for intracranial stereotactic radiosurgery.

PubMed

Oh, Se An; Park, Jae Won; Yea, Ji Woon; Kim, Sung Kyu

2017-01-01

The objective of this study was to evaluate the setup discrepancy between BrainLAB 6 degree-of-freedom (6D) ExacTrac and cone-beam computed tomography (CBCT) used with the imaging guidance system Novalis Tx for intracranial stereotactic radiosurgery. We included 107 consecutive patients for whom white stereotactic head frame masks (R408; Clarity Medical Products, Newark, OH) were used to fix the head during intracranial stereotactic radiosurgery, between August 2012 and July 2016. The patients were immobilized in the same state for both the verification image using 6D ExacTrac and online 3D CBCT. In addition, after radiation treatment, registration between the computed tomography simulation images and the CBCT images was performed with offline 6D fusion in an offline review. The root-mean-square of the difference in the translational dimensions between the ExacTrac system and CBCT was <1.01 mm for online matching and <1.10 mm for offline matching. Furthermore, the root-mean-square of the difference in the rotational dimensions between the ExacTrac system and the CBCT were <0.82° for online matching and <0.95° for offline matching. It was concluded that while the discrepancies in residual setup errors between the ExacTrac 6D X-ray and the CBCT were minor, they should not be ignored.

Three-rooted premolar analyzed by high-resolution and cone beam CT.

PubMed

Marca, Caroline; Dummer, Paul M H; Bryant, Susan; Vier-Pelisser, Fabiana Vieira; Só, Marcus Vinicius Reis; Fontanella, Vania; Dutra, Vinicius D'avila; de Figueiredo, José Antonio Poli

2013-07-01

The aim of this study was to analyze the variations in canal and root cross-sectional area in three-rooted maxillary premolars between high-resolution computed tomography (μCT) and cone beam computed tomography (CBCT). Sixteen extracted maxillary premolars with three distinct roots and fully formed apices were scanned using μCT and CBCT. Photoshop CS software was used to measure root and canal cross-sectional areas at the most cervical and the most apical points of each root third in images obtained using the two tomographic computed (CT) techniques, and at 30 root sections equidistant from both root ends using μCT images. Canal and root areas were compared between each method using the Student t test for paired samples and 95 % confidence intervals. Images using μCT were sharper than those obtained using CBCT. There were statistically significant differences in mean area measurements of roots and canals between the μCT and CBCT techniques (P < 0.05). Root and canal areas had similar variations in cross-sectional μCT images and became proportionally smaller in a cervical to apical direction as the cementodentinal junction was approached, from where the area then increased apically. Although variation was similar in the roots and canals under study, CBCT produced poorer image details than μCT. Although CBCT is a strong diagnosis tool, it still needs improvement to provide accuracy in details of the root canal system, especially in cases with anatomical variations, such as the three-rooted maxillary premolars.

TH-A-16A-01: Image Quality for the Radiation Oncology Physicist: Review of the Fundamentals and Implementation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seibert, J; Imbergamo, P

The expansion and integration of diagnostic imaging technologies such as On Board Imaging (OBI) and Cone Beam Computed Tomography (CBCT) into radiation oncology has required radiation oncology physicists to be responsible for and become familiar with assessing image quality. Unfortunately many radiation oncology physicists have had little or no training or experience in measuring and assessing image quality. Many physicists have turned to automated QA analysis software without having a fundamental understanding of image quality measures. This session will review the basic image quality measures of imaging technologies used in the radiation oncology clinic, such as low contrast resolution, highmore » contrast resolution, uniformity, noise, and contrast scale, and how to measure and assess them in a meaningful way. Additionally a discussion of the implementation of an image quality assurance program in compliance with Task Group recommendations will be presented along with the advantages and disadvantages of automated analysis methods. Learning Objectives: Review and understanding of the fundamentals of image quality. Review and understanding of the basic image quality measures of imaging modalities used in the radiation oncology clinic. Understand how to implement an image quality assurance program and to assess basic image quality measures in a meaningful way.« less

Evaluation of subjective image quality in relation to diagnostic task for cone beam computed tomography with different fields of view.

PubMed

Lofthag-Hansen, Sara; Thilander-Klang, Anne; Gröndahl, Kerstin

2011-11-01

To evaluate subjective image quality for two diagnostic tasks, periapical diagnosis and implant planning, for cone beam computed tomography (CBCT) using different exposure parameters and fields of view (FOVs). Examinations were performed in posterior part of the jaws on a skull phantom with 3D Accuitomo (FOV 3 cm×4 cm) and 3D Accuitomo FPD (FOVs 4 cm×4 cm and 6 cm×6 cm). All combinations of 60, 65, 70, 75, 80 kV and 2, 4, 6, 8, 10 mA with a rotation of 180° and 360° were used. Dose-area product (DAP) value was determined for each combination. The images were presented, displaying the object in axial, cross-sectional and sagittal views, without scanning data in a random order for each FOV and jaw. Seven observers assessed image quality on a six-point rating scale. Intra-observer agreement was good (κw=0.76) and inter-observer agreement moderate (κw=0.52). Stepwise logistic regression showed kV, mA and diagnostic task to be the most important variables. Periapical diagnosis, regardless jaw, required higher exposure parameters compared to implant planning. Implant planning in the lower jaw required higher exposure parameters compared to upper jaw. Overall ranking of FOVs gave 4 cm×4 cm, 6 cm×6 cm followed by 3 cm×4 cm. This study has shown that exposure parameters should be adjusted according to diagnostic task. For this particular CBCT brand a rotation of 180° gave good subjective image quality, hence a substantial dose reduction can be achieved without loss of diagnostic information. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A cone beam CT-Based Study for Clinical Target Definition Using Pelvic Anatomy During Postprostatectomy Radiotherapy.

PubMed

Showalter, Timothy N; Nawaz, A Omer; Xiao, Ying; Galvin, James M; Valicenti, Richard K

2008-02-01

There are no accepted guidelines for target volume definition for online image-guided radiation therapy (IGRT) after radical prostatectomy (RP). This study used cone beam CT (CBCT) imaging to generate information for use in post-RP IGRT. The pelvic anatomy of 10 prostate cancer patients undergoing post-RP radiation therapy (RT) to 68.4 Gy was studied using CBCT images obtained immediately before treatment. Contoured bladder and rectal volumes on CBCT images were compared with planning CT (CT(ref)) volumes from seminal vesicle stump (SVS) to bladder-urethral junction. This region was chosen to approximate the prostatic fossa (PF) during a course of post-RP RT. Anterior and posterior planning target volume margins were calculated using ICRU report 71 guidelines, accounting for systematic and random error based on bladder and rectal motion, respectively. A total of 176 CBCT study sets obtained 2 to 5 times weekly were analyzed. The rectal and bladder borders were reliably identified in 166 of 176 (94%) of CBCT images. Relative to CT(ref), mean posterior bladder wall position was anterior by 0.1 to 1.5 mm, and mean anterior rectum wall position was posterior by 1.6 to 2.7 mm. Calculated anterior margin as derived from bladder motion ranged from 5.9 to 7.1 mm. Calculated posterior margin as derived from rectal motion ranged from 8.6 to 10.2 mm. Normal tissue anatomy was definable by CBCT imaging throughout the course of post-RP RT, and the interfraction anteroposterior motion of the bladder and rectum was studied. This information should be considered in devising post-RP RT techniques using image guidance.

Planning Evaluation of C-Arm Cone Beam CT Angiography for Target Delineation in Stereotactic Radiation Surgery of Brain Arteriovenous Malformations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, Jun; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Huang, Judy

Purpose: Stereotactic radiation surgery (SRS) is one of the therapeutic modalities currently available to treat cerebral arteriovenous malformations (AVM). Conventionally, magnetic resonance imaging (MRI) and MR angiography (MRA) and digital subtraction angiography (DSA) are used in combination to identify the target volume for SRS treatment. The purpose of this study was to evaluate the use of C-arm cone beam computed tomography (CBCT) in the treatment planning of SRS for cerebral AVMs. Methods and Materials: Sixteen consecutive patients treated for brain AVMs at our institution were included in this retrospective study. Prior to treatment, all patients underwent MRA, DSA, and C-arm CBCT.more » All images were coregistered using the GammaPlan planning system. AVM regions were delineated independently by 2 physicians using either C-arm CBCT or MRA, resulting in 2 volumes: a CBCT volume (VCBCT) and an MRA volume (V{sub MRA}). SRS plans were generated based on the delineated regions. Results: The average volume of treatment targets delineated using C-arm CBCT and MRA were similar, 6.40 cm{sup 3} and 6.98 cm{sup 3}, respectively (P=.82). However, significant regions of nonoverlap existed. On average, the overlap of the MRA with the C-arm CBCT was only 52.8% of the total volume. In most cases, radiation plans based on V{sub MRA} did not provide adequate dose to the region identified on C-arm CBCT; the mean minimum dose to V{sub CBCT} was 29.5%, whereas the intended goal was 45% (P<.001). The mean volume of normal brain receiving 12 Gy or more in C-arm CBCT-based plans was not greater than in the MRA-based plans. Conclusions: Use of C-arm CBCT images significantly alters the delineated regions of AVMs for SRS planning, compared to that of MRA/MRI images. CT-based planning can be accomplished without increasing the dose to normal brain and may represent a more accurate definition of the nidus, increasing the chances for successful obliteration.« less

SU-E-T-235: Data Mining for Evaluating Treatment Performances Over a Large Quantity of Data to Monitor and Improve SBRT Workflow

DOE Office of Scientific and Technical Information (OSTI.GOV)

Feng, W; Bayhealth Medical Center, Dover, DE; Chu, A

Purpose: To quality assure a large quantity of retrospective treatment cases for treatment performances by randomly sampling is inefficient. Here we provide a method to efficiently monitor and investigate the QA of SBRT workflow over Mosaiq. Methods: The code developed with Microsoft SQL Server Management Studio 2008R2 and VBA was used for retrieving and sorting data from Mosaiq (version 2.3–2.6 during 2012–2015). SBRT patients were filtered by fractional dose over 350cGy and total fraction number less than 6, which SBRT prescriptions were defined. The quality assurance on the SBRT workflow was focused on the treatment deliveries such as patient positioningmore » setup, CBCT indicated offsets and couch shifted corrections. The treatment delivery were done by Varian Truebeam systems and the record/verify by Mosaiq. Results: Total 82 SBRT patients corresponding to 103 courses and 854 CBCT images were found by the retrieval query. Most centers record daily pre-treatment (Pre-Tx: before treatment shift) image-guided shifts along treatment course for inter-fraction motion record, and it is useful to also verify it with post-treatment imaging (Post-Tx: after treatment CBCT verification) to verify intra-fraction motion. Analyzing the details of daily recorded shifts can reveals the information of patient-setup and staff’s record/verify behaviors. 3 examples were provided as solid evidences and on-going rectification for preventing future mistakes. Conclusions: The report gave feasible examples for inspector to verify a large amount of data during site investigation. This program can also be extended to a scheduled data mining with software to periodical analyze the timely records in Mosaiq, for example, a various control charts for different QA purposes. As the current trend of automation in radiation therapy field, the data mining would be a necessary tool in the future, just as the automatic plan quality evaluation has been under development in Eclipse.« less

A pragmatic approach to determine the optimal kVp in cone beam CT: balancing contrast-to-noise ratio and radiation dose

PubMed Central

Silkosessak, O; Jacobs, R; Bogaerts, R; Bosmans, H; Panmekiate, S

2014-01-01

Objectives: To determine the optimal kVp setting for a particular cone beam CT (CBCT) device by maximizing technical image quality at a fixed radiation dose. Methods: The 3D Accuitomo 170 (J. Morita Mfg. Corp., Kyoto, Japan) CBCT was used. The radiation dose as a function of kVp was measured in a cylindrical polymethyl methacrylate (PMMA) phantom using a small-volume ion chamber. Contrast-to-noise ratio (CNR) was measured using a PMMA phantom containing four materials (air, aluminium, polytetrafluoroethylene and low-density polyethylene), which was scanned using 180 combinations of kVp/mA, ranging from 60/1 to 90/8. The CNR was measured for each material using PMMA as background material. The pure effect of kVp and mAs on the CNR values was analysed. Using a polynomial fit for CNR as a function of mA for each kVp value, the optimal kVp was determined at five dose levels. Results: Absorbed doses ranged between 0.034 mGy mAs−1 (14 × 10 cm, 60 kVp) and 0.108 mGy mAs−1 (14 × 10 cm, 90 kVp). The relation between kVp and dose was quasilinear (R2 > 0.99). The effect of mA and kVp on CNR could be modelled using a second-degree polynomial. At a fixed dose, there was a tendency for higher CNR values at increasing kVp values, especially at low dose levels. A dose reduction through mA was more efficient than an equivalent reduction through kVp in terms of image quality deterioration. Conclusions: For the investigated CBCT model, the most optimal contrast at a fixed dose was found at the highest available kVp setting. There is great potential for dose reduction through mA with a minimal loss in image quality. PMID:24708447

Shading correction assisted iterative cone-beam CT reconstruction

NASA Astrophysics Data System (ADS)

Yang, Chunlin; Wu, Pengwei; Gong, Shutao; Wang, Jing; Lyu, Qihui; Tang, Xiangyang; Niu, Tianye

2017-11-01

Recent advances in total variation (TV) technology enable accurate CT image reconstruction from highly under-sampled and noisy projection data. The standard iterative reconstruction algorithms, which work well in conventional CT imaging, fail to perform as expected in cone beam CT (CBCT) applications, wherein the non-ideal physics issues, including scatter and beam hardening, are more severe. These physics issues result in large areas of shading artifacts and cause deterioration to the piecewise constant property assumed in reconstructed images. To overcome this obstacle, we incorporate a shading correction scheme into low-dose CBCT reconstruction and propose a clinically acceptable and stable three-dimensional iterative reconstruction method that is referred to as the shading correction assisted iterative reconstruction. In the proposed method, we modify the TV regularization term by adding a shading compensation image to the reconstructed image to compensate for the shading artifacts while leaving the data fidelity term intact. This compensation image is generated empirically, using image segmentation and low-pass filtering, and updated in the iterative process whenever necessary. When the compensation image is determined, the objective function is minimized using the fast iterative shrinkage-thresholding algorithm accelerated on a graphic processing unit. The proposed method is evaluated using CBCT projection data of the Catphan© 600 phantom and two pelvis patients. Compared with the iterative reconstruction without shading correction, the proposed method reduces the overall CT number error from around 200 HU to be around 25 HU and increases the spatial uniformity by a factor of 20 percent, given the same number of sparsely sampled projections. A clinically acceptable and stable iterative reconstruction algorithm for CBCT is proposed in this paper. Differing from the existing algorithms, this algorithm incorporates a shading correction scheme into the low-dose CBCT reconstruction and achieves more stable optimization path and more clinically acceptable reconstructed image. The method proposed by us does not rely on prior information and thus is practically attractive to the applications of low-dose CBCT imaging in the clinic.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schernthaner, Ruediger Egbert; Lin, MingDe; Duran, Rafael

PurposeTo evaluate the detectability of intrahepatic cholangiocarcinoma (ICC) on dual-phase cone-beam CT (DPCBCT) during conventional transarterial chemoembolization (cTACE) compared to that of digital subtraction angiography (DSA) with respect to pre-procedure contrast-enhanced magnetic resonance imaging (CE-MRI) of the liver.MethodsThis retrospective study included 17 consecutive patients (10 male, mean age 64) with ICC who underwent pre-procedure CE-MRI of the liver, and DSA and DPCBCT (early-arterial phase (EAP) and delayed-arterial phase (DAP)) just before cTACE. The visibility of each ICC lesion was graded by two radiologists on a three-rank scale (complete, partial, and none) on DPCBCT and DSA images, and then compared tomore » pre-procedure CE-MRI.ResultsOf 61 ICC lesions, only 45.9 % were depicted by DSA, whereas EAP- and DAP-CBCT yielded a significantly higher detectability rate of 73.8 % and 93.4 %, respectively (p < 0.01). Out of the 33 lesions missed on DSA, 18 (54.5 %) and 30 (90.9 %) were revealed on EAP- and DAP-CBCT images, respectively. DSA depicted only one lesion that was missed by DPCBCT due to streak artifacts caused by a prosthetic mitral valve. DAP-CBCT identified significantly more lesions than EAP-CBCT (p < 0.01). Conversely, EAP-CBCT did not detect lesions missed by DAP-CBCT. For complete lesion visibility, DAP-CBCT yielded significantly higher detectability (78.7 %) compared to EAP (31.1 %) and DSA (21.3 %) (p < 0.01).ConclusionDPCBCT, and especially the DAP-CBCT, significantly improved the detectability of ICC lesions during cTACE compared to DSA. We recommend the routine use of DAP-CBCT in patients with ICC for per-procedure detectability and treatment planning in the setting of TACE.« less

MO-FG-CAMPUS-JeP3-03: Detection of Unpredictable Patient Movement During SBRT Using a Single KV Projection of An On-Board CBCT System: Simulation Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, Y; Sharp, G; Winey, B

Purpose: An unpredictable movement of a patient can occur during SBRT even when immobilization devices are applied. In the SBRT treatments using a conventional linear accelerator detection of such movements relies heavily on human interaction and monitoring. This study aims to detect such positional abnormalities in real-time by assessing intra-fractional gantry mounted kV projection images of a patient’s spine. Methods: We propose a self-CBCT image based spine tracking method consisting of the following steps: (1)Acquire a pre-treatment CBCT image; (2)Transform the CBCT volume according to the couch correction; (3)Acquire kV projections during treatment beam delivery; (4)Simultaneously with each acquisition generatemore » a DRR from the CBCT volume based-on the current projection geometry; (5)Perform an intensity gradient-based 2D registration between spine ROI images of the projection and the DRR images; (6)Report an alarm if the detected 2D displacement is beyond a threshold value. To demonstrate the feasibility, retrospective simulations were performed on 1,896 projections from nine CBCT sessions of three patients who received lung SBRT. The unpredictable movements were simulated by applying random rotations and translations to the reference CBCT prior to each DRR generation. As the ground truth, the 3D translations and/or rotations causing >3 mm displacement of the midpoint of the thoracic spine were regarded as abnormal. In the measurements, different threshold values of 2D displacement were tested to investigate sensitivity and specificity of the proposed method. Results: A linear relationship between the ground truth 3D displacement and the detected 2D displacement was observed (R{sup 2} = 0.44). When the 2D displacement threshold was set to 3.6 mm the overall sensitivity and specificity were 77.7±5.7% and 77.9±3.5% respectively. Conclusion: In this simulation study, it was demonstrated that intrafractional kV projections from an on-board CBCT system have a potential to detect unpredictable patient movement during SBRT. This research is funded by Interfractional Imaging Research Grant from Elekta.« less

SU-E-J-214: Comparative Assessment On IGRT On Partial Bladder Cancer Treatment Between CT-On-Rails (CTOR) and KV Cone Beam CT (CBCT)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lin, T; Ma, C

2014-06-01

Purpose: Image-Guided radiation therapy(IGRT) depends on reliable online patient-specific anatomy information to address random and progressive anatomy changes. Large margins have been suggested to bladder cancer treatment due to large daily bladder anatomy variation. KV Cone beam CT(CBCT) has been used in IGRT localization prevalently; however, its lack of soft tissue contrast makes clinicians hesitate to perform daily soft tissue alignment with CBCT for partial bladder cancer treatment. This study compares the localization uncertainties of bladder cancer IGRT using CTon- Rails(CTOR) and CBCT. Methods: Three T2N0M0 bladder cancer patients (total of 66 Gy to partial bladder alone) were localized dailymore » with either CTOR or CBCT for their entire treatment course. A total of 71 sets of CTOR and 22 sets of CBCT images were acquired and registered with original planning CT scans by radiation therapists and approved by radiation oncologists for the daily treatment. CTOR scanning entailed 2mm slice thickness, 0.98mm axial voxel size, 120kVp and 240mAs. CBCT used a half fan pelvis protocol from Varian OBI system with 2mm slice thickness, 0.98axial voxel size, 125kVp, and 680mAs. Daily localization distribution was compared. Accuracy of CTOR and CBCT on partial bladder alignment was also evaluated by comparing bladder PTV coverage. Results: 1cm all around PTV margins were used in every patient except target superior limit margin to 0mm due to bowel constraint. Daily shifts on CTOR averaged to 0.48, 0.24, 0.19 mms(SI,Lat,AP directions); CBCT averaged to 0.43, 0.09, 0.19 mms(SI,Lat,AP directions). The CTOR daily localization showed superior results of V100% of PTV(102% CTOR vs. 89% CBCT) and bowel(Dmax 69.5Gy vs. 78Gy CBCT). CTOR images showed much higher contrast on bladder PTV alignment. Conclusion: CTOR daily localization for IGRT is more dosimetrically beneficial for partial bladder cancer treatment than kV CBCT localization and provided better soft tissue PTV identification.« less

Comparison of setup accuracy of three different image assessment methods for tangential breast radiotherapy.

PubMed

Batumalai, Vikneswary; Phan, Penny; Choong, Callie; Holloway, Lois; Delaney, Geoff P

2016-12-01

To compare the differences in setup errors measured with electronic portal image (EPI) and cone-beam computed tomography (CBCT) in patients undergoing tangential breast radiotherapy (RT). Relationship between setup errors, body mass index (BMI) and breast size was assessed. Twenty-five patients undergoing postoperative RT to the breast were consented for this study. Weekly CBCT scans were acquired and retrospectively registered to the planning CT in three dimensions, first using bony anatomy for bony registration (CBCT-B) and again using breast tissue outline for soft tissue registration (CBCT-S). Digitally reconstructed radiographs (DRR) generated from CBCT to simulate EPI were compared to the planning DRR using bony anatomy in the V (parallel to the cranio-caudal axis) and U (perpendicular to V) planes. The systematic (Σ) and random (σ) errors were calculated and correlated with BMI and breast size. The systematic and random errors for EPI (Σ V = 3.7 mm, Σ U = 2.8 mm and σ V = 2.9 mm, σ U = 2.5) and CBCT-B (Σ V = 3.5 mm, Σ U = 3.4 mm and σ V = 2.8 mm, σ U = 2.8) were of similar magnitude in the V and U planes. Similarly, the differences in setup errors for CBCT-B and CBCT-S in three dimensions were less than 1 mm. Only CBCT-S setup error correlated with BMI and breast size. CBCT and EPI show insignificant variation in their ability to detect setup error. These findings suggest no significant differences that would make one modality considered superior over the other and EPI should remain the standard of care for most patients. However, there is a correlation with breast size, BMI and setup error as detected by CBCT-S, justifying the use of CBCT-S for larger patients. © 2016 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Three-dimensional images contribute to the diagnosis of mucous retention cyst in maxillary sinus

PubMed Central

Donizeth-Rodrigues, Cleomar; Fonseca-Da Silveira, Márcia; Gonçalves-De Alencar, Ana H.; Garcia-Santos-Silva, Maria A.; Francisco-De-Mendonça, Elismauro

2013-01-01

Objective: To evaluate the detection of mucous retention cyst of maxillary sinus (MRCMS) using panoramic radiography and cone beam computed tomography (CBCT). Study Design: A digital database with 6,000 panoramic radiographs was reviewed for MRCMS. Suggestive images of MRCMS were detected on 185 radiographs, and patients were located and invited to return for follow-up. Thirty patients returned, and control panoramic radiographs were obtained 6 to 46 months after the initial radiograph. When MRCMS was found on control radiographs, CBCT scans were obtained. Cysts were measured and compared on radiographs and scans. The Wilcoxon, Spearman and Kolmorogov-Smirnov tests were used for statistical analysis. The level of significance was set at 5%. Results: There were statistically significant differences between the two methods (p<0.05): 23 MRCMS detected on panoramic radiographs were confirmed by CBCT, but 5 MRCMS detected on CBCT images had not been identified by panoramic radiography. Eight MRCMS detected on control radiographs were not confirmed by CBCT. MRCMS size differences from initial to control panoramic radiographs and CBCT scans were not statistically significant (p= 0.617 and p= 0.626). The correlation between time and MRCMS size differences was not significant (r = -0.16, p = 0.381). Conclusion: CBCT scanning detect MRCMS more accurately than panoramic radiography. Key words:Mucous cyst, maxillary sinus, panoramic radiograph, cone beam computed tomography. PMID:23229251

Implant treatment planning regarding augmentation procedures: panoramic radiographs vs. cone beam computed tomography images.

PubMed

Dagassan-Berndt, Dorothea C; Zitzmann, Nicola U; Walter, Clemens; Schulze, Ralf K W

2016-08-01

To evaluate the impact of cone beam computed tomography (CBCT) imaging on treatment planning regarding augmentation procedures for implant placement. Panoramic radiographs and CBCT images of 40 patients requesting single-tooth implants in 59 sites were retrospectively analyzed by six specialists in implantology, and treatment planning was performed. Therapeutic recommendations were compared with the surgical protocol performed initially. Bone height estimation from panoramic radiographs yielded to higher measures and greater variability compared to CBCT. The suggested treatment plan for lateral and vertical augmentation procedures based on CBCT or panoramic radiographs coincided for 55-72% of the cases. A trend to a more invasive augmentation procedure was seen when planning was based on CBCT. Panoramic radiography revealed 57-63% (lateral) vs. 67% (vertical augmentation) congruent plans in agreement with surgery. Among the dissenting sites, there was a trend toward less invasive planning for lateral augmentation with panoramic radiographs, while vertical augmentation requirements were more frequently more invasive when based on CBCT. Vertical augmentation requirements can be adequately determined from panoramic radiographs. In difficult cases with a deficient lateral alveolar bone, the augmentation schedule may better be evaluated from CBCT to avoid underestimation, which occurs more frequently when based on panoramic radiographs only. However, overall, radiographic interpretation and diagnostic thinking accuracy seem to be mainly depending on the opinion of observers. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of the reliability and accuracy of using cone-beam computed tomography for diagnosing periapical cysts from granulomas.

PubMed

Guo, Jing; Simon, James H; Sedghizadeh, Parish; Soliman, Osman N; Chapman, Travis; Enciso, Reyes

2013-12-01

The purpose of this study was to evaluate the reliability and accuracy of cone-beam computed tomographic (CBCT) imaging against the histopathologic diagnosis for the differential diagnosis of periapical cysts (cavitated lesions) from (solid) granulomas. Thirty-six periapical lesions were imaged using CBCT scans. Apicoectomy surgeries were conducted for histopathological examination. Evaluator 1 examined each CBCT scan for the presence of 6 radiologic characteristics of a cyst (ie, location, periphery, shape, internal structure, effects on surrounding structure, and perforation of the cortical plate). Not every cyst showed all radiologic features (eg, not all cysts perforate the cortical plate). For the purpose of finding the minimum number of diagnostic criteria present in a scan to diagnose a lesion as a cyst, we conducted 6 receiver operating characteristic curve analyses comparing CBCT diagnoses with the histopathologic diagnosis. Two other independent evaluators examined the CBCT lesions. Statistical tests were conducted to examine the accuracy, inter-rater reliability, and intrarater reliability of CBCT images. Findings showed that a score of ≥4 positive findings was the optimal scoring system. The accuracies of differential diagnoses of 3 evaluators were moderate (area under the curve = 0.76, 0.70, and 0.69 for evaluators 1, 2, and 3, respectively). The inter-rater agreement of the 3 evaluators was excellent (α = 0.87). The intrarater agreement was good to excellent (κ = 0.71, 0.76, and 0.77). CBCT images can provide a moderately accurate diagnosis between cysts and granulomas. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A gaussian mixture + demons deformable registration method for cone-beam CT-guided robotic transoral base-of-tongue surgery

NASA Astrophysics Data System (ADS)

Reaungamornrat, S.; Liu, W. P.; Schafer, S.; Otake, Y.; Nithiananthan, S.; Uneri, A.; Richmon, J.; Sorger, J.; Siewerdsen, J. H.; Taylor, R. H.

2013-03-01

Purpose: An increasingly popular minimally invasive approach to resection of oropharyngeal / base-of-tongue cancer is made possible by a transoral technique conducted with the assistance of a surgical robot. However, the highly deformed surgical setup (neck flexed, mouth open, and tongue retracted) compared to the typical patient orientation in preoperative images poses a challenge to guidance and localization of the tumor target and adjacent critical anatomy. Intraoperative cone-beam CT (CBCT) can account for such deformation, but due to the low contrast of soft-tissue in CBCT images, direct localization of the target and critical tissues in CBCT images can be difficult. Such structures may be more readily delineated in preoperative CT or MR images, so a method to deformably register such information to intraoperative CBCT could offer significant value. This paper details the initial implementation of a deformable registration framework to align preoperative images with the deformed intraoperative scene and gives preliminary evaluation of the geometric accuracy of registration in CBCT-guided TORS. Method: The deformable registration aligns preoperative CT or MR to intraoperative CBCT by integrating two established approaches. The volume of interest is first segmented (specifically, the region of the tongue from the tip to the hyoid), and a Gaussian mixture (GM) mode1 of surface point clouds is used for rigid initialization (GMRigid) as well as an initial deformation (GMNonRigid). Next, refinement of the registration is performed using the Demons algorithm applied to distance transformations of the GM-registered and CBCT volumes. The registration accuracy of the framework was quantified in preliminary studies using a cadaver emulating preoperative and intraoperative setups. Geometric accuracy of registration was quantified in terms of target registration error (TRE) and surface distance error. Result: With each step of the registration process, the framework demonstrated improved registration, achieving mean TRE of 3.0 mm following the GM rigid, 1.9 mm following GM nonrigid, and 1.5 mm at the output of the registration process. Analysis of surface distance demonstrated a corresponding improvement of 2.2, 0.4, and 0.3 mm, respectively. The evaluation of registration error revealed the accurate alignment in the region of interest for base-of-tongue robotic surgery owing to point-set selection in the GM steps and refinement in the deep aspect of the tongue in the Demons step. Conclusions: A promising framework has been developed for CBCT-guided TORS in which intraoperative CBCT provides a basis for registration of preoperative images to the highly deformed intraoperative setup. The registration framework is invariant to imaging modality (accommodating preoperative CT or MR) and is robust against CBCT intensity variations and artifact, provided corresponding segmentation of the volume of interest. The approach could facilitate overlay of preoperative planning data directly in stereo-endoscopic video in support of CBCT-guided TORS.

Applications of cone beam computed tomography for a prosthodontist.

PubMed

John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R B

2016-01-01

Cone beam computed tomography (CBCT) is a medical imaging technique of X-ray computed tomography where the X-rays are divergent, forming a cone. CBCT systems have been designed for imaging hard tissues of the maxillofacial region. The increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. This article is intended to elaborate and enunciate on the various applications and benefits of CBCT, in the realm of maxillofacial prosthodontics, over and beyond its obvious benefits in the rehabilitation of patients with implants. With the onus of meticulous reconstruction of near ideal occlusion resting on the prosthodontist, CBCT provides a unique imaging option, which can be a boon in various aspects of prosthodontic practice - from imaging of the temporomandibular joint for accurate movement simulation, to template assisted maxillofacial reconstruction or even over denture therapy. CBCT could play a crucial role in lessening the burden of a hectic prosthodontic routine for the clinician and critically contribute to accurate and effective treatment for the patient. Apart from the authors' clinical experiences shared here, a web-based search for relevant articles in this specific area of interest was also conducted. The selected articles were critically reviewed and the data acquired were systematically compiled.

Applications of cone beam computed tomography for a prosthodontist

PubMed Central

John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R. B.

2016-01-01

Cone beam computed tomography (CBCT) is a medical imaging technique of X-ray computed tomography where the X-rays are divergent, forming a cone. CBCT systems have been designed for imaging hard tissues of the maxillofacial region. The increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. This article is intended to elaborate and enunciate on the various applications and benefits of CBCT, in the realm of maxillofacial prosthodontics, over and beyond its obvious benefits in the rehabilitation of patients with implants. With the onus of meticulous reconstruction of near ideal occlusion resting on the prosthodontist, CBCT provides a unique imaging option, which can be a boon in various aspects of prosthodontic practice – from imaging of the temporomandibular joint for accurate movement simulation, to template assisted maxillofacial reconstruction or even over denture therapy. CBCT could play a crucial role in lessening the burden of a hectic prosthodontic routine for the clinician and critically contribute to accurate and effective treatment for the patient. Apart from the authors’ clinical experiences shared here, a web-based search for relevant articles in this specific area of interest was also conducted. The selected articles were critically reviewed and the data acquired were systematically compiled. PMID:27134420

Use of cone beam computed tomography in periodontology

PubMed Central

Acar, Buket; Kamburoğlu, Kıvanç

2014-01-01

Diagnosis of periodontal disease mainly depends on clinical signs and symptoms. However, in the case of bone destruction, radiographs are valuable diagnostic tools as an adjunct to the clinical examination. Two dimensional periapical and panoramic radiographs are routinely used for diagnosing periodontal bone levels. In two dimensional imaging, evaluation of bone craters, lamina dura and periodontal bone level is limited by projection geometry and superpositions of adjacent anatomical structures. Those limitations of 2D radiographs can be eliminated by three-dimensional imaging techniques such as computed tomography. Cone beam computed tomography (CBCT) generates 3D volumetric images and is also commonly used in dentistry. All CBCT units provide axial, coronal and sagittal multi-planar reconstructed images without magnification. Also, panoramic images without distortion and magnification can be generated with curved planar reformation. CBCT displays 3D images that are necessary for the diagnosis of intra bony defects, furcation involvements and buccal/lingual bone destructions. CBCT applications provide obvious benefits in periodontics, however; it should be used only in correct indications considering the necessity and the potential hazards of the examination. PMID:24876918

Computed tomography: Will the slices reveal the truth

PubMed Central

Haridas, Harish; Mohan, Abarajithan; Papisetti, Sravanthi; Ealla, Kranti K. R.

2016-01-01

With the advances in the field of imaging sciences, new methods have been developed in dental radiology. These include digital radiography, density analyzing methods, cone beam computed tomography (CBCT), magnetic resonance imaging, ultrasound, and nuclear imaging techniques, which provide high-resolution detailed images of oral structures. The current review aims to critically elaborate the use of CBCT in endodontics. PMID:27652253

A low-complexity 2-point step size gradient projection method with selective function evaluations for smoothed total variation based CBCT reconstructions

NASA Astrophysics Data System (ADS)

Song, Bongyong; Park, Justin C.; Song, William Y.

2014-11-01

The Barzilai-Borwein (BB) 2-point step size gradient method is receiving attention for accelerating Total Variation (TV) based CBCT reconstructions. In order to become truly viable for clinical applications, however, its convergence property needs to be properly addressed. We propose a novel fast converging gradient projection BB method that requires ‘at most one function evaluation’ in each iterative step. This Selective Function Evaluation method, referred to as GPBB-SFE in this paper, exhibits the desired convergence property when it is combined with a ‘smoothed TV’ or any other differentiable prior. This way, the proposed GPBB-SFE algorithm offers fast and guaranteed convergence to the desired 3DCBCT image with minimal computational complexity. We first applied this algorithm to a Shepp-Logan numerical phantom. We then applied to a CatPhan 600 physical phantom (The Phantom Laboratory, Salem, NY) and a clinically-treated head-and-neck patient, both acquired from the TrueBeam™ system (Varian Medical Systems, Palo Alto, CA). Furthermore, we accelerated the reconstruction by implementing the algorithm on NVIDIA GTX 480 GPU card. We first compared GPBB-SFE with three recently proposed BB-based CBCT reconstruction methods available in the literature using Shepp-Logan numerical phantom with 40 projections. It is found that GPBB-SFE shows either faster convergence speed/time or superior convergence property compared to existing BB-based algorithms. With the CatPhan 600 physical phantom, the GPBB-SFE algorithm requires only 3 function evaluations in 30 iterations and reconstructs the standard, 364-projection FDK reconstruction quality image using only 60 projections. We then applied the algorithm to a clinically-treated head-and-neck patient. It was observed that the GPBB-SFE algorithm requires only 18 function evaluations in 30 iterations. Compared with the FDK algorithm with 364 projections, the GPBB-SFE algorithm produces visibly equivalent quality CBCT image for the head-and-neck patient with only 180 projections, in 131.7 s, further supporting its clinical applicability.

A low-complexity 2-point step size gradient projection method with selective function evaluations for smoothed total variation based CBCT reconstructions.

PubMed

Song, Bongyong; Park, Justin C; Song, William Y

2014-11-07

The Barzilai-Borwein (BB) 2-point step size gradient method is receiving attention for accelerating Total Variation (TV) based CBCT reconstructions. In order to become truly viable for clinical applications, however, its convergence property needs to be properly addressed. We propose a novel fast converging gradient projection BB method that requires 'at most one function evaluation' in each iterative step. This Selective Function Evaluation method, referred to as GPBB-SFE in this paper, exhibits the desired convergence property when it is combined with a 'smoothed TV' or any other differentiable prior. This way, the proposed GPBB-SFE algorithm offers fast and guaranteed convergence to the desired 3DCBCT image with minimal computational complexity. We first applied this algorithm to a Shepp-Logan numerical phantom. We then applied to a CatPhan 600 physical phantom (The Phantom Laboratory, Salem, NY) and a clinically-treated head-and-neck patient, both acquired from the TrueBeam™ system (Varian Medical Systems, Palo Alto, CA). Furthermore, we accelerated the reconstruction by implementing the algorithm on NVIDIA GTX 480 GPU card. We first compared GPBB-SFE with three recently proposed BB-based CBCT reconstruction methods available in the literature using Shepp-Logan numerical phantom with 40 projections. It is found that GPBB-SFE shows either faster convergence speed/time or superior convergence property compared to existing BB-based algorithms. With the CatPhan 600 physical phantom, the GPBB-SFE algorithm requires only 3 function evaluations in 30 iterations and reconstructs the standard, 364-projection FDK reconstruction quality image using only 60 projections. We then applied the algorithm to a clinically-treated head-and-neck patient. It was observed that the GPBB-SFE algorithm requires only 18 function evaluations in 30 iterations. Compared with the FDK algorithm with 364 projections, the GPBB-SFE algorithm produces visibly equivalent quality CBCT image for the head-and-neck patient with only 180 projections, in 131.7 s, further supporting its clinical applicability.

Spine stereotactic body radiotherapy utilizing cone-beam CT image-guidance with a robotic couch: intrafraction motion analysis accounting for all six degrees of freedom.

PubMed

Hyde, Derek; Lochray, Fiona; Korol, Renee; Davidson, Melanie; Wong, C Shun; Ma, Lijun; Sahgal, Arjun

2012-03-01

To evaluate the residual setup error and intrafraction motion following kilovoltage cone-beam CT (CBCT) image guidance, for immobilized spine stereotactic body radiotherapy (SBRT) patients, with positioning corrected for in all six degrees of freedom. Analysis is based on 42 consecutive patients (48 thoracic and/or lumbar metastases) treated with a total of 106 fractions and 307 image registrations. Following initial setup, a CBCT was acquired for patient alignment and a pretreatment CBCT taken to verify shifts and determine the residual setup error, followed by a midtreatment and posttreatment CBCT image. For 13 single-fraction SBRT patients, two midtreatment CBCT images were obtained. Initially, a 1.5-mm and 1° tolerance was used to reposition the patient following couch shifts which was subsequently reduced to 1 mm and 1° degree after the first 10 patients. Small positioning errors after the initial CBCT setup were observed, with 90% occurring within 1 mm and 97% within 1°. In analyzing the impact of the time interval for verification imaging (10 ± 3 min) and subsequent image acquisitions (17 ± 4 min), the residual setup error was not significantly different (p > 0.05). A significant difference (p = 0.04) in the average three-dimensional intrafraction positional deviations favoring a more strict tolerance in translation (1 mm vs. 1.5 mm) was observed. The absolute intrafraction motion averaged over all patients and all directions along x, y, and z axis (± SD) were 0.7 ± 0.5 mm and 0.5 ± 0.4 mm for the 1.5 mm and 1 mm tolerance, respectively. Based on a 1-mm and 1° correction threshold, the target was localized to within 1.2 mm and 0.9° with 95% confidence. Near-rigid body immobilization, intrafraction CBCT imaging approximately every 15-20 min, and strict repositioning thresholds in six degrees of freedom yields minimal intrafraction motion allowing for safe spine SBRT delivery. Copyright © 2012 Elsevier Inc. All rights reserved.

SU-E-J-150: Four-Dimensional Cone-Beam CT Algorithm by Extraction of Physical and Motion Parameter of Mobile Targets Retrospective to Image Reconstruction with Motion Modeling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ali, I; Ahmad, S; Alsbou, N

Purpose: To develop 4D-cone-beam CT (CBCT) algorithm by motion modeling that extracts actual length, CT numbers level and motion amplitude of a mobile target retrospective to image reconstruction by motion modeling. Methods: The algorithm used three measurable parameters: apparent length and blurred CT number distribution of a mobile target obtained from CBCT images to determine actual length, CT-number value of the stationary target, and motion amplitude. The predictions of this algorithm were tested with mobile targets that with different well-known sizes made from tissue-equivalent gel which was inserted into a thorax phantom. The phantom moved sinusoidally in one-direction to simulatemore » respiratory motion using eight amplitudes ranging 0–20mm. Results: Using this 4D-CBCT algorithm, three unknown parameters were extracted that include: length of the target, CT number level, speed or motion amplitude for the mobile targets retrospective to image reconstruction. The motion algorithms solved for the three unknown parameters using measurable apparent length, CT number level and gradient for a well-defined mobile target obtained from CBCT images. The motion model agreed with measured apparent lengths which were dependent on the actual target length and motion amplitude. The gradient of the CT number distribution of the mobile target is dependent on the stationary CT number level, actual target length and motion amplitude. Motion frequency and phase did not affect the elongation and CT number distribution of the mobile target and could not be determined. Conclusion: A 4D-CBCT motion algorithm was developed to extract three parameters that include actual length, CT number level and motion amplitude or speed of mobile targets directly from reconstructed CBCT images without prior knowledge of the stationary target parameters. This algorithm provides alternative to 4D-CBCT without requirement to motion tracking and sorting of the images into different breathing phases which has potential applications in diagnostic CT imaging and radiotherapy.« less

The Reliability of Panoramic Radiography Versus Cone Beam Computed Tomography when Evaluating the Distance to the Alveolar Nerve in the Site of Lateral Teeth.

PubMed

Česaitienė, Gabrielė; Česaitis, Kęstutis; Junevičius, Jonas; Venskutonis, Tadas

2017-07-04

BACKGROUND The aim of this study was to compare the reliability of panoramic radiography (PR) and cone beam computed tomography (CBCT) in the evaluation of the distance of the roots of lateral teeth to the inferior alveolar nerve canal (IANC). MATERIAL AND METHODS 100 PR and 100 CBCT images that met the selection criteria were selected from the database. In PR images, the distances were measured using an electronic caliper with 0.01 mm accuracy and white light x-ray film reviewer. Actual values of the measurements were calculated taking into consideration the magnification used in PR images (130%). Measurements on CBCT images were performed using i-CAT Vision software. Statistical data analysis was performed using R software and applying Welch's t-test and the Wilcoxon test. RESULTS There was no statistically significant difference in the mean distance from the root of the second premolar and the mesial and distal roots of the first molar to the IANC between PR and CBCT images. The difference in the mean distance from the mesial and distal roots of the second and the third molars to the IANC measured in PR and CBCT images was statistically significant. CONCLUSIONS PR may be uninformative or misleading when measuring the distance from the mesial and distal roots of the second and the third molars to the IANC.

The Reliability of Panoramic Radiography Versus Cone Beam Computed Tomography when Evaluating the Distance to the Alveolar Nerve in the Site of Lateral Teeth

PubMed Central

Česaitienė, Gabrielė; Česaitis, Kęstutis; Junevičius, Jonas; Venskutonis, Tadas

2017-01-01

Background The aim of this study was to compare the reliability of panoramic radiography (PR) and cone beam computed tomography (CBCT) in the evaluation of the distance of the roots of lateral teeth to the inferior alveolar nerve canal (IANC). Material/Methods 100 PR and 100 CBCT images that met the selection criteria were selected from the database. In PR images, the distances were measured using an electronic caliper with 0.01 mm accuracy and white light x-ray film reviewer. Actual values of the measurements were calculated taking into consideration the magnification used in PR images (130%). Measurements on CBCT images were performed using i-CAT Vision software. Statistical data analysis was performed using R software and applying Welch’s t-test and the Wilcoxon test. Results There was no statistically significant difference in the mean distance from the root of the second premolar and the mesial and distal roots of the first molar to the IANC between PR and CBCT images. The difference in the mean distance from the mesial and distal roots of the second and the third molars to the IANC measured in PR and CBCT images was statistically significant. Conclusions PR may be uninformative or misleading when measuring the distance from the mesial and distal roots of the second and the third molars to the IANC. PMID:28674379

Correction of patient motion in cone-beam CT using 3D-2D registration

NASA Astrophysics Data System (ADS)

Ouadah, S.; Jacobson, M.; Stayman, J. W.; Ehtiati, T.; Weiss, C.; Siewerdsen, J. H.

2017-12-01

Cone-beam CT (CBCT) is increasingly common in guidance of interventional procedures, but can be subject to artifacts arising from patient motion during fairly long (~5-60 s) scan times. We present a fiducial-free method to mitigate motion artifacts using 3D-2D image registration that simultaneously corrects residual errors in the intrinsic and extrinsic parameters of geometric calibration. The 3D-2D registration process registers each projection to a prior 3D image by maximizing gradient orientation using the covariance matrix adaptation-evolution strategy optimizer. The resulting rigid transforms are applied to the system projection matrices, and a 3D image is reconstructed via model-based iterative reconstruction. Phantom experiments were conducted using a Zeego robotic C-arm to image a head phantom undergoing 5-15 cm translations and 5-15° rotations. To further test the algorithm, clinical images were acquired with a CBCT head scanner in which long scan times were susceptible to significant patient motion. CBCT images were reconstructed using a penalized likelihood objective function. For phantom studies the structural similarity (SSIM) between motion-free and motion-corrected images was  >0.995, with significant improvement (p  <  0.001) compared to the SSIM values of uncorrected images. Additionally, motion-corrected images exhibited a point-spread function with full-width at half maximum comparable to that of the motion-free reference image. Qualitative comparison of the motion-corrupted and motion-corrected clinical images demonstrated a significant improvement in image quality after motion correction. This indicates that the 3D-2D registration method could provide a useful approach to motion artifact correction under assumptions of local rigidity, as in the head, pelvis, and extremities. The method is highly parallelizable, and the automatic correction of residual geometric calibration errors provides added benefit that could be valuable in routine use.

Use of cone beam computed tomography in implant dentistry: the International Congress of Oral Implantologists consensus report.

PubMed

Benavides, Erika; Rios, Hector F; Ganz, Scott D; An, Chang-Hyeon; Resnik, Randolph; Reardon, Gayle Tieszen; Feldman, Steven J; Mah, James K; Hatcher, David; Kim, Myung-Jin; Sohn, Dong-Seok; Palti, Ady; Perel, Morton L; Judy, Kenneth W M; Misch, Carl E; Wang, Hom-Lay

2012-04-01

The International Congress of Oral Implantologists has supported the development of this consensus report involving the use of Cone Beam Computed Tomography (CBCT) in implant dentistry with the intent of providing scientifically based guidance to clinicians regarding its use as an adjunct to traditional imaging modalities. The literature regarding CBCT and implant dentistry was systematically reviewed. A PubMed search that included studies published between January 1, 2000, and July 31, 2011, was conducted. Oral presentations, in conjunction with these studies, were given by Dr. Erika Benavides, Dr. Scott Ganz, Dr. James Mah, Dr. Myung-Jin Kim, and Dr. David Hatcher at a meeting of the International Congress of Oral Implantologists in Seoul, Korea, on October 6-8, 2011. The studies published could be divided into four main groups: diagnostics, implant planning, surgical guidance, and postimplant evaluation. The literature supports the use of CBCT in dental implant treatment planning particularly in regards to linear measurements, three-dimensional evaluation of alveolar ridge topography, proximity to vital anatomical structures, and fabrication of surgical guides. Areas such as CBCT-derived bone density measurements, CBCT-aided surgical navigation, and postimplant CBCT artifacts need further research. ICOI RECOMMENDATIONS: All CBCT examinations, as all other radiographic examinations, must be justified on an individualized needs basis. The benefits to the patient for each CBCT scan must outweigh the potential risks. CBCT scans should not be taken without initially obtaining thorough medical and dental histories and performing a comprehensive clinical examination. CBCT should be considered as an imaging alternative in cases where the projected implant receptor or bone augmentation site(s) are suspect, and conventional radiography may not be able to assess the true regional three-dimensional anatomical presentation. The smallest possible field of view should be used, and the entire image volume should be interpreted.

The effect of irregular breathing patterns on internal target volumes in four-dimensional CT and cone-beam CT images in the context of stereotactic lung radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clements, N.; Kron, T.; Roxby, P.

2013-02-15

Purpose: Stereotactic lung radiotherapy is complicated by tumor motion from patient respiration. Four-dimensional CT (4DCT) imaging is a motion compensation method used in treatment planning to generate a maximum intensity projection (MIP) internal target volume (ITV). Image guided radiotherapy during treatment may involve acquiring a volumetric cone-beam CT (CBCT) image and visually aligning the tumor to the planning 4DCT MIP ITV contour. Moving targets imaged with CBCT can appear blurred and currently there are no studies reporting on the effect that irregular breathing patterns have on CBCT volumes and their alignment to 4DCT MIP ITV contours. The objective of thismore » work was therefore to image a phantom moving with irregular breathing patterns to determine whether any configurations resulted in errors in volume contouring or alignment. Methods: A Perspex thorax phantom was used to simulate a patient. Three wooden 'lung' inserts with embedded Perspex 'lesions' were moved up to 4 cm with computer-generated motion patterns, and up to 1 cm with patient-specific breathing patterns. The phantom was imaged on 4DCT and CBCT with the same acquisition settings used for stereotactic lung patients in the clinic and the volumes on all phantom images were contoured. This project assessed the volumes for qualitative and quantitative changes including volume, length of the volume, and errors in alignment between CBCT volumes and 4DCT MIP ITV contours. Results: When motion was introduced 4DCT and CBCT volumes were reduced by up to 20% and 30% and shortened by up to 7 and 11 mm, respectively, indicating that volume was being under-represented at the extremes of motion. Banding artifacts were present in 4DCT MIP images, while CBCT volumes were largely reduced in contrast. When variable amplitudes from patient traces were used and CBCT ITVs were compared to 4DCT MIP ITVs there was a distinct trend in reduced ITV with increasing amplitude that was not seen when compared to true ITVs. Breathing patterns with a rest period following expiration resulted in well-defined superior edges and were better aligned using an edge-to-edge alignment technique. In most cases, sinusoidal motion patterns resulted in the closest agreements to true values and the smallest misalignments. Conclusions: Strategies are needed to compensate for volume losses at the extremes of motion for both 4DCT MIP and CBCT images for larger and varied amplitudes, and for patterns with rest periods following expiration. Lesions moving greater than 2 cm would warrant larger treatment margins added to the 4DCT MIP ITV to account for the volume being under-represented at the extremes of motion. Lesions moving with a rest period following expiration would be better aligned using an edge-to-edge alignment technique. Sinusoidal patterns represented the ideal clinical scenario, reinforcing the importance of investigating clinically relevant motions and their effects on 4DCT MIP and CBCT volumes. Since most patients do not breathe sinusoidally this may lead to misinterpretation of previous studies using only sinusoidal motion.« less

The effect of irregular breathing patterns on internal target volumes in four-dimensional CT and cone-beam CT images in the context of stereotactic lung radiotherapy.

PubMed

Clements, N; Kron, T; Franich, R; Dunn, L; Roxby, P; Aarons, Y; Chesson, B; Siva, S; Duplan, D; Ball, D

2013-02-01

Stereotactic lung radiotherapy is complicated by tumor motion from patient respiration. Four-dimensional CT (4DCT) imaging is a motion compensation method used in treatment planning to generate a maximum intensity projection (MIP) internal target volume (ITV). Image guided radiotherapy during treatment may involve acquiring a volumetric cone-beam CT (CBCT) image and visually aligning the tumor to the planning 4DCT MIP ITV contour. Moving targets imaged with CBCT can appear blurred and currently there are no studies reporting on the effect that irregular breathing patterns have on CBCT volumes and their alignment to 4DCT MIP ITV contours. The objective of this work was therefore to image a phantom moving with irregular breathing patterns to determine whether any configurations resulted in errors in volume contouring or alignment. A Perspex thorax phantom was used to simulate a patient. Three wooden "lung" inserts with embedded Perspex "lesions" were moved up to 4 cm with computer-generated motion patterns, and up to 1 cm with patient-specific breathing patterns. The phantom was imaged on 4DCT and CBCT with the same acquisition settings used for stereotactic lung patients in the clinic and the volumes on all phantom images were contoured. This project assessed the volumes for qualitative and quantitative changes including volume, length of the volume, and errors in alignment between CBCT volumes and 4DCT MIP ITV contours. When motion was introduced 4DCT and CBCT volumes were reduced by up to 20% and 30% and shortened by up to 7 and 11 mm, respectively, indicating that volume was being under-represented at the extremes of motion. Banding artifacts were present in 4DCT MIP images, while CBCT volumes were largely reduced in contrast. When variable amplitudes from patient traces were used and CBCT ITVs were compared to 4DCT MIP ITVs there was a distinct trend in reduced ITV with increasing amplitude that was not seen when compared to true ITVs. Breathing patterns with a rest period following expiration resulted in well-defined superior edges and were better aligned using an edge-to-edge alignment technique. In most cases, sinusoidal motion patterns resulted in the closest agreements to true values and the smallest misalignments. Strategies are needed to compensate for volume losses at the extremes of motion for both 4DCT MIP and CBCT images for larger and varied amplitudes, and for patterns with rest periods following expiration. Lesions moving greater than 2 cm would warrant larger treatment margins added to the 4DCT MIP ITV to account for the volume being under-represented at the extremes of motion. Lesions moving with a rest period following expiration would be better aligned using an edge-to-edge alignment technique. Sinusoidal patterns represented the ideal clinical scenario, reinforcing the importance of investigating clinically relevant motions and their effects on 4DCT MIP and CBCT volumes. Since most patients do not breathe sinusoidally this may lead to misinterpretation of previous studies using only sinusoidal motion.

A review of setup error in supine breast radiotherapy using cone-beam computed tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Batumalai, Vikneswary, E-mail: Vikneswary.batumalai@sswahs.nsw.gov.au; Liverpool and Macarthur Cancer Therapy Centres, New South Wales; Ingham Institute of Applied Medical Research, Sydney, New South Wales

2016-10-01

Setup error in breast radiotherapy (RT) measured with 3-dimensional cone-beam computed tomography (CBCT) is becoming more common. The purpose of this study is to review the literature relating to the magnitude of setup error in breast RT measured with CBCT. The different methods of image registration between CBCT and planning computed tomography (CT) scan were also explored. A literature search, not limited by date, was conducted using Medline and Google Scholar with the following key words: breast cancer, RT, setup error, and CBCT. This review includes studies that reported on systematic and random errors, and the methods used when registeringmore » CBCT scans with planning CT scan. A total of 11 relevant studies were identified for inclusion in this review. The average magnitude of error is generally less than 5 mm across a number of studies reviewed. The common registration methods used when registering CBCT scans with planning CT scan are based on bony anatomy, soft tissue, and surgical clips. No clear relationships between the setup errors detected and methods of registration were observed from this review. Further studies are needed to assess the benefit of CBCT over electronic portal image, as CBCT remains unproven to be of wide benefit in breast RT.« less

Spatial frequency spectrum of the x-ray scatter distribution in CBCT projections

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bootsma, G. J.; Verhaegen, F.; Department of Oncology, Medical Physics Unit, McGill University, Montreal, Quebec H3G 1A4

2013-11-15

Purpose: X-ray scatter is a source of significant image quality loss in cone-beam computed tomography (CBCT). The use of Monte Carlo (MC) simulations separating primary and scattered photons has allowed the structure and nature of the scatter distribution in CBCT to become better elucidated. This work seeks to quantify the structure and determine a suitable basis function for the scatter distribution by examining its spectral components using Fourier analysis.Methods: The scatter distribution projection data were simulated using a CBCT MC model based on the EGSnrc code. CBCT projection data, with separated primary and scatter signal, were generated for a 30.6more » cm diameter water cylinder [single angle projection with varying axis-to-detector distance (ADD) and bowtie filters] and two anthropomorphic phantoms (head and pelvis, 360 projections sampled every 1°, with and without a compensator). The Fourier transform of the resulting scatter distributions was computed and analyzed both qualitatively and quantitatively. A novel metric called the scatter frequency width (SFW) is introduced to determine the scatter distribution's frequency content. The frequency content results are used to determine a set basis functions, consisting of low-frequency sine and cosine functions, to fit and denoise the scatter distribution generated from MC simulations using a reduced number of photons and projections. The signal recovery is implemented using Fourier filtering (low-pass Butterworth filter) and interpolation. Estimates of the scatter distribution are used to correct and reconstruct simulated projections.Results: The spatial and angular frequencies are contained within a maximum frequency of 0.1 cm{sup −1} and 7/(2π) rad{sup −1} for the imaging scenarios examined, with these values varying depending on the object and imaging setup (e.g., ADD and compensator). These data indicate spatial and angular sampling every 5 cm and π/7 rad (∼25°) can be used to properly capture the scatter distribution, with reduced sampling possible depending on the imaging scenario. Using a low-pass Butterworth filter, tuned with the SFW values, to denoise the scatter projection data generated from MC simulations using 10{sup 6} photons resulted in an error reduction of greater than 85% for the estimating scatter in single and multiple projections. Analysis showed that the use of a compensator helped reduce the error in estimating the scatter distribution from limited photon simulations by more than 37% when compared to the case without a compensator for the head and pelvis phantoms. Reconstructions of simulated head phantom projections corrected by the filtered and interpolated scatter estimates showed improvements in overall image quality.Conclusions: The spatial frequency content of the scatter distribution in CBCT is found to be contained within the low frequency domain. The frequency content is modulated both by object and imaging parameters (ADD and compensator). The low-frequency nature of the scatter distribution allows for a limited set of sine and cosine basis functions to be used to accurately represent the scatter signal in the presence of noise and reduced data sampling decreasing MC based scatter estimation time. Compensator induced modulation of the scatter distribution reduces the frequency content and improves the fitting results.« less

SU-E-J-119: Head-And-Neck Digital Phantoms for Geometric and Dosimetric Uncertainty Evaluation of CT-CBCT Deformable Image Registration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shen, Z; Koyfman, S; Xia, P

2015-06-15

Purpose: To evaluate geometric and dosimetric uncertainties of CT-CBCT deformable image registration (DIR) algorithms using digital phantoms generated from real patients. Methods: We selected ten H&N cancer patients with adaptive IMRT. For each patient, a planning CT (CT1), a replanning CT (CT2), and a pretreatment CBCT (CBCT1) were used as the basis for digital phantom creation. Manually adjusted meshes were created for selected ROIs (e.g. PTVs, brainstem, spinal cord, mandible, and parotids) on CT1 and CT2. The mesh vertices were input into a thin-plate spline algorithm to generate a reference displacement vector field (DVF). The reference DVF was applied tomore » CBCT1 to create a simulated mid-treatment CBCT (CBCT2). The CT-CBCT digital phantom consisted of CT1 and CBCT2, which were linked by the reference DVF. Three DIR algorithms (Demons, B-Spline, and intensity-based) were applied to these ten digital phantoms. The images, ROIs, and volumetric doses were mapped from CT1 to CBCT2 using the DVFs computed by these three DIRs and compared to those mapped using the reference DVF. Results: The average Dice coefficients for selected ROIs were from 0.83 to 0.94 for Demons, from 0.82 to 0.95 for B-Spline, and from 0.67 to 0.89 for intensity-based DIR. The average Hausdorff distances for selected ROIs were from 2.4 to 6.2 mm for Demons, from 1.8 to 5.9 mm for B-Spline, and from 2.8 to 11.2 mm for intensity-based DIR. The average absolute dose errors for selected ROIs were from 0.7 to 2.1 Gy for Demons, from 0.7 to 2.9 Gy for B- Spline, and from 1.3 to 4.5 Gy for intensity-based DIR. Conclusion: Using clinically realistic CT-CBCT digital phantoms, Demons and B-Spline were shown to have similar geometric and dosimetric uncertainties while intensity-based DIR had the worst uncertainties. CT-CBCT DIR has the potential to provide accurate CBCT-based dose verification for H&N adaptive radiotherapy. Z Shen: None; K Bzdusek: an employee of Philips Healthcare; S Koyfman: None; P Xia: received research grants from Philips Healthcare and Siemens Healthcare.« less

Use of Reference Ear Plug to improve accuracy of lateral cephalograms generated from cone-beam computed tomography scans

PubMed Central

Lee, Kyung-Min; Uhm, Gi-Soo; Cho, Jin-Hyoung; McNamara, James A.

2013-01-01

Objective The purpose of this study was to evaluate the effectiveness of the use of Reference Ear Plug (REP) during cone-beam computed tomography (CBCT) scan for the generation of lateral cephalograms from CBCT scan data. Methods Two CBCT scans were obtained from 33 adults. One CBCT scan was acquired using conventional methods, and the other scan was acquired with the use of REP. Virtual lateral cephalograms created from each CBCT image were traced and compared with tracings of the real cephalograms obtained from the same subject. Results CBCT scan with REP resulted in a smaller discrepancy between real and virtual cephalograms. In comparing the real and virtual cephalograms, no measurements significantly differed from real cephalogram values in case of CBCT scan with REP, whereas many measurements significantly differed in the case of CBCT scan without REP. Conclusion Measurements from CBCT-generated cephalograms are more similar to those from real cephalograms when REP are used during CBCT scan. Thus, the use of REP is suggested during CBCT scan to generate accurate virtual cephalograms from CBCT scan data. PMID:23671830

The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature.

PubMed

Venskutonis, Tadas; Plotino, Gianluca; Juodzbalys, Gintaras; Mickevičienė, Lina

2014-12-01

To obtain essential information in clinical endodontics, cone-beam computed tomographic (CBCT) imaging can be used in all phases of treatment including diagnosis, treatment planning, during the treatment phase, and through post-treatment assessment and follow-up. The purpose of this article was to review the use of CBCT imaging in the diagnosis, treatment planning, and assessing the outcome of endodontic complications. Literature was selected through a search of PubMed electronic databases for the following keywords: tooth root injuries, tooth root radiography, tooth root perforation, tomography, cone-beam computed tomography, endodontic complications, tooth root internal/external resorption, root fractures, and broken instruments. The research was restricted to articles published in English. One hundred twelve articles met the inclusion criteria and were included in this review. Currently, intraoral radiography is the imaging technique of choice for the management of endodontic disease, but CBCT imaging appears to have a superior validity and reliability in the management of endodontic diagnosis and complications. Endodontic cases should be judged individually, and CBCT imaging should be considered in situations in which information from conventional imaging systems may not yield an adequate amount of information to allow the appropriate management of endodontic problems. CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses will be available. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Measurement of skin dose from cone-beam computed tomography imaging.

PubMed

Akyalcin, Sercan; English, Jeryl D; Abramovitch, Kenneth M; Rong, Xiujiang J

2013-10-09

To measure surface skin dose from various cone-beam computed tomography (CBCT) scanners using point-dosimeters. A head anthropomorphic phantom was used with nanoDOT optically stimulated luminescence (OSL) dosimeters (Landauer Corp., Glenwood, IL) attached to various anatomic landmarks. The phantom was scanned using multiple exposure protocols for craniofacial evaluations in three different CBCT units and a conventional x-ray imaging system. The dosimeters were calibrated for each of the scan protocols on the different imaging systems. Peak skin dose and surface doses at the eye lens, thyroid, submandibular and parotid gland levels were measured. The measured skin doses ranged from 0.09 to 4.62 mGy depending on dosimeter positions and imaging systems. The average surface doses to the lens locations were ~4.0 mGy, well below the threshold for cataractogenesis (500 mGy). The results changed accordingly with x-ray tube output (mAs and kV) and also were sensitive to scan field of view (SFOV). As compared to the conventional panoramic and cephalometric imaging system, doses from all three CBCT systems were at least an order of magnitude higher. Peak skin dose and surface doses at the eye lens, thyroid, and salivary gland levels measured from the CBCT imaging systems were lower than the thresholds to induce deterministic effects. However, our findings do not justify the routine use of CBCT imaging in orthodontics considering the lifetime-attributable risk to the individual.

Measurement of skin dose from cone-beam computed tomography imaging

PubMed Central

2013-01-01

Objective To measure surface skin dose from various cone-beam computed tomography (CBCT) scanners using point-dosimeters. Materials & methods A head anthropomorphic phantom was used with nanoDOT optically stimulated luminescence (OSL) dosimeters (Landauer Corp., Glenwood, IL) attached to various anatomic landmarks. The phantom was scanned using multiple exposure protocols for craniofacial evaluations in three different CBCT units and a conventional x-ray imaging system. The dosimeters were calibrated for each of the scan protocols on the different imaging systems. Peak skin dose and surface doses at the eye lens, thyroid, submandibular and parotid gland levels were measured. Results The measured skin doses ranged from 0.09 to 4.62 mGy depending on dosimeter positions and imaging systems. The average surface doses to the lens locations were ~4.0 mGy, well below the threshold for cataractogenesis (500 mGy). The results changed accordingly with x-ray tube output (mAs and kV) and also were sensitive to scan field of view (SFOV). As compared to the conventional panoramic and cephalometric imaging system, doses from all three CBCT systems were at least an order of magnitude higher. Conclusions Peak skin dose and surface doses at the eye lens, thyroid, and salivary gland levels measured from the CBCT imaging systems were lower than the thresholds to induce deterministic effects. However, our findings do not justify the routine use of CBCT imaging in orthodontics considering the lifetime-attributable risk to the individual. PMID:24192155

Automatic image registration performance for two different CBCT systems; variation with imaging dose

NASA Astrophysics Data System (ADS)

Barber, J.; Sykes, J. R.; Holloway, L.; Thwaites, D. I.

2014-03-01

The performance of an automatic image registration algorithm was compared on image sets collected with two commercial CBCT systems, and the relationship with imaging dose was explored. CBCT images of a CIRS Virtually Human Male Pelvis phantom (VHMP) were collected on Varian TrueBeam/OBI and Elekta Synergy/XVI linear accelerators, across a range of mAs settings. Each CBCT image was registered 100 times, with random initial offsets introduced. Image registration was performed using the grey value correlation ratio algorithm in the Elekta XVI software, to a mask of the prostate volume with 5 mm expansion. Residual registration errors were calculated after correcting for the initial introduced phantom set-up error. Registration performance with the OBI images was similar to that of XVI. There was a clear dependence on imaging dose for the XVI images with residual errors increasing below 4mGy. It was not possible to acquire images with doses lower than ~5mGy with the OBI system and no evidence of reduced performance was observed at this dose. Registration failures (maximum target registration error > 3.6 mm on the surface of a 30mm sphere) occurred in 5% to 9% of registrations except for the lowest dose XVI scan (31%). The uncertainty in automatic image registration with both OBI and XVI images was found to be adequate for clinical use within a normal range of acquisition settings.

PTV margin definition in hypofractionated IGRT of localized prostate cancer using cone beam CT and orthogonal image pairs with fiducial markers.

PubMed

Oehler, Christoph; Lang, Stephanie; Dimmerling, Peter; Bolesch, Christian; Kloeck, Stephan; Tini, Alessandra; Glanzmann, Christoph; Najafi, Yousef; Studer, Gabriela; Zwahlen, Daniel R

2014-11-11

To evaluate PTV margins for hypofractionated IGRT of prostate comparing kV/kV imaging or CBCT. Between 2009 and 2012, 20 patients with low- (LR), intermediate- (IR) and high-risk (HR) prostate cancer were treated with VMAT in supine position with fiducial markers (FM), endorectal balloon (ERB) and full bladder. CBCT's and kV/kV imaging were performed before and additional CBCT's after treatment assessing intra-fraction motion. CTVP for 5 patients with LR and CTVPSV for 5 patients with IR/HR prostate cancer were contoured independently by 3 radiation oncologists using MRI. The van Hark formula (PTV margin =2.5Σ +0.7σ) was applied to calculate PTV margins of prostate/seminal vesicles (P/PSV) using CBCT or FM. 172 and 52 CBCTs before and after RT and 507 kV/kV images before RT were analysed. Differences between FM in CBCT or in planar kV image pairs were below 1 mm. Accounting for both random and systematic uncertainties anisotropic PTV margins were 5-8 mm for P (LR) and 6-11 mm for PSV (IR/HR). Random uncertainties like intra-fraction and inter-fraction (setup) uncertainties were of similar magnitude (0.9-1.4 mm). Largest uncertainty was introduced by CTV delineation (LR: 1-2 mm, IR/HR: 1.6-3.5 mm). Patient positioning using bone matching or ERB-matching resulted in larger PTV margins. For IGRT CBCT or kV/kV-image pairs with FM are interchangeable in respect of accuracy. Especially for hypofractionated RT, PTV margins can be kept in the range of 5 mm or below if stringent daily IGRT, ideally including prostate tracking, is applied. MR-based CTV delineation optimization is recommended.

WE-DE-BRA-01: SCIENCE COUNCIL JUNIOR INVESTIGATOR COMPETITION WINNER: Acceleration of a Limited-Angle Intrafraction Verification (LIVE) System Using Adaptive Prior Knowledge Based Image Estimation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Y; Yin, F; Ren, L

Purpose: To develop an adaptive prior knowledge based image estimation method to reduce the scan angle needed in the LIVE system to reconstruct 4D-CBCT for intrafraction verification. Methods: The LIVE system has been previously proposed to reconstructs 4D volumetric images on-the-fly during arc treatment for intrafraction target verification and dose calculation. This system uses limited-angle beam’s eye view (BEV) MV cine images acquired from the treatment beam together with the orthogonally acquired limited-angle kV projections to reconstruct 4D-CBCT images for target verification during treatment. In this study, we developed an adaptive constrained free-form deformation reconstruction technique in LIVE to furthermore » reduce the scanning angle needed to reconstruct the CBCT images. This technique uses free form deformation with energy minimization to deform prior images to estimate 4D-CBCT based on projections acquired in limited angle (orthogonal 6°) during the treatment. Note that the prior images are adaptively updated using the latest CBCT images reconstructed by LIVE during treatment to utilize the continuity of patient motion.The 4D digital extended-cardiac-torso (XCAT) phantom was used to evaluate the efficacy of this technique with LIVE system. A lung patient was simulated with different scenario, including baseline drifts, amplitude change and phase shift. Limited-angle orthogonal kV and beam’s eye view (BEV) MV projections were generated for each scenario. The CBCT reconstructed by these projections were compared with the ground-truth generated in XCAT.Volume-percentage-difference (VPD) and center-of-mass-shift (COMS) were calculated between the reconstructed and the ground-truth tumors to evaluate the reconstruction accuracy. Results: Using orthogonal-view of 6° kV and BEV- MV projections, the VPD/COMS values were 12.7±4.0%/0.7±0.5 mm, 13.0±5.1%/0.8±0.5 mm, and 11.4±5.4%/0.5±0.3 mm for the three scenarios, respectively. Conclusion: The technique enables LIVE to accurately reconstruct 4D-CBCT images using only orthogonal 6° angle, which greatly improves the efficiency and reduces dose of LIVE for intrafraction verification.« less

Mandibular incisive canal: cone beam computed tomography.

PubMed

Pires, Carlos A; Bissada, Nabil F; Becker, Jeffery J; Kanawati, Ali; Landers, Michael A

2012-03-01

Panoramic radiography is often used to analyze the anatomical structure of the teeth, jaws, and temporomandibular joints. Cone beam computed tomography (CBCT) imaging allows multiple axial slices of the image to be obtained through these anatomical structures. The aim of this study was to assess CBCT compared with panoramic radiography to verify the presence, location, and dimensions of the mandibular incisive canal. CBCT scan images and panoramic radiographs of 89 subjects were compared for the presence of the mandibular incisive canal, its location, size, and anterior-posterior length. The distance between the incisive canal and the buccal and lingual plate of the alveolar bone, and the distance from the canal to the inferior border of the mandible and the tooth apex were also measured. A paired t-test was used to calculate any significant difference between the two imaging techniques. Eighty-three percent of the CBCT scans showed the presence of the incisive canal, as did 11% of the panoramic radiographs. The range of the incisive canal diameter, as seen in the CBCT scans, was from 0.4 × 0.4 mm to 4.6 × 3.2 mm. The mean length of the canal was 7 ± 3.8 mm. The distance from the inferior border of the mandible to the canal was 10.2 ± 2.4 mm, and the mean distance to the buccal plate was 2.4 mm. The apex-canal distance (in dentate subjects) was 5.3 mm. The presence, location, and dimensions of the mandibular incisive canal are better determined by CBCT imaging than by panoramic radiography. © 2009 Wiley Periodicals, Inc.

Integration of optical imaging with a small animal irradiator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weersink, Robert A., E-mail: robert.weersink@rmp.uhn.on.ca; Ansell, Steve; Wang, An

Purpose: The authors describe the integration of optical imaging with a targeted small animal irradiator device, focusing on design, instrumentation, 2D to 3D image registration, 2D targeting, and the accuracy of recovering and mapping the optical signal to a 3D surface generated from the cone-beam computed tomography (CBCT) imaging. The integration of optical imaging will improve targeting of the radiation treatment and offer longitudinal tracking of tumor response of small animal models treated using the system. Methods: The existing image-guided small animal irradiator consists of a variable kilovolt (peak) x-ray tube mounted opposite an aSi flat panel detector, both mountedmore » on a c-arm gantry. The tube is used for both CBCT imaging and targeted irradiation. The optical component employs a CCD camera perpendicular to the x-ray treatment/imaging axis with a computer controlled filter for spectral decomposition. Multiple optical images can be acquired at any angle as the gantry rotates. The optical to CBCT registration, which uses a standard pinhole camera model, was modeled and tested using phantoms with markers visible in both optical and CBCT images. Optically guided 2D targeting in the anterior/posterior direction was tested on an anthropomorphic mouse phantom with embedded light sources. The accuracy of the mapping of optical signal to the CBCT surface was tested using the same mouse phantom. A surface mesh of the phantom was generated based on the CBCT image and optical intensities projected onto the surface. The measured surface intensity was compared to calculated surface for a point source at the actual source position. The point-source position was also optimized to provide the closest match between measured and calculated intensities, and the distance between the optimized and actual source positions was then calculated. This process was repeated for multiple wavelengths and sources. Results: The optical to CBCT registration error was 0.8 mm. Two-dimensional targeting of a light source in the mouse phantom based on optical imaging along the anterior/posterior direction was accurate to 0.55 mm. The mean square residual error in the normalized measured projected surface intensities versus the calculated normalized intensities ranged between 0.0016 and 0.006. Optimizing the position reduced this error from 0.00016 to 0.0004 with distances ranging between 0.7 and 1 mm between the actual and calculated position source positions. Conclusions: The integration of optical imaging on an existing small animal irradiation platform has been accomplished. A targeting accuracy of 1 mm can be achieved in rigid, homogeneous phantoms. The combination of optical imaging with a CBCT image-guided small animal irradiator offers the potential to deliver functionally targeted dose distributions, as well as monitor spatial and temporal functional changes that occur with radiation therapy.« less

SU-F-J-77: Variations in the Displacement Vector Fields Calculated by Different Deformable Image Registration Algorithms Used in Helical, Axial and Cone-Beam CT Images of a Mobile

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ali, I; Jaskowiak, J; Ahmad, S

Purpose: To investigate quantitatively the displacement-vector-fields (DVF) obtained from different deformable image registration algorithms (DIR) in helical (HCT), axial (ACT) and cone-beam CT (CBCT) to register CT images of a mobile phantom and its correlation with motion amplitudes and frequencies. Methods: HCT, ACT and CBCT are used to image a mobile phantom which includes three targets with different sizes that are manufactured from water-equivalent material and embedded in low density foam. The phantom is moved with controlled motion patterns where a range of motion amplitudes (0–40mm) and frequencies (0.125–0.5Hz) are used. The CT images obtained from scanning of the mobilemore » phantom are registered with the stationary CT-images using four deformable image registration algorithms including demons, fast-demons, Horn-Schunk and Locas-Kanade from DIRART software. Results: The DVF calculated by the different algorithms correlate well with the motion amplitudes that are applied on the mobile phantom where maximal DVF increase linearly with the motion amplitudes of the mobile phantom in CBCT. Similarly in HCT, DVF increase linearly with motion amplitude, however, its correlation is weaker than CBCT. In ACT, the DVF’s do not correlate well with the motion amplitudes where motion induces strong image artifacts and DIR algorithms are not able to deform the ACT image of the mobile targets to the stationary targets. Three DIR-algorithms produce comparable values and patterns of the DVF for certain CT imaging modality. However, DVF from fast-demons deviated strongly from other algorithms at large motion amplitudes. Conclusion: In CBCT and HCT, the DVF correlate well with the motion amplitude of the mobile phantom. However, in ACT, DVF do not correlate with motion amplitudes. Correlations of DVF with motion amplitude as in CBCT and HCT imaging techniques can provide information about unknown motion parameters of the mobile organs in real patients as demonstrated in this phantom visibility study.« less

Variations of target volume definition and daily target volume localization in stereotactic body radiotherapy for early-stage non-small cell lung cancer patients under abdominal compression.

PubMed

Han, Chunhui; Sampath, Sagus; Schultheisss, Timothy E; Wong, Jeffrey Y C

2017-01-01

We aimed to compare gross tumor volumes (GTV) in 3-dimensional computed tomography (3DCT) simulation and daily cone beam CT (CBCT) with the internal target volume (ITV) in 4-dimensional CT (4DCT) simulation in stereotactic body radiotherapy (SBRT) treatment of patients with early-stage non-small cell lung cancer (NSCLC) under abdominal compression. We retrospectively selected 10 patients with NSCLC who received image-guided SBRT treatments under abdominal compression with daily CBCT imaging. GTVs were contoured as visible gross tumor on the planning 3DCT and daily CBCT, and ITVs were contoured using maximum intensity projection (MIP) images of the planning 4DCT. Daily CBCTs were registered with 3DCT and MIP images by matching of bony landmarks in the thoracic region to evaluate interfractional GTV position variations. Relative to MIP-based ITVs, the average 3DCT-based GTV volume was 66.3 ± 17.1% (range: 37.5% to 92.0%) (p < 0.01 in paired t-test), and the average CBCT-based GTV volume was 90.0 ± 6.7% (daily range: 75.7% to 107.1%) (p = 0.02). Based on bony anatomy matching, the center-of-mass coordinates for CBCT-based GTVs had maximum absolute shift of 2.4 mm (left-right), 7.0 mm (anterior-posterior [AP]), and 5.2 mm (superior-inferior [SI]) relative to the MIP-based ITV. CBCT-based GTVs had average overlapping ratio of 81.3 ± 11.2% (range: 45.1% to 98.9%) with the MIP-based ITV, and 57.7 ± 13.7% (range: 35.1% to 83.2%) with the 3DCT-based GTV. Even with abdominal compression, both 3DCT simulations and daily CBCT scans significantly underestimated the full range of tumor motion. In daily image-guided patient setup corrections, automatic bony anatomy-based image registration could lead to target misalignment. Soft tissue-based image registration should be performed for accurate treatment delivery. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Variations of target volume definition and daily target volume localization in stereotactic body radiotherapy for early-stage non–small cell lung cancer patients under abdominal compression

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han, Chunhui, E-mail: chan@coh.org; Sampath, Sagus; Schultheisss, Timothy E.

We aimed to compare gross tumor volumes (GTV) in 3-dimensional computed tomography (3DCT) simulation and daily cone beam CT (CBCT) with the internal target volume (ITV) in 4-dimensional CT (4DCT) simulation in stereotactic body radiotherapy (SBRT) treatment of patients with early-stage non–small cell lung cancer (NSCLC) under abdominal compression. We retrospectively selected 10 patients with NSCLC who received image-guided SBRT treatments under abdominal compression with daily CBCT imaging. GTVs were contoured as visible gross tumor on the planning 3DCT and daily CBCT, and ITVs were contoured using maximum intensity projection (MIP) images of the planning 4DCT. Daily CBCTs were registeredmore » with 3DCT and MIP images by matching of bony landmarks in the thoracic region to evaluate interfractional GTV position variations. Relative to MIP-based ITVs, the average 3DCT-based GTV volume was 66.3 ± 17.1% (range: 37.5% to 92.0%) (p < 0.01 in paired t-test), and the average CBCT-based GTV volume was 90.0 ± 6.7% (daily range: 75.7% to 107.1%) (p = 0.02). Based on bony anatomy matching, the center-of-mass coordinates for CBCT-based GTVs had maximum absolute shift of 2.4 mm (left-right), 7.0 mm (anterior-posterior [AP]), and 5.2 mm (superior-inferior [SI]) relative to the MIP-based ITV. CBCT-based GTVs had average overlapping ratio of 81.3 ± 11.2% (range: 45.1% to 98.9%) with the MIP-based ITV, and 57.7 ± 13.7% (range: 35.1% to 83.2%) with the 3DCT-based GTV. Even with abdominal compression, both 3DCT simulations and daily CBCT scans significantly underestimated the full range of tumor motion. In daily image-guided patient setup corrections, automatic bony anatomy-based image registration could lead to target misalignment. Soft tissue-based image registration should be performed for accurate treatment delivery.« less

SU-F-J-198: A Cross-Platform Adaptation of An a Priori Scatter Correction Algorithm for Cone-Beam Projections to Enable Image- and Dose-Guided Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andersen, A; Casares-Magaz, O; Elstroem, U

Purpose: Cone-beam CT (CBCT) imaging may enable image- and dose-guided proton therapy, but is challenged by image artefacts. The aim of this study was to demonstrate the general applicability of a previously developed a priori scatter correction algorithm to allow CBCT-based proton dose calculations. Methods: The a priori scatter correction algorithm used a plan CT (pCT) and raw cone-beam projections acquired with the Varian On-Board Imager. The projections were initially corrected for bow-tie filtering and beam hardening and subsequently reconstructed using the Feldkamp-Davis-Kress algorithm (rawCBCT). The rawCBCTs were intensity normalised before a rigid and deformable registration were applied on themore » pCTs to the rawCBCTs. The resulting images were forward projected onto the same angles as the raw CB projections. The two projections were subtracted from each other, Gaussian and median filtered, and then subtracted from the raw projections and finally reconstructed to the scatter-corrected CBCTs. For evaluation, water equivalent path length (WEPL) maps (from anterior to posterior) were calculated on different reconstructions of three data sets (CB projections and pCT) of three parts of an Alderson phantom. Finally, single beam spot scanning proton plans (0–360 deg gantry angle in steps of 5 deg; using PyTRiP) treating a 5 cm central spherical target in the pCT were re-calculated on scatter-corrected CBCTs with identical targets. Results: The scatter-corrected CBCTs resulted in sub-mm mean WEPL differences relative to the rigid registration of the pCT for all three data sets. These differences were considerably smaller than what was achieved with the regular Varian CBCT reconstruction algorithm (1–9 mm mean WEPL differences). Target coverage in the re-calculated plans was generally improved using the scatter-corrected CBCTs compared to the Varian CBCT reconstruction. Conclusion: We have demonstrated the general applicability of a priori CBCT scatter correction, potentially opening for CBCT-based image/dose-guided proton therapy, including adaptive strategies. Research agreement with Varian Medical Systems, not connected to the present project.« less

Computed gray levels in multislice and cone-beam computed tomography.

PubMed

Azeredo, Fabiane; de Menezes, Luciane Macedo; Enciso, Reyes; Weissheimer, Andre; de Oliveira, Rogério Belle

2013-07-01

Gray level is the range of shades of gray in the pixels, representing the x-ray attenuation coefficient that allows for tissue density assessments in computed tomography (CT). An in-vitro study was performed to investigate the relationship between computed gray levels in 3 cone-beam CT (CBCT) scanners and 1 multislice spiral CT device using 5 software programs. Six materials (air, water, wax, acrylic, plaster, and gutta-percha) were scanned with the CBCT and CT scanners, and the computed gray levels for each material at predetermined points were measured with OsiriX Medical Imaging software (Geneva, Switzerland), OnDemand3D (CyberMed International, Seoul, Korea), E-Film (Merge Healthcare, Milwaukee, Wis), Dolphin Imaging (Dolphin Imaging & Management Solutions, Chatsworth, Calif), and InVivo Dental Software (Anatomage, San Jose, Calif). The repeatability of these measurements was calculated with intraclass correlation coefficients, and the gray levels were averaged to represent each material. Repeated analysis of variance tests were used to assess the differences in gray levels among scanners and materials. There were no differences in mean gray levels with the different software programs. There were significant differences in gray levels between scanners for each material evaluated (P <0.001). The software programs were reliable and had no influence on the CT and CBCT gray level measurements. However, the gray levels might have discrepancies when different CT and CBCT scanners are used. Therefore, caution is essential when interpreting or evaluating CBCT images because of the significant differences in gray levels between different CBCT scanners, and between CBCT and CT values. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

SU-E-J-100: The Combination of Deformable Image Registration and Regions-Of-Interest Mapping Technique to Accomplish Accurate Dose Calculation On Cone Beam Computed Tomography for Esophageal Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, B-T; Lu, J-Y

Purpose: We introduce a new method combined with the deformable image registration (DIR) and regions-of-interest mapping (ROIM) technique to accurately calculate dose on daily CBCT for esophageal cancer. Methods: Patients suffered from esophageal cancer were enrolled in the study. Prescription was set to 66 Gy/30 F and 54 Gy/30 F to the primary tumor (PTV66) and subclinical disease (PTV54) . Planning CT (pCT) were segmented into 8 substructures in terms of their differences in physical density, such as gross target volume (GTV), venae cava superior (SVC), aorta, heart, spinal cord, lung, muscle and bones. The pCT and its substructures weremore » transferred to the MIM software to readout their mean HU values. Afterwards, a deformable planning CT to daily KV-CBCT image registration method was then utilized to acquire a new structure set on CBCT. The newly generated structures on CBCT were then transferred back to the treatment planning system (TPS) and its HU information were overridden manually with mean HU values obtained from pCT. Finally, the treatment plan was projected onto the CBCT images with the same beam arrangements and monitor units (MUs) to accomplish dose calculation. Planning target volume (PTV) and organs at risk (OARs) from both of the pCT and CBCT were compared to evaluate the dose calculation accuracy. Results: It was found that the dose distribution in the CBCT showed little differences compared to the pCT, regardless of whether PTV or OARs were concerned. Specifically, dose variation in GTV, PTV54, PTV66, SVC, lung and heart were within 0.1%. The maximum dose variation was presented in the spinal cord, which was up to 2.7% dose difference. Conclusion: The proposed method combined with DIR and ROIM technique to accurately calculate dose distribution on CBCT for esophageal cancer is feasible.« less

SU-D-206-03: Segmentation Assisted Fast Iterative Reconstruction Method for Cone-Beam CT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, P; Mao, T; Gong, S

2016-06-15

Purpose: Total Variation (TV) based iterative reconstruction (IR) methods enable accurate CT image reconstruction from low-dose measurements with sparse projection acquisition, due to the sparsifiable feature of most CT images using gradient operator. However, conventional solutions require large amount of iterations to generate a decent reconstructed image. One major reason is that the expected piecewise constant property is not taken into consideration at the optimization starting point. In this work, we propose an iterative reconstruction method for cone-beam CT (CBCT) using image segmentation to guide the optimization path more efficiently on the regularization term at the beginning of the optimizationmore » trajectory. Methods: Our method applies general knowledge that one tissue component in the CT image contains relatively uniform distribution of CT number. This general knowledge is incorporated into the proposed reconstruction using image segmentation technique to generate the piecewise constant template on the first-pass low-quality CT image reconstructed using analytical algorithm. The template image is applied as an initial value into the optimization process. Results: The proposed method is evaluated on the Shepp-Logan phantom of low and high noise levels, and a head patient. The number of iterations is reduced by overall 40%. Moreover, our proposed method tends to generate a smoother reconstructed image with the same TV value. Conclusion: We propose a computationally efficient iterative reconstruction method for CBCT imaging. Our method achieves a better optimization trajectory and a faster convergence behavior. It does not rely on prior information and can be readily incorporated into existing iterative reconstruction framework. Our method is thus practical and attractive as a general solution to CBCT iterative reconstruction. This work is supported by the Zhejiang Provincial Natural Science Foundation of China (Grant No. LR16F010001), National High-tech R&D Program for Young Scientists by the Ministry of Science and Technology of China (Grant No. 2015AA020917).« less

Diagnostic reliability of 3.0-T MRI for detecting osseous abnormalities of the temporomandibular joint.

PubMed

Sawada, Kunihiko; Amemiya, Toshihiko; Hirai, Shigenori; Hayashi, Yusuke; Suzuki, Toshihiro; Honda, Masahiko; Sisounthone, Johnny; Matsumoto, Kunihito; Honda, Kazuya

2018-01-01

We compared the diagnostic reliability of 3.0-T magnetic resonance imaging (MRI) for detection of osseous abnormalities of the temporomandibular joint (TMJ) with that of the gold standard, cone-beam computed tomography (CBCT). Fifty-six TMJs were imaged with CBCT and MRI, and images of condyles and fossae were independently assessed for the presence of osseous abnormalities. The accuracy, sensitivity, and specificity of 3.0-T MRI were 0.88, 1.0, and 0.73, respectively, in condyle evaluation and 0.91, 0.75, and 0.95 in fossa evaluation. The McNemar test showed no significant difference (P > 0.05) between MRI and CBCT in the evaluation of osseous abnormalities in condyles and fossae. The present results indicate that 3.0-T MRI is equal to CBCT in the diagnostic evaluation of osseous abnormalities of the mandibular condyle.

Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bapst, Blanche, E-mail: blanchebapst@hotmail.com; Lagadec, Matthieu, E-mail: matthieu.lagadec@bjn.aphp.fr; Breguet, Romain, E-mail: romain.breguet@hcuge.ch

Cone beam computed tomography (CBCT) is an imaging modality that provides computed tomographic images using a rotational C-arm equipped with a flat panel detector as part of the Angiography suite. The aim of this technique is to provide additional information to conventional 2D imaging to improve the performance of interventional liver oncology procedures (intraarterial treatments such as chemoembolization or selective internal radiation therapy, and percutaneous tumor ablation). CBCT provides accurate tumor detection and targeting, periprocedural guidance, and post-procedural evaluation of treatment success. This technique can be performed during intraarterial or intravenous contrast agent administration with various acquisition protocols to highlightmore » liver tumors, liver vessels, or the liver parenchyma. The purpose of this review is to present an extensive overview of published data on CBCT in interventional oncology of the liver, for both percutaneous ablation and intraarterial procedures.« less

A suggested technique for the application of the cone beam computed tomography periapical index

PubMed Central

Esposito, S; Cardaropoli, M; Cotti, E

2011-01-01

Objectives Cone beam CT (CBCT) produces undistorted three-dimensional (3D) images of the maxillofacial region with a radiation dosage lower than conventional CT. The periapical index score (PAI) is commonly used to follow up the lesions in the bone using periapical radiographs. Recently, a new PAI based on CBCT was introduced (CBCT-PAI). The aim of this technical report is to present a modified reproducible method to assess the CBCT-PAI. Methods CBCT was used to evaluate a periapical bone lesion observed in the area of tooth number 13 before treatment and 2 years after treatment. The modified CBCT-PAI was applied to both the examinations to measure the lesion. The dimensional analysis of the lesion was performed in each plane, assessing three fixed and reproducible dimensions: mesiodistal (M-D), buccolingual (B-L) and coronoapical (C-A). The images were evaluated by three mutually independent examiners. Data were collected and reported in a chart. The results were compared with each other and with the PAI score from the periapical radiographs. Results The three observers reported the same measurements of the lesion for each plane. The CBCT-PAI follow-up showed a reduction of the size of the lesion (5D vs 4D) but also an increase in the erosion of the buccal cortical plate. The comparison of CBCT-PAI with classic PAI showed the first method to be more precise. Conclusions This technical report shows how the CBCT-PAI can be applied to the CBCT exam of a periapical lesion in a reproducible way. PMID:22065800

Quantification of dental prostheses on cone‐beam CT images by the Taguchi method

PubMed Central

Kuo, Rong‐Fu; Fang, Kwang‐Ming; TY, Wong

2016-01-01

The gray values accuracy of dental cone‐beam computed tomography (CBCT) is affected by dental metal prostheses. The distortion of dental CBCT gray values could lead to inaccuracies of orthodontic and implant treatment. The aim of this study was to quantify the effect of scanning parameters and dental metal prostheses on the accuracy of dental cone‐beam computed tomography (CBCT) gray values using the Taguchi method. Eight dental model casts of an upper jaw including prostheses, and a ninth prosthesis‐free dental model cast, were scanned by two dental CBCT devices. The mean gray value of the selected circular regions of interest (ROIs) were measured using dental CBCT images of eight dental model casts and were compared with those measured from CBCT images of the prosthesis‐free dental model cast. For each image set, four consecutive slices of gingiva were selected. The seven factors (CBCTs, occlusal plane canting, implant connection, prosthesis position, coping material, coping thickness, and types of dental restoration) were used to evaluate scanning parameter and dental prostheses effects. Statistical methods of signal to noise ratio (S/N) and analysis of variance (ANOVA) with 95% confidence were applied to quantify the effects of scanning parameters and dental prostheses on dental CBCT gray values accuracy. For ROIs surrounding dental prostheses, the accuracy of CBCT gray values were affected primarily by implant connection (42%), followed by type of restoration (29%), prostheses position (19%), coping material (4%), and coping thickness (4%). For a single crown prosthesis (without support of implants) placed in dental model casts, gray value differences for ROIs 1–9 were below 12% and gray value differences for ROIs 13–18 away from prostheses were below 10%. We found the gray value differences set to be between 7% and 8% for regions next to a single implant‐supported titanium prosthesis, and between 46% and 59% for regions between double implant‐supported, nickel‐chromium alloys (Ni‐Cr) prostheses. Quantification of the effect of prostheses and scanning parameters on dental CBCT gray values was assessed. PACS numbers: 87.59.bd, 87.57Q PMID:26894354

Automated ultrafast kilovoltage-megavoltage cone-beam CT for image guided radiotherapy of lung cancer: System description and real-time results.

PubMed

Blessing, Manuel; Arns, Anna; Wertz, Hansjoerg; Stsepankou, Dzmitry; Boda-Heggemann, Judit; Hesser, Juergen; Wenz, Frederik; Lohr, Frank

2018-04-01

To establish a fully automated kV-MV CBCT imaging method on a clinical linear accelerator that allows image acquisition of thoracic targets for patient positioning within one breath-hold (∼15s) under realistic clinical conditions. Our previously developed FPGA-based hardware unit which allows synchronized kV-MV CBCT projection acquisition is connected to a clinical linear accelerator system via a multi-pin switch; i.e. either kV-MV imaging or conventional clinical mode can be selected. An application program was developed to control the relevant linac parameters automatically and to manage the MV detector readout as well as the gantry angle capture for each MV projection. The kV projections are acquired with the conventional CBCT system. GPU-accelerated filtered backprojection is performed separately for both data sets. After appropriate grayscale normalization both modalities are combined and the final kV-MV volume is re-imported in the CBCT system to enable image matching. To demonstrate adequate geometrical accuracy of the novel imaging system the Penta-Guide phantom QA procedure is performed. Furthermore, a human plastinate and different tumor shapes in a thorax phantom are scanned. Diameters of the known tumor shapes are measured in the kV-MV reconstruction. An automated kV-MV CBCT workflow was successfully established in a clinical environment. The overall procedure, from starting the data acquisition until the reconstructed volume is available for registration, requires ∼90s including 17s acquisition time for 100° rotation. It is very simple and allows target positioning in the same way as for conventional CBCT. Registration accuracy of the QA phantom is within ±1mm. The average deviation from the known tumor dimensions measured in the thorax phantom was 0.7mm which corresponds to an improvement of 36% compared to our previous kV-MV imaging system. Due to automation the kV-MV CBCT workflow is speeded up by a factor of >10 compared to the manual approach. Thus, the system allows a simple, fast and reliable imaging procedure and fulfills all requirements to be successfully introduced into the clinical workflow now, enabling single-breath-hold volume imaging. Copyright © 2018. Published by Elsevier GmbH.

Reconstruction of implanted marker trajectories from cone-beam CT projection images using interdimensional correlation modeling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chung, Hyekyun

Purpose: Cone-beam CT (CBCT) is a widely used imaging modality for image-guided radiotherapy. Most vendors provide CBCT systems that are mounted on a linac gantry. Thus, CBCT can be used to estimate the actual 3-dimensional (3D) position of moving respiratory targets in the thoracic/abdominal region using 2D projection images. The authors have developed a method for estimating the 3D trajectory of respiratory-induced target motion from CBCT projection images using interdimensional correlation modeling. Methods: Because the superior–inferior (SI) motion of a target can be easily analyzed on projection images of a gantry-mounted CBCT system, the authors investigated the interdimensional correlation ofmore » the SI motion with left–right and anterior–posterior (AP) movements while the gantry is rotating. A simple linear model and a state-augmented model were implemented and applied to the interdimensional correlation analysis, and their performance was compared. The parameters of the interdimensional correlation models were determined by least-square estimation of the 2D error between the actual and estimated projected target position. The method was validated using 160 3D tumor trajectories from 46 thoracic/abdominal cancer patients obtained during CyberKnife treatment. The authors’ simulations assumed two application scenarios: (1) retrospective estimation for the purpose of moving tumor setup used just after volumetric matching with CBCT; and (2) on-the-fly estimation for the purpose of real-time target position estimation during gating or tracking delivery, either for full-rotation volumetric-modulated arc therapy (VMAT) in 60 s or a stationary six-field intensity-modulated radiation therapy (IMRT) with a beam delivery time of 20 s. Results: For the retrospective CBCT simulations, the mean 3D root-mean-square error (RMSE) for all 4893 trajectory segments was 0.41 mm (simple linear model) and 0.35 mm (state-augmented model). In the on-the-fly simulations, prior projections over more than 60° appear to be necessary for reliable estimations. The mean 3D RMSE during beam delivery after the simple linear model had established with a prior 90° projection data was 0.42 mm for VMAT and 0.45 mm for IMRT. Conclusions: The proposed method does not require any internal/external correlation or statistical modeling to estimate the target trajectory and can be used for both retrospective image-guided radiotherapy with CBCT projection images and real-time target position monitoring for respiratory gating or tracking.« less

A web-based instruction module for interpretation of craniofacial cone beam CT anatomy.

PubMed

Hassan, B A; Jacobs, R; Scarfe, W C; Al-Rawi, W T

2007-09-01

To develop a web-based module for learner instruction in the interpretation and recognition of osseous anatomy on craniofacial cone-beam CT (CBCT) images. Volumetric datasets from three CBCT systems were acquired (i-CAT, NewTom 3G and AccuiTomo FPD) for various subjects using equipment-specific scanning protocols. The datasets were processed using multiple software to provide two-dimensional (2D) multiplanar reformatted (MPR) images (e.g. sagittal, coronal and axial) and three-dimensional (3D) visual representations (e.g. maximum intensity projection, minimum intensity projection, ray sum, surface and volume rendering). Distinct didactic modules which illustrate the principles of CBCT systems, guided navigation of the volumetric dataset, and anatomic correlation of 3D models and 2D MPR graphics were developed using a hybrid combination of web authoring and image analysis techniques. Interactive web multimedia instruction was facilitated by the use of dynamic highlighting and labelling, and rendered video illustrations, supplemented with didactic textual material. HTML coding and Java scripting were heavily implemented for the blending of the educational modules. An interactive, multimedia educational tool for visualizing the morphology and interrelationships of osseous craniofacial anatomy, as depicted on CBCT MPR and 3D images, was designed and implemented. The present design of a web-based instruction module may assist radiologists and clinicians in learning how to recognize and interpret the craniofacial anatomy of CBCT based images more efficiently.

The potential failure risk of the cone-beam computed tomography-based planning target volume margin definition for prostate image-guided radiotherapy based on a prospective single-institutional hybrid analysis.

PubMed

Hirose, Katsumi; Sato, Mariko; Hatayama, Yoshiomi; Kawaguchi, Hideo; Komai, Fumio; Sohma, Makoto; Obara, Hideki; Suzuki, Masashi; Tanaka, Mitsuki; Fujioka, Ichitaro; Ichise, Koji; Takai, Yoshihiro; Aoki, Masahiko

2018-06-07

The purpose of this study was to evaluate the impact of markerless on-board kilovoltage (kV) cone-beam computed tomography (CBCT)-based positioning uncertainty on determination of the planning target volume (PTV) margin by comparison with kV on-board imaging (OBI) with gold fiducial markers (FMs), and to validate a methodology for the evaluation of PTV margins for markerless kV-CBCT in prostate image-guided radiotherapy (IGRT). A total of 1177 pre- and 1177 post-treatment kV-OBI and 1177 pre- and 206 post-treatment kV-CBCT images were analyzed in 25 patients who received prostate IGRT with daily localization by implanted FMs. Intrafractional motion of the prostate was evaluated between each pre- and post-treatment image with these two different techniques. The differences in prostate deviations and intrafractional motions between matching by FM in kV-OBI (OBI-FM) and matching by soft tissues in kV-CBCT (CBCT-ST) were compared by Bland-Altman limits of agreement. Compensated PTV margins were determined and compensated by references. Mean differences between OBI-FM and CBCT-ST in the anterior to posterior (AP), superior to inferior (SI), and left to right (LR) directions were - 0.43 ± 1.45, - 0.09 ± 1.65, and - 0.12 ± 0.80 mm, respectively, with R 2  = 0.85, 0.88, and 0.83, respectively. Intrafractional motions obtained from CBCT-ST were 0.00 ± 1.46, 0.02 ± 1.49, and 0.15 ± 0.64 mm, respectively, which were smaller than the results from OBI-FM, with 0.43 ± 1.90, 0.12 ± 1.98, and 0.26 ± 0.80 mm, respectively, with R 2  = 0.42, 0.33, and 0.16, respectively. Bland-Altman analysis showed a significant proportional bias. PTV margins of 1.5 mm, 1.4 mm, and 0.9 mm for CBCT-ST were calculated from the values of CBCT-ST, which were also smaller than the values of 3.15 mm, 3.66 mm, and 1.60 mm from OBI-FM. The practical PTV margin for CBCT-ST was compensated with the values from OBI-FM as 4.1 mm, 4.8 mm, and 2.2 mm. PTV margins calculated from CBCT-ST might be underestimated compared to the true PTV margins. To determine a reliable CBCT-ST-based PTV margin, at least the systemic error Σ and the random error σ for on-line matching errors need to be investigated by supportive preliminary FM evaluation at least once.

Cone-Beam Computed Tomography Internal Motion Tracking Should Be Used to Validate 4-Dimensional Computed Tomography for Abdominal Radiation Therapy Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rankine, Leith; Wan, Hanlin; Parikh, Parag

Purpose: To demonstrate that fiducial tracking during pretreatment Cone-Beam CT (CBCT) can accurately measure tumor motion and that this method should be used to validate 4-dimensional CT (4DCT) margins before each treatment fraction. Methods and Materials: For 31 patients with abdominal tumors and implanted fiducial markers, tumor motion was measured daily with CBCT and fluoroscopy for 202 treatment fractions. Fiducial tracking and maximum-likelihood algorithms extracted 3-dimensional fiducial trajectories from CBCT projections. The daily internal margin (IM) (ie, range of fiducial motion) was calculated for CBCT and fluoroscopy as the 5th-95th percentiles of displacement in each cardinal direction. The planning IMmore » from simulation 4DCT (IM{sub 4DCT}) was considered adequate when within ±1.2 mm (anterior–posterior, left–right) and ±3 mm (superior–inferior) of the daily measured IM. We validated CBCT fiducial tracking as an accurate predictive measure of intrafraction motion by comparing the daily measured IM{sub CBCT} with the daily IM measured by pretreatment fluoroscopy (IM{sub pre-fluoro}); these were compared with pre- and posttreatment fluoroscopy (IM{sub fluoro}) to identify those patients who could benefit from imaging during treatment. Results: Four-dimensional CT could not accurately predict intrafractional tumor motion for ≥80% of fractions in 94% (IM{sub CBCT}), 97% (IM{sub pre-fluoro}), and 100% (IM{sub fluoro}) of patients. The IM{sub CBCT} was significantly closer to IM{sub pre-fluoro} than IM{sub 4DCT} (P<.01). For patients with median treatment time t < 7.5 minutes, IM{sub CBCT} was in agreement with IM{sub fluoro} for 93% of fractions (superior–inferior), compared with 63% for the t > 7.5 minutes group, demonstrating the need for patient-specific intratreatment imaging. Conclusions: Tumor motion determined from 4DCT simulation does not accurately predict the daily motion observed on CBCT or fluoroscopy. Cone-beam CT could replace fluoroscopy for pretreatment verification of simulation IM{sub 4DCT}, reducing patient setup time and imaging dose. Patients with treatment time t > 7.5 minutes could benefit from the addition of intratreatment imaging.« less

[Cone-beam computed tomography in paleoanthropology].

PubMed

Vasil'ev, A Iu; Buzhilova, A P; Egorova, E A; Makarova, D V; Berezina, N Ia; Zorina, I S; Khartanovich, V I

2014-01-01

To study the capabilities of cone-bean computed tomography (CBCT) in estimating the bone structure when analyzing anthropological findings. Twenty-four bone fragments (remains) of Napoléon Bonaparte Imperial Army soldiers who had died at a Königsberg military hospital during their retreat from Russia in the War of 1812 were examined by CBCT. A total of 28 tubular bones with different injury healing signs and a skull with maxillofacial trauma marks were investigated. Furthermore, an object from D.G. Rokhlin's paleopathological collection was used to analyze a complicated humeral infectious process. CBCT was performed by individually selecting the scanning foldings, physicotechnical conditions and regimens in relation to the anatomic location and size of fragments. Processing of the obtained images reveled fractures of different bones in 19 (65.5%) cases. The signs of ununited fractures were visualized in 20.7% of the samples. Image post-processing showed intraarticular consolidated fractures in 13.8% of the anthropological findings. The CBCT examination of bone fragments exhibited the signs of their fusion. A wound pattern was established in 31% of the samples. The specific features of a bone amputation stump could be characterized in detail in 17.2% of the anthropological findings. 51.7% of the cases were found to have signs of sustained bone inflammatory diseases of various genesis, which in 41.4% of them were presented by linear, bulbar, and assimilated periostal reactions and significantly detectable on CBCT scans. Sequestral cavities were imaged in 31% of the fragments. The CBCT images are characterized by high informative value (from 7.5 to 10.6 pixels/mm), optimal spatial resolution, definition, and hardness. The software of CBCT involves the parameters and possible postprocessing of images (building of panoramic and mulplanar reconstructions, assessment of the density characteristics of tissues), which allow an analysis of anthropological material, by needlessly destroying them.

SU-G-JeP3-12: Use of Cone Beam CT and Deformable Image Registration for Assessing Geometrical and Dosimetric Variations During Lung Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jurkovic, I; Stathakis, S; Markovic, M

Purpose: To assess the value of cone beam CT (CBCT) combined with deformable image registration in estimating the accuracy of the delivered treatment and the suitability of the applied target margins. Methods: Two patients with lung tumor were selected. Using their CT images intensity modulated radiation therapy (IMRT) treatment plans were developed to deliver 66Gy to the 95% of the PTV in 2Gy fractions. Using the Velocity AI software, the planning CT of each patient was registered with the fractional CBCT images that were obtained through the course of the treatment. After a CT to CBCT deformable image registration (DIR),more » the same fractional deformation matrix was used for the deformation of the planned dose distributions, as well as of all the contoured volumes, to each CBCT dataset. The dosimetric differences between the planning target volume (PTV) and various organs at risk (OARs) were recorded and compared. Results: CBCT data such as CTV volume change and PTV coverage was analyzed. There was a moderate relationship between volume changes and contouring method (automatic contouring using the DIR transformation vs. manual contouring on each CBCT) for patient #1 (r = 0.49), and a strong relationship for patient #2 (r = 0.83). The average PTV volume coverage from all the CBCT datasets was 91.2% for patient #1 and 95.6% for patient #2. Conclusion: Daily setup variations, tumor volume motion and lung deformation due to breathing yield differences in the actual delivered dose distributions versus the planned ones. The results presented indicate that these differences are apparent even with the use of daily IGRT. In certain fractions, the margins used seem to be insufficient to ensure acceptable lung tumor coverage. The observed differences notably depend on the tumor volume size and location. A larger cohort of patient is under investigation to verify those findings.« less

Investigating different computed tomography techniques for internal target volume definition.

PubMed

Yoganathan, S A; Maria Das, K J; Subramanian, V Siva; Raj, D Gowtham; Agarwal, Arpita; Kumar, Shaleen

2017-01-01

The aim of this work was to evaluate the various computed tomography (CT) techniques such as fast CT, slow CT, breath-hold (BH) CT, full-fan cone beam CT (FF-CBCT), half-fan CBCT (HF-CBCT), and average CT for delineation of internal target volume (ITV). In addition, these ITVs were compared against four-dimensional CT (4DCT) ITVs. Three-dimensional target motion was simulated using dynamic thorax phantom with target insert of diameter 3 cm for ten respiration data. CT images were acquired using a commercially available multislice CT scanner, and the CBCT images were acquired using On-Board-Imager. Average CT was generated by averaging 10 phases of 4DCT. ITVs were delineated for each CT by contouring the volume of the target ball; 4DCT ITVs were generated by merging all 10 phases target volumes. Incase of BH-CT, ITV was derived by boolean of CT phases 0%, 50%, and fast CT target volumes. ITVs determined by all CT and CBCT scans were significantly smaller (P < 0.05) than the 4DCT ITV, whereas there was no significant difference between average CT and 4DCT ITVs (P = 0.17). Fast CT had the maximum deviation (-46.1% ± 20.9%) followed by slow CT (-34.3% ± 11.0%) and FF-CBCT scans (-26.3% ± 8.7%). However, HF-CBCT scans (-12.9% ± 4.4%) and BH-CT scans (-11.1% ± 8.5%) resulted in almost similar deviation. On the contrary, average CT had the least deviation (-4.7% ± 9.8%). When comparing with 4DCT, all the CT techniques underestimated ITV. In the absence of 4DCT, the HF-CBCT target volumes with appropriate margin may be a reasonable approach for defining the ITV.

Poster - Thurs Eve-16: Just-in-time tomography (JiTT).

PubMed

Pang, G; Rowlands, J A

2008-07-01

Soft-tissue target motion is one of the main concerns in high-precision radiation therapy. Cone beam computed tomography (CBCT) has been developed recently to image soft-tissue targets in the treatment room for image-guided radiation therapy. However, due to its relatively long image acquisition time the CBCT approach cannot provide images of the target at the instant of the treatment and thus is not adequate for imaging targets with intrafraction motion. In this work, a new concept for image-guided radiation therapy- just-in-time tomography (JiTT) - is introduced. Differing from CBCT, JiTT takes much less time to generate the needed tomographical, beam's-eye-view images of the treatment target at the right moment to guide the radiation therapy treatment. A system to achieve JiTT is proposed and its feasibility is investigated. Research supported by Siemens. © 2008 American Association of Physicists in Medicine.

Automatic Synthesis of Panoramic Radiographs from Dental Cone Beam Computed Tomography Data.

PubMed

Luo, Ting; Shi, Changrong; Zhao, Xing; Zhao, Yunsong; Xu, Jinqiu

2016-01-01

In this paper, we propose an automatic method of synthesizing panoramic radiographs from dental cone beam computed tomography (CBCT) data for directly observing the whole dentition without the superimposition of other structures. This method consists of three major steps. First, the dental arch curve is generated from the maximum intensity projection (MIP) of 3D CBCT data. Then, based on this curve, the long axial curves of the upper and lower teeth are extracted to create a 3D panoramic curved surface describing the whole dentition. Finally, the panoramic radiograph is synthesized by developing this 3D surface. Both open-bite shaped and closed-bite shaped dental CBCT datasets were applied in this study, and the resulting images were analyzed to evaluate the effectiveness of this method. With the proposed method, a single-slice panoramic radiograph can clearly and completely show the whole dentition without the blur and superimposition of other dental structures. Moreover, thickened panoramic radiographs can also be synthesized with increased slice thickness to show more features, such as the mandibular nerve canal. One feature of the proposed method is that it is automatically performed without human intervention. Another feature of the proposed method is that it requires thinner panoramic radiographs to show the whole dentition than those produced by other existing methods, which contributes to the clarity of the anatomical structures, including the enamel, dentine and pulp. In addition, this method can rapidly process common dental CBCT data. The speed and image quality of this method make it an attractive option for observing the whole dentition in a clinical setting.

Compressed-sensing-based content-driven hierarchical reconstruction: Theory and application to C-arm cone-beam tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Langet, Hélène; Laboratoire des Signaux et Systèmes, CentraleSupélec, Gif-sur-Yvette F-91192; Center for Visual Computing, CentraleSupélec, Châtenay-Malabry F-92295

2015-09-15

Purpose: This paper addresses the reconstruction of x-ray cone-beam computed tomography (CBCT) for interventional C-arm systems. Subsampling of CBCT is a significant issue with C-arms due to their slow rotation and to the low frame rate of their flat panel x-ray detectors. The aim of this work is to propose a novel method able to handle the subsampling artifacts generally observed with analytical reconstruction, through a content-driven hierarchical reconstruction based on compressed sensing. Methods: The central idea is to proceed with a hierarchical method where the most salient features (high intensities or gradients) are reconstructed first to reduce the artifactsmore » these features induce. These artifacts are addressed first because their presence contaminates less salient features. Several hierarchical schemes aiming at streak artifacts reduction are introduced for C-arm CBCT: the empirical orthogonal matching pursuit approach with the ℓ{sub 0} pseudonorm for reconstructing sparse vessels; a convex variant using homotopy with the ℓ{sub 1}-norm constraint of compressed sensing, for reconstructing sparse vessels over a nonsparse background; homotopy with total variation (TV); and a novel empirical extension to nonlinear diffusion (NLD). Such principles are implemented with penalized iterative filtered backprojection algorithms. For soft-tissue imaging, the authors compare the use of TV and NLD filters as sparsity constraints, both optimized with the alternating direction method of multipliers, using a threshold for TV and a nonlinear weighting for NLD. Results: The authors show on simulated data that their approach provides fast convergence to good approximations of the solution of the TV-constrained minimization problem introduced by the compressed sensing theory. Using C-arm CBCT clinical data, the authors show that both TV and NLD can deliver improved image quality by reducing streaks. Conclusions: A flexible compressed-sensing-based algorithmic approach is proposed that is able to accommodate for a wide range of constraints. It is successfully applied to C-arm CBCT images that may not be so well approximated by piecewise constant functions.« less

A novel approach for establishing benchmark CBCT/CT deformable image registrations in prostate cancer radiotherapy

PubMed Central

Kim, Jinkoo; Kumar, Sanath; Liu, Chang; Zhong, Hualiang; Pradhan, Deepak; Shah, Mira; Cattaneo, Richard; Yechieli, Raphael; Robbins, Jared R.; Elshaikh, Mohamed A.; Chetty, Indrin J.

2014-01-01

Purpose Deformable image registration (DIR) is an integral component for adaptive radiation therapy. However, accurate registration between daily cone-beam computed tomography (CBCT) and treatment planning CT is challenging, due to significant daily variations in rectal and bladder fillings as well as the increased noise levels in CBCT images. Another significant challenge is the lack of “ground-truth” registrations in the clinical setting, which is necessary for quantitative evaluation of various registration algorithms. The aim of this study is to establish benchmark registrations of clinical patient data. Materials/Methods Three pairs of CT/CBCT datasets were chosen for this IRB-approved retrospective study. On each image, in order to reduce the contouring uncertainty, ten independent sets of organs were manually delineated by five physicians. The mean contour set for each image was derived from the ten contours. A set of distinctive points (round natural calcifications and 3 implanted prostate fiducial markers) were also manually identified. The mean contours and point features were then incorporated as constraints into a B-spline based DIR algorithm. Further, a rigidity penalty was imposed on the femurs and pelvic bones to preserve their rigidity. A piecewise-rigid registration approach was adapted to account for the differences in femur pose and the sliding motion between bones. For each registration, the magnitude of the spatial Jacobian (|JAC|) was calculated to quantify the tissue compression and expansion. Deformation grids and finite-element-model-based unbalanced energy maps were also reviewed visually to evaluate the physical soundness of the resultant deformations. Organ DICE indices (indicating the degree of overlap between registered organs) and residual misalignments of the fiducial landmarks were quantified. Results Manual organ delineation on CBCT images varied significantly among physicians with overall mean DICE index of only 0.7 among redundant contours. Seminal vesicle contours were found to have the lowest correlation amongst physicians (DICE=0.5). After DIR, the organ surfaces between CBCT and planning CT were in good alignment with mean DICE indices of 0.9 for prostate, rectum, and bladder, and 0.8 for seminal vesicles. The Jacobian magnitudes |JAC| in the prostate, rectum, and seminal vesicles were in the range of 0.4–1.5, indicating mild compression/expansion. The bladder volume differences were larger between CBCT and CT images with mean |JAC| values of 2.2, 0.7, and 1.0 for three respective patients. Bone deformation was negligible (|JAC|=~1.0). The difference between corresponding landmark points between CBCT and CT was less than 1.0 mm after DIR. Conclusions We have presented a novel method of establishing benchmark deformable image registration accuracy between CT and CBCT images in the pelvic region. The method incorporates manually delineated organ surfaces and landmark points as well as pixel similarity in the optimization, while ensuring bone rigidity and avoiding excessive deformation in soft tissue organs. Redundant contouring is necessary to reduce the overall registration uncertainty. PMID:24171908

Con-forming bodies: the interplay of machines and bodies and the implications of agency in medical imaging.

PubMed

Wood, Lisa A

2016-06-01

Attending to the material discursive constructions of the patient body within cone beam computed tomography (CBCT) imaging in radiotherapy treatments, in this paper I describe how bodies and machines co-create images. Using an analytical framework inspired by Science and Technology Studies and Feminist Technoscience, I describe the interplay between machines and bodies and the implications of materialities and agency. I argue that patients' bodies play a part in producing scans within acceptable limits of machines as set out through organisational arrangements. In doing so I argue that bodies are fabricated into the order of work prescribed and embedded within and around the CBCT system, becoming, not only the subject of resulting images, but part of that image. The scan is not therefore a representation of a passive subject (a body) but co-produced by the work of practitioners and patients who actively control (and contort) and discipline their body according to protocols and instructions and the CBCT system. In this way I suggest they are 'con-forming' the CBCT image. A Virtual Abstract of this paper can be found at: https://youtu.be/qysCcBGuNSM. © 2015 Foundation for the Sociology of Health & Illness.

Automated framework for estimation of lung tumor locations in kV-CBCT images for tumor-based patient positioning in stereotactic lung body radiotherapy

NASA Astrophysics Data System (ADS)

Yoshidome, Satoshi; Arimura, Hidetaka; Terashima, Koutarou; Hirakawa, Masakazu; Hirose, Taka-aki; Fukunaga, Junichi; Nakamura, Yasuhiko

2017-03-01

Recently, image-guided radiotherapy (IGRT) systems using kilovolt cone-beam computed tomography (kV-CBCT) images have become more common for highly accurate patient positioning in stereotactic lung body radiotherapy (SLBRT). However, current IGRT procedures are based on bone structures and subjective correction. Therefore, the aim of this study was to evaluate the proposed framework for automated estimation of lung tumor locations in kV-CBCT images for tumor-based patient positioning in SLBRT. Twenty clinical cases are considered, involving solid, pure ground-glass opacity (GGO), mixed GGO, solitary, and non-solitary tumor types. The proposed framework consists of four steps: (1) determination of a search region for tumor location detection in a kV-CBCT image; (2) extraction of a tumor template from a planning CT image; (3) preprocessing for tumor region enhancement (edge and tumor enhancement using a Sobel filter and a blob structure enhancement (BSE) filter, respectively); and (4) tumor location estimation based on a template-matching technique. The location errors in the original, edge-, and tumor-enhanced images were found to be 1.2 ± 0.7 mm, 4.2 ± 8.0 mm, and 2.7 ± 4.6 mm, respectively. The location errors in the original images of solid, pure GGO, mixed GGO, solitary, and non-solitary types of tumors were 1.2 ± 0.7 mm, 1.3 ± 0.9 mm, 0.4 ± 0.6 mm, 1.1 ± 0.8 mm and 1.0 ± 0.7 mm, respectively. These results suggest that the proposed framework is robust as regards automatic estimation of several types of tumor locations in kV-CBCT images for tumor-based patient positioning in SLBRT.

Evaluation of demineralized bone and bone transplants in vitro and in vivo with cone beam computed tomography imaging.

PubMed

Draenert, F G; Gebhart, F; Berthold, M; Gosau, M; Wagner, W

2010-07-01

The objective of this study was to determine the ability of two flat panel cone beam CT (CBCT) devices to identify demineralized bone and bone transplants in vivo and in vitro. Datasets from patients with autologous bone grafts (n = 9, KaVo 3DeXam (KaVo, Biberach, Germany); n = 38, Accuitomo 40 (Morita, Osaka, Japan)) were retrospectively evaluated. Demineralized and non-demineralized porcine cancellous bone blocks were examined with the two CBCT devices. A SawBone skull (Pacific Research Laboratories, Vashon, WA) was used as a positioning tool for the bone blocks. Descriptive evaluation and image quality assessment were conducted on the KaVo 3DeXam data (voxel size 0.3 mm) using the OsiriX viewer as well as on the Morita Accuitomo data (voxel size 0.25 mm) using proprietary viewer software. Both in vivo and in vitro, the descriptive analysis of the images of the two devices showed well-visualized bone transplants with clearly defined cancellous bones and well-defined single bone trabeculae in all cross-sections. In vitro, demineralized samples showed lower radiographic opacity but no significant loss of quality compared with fresh bone (P = 0.070). Single cancellous bone trabeculae were significantly better visualized with the Morita 3D Accuitomo device than with the KaVo 3DeXam device (P = 0.038). Both the KaVo 3DeXam and Morita 3D Accuitomo devices produce good-quality images of cancellous bones in in vivo remodelling as well as after in vitro demineralization.

Dosimetric impact of contouring and image registration variability on dynamic 125I prostate brachytherapy.

PubMed

Westendorp, Hendrik; Surmann, Kathrin; van de Pol, Sandrine M G; Hoekstra, Carel J; Kattevilder, Robert A J; Nuver, Tonnis T; Moerland, Marinus A; Slump, Cornelis H; Minken, André W

The quality of permanent prostate brachytherapy can be increased by addition of imaging modalities in the intraoperative procedure. This addition involves image registration, which inherently has inter- and intraobserver variabilities. We sought to quantify the inter- and intraobserver variabilities in geometry and dosimetry for contouring and image registration and analyze the results for our dynamic 125 I brachytherapy procedure. Five observers contoured 11 transrectal ultrasound (TRUS) data sets three times and 11 CT data sets one time. The observers registered 11 TRUS and MRI data sets to cone beam CT (CBCT) using fiducial gold markers. Geometrical and dosimetrical inter- and intraobserver variabilities were assessed. For the contouring study, structures were subdivided into three parts along the craniocaudal axis. We analyzed 165 observations. Interobserver geometrical variability for prostate was 1.1 mm, resulting in a dosimetric variability of 1.6% for V 100 and 9.3% for D 90 . The geometric intraobserver variability was 0.6 mm with a V 100 of 0.7% and D 90 of 1.1%. TRUS-CBCT registration showed an interobserver variability in V 100 of 2.0% and D 90 of 3.1%. Intraobserver variabilities were 0.9% and 1.6%, respectively. For MRI-CBCT registration, V 100 and D 90 were 1.3% and 2.1%. Intraobserver variabilities were 0.7% and 1.1% for the same. Prostate dosimetry is affected by interobserver contouring and registration variability. The observed variability is smaller than underdosages that are adapted during our dynamic brachytherapy procedure. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

The possible usability of three-dimensional cone beam computed dental tomography in dental research

NASA Astrophysics Data System (ADS)

Yavuz, I.; Rizal, M. F.; Kiswanjaya, B.

2017-08-01

The innovations and advantages of three-dimensional cone beam computed dental tomography (3D CBCT) are continually growing for its potential use in dental research. Imaging techniques are important for planning research in dentistry. Newly improved 3D CBCT imaging systems and accessory computer programs have recently been proven effective for use in dental research. The aim of this study is to introduce 3D CBCT and open a window for future research possibilities that should be given attention in dental research.

A dosimetry technique for measuring kilovoltage cone‐beam CT dose on a linear accelerator using radiotherapy equipment

PubMed Central

Lawford, Catherine E.

2014-01-01

This work develops a technique for kilovoltage cone‐beam CT (CBCT) dosimetry that incorporates both point dose and integral dose in the form of dose length product, and uses readily available radiotherapy equipment. The dose from imaging protocols for a range of imaging parameters and treatment sites was evaluated. Conventional CT dosimetry using 100 mm long pencil chambers has been shown to be inadequate for the large fields in CBCT and has been replaced in this work by a combination of point dose and integral dose. Absolute dose measurements were made with a small volume ion chamber at the central slice of a radiotherapy phantom. Beam profiles were measured using a linear diode array large enough to capture the entire imaging field. These profiles were normalized to absolute dose to form dose line integrals, which were then weighted with radial depth to form the DLPCBCT. This metric is analogous to the standard dose length product (DLP), but derived differently to suit the unique properties of CBCT. Imaging protocols for head and neck, chest, and prostate sites delivered absolute doses of 0.9, 2.2, and 2.9 cGy to the center of the phantom, and DLPCBCT of 28.2, 665.1, and 565.3 mGy.cm, respectively. Results are displayed as dose per 100 mAs and as a function of key imaging parameters such as kVp, mAs, and collimator selection in a summary table. DLPCBCT was found to correlate closely with the dimension of the imaging region and provided a good indication of integral dose. It is important to assess integral dose when determining radiation doses to patients using CBCT. By incorporating measured beam profiles and DLP, this technique provides a CBCT dosimetry in radiotherapy phantoms and allows the prediction of imaging dose for new CBCT protocols. PACS number: 87.57.uq PMID:25207398

A dosimetry technique for measuring kilovoltage cone-beam CT dose on a linear accelerator using radiotherapy equipment.

PubMed

Scandurra, Daniel; Lawford, Catherine E

2014-07-08

This work develops a technique for kilovoltage cone-beam CT (CBCT) dosimetry that incorporates both point dose and integral dose in the form of dose length product, and uses readily available radiotherapy equipment. The dose from imaging protocols for a range of imaging parameters and treatment sites was evaluated. Conventional CT dosimetry using 100 mm long pencil chambers has been shown to be inadequate for the large fields in CBCT and has been replaced in this work by a combination of point dose and integral dose. Absolute dose measurements were made with a small volume ion chamber at the central slice of a radiotherapy phantom. Beam profiles were measured using a linear diode array large enough to capture the entire imaging field. These profiles were normalized to absolute dose to form dose line integrals, which were then weighted with radial depth to form the DLPCBCT. This metric is analogous to the standard dose length product (DLP), but derived differently to suit the unique properties of CBCT. Imaging protocols for head and neck, chest, and prostate sites delivered absolute doses of 0.9, 2.2, and 2.9 cGy to the center of the phantom, and DLPCBCT of 28.2, 665.1, and 565.3mGy.cm, respectively. Results are displayed as dose per 100 mAs and as a function of key imaging parameters such as kVp, mAs, and collimator selection in a summary table. DLPCBCT was found to correlate closely with the dimension of the imaging region and provided a good indication of integral dose. It is important to assess integral dose when determining radiation doses to patients using CBCT. By incorporating measured beam profiles and DLP, this technique provides a CBCT dosimetry in radiotherapy phantoms and allows the prediction of imaging dose for new CBCT protocols.

SU-E-J-133: Evaluation of Inter- and Intra-Fractional Pancreas Tumor Residual Motions with Abdominal Compression

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Y; Shi, F; Tian, Z

2014-06-01

Purpose: Abdominal compression (AC) has been widely used to reduce pancreas motion due to respiration for pancreatic cancer patients undergoing stereotactic body radiotherapy (SBRT). However, the inter-fractional and intra-fractional patient motions may degrade the treatment. The purpose of this work is to study daily CBCT projections and 4DCT to evaluate the inter-fractional and intra-fractional pancreatic motions. Methods: As a standard of care at our institution, 4D CT scan was performed for treatment planning. At least two CBCT scans were performed for daily treatment. Retrospective studies were performed on patients with implanted internal fiducial markers or surgical clips. The initial motionmore » pattern was obtained by extracting marker positions on every phase of 4D CT images. Daily motions were presented by marker positions on CBCT scan projection images. An adaptive threshold segmentation algorithm was used to extract maker positions. Both marker average positions and motion ranges were compared among three sets of scans, 4D CT, positioning CBCT, and conformal CBCT, for inter-fractional and intra-fractional motion variations. Results: Data from four pancreatic cancer patients were analyzed. These patients had three fiducial markers implanted. All patients were treated by an Elekta Synergy with single fraction SBRT. CBCT projections were acquired by XVI. Markers were successfully detected on most of the projection images. The inter-fractional changes were determined by 4D CT and the first CBCT while the intra-fractional changes were determined by multiple CBCT scans. It is found that the average motion range variations are within 2 mm, however, the average marker positions may drift by 6.5 mm. Conclusion: The patients respiratory motion variation for pancreas SBRT with AC was evaluated by detecting markers from CBCT projections and 4DCT, both the inter-fraction and intra-fraction motion range change is small but the drift of marker positions may be comparable to motion ranges.« less

SU-F-J-109: Generate Synthetic CT From Cone Beam CT for CBCT-Based Dose Calculation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, H; Barbee, D; Wang, W

Purpose: The use of CBCT for dose calculation is limited by its HU inaccuracy from increased scatter. This study presents a method to generate synthetic CT images from CBCT data by a probabilistic classification that may be robust to CBCT noise. The feasibility of using the synthetic CT for dose calculation is evaluated in IMRT for unilateral H&N cancer. Methods: In the training phase, a fuzzy c-means classification was performed on HU vectors (CBCT, CT) of planning CT and registered day-1 CBCT image pair. Using the resulting centroid CBCT and CT values for five classified “tissue” types, a synthetic CTmore » for a daily CBCT was created by classifying each CBCT voxel to obtain its probability belonging to each tissue class, then assigning a CT HU with a probability-weighted summation of the classes’ CT centroids. Two synthetic CTs from a CBCT were generated: s-CT using the centroids from classification of individual patient CBCT/CT data; s2-CT using the same centroids for all patients to investigate the applicability of group-based centroids. IMRT dose calculations for five patients were performed on the synthetic CTs and compared with CT-planning doses by dose-volume statistics. Results: DVH curves of PTVs and critical organs calculated on s-CT and s2-CT agree with those from planning-CT within 3%, while doses calculated with heterogeneity off or on raw CBCT show DVH differences up to 15%. The differences in PTV D95% and spinal cord max are 0.6±0.6% and 0.6±0.3% for s-CT, and 1.6±1.7% and 1.9±1.7% for s2-CT. Gamma analysis (2%/2mm) shows 97.5±1.6% and 97.6±1.6% pass rates for using s-CTs and s2-CTs compared with CT-based doses, respectively. Conclusion: CBCT-synthesized CTs using individual or group-based centroids resulted in dose calculations that are comparable to CT-planning dose for unilateral H&N cancer. The method may provide a tool for accurate dose calculation based on daily CBCT.« less

SU-F-J-27: Segmentation of Prostate CBCT Images with Implanted Calypso Transponders Using Double Haar Wavelet Transform

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Y; Saleh, Z; Tang, X

Purpose: Segmentation of prostate CBCT images is an essential step towards real-time adaptive radiotherapy. It is challenging For Calypso patients, as more artifacts are generated by the beacon transponders. We herein propose a novel wavelet-based segmentation algorithm for rectum, bladder, and prostate of CBCT images with implanted Calypso transponders. Methods: Five hypofractionated prostate patients with daily CBCT were studied. Each patient had 3 Calypso transponder beacons implanted, and the patients were setup and treated with Calypso tracking system. Two sets of CBCT images from each patient were studied. The structures (i.e. rectum, bladder, and prostate) were contoured by a trainedmore » expert, and these served as ground truth. For a given CBCT, the moving window-based Double Haar transformation is applied first to obtain the wavelet coefficients. Based on a user defined point in the object of interest, a cluster algorithm based adaptive thresholding is applied to the low frequency components of the wavelet coefficients, and a Lee filter theory based adaptive thresholding is applied to the high frequency components. For the next step, the wavelet reconstruction is applied to the thresholded wavelet coefficients. A binary/segmented image of the object of interest is therefore obtained. DICE, sensitivity, inclusiveness and ΔV were used to evaluate the segmentation result. Results: Considering all patients, the bladder has the DICE, sensitivity, inclusiveness, and ΔV ranges of [0.81–0.95], [0.76–0.99], [0.83–0.94], [0.02–0.21]. For prostate, the ranges are [0.77–0.93], [0.84–0.97], [0.68–0.92], [0.1–0.46]. For rectum, the ranges are [0.72–0.93], [0.57–0.99], [0.73–0.98], [0.03–0.42]. Conclusion: The proposed algorithm appeared effective segmenting prostate CBCT images with the present of the Calypso artifacts. However, it is not robust in two scenarios: 1) rectum with significant amount of gas; 2) prostate with very low contrast. Model based algorithm might improve the segmentation in these two scenarios.« less

Functional imaging to monitor vascular and metabolic response in canine head and neck tumors during fractionated radiotherapy.

PubMed

Rødal, Jan; Rusten, Espen; Søvik, Åste; Skogmo, Hege Kippenes; Malinen, Eirik

2013-10-01

Radiotherapy causes alterations in tumor biology, and non-invasive early assessment of such alterations may become useful for identifying treatment resistant disease. The purpose of the current work is to assess changes in vascular and metabolic features derived from functional imaging of canine head and neck tumors during fractionated radiotherapy. Material and methods. Three dogs with spontaneous head and neck tumors received intensity-modulated radiotherapy (IMRT). Contrast-enhanced cone beam computed tomography (CE-CBCT) at the treatment unit was performed at five treatment fractions. Dynamic (18)FDG-PET (D-PET) was performed prior to the start of radiotherapy, at mid-treatment and at 3-12 weeks after the completion of treatment. Tumor contrast enhancement in the CE-CBCT images was used as a surrogate for tumor vasculature. Vascular and metabolic tumor parameters were further obtained from the D-PET images. Changes in these tumor parameters were assessed, with emphasis on intra-tumoral distributions. Results. For all three patients, metabolic imaging parameters obtained from D-PET decreased from the pre- to the inter-therapy session. Correspondingly, for two of three patients, vascular imaging parameters obtained from both CE-CBCT and D-PET increased. Only one of the tumors showed a clear metabolic response after therapy. No systematic changes in the intra-tumor heterogeneity in the imaging parameters were found. Conclusion. Changes in vascular and metabolic parameters could be detected by the current functional imaging methods. Vascular tumor features from CE-CBCT and D-PET corresponded well. CE-CBCT is a potential method for easy response assessment when the patient is at the treatment unit.

Volume and tissue composition preserving deformation of breast CT images to simulate breast compression in mammographic imaging

NASA Astrophysics Data System (ADS)

Han, Tao; Chen, Lingyun; Lai, Chao-Jen; Liu, Xinming; Shen, Youtao; Zhong, Yuncheng; Ge, Shuaiping; Yi, Ying; Wang, Tianpeng; Shaw, Chris C.

2009-02-01

Images of mastectomy breast specimens have been acquired with a bench top experimental Cone beam CT (CBCT) system. The resulting images have been segmented to model an uncompressed breast for simulation of various CBCT techniques. To further simulate conventional or tomosynthesis mammographic imaging for comparison with the CBCT technique, a deformation technique was developed to convert the CT data for an uncompressed breast to a compressed breast without altering the breast volume or regional breast density. With this technique, 3D breast deformation is separated into two 2D deformations in coronal and axial views. To preserve the total breast volume and regional tissue composition, each 2D deformation step was achieved by altering the square pixels into rectangular ones with the pixel areas unchanged and resampling with the original square pixels using bilinear interpolation. The compression was modeled by first stretching the breast in the superior-inferior direction in the coronal view. The image data were first deformed by distorting the voxels with a uniform distortion ratio. These deformed data were then deformed again using distortion ratios varying with the breast thickness and re-sampled. The deformation procedures were applied in the axial view to stretch the breast in the chest wall to nipple direction while shrinking it in the mediolateral to lateral direction re-sampled and converted into data for uniform cubic voxels. Threshold segmentation was applied to the final deformed image data to obtain the 3D compressed breast model. Our results show that the original segmented CBCT image data were successfully converted into those for a compressed breast with the same volume and regional density preserved. Using this compressed breast model, conventional and tomosynthesis mammograms were simulated for comparison with CBCT.

Morphology of Mesiobuccal Root Canals of Maxillary First Molars: a comparison of CBCT scanning and Cross-sectioning.

PubMed

Lyra, Carina Maria; Delai, Débora; Pereira, Keila Cristina Rausch; Pereira, Guy Martins; Pasternak Júnior, Bráulio; Oliveira, César Augusto Pereira

2015-10-01

The aim of this study was to evaluate the mesiobuccal root of maxillary first molars, according to the root canal configuration, prevalence and location of isthmuses at 3 and 6 mm from the apex, comparing cone-beam computed tomography (CBCT) analysis and cross sectioning of roots by thirds. Images of the mesiobuccal root of 100 maxillary first molars were acquired by CBCT and then roots were cross-sectioned into two parts, starting at 3 mm from the apex. Data were recorded and analyzed according to Weine's classification for root canal configuration, and Hsu and Kim's classification for isthmuses. In the analysis of CBCT images, 8 root canals were classified as type I, 57 as type II, 35 as type III. In the cross-sectioning technique, 19 root canals were classified as type I, 60 as type II, 20 as type III and 1 as type IV. The classification of isthmuses was predominantly type I in both CBCT and cross-sectioning evaluations for sections at 3 mm from the apex, while for sections at 6 mm from the apex, the classification of isthmuses was predominantly types V and II in CBCT and cross-sectioning evaluations, respectively. The cross-sectioning technique showed better results in detection of the internal morphology of root canals than CBCT scanning.

Cone-beam computed tomography in children with cochlear implants: The effect of electrode array position on ECAP.

PubMed

Lathuillière, Marine; Merklen, Fanny; Piron, Jean-Pierre; Sicard, Marielle; Villemus, Françoise; Menjot de Champfleur, Nicolas; Venail, Frédéric; Uziel, Alain; Mondain, Michel

2017-01-01

To assess the feasibility of using cone-beam computed tomography (CBCT) in young children with cochlear implants (CIs) and study the effect of intracochlear position on electrophysiological and behavioral measurements. A total of 40 children with either unilateral or bilateral cochlear implants were prospectively included in the study. Electrode placement and insertion angles were studied in 55 Cochlear ® implants (16 straight arrays and 39 perimodiolar arrays), using either CBCT or X-ray imaging. CBCT or X-ray imaging were scheduled when the children were leaving the recovery room. We recorded intraoperative and postoperative neural response telemetry threshold (T-NRT) values, intraoperative and postoperative electrode impedance values, as well as behavioral T (threshold) and C (comfort) levels on electrodes 1, 5, 10, 15 and 20. CBCT imaging was feasible without any sedation in 24 children (60%). Accidental scala vestibuli insertion was observed in 3 out of 24 implants as assessed by CBCT. The mean insertion angle was 339.7°±35.8°. The use of a perimodiolar array led to higher angles of insertion, lower postoperative T-NRT, as well as decreased behavioral T and C levels. We found no significant effect of either electrode array position or angle of insertion on electrophysiological data. CBCT appears to be a reliable tool for anatomical assessment of young children with CIs. Intracochlear position had no significant effect on the electrically evoked compound action potential (ECAP) threshold. Our CBCT protocol must be improved to increase the rate of successful investigations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Influence of Cone-beam Computed Tomography on Endodontic Retreatment Strategies among General Dental Practitioners and Endodontists.

PubMed

Rodríguez, Gustavo; Patel, Shanon; Durán-Sindreu, Fernando; Roig, Miguel; Abella, Francesc

2017-09-01

Treatment options for endodontic failure include nonsurgical or surgical endodontic retreatment, intentional replantation, and extraction with or without replacement of the tooth. The aim of the present study was to determine the impact of cone-beam computed tomographic (CBCT) imaging on clinical decision making among general dental practitioners and endodontists after failed root canal treatment. A second objective was to assess the self-reported level of difficulty in making a treatment choice before and after viewing a preoperative CBCT scan. Eight patients with endodontically treated teeth diagnosed as symptomatic apical periodontitis, acute apical abscess, or chronic apical abscess were selected. In the first session, the examiners were given the details of each case, including any relevant radiographs, and were asked to choose 1 of the proposed treatment alternatives and assess the difficulty of making a decision. One month later, the examiners reviewed randomly the same 8 cases with the additional information from the CBCT data. The examiners altered their treatment plan after viewing the CBCT scan in 49.8% of the cases. A significant difference in the treatment plan between the 2 imaging modalities was recorded for endodontists and general practitioners (P < .05). After CBCT evaluation, neither group altered their self-reported level of difficulty when choosing a treatment plan (P = .0524). The extraction option rose significantly to 20% after viewing the CBCT scan (P < .05). CBCT imaging directly influences endodontic retreatment strategies among general dental practitioners and endodontists. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Quantification of bone quality using different cone beam computed tomography devices: Accuracy assessment for edentulous human mandibles.

PubMed

Van Dessel, Jeroen; Nicolielo, Laura Ferreira Pinheiro; Huang, Yan; Slagmolen, Pieter; Politis, Constantinus; Lambrichts, Ivo; Jacobs, Reinhilde

To determine the accuracy of the latest cone beam computed tomography (CBCT) machines in comparison to multi-slice computer tomography (MSCT) and micro computed tomography (micro-CT) for objectively assessing trabecular and cortical bone quality prior to implant placement. Eight edentulous human mandibular bone samples were scanned with seven CBCT scanners (3D Accuitomo 170, i-CAT Next Generation, ProMax 3D Max, Scanora 3D, Cranex 3D, Newtom GiANO and Carestream 9300) and one MSCT system (Somatom Definition Flash) using the clinical exposure protocol with the highest resolution. Micro-CT (SkyScan 1174) images served as a gold standard. A volume of interest (VOI) comprising trabecular and cortical bone only was delineated on the micro-CT. After spatial alignment of all scan types, micro-CT VOIs were overlaid on the CBCT and MSCT images. Segmentation was applied and morphometric parameters were calculated for each scanner. CBCT and MSCT morphometric parameters were compared with micro-CT using mixed-effect models. Intraclass correlation analysis was used to grade the accuracy of each scanner in assessing trabecular and cortical quality in comparison with the gold standard. Bone structure patterns of each scanner were compared with micro-CT in 2D and 3D to facilitate the interpretation of the morphometric analysis. Morphometric analysis showed an overestimation of the cortical and trabecular bone quantity during CBCT and MSCT evaluation compared to the gold standard micro-CT. The trabecular thickness (Tb.Th) was found to be significantly (P < 0.05) different and the smallest overestimation was found for the ProMax 3D Max (180 µm), followed by the 3D Accuitomo 170 (200 µm), Carestream 9300 (220 µm), Newtom GiANO (240 µm), Cranex 3D (280 µm), Scanora 3D (300 µm), high resolution MSCT (310 µm), i-CAT Next Generation (430 µm) and standard resolution MSCT (510 µm). The underestimation of the cortical thickness (Ct.Th) in ProMax 3D Max (-10 µm), the overestimation in Newtom GiANO (10 µm) and the high resolution MSCT (10 µm) were neglible. However, a significant overestimation (P < 0.05) was found for 3D Accuitomo 170 (110 µm), Scanora 3D (140 µm), standard resolution MSCT (150 µm), Carestream 9300 (190 µm), Cranex 3D (190 µm) and i-CAT Next Generation (230 µm). Comparison of the 2D network and 3D surface distance confirmed the overestimation in bone quantity, but only demonstrated a deviant trabecular network for the i-CAT Next Generation and the standard resolution MSCT. Intraclass correlation coefficients (ICCs) showed a significant (P < 0.05) high intra-observer reliability (ICC > 0.70) in morphometric evaluation between micro-CT and commercially available CBCT scanners (3D Accuitomo 170, Newtom GiANO and ProMax 3D Max). The ICC for Tb.Th and Ct.Th were 0.72 and 0.98 (3D Accuitomo 170), 0.71 and 0.96 (Newtom GiANO), and 0.87 and 0.92 (ProMax 3D Max), respectively. High resolution CBCT offers a clinical alternative to MSCT to objectively determine the bone quality prior to implant placement. However, not all tested CBCT machines have sufficient resolution to accurately depict the trabecular network or cortical bone. Conflict-of-interest statement: There is no conflict of interest to declare. Fellowship support came from Research Foundation Flanders (FWO) from the Belgian government, and Coordination for the Improvement of Higher Education Personnel (CAPES) program and Science without borders from the Brazilian government.

CBCT findings of periapical cemento-osseous dysplasia: A case report.

PubMed

Eskandarloo, Amir; Yousefi, Faezeh

2013-09-01

Periapical cemento-osseous dysplasia (PCOD) is a subtype of cemento-osseous dysplasia that usually occurs in middle-aged black women. This report described a case of a 45-year-old Iranian woman who was diagnosed with PCOD on the basis of cone beam computed tomographic (CBCT) findings. CBCT enabled detailed visualization of the bone changes. This report described the special radiographic characteristics of PCOD, including discontinuity of the lingual cortex on the CBCT sectional and three-dimensional images.

CBCT findings of periapical cemento-osseous dysplasia: A case report

PubMed Central

Eskandarloo, Amir

2013-01-01

Periapical cemento-osseous dysplasia (PCOD) is a subtype of cemento-osseous dysplasia that usually occurs in middle-aged black women. This report described a case of a 45-year-old Iranian woman who was diagnosed with PCOD on the basis of cone beam computed tomographic (CBCT) findings. CBCT enabled detailed visualization of the bone changes. This report described the special radiographic characteristics of PCOD, including discontinuity of the lingual cortex on the CBCT sectional and three-dimensional images. PMID:24083217

SU-E-I-11: A New Cone-Beam CT System for Bedside Head Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sun, H; Zeng, W; Xu, P

Purpose: To design and develop a new mobile cone-beam CT (CBCT) system for head imaging with good soft-tissue visibility, to be used bedside in ICU and neurosurgery department to monitor treatment and operation outcome in brain patients. Methods: The imaging chain consists of a 30cmx25cm amorphous silicon flat panel detector and a pulsed, stationary anode monoblock x-ray source of 100kVp at a maximal tube current of 10mA. The detector and source are supported on motorized mechanisms to provide detector lateral shift and source angular tilt, enabling a centered digital radiographic imaging mode and half-fan CBCT, while maximizing the use ofmore » the x-ray field and keep the source to detector distance short. A focused linear anti-scatter grid is mounted on the detector, and commercial software with scatter and other corrective algorithms is used for data processing and image reconstruction. The gantry rotates around a horizontal axis, and is able to adjust its height for different patient table positions. Cables are routed through a custom protective sleeve over a large bore with an in-plane twister band, facilitating single 360-degree rotation without a slip-ring at a speed up to 5 seconds per rotation. A UPS provides about 10 minutes of operation off the battery when unplugged. The gantry is on locked casters, whose brake is control by two push handles on both sides for easy reposition. The entire system is designed to have a light weight and a compact size for excellent maneuverability. Results: System design is complete and main imaging components are tested. Initial results will be presented and discussed later in the presentation. Conclusion: A new mobile CBCT system for head imaging is being developed. With its compact size, a large bore, and quality design, it is expected to be a useful imaging tool for bedside uses. The work is supported by a grant from Chinese Academy of Sciences.« less

A novel approach for establishing benchmark CBCT/CT deformable image registrations in prostate cancer radiotherapy

NASA Astrophysics Data System (ADS)

Kim, Jinkoo; Kumar, Sanath; Liu, Chang; Zhong, Hualiang; Pradhan, Deepak; Shah, Mira; Cattaneo, Richard; Yechieli, Raphael; Robbins, Jared R.; Elshaikh, Mohamed A.; Chetty, Indrin J.

2013-11-01

Deformable image registration (DIR) is an integral component for adaptive radiation therapy. However, accurate registration between daily cone-beam computed tomography (CBCT) and treatment planning CT is challenging, due to significant daily variations in rectal and bladder fillings as well as the increased noise levels in CBCT images. Another significant challenge is the lack of ‘ground-truth’ registrations in the clinical setting, which is necessary for quantitative evaluation of various registration algorithms. The aim of this study is to establish benchmark registrations of clinical patient data. Three pairs of CT/CBCT datasets were chosen for this institutional review board approved retrospective study. On each image, in order to reduce the contouring uncertainty, ten independent sets of organs were manually delineated by five physicians. The mean contour set for each image was derived from the ten contours. A set of distinctive points (round natural calcifications and three implanted prostate fiducial markers) were also manually identified. The mean contours and point features were then incorporated as constraints into a B-spline based DIR algorithm. Further, a rigidity penalty was imposed on the femurs and pelvic bones to preserve their rigidity. A piecewise-rigid registration approach was adapted to account for the differences in femur pose and the sliding motion between bones. For each registration, the magnitude of the spatial Jacobian (|JAC|) was calculated to quantify the tissue compression and expansion. Deformation grids and finite-element-model-based unbalanced energy maps were also reviewed visually to evaluate the physical soundness of the resultant deformations. Organ DICE indices (indicating the degree of overlap between registered organs) and residual misalignments of the fiducial landmarks were quantified. Manual organ delineation on CBCT images varied significantly among physicians with overall mean DICE index of only 0.7 among redundant contours. Seminal vesicle contours were found to have the lowest correlation amongst physicians (DICE = 0.5). After DIR, the organ surfaces between CBCT and planning CT were in good alignment with mean DICE indices of 0.9 for prostate, rectum, and bladder, and 0.8 for seminal vesicles. The Jacobian magnitudes |JAC| in the prostate, rectum, and seminal vesicles were in the range of 0.4-1.5, indicating mild compression/expansion. The bladder volume differences were larger between CBCT and CT images with mean |JAC| values of 2.2, 0.7, and 1.0 for three respective patients. Bone deformation was negligible (|JAC| = ˜ 1.0). The difference between corresponding landmark points between CBCT and CT was less than 1.0 mm after DIR. We have presented a novel method of establishing benchmark DIR accuracy between CT and CBCT images in the pelvic region. The method incorporates manually delineated organ surfaces and landmark points as well as pixel similarity in the optimization, while ensuring bone rigidity and avoiding excessive deformation in soft tissue organs. Redundant contouring is necessary to reduce the overall registration uncertainty.

Evaluation of online/offline image guidance/adaptation approaches for prostate cancer radiation therapy.

PubMed

Qin, An; Sun, Ying; Liang, Jian; Yan, Di

2015-04-01

To evaluate online/offline image-guided/adaptive treatment techniques for prostate cancer radiation therapy with daily cone-beam CT (CBCT) imaging. Three treatment techniques were evaluated retrospectively using daily pre- and posttreatment CBCT images on 22 prostate cancer patients. Prostate, seminal vesicles (SV), rectal wall, and bladder were delineated on all CBCT images. For each patient, a pretreatment intensity modulated radiation therapy plan with clinical target volume (CTV) = prostate + SV and planning target volume (PTV) = CTV + 3 mm was created. The 3 treatment techniques were as follows: (1) Daily Correction: The pretreatment intensity modulated radiation therapy plan was delivered after online CBCT imaging, and position correction; (2) Online Planning: Daily online inverse plans with 3-mm CTV-to-PTV margin were created using online CBCT images, and delivered; and (3) Hybrid Adaption: Daily Correction plus an offline adaptive inverse planning performed after the first week of treatment. The adaptive plan was delivered for all remaining 15 fractions. Treatment dose for each technique was constructed using the daily posttreatment CBCT images via deformable image registration. Evaluation was performed using treatment dose distribution in target and critical organs. Treatment equivalent uniform dose (EUD) for the CTV was within [85.6%, 100.8%] of the pretreatment planned target EUD for Daily Correction; [98.7%, 103.0%] for Online Planning; and [99.2%, 103.4%] for Hybrid Adaptation. Eighteen percent of the 22 patients in Daily Correction had a target dose deficiency >5%. For rectal wall, the mean ± SD of the normalized EUD was 102.6% ± 2.7% for Daily Correction, 99.9% ± 2.5% for Online Planning, and 100.6% ± 2.1% for Hybrid Adaptation. The mean ± SD of the normalized bladder EUD was 108.7% ± 8.2% for Daily Correction, 92.7% ± 8.6% for Online Planning, and 89.4% ± 10.8% for Hybrid Adaptation. Both Online Planning and Hybrid Adaptation can achieve comparable target coverage and normal tissue sparing and are superior to the Daily Correction technique. The Daily Correction technique using a 3-mm target margin in the pretreatment plan is not appropriate to compensate for residual variations in CBCT image-guided prostate cancer radiation therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of Online/Offline Image Guidance/Adaptation Approaches for Prostate Cancer Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qin, An; Sun, Ying; Liang, Jian

Purpose: To evaluate online/offline image-guided/adaptive treatment techniques for prostate cancer radiation therapy with daily cone-beam CT (CBCT) imaging. Methods and Materials: Three treatment techniques were evaluated retrospectively using daily pre- and posttreatment CBCT images on 22 prostate cancer patients. Prostate, seminal vesicles (SV), rectal wall, and bladder were delineated on all CBCT images. For each patient, a pretreatment intensity modulated radiation therapy plan with clinical target volume (CTV) = prostate + SV and planning target volume (PTV) = CTV + 3 mm was created. The 3 treatment techniques were as follows: (1) Daily Correction: The pretreatment intensity modulated radiation therapy plan was delivered after online CBCT imaging, and positionmore » correction; (2) Online Planning: Daily online inverse plans with 3-mm CTV-to-PTV margin were created using online CBCT images, and delivered; and (3) Hybrid Adaption: Daily Correction plus an offline adaptive inverse planning performed after the first week of treatment. The adaptive plan was delivered for all remaining 15 fractions. Treatment dose for each technique was constructed using the daily posttreatment CBCT images via deformable image registration. Evaluation was performed using treatment dose distribution in target and critical organs. Results: Treatment equivalent uniform dose (EUD) for the CTV was within [85.6%, 100.8%] of the pretreatment planned target EUD for Daily Correction; [98.7%, 103.0%] for Online Planning; and [99.2%, 103.4%] for Hybrid Adaptation. Eighteen percent of the 22 patients in Daily Correction had a target dose deficiency >5%. For rectal wall, the mean ± SD of the normalized EUD was 102.6% ± 2.7% for Daily Correction, 99.9% ± 2.5% for Online Planning, and 100.6% ± 2.1% for Hybrid Adaptation. The mean ± SD of the normalized bladder EUD was 108.7% ± 8.2% for Daily Correction, 92.7% ± 8.6% for Online Planning, and 89.4% ± 10.8% for Hybrid Adaptation. Conclusions: Both Online Planning and Hybrid Adaptation can achieve comparable target coverage and normal tissue sparing and are superior to the Daily Correction technique. The Daily Correction technique using a 3-mm target margin in the pretreatment plan is not appropriate to compensate for residual variations in CBCT image-guided prostate cancer radiation therapy.« less

Evaluation of the resolving potency of a novel reconstruction filter on periodontal ligament space with dental cone-beam CT: a quantitative phantom study

NASA Astrophysics Data System (ADS)

Houno, Yuuki; Hishikawa, Toshimitsu; Gotoh, Ken-ichi; Naitoh, Munetaka; Ariji, Eiichiro; Kodera, Yoshie

2014-03-01

Diagnosis of the alveolar bone condition is important for the treatment planning of periodontal disease. Especially the determination of periodontal ligament space is the most important remark because it represents the periodontal tissue support for tooth retention. However, owing to the image blur of the current cone-beam CT (CBCT) imaging technique, the periodontal ligament space is difficult to visualize. In this study, we developed an original periodontal ligament phantom (PLP) and evaluated the image quality of simulated periodontal ligament space using a novel reconstruction filter for CBCT that emphasized high frequency component. PLP was composed from two resin blocks of different materials, the bone equivalent block and the dentine equivalent block. They were assembled to make continuously changing space from 0.0 to 1.0 millimeter that mimics periodontal ligament space. PLP was placed in water and the image was obtained by using Alphard-3030 dental cone-beam CT (Asahi Roentgen Industry Co., Ltd.). Then we reconstructed the projection data with a novel reconstruction filter. The axial images were compared with conventional reconstructed images. In novel filter reconstruction images, 0.4 millimeter of the space width was steadily detected by calculation of pixel value, on the other hand 0.6 millimeter was in conventional images. With our method, the resolving potency of conebeam CT images was improved.

3D reconstruction based on compressed-sensing (CS)-based framework by using a dental panoramic detector.

PubMed

Je, U K; Cho, H M; Hong, D K; Cho, H S; Park, Y O; Park, C K; Kim, K S; Lim, H W; Kim, G A; Park, S Y; Woo, T H; Cho, S I

2016-01-01

In this work, we propose a practical method that can combine the two functionalities of dental panoramic and cone-beam CT (CBCT) features in one by using a single panoramic detector. We implemented a CS-based reconstruction algorithm for the proposed method and performed a systematic simulation to demonstrate its viability for 3D dental X-ray imaging. We successfully reconstructed volumetric images of considerably high accuracy by using a panoramic detector having an active area of 198.4 mm × 6.4 mm and evaluated the reconstruction quality as a function of the pitch (p) and the angle step (Δθ). Our simulation results indicate that the CS-based reconstruction almost completely recovered the phantom structures, as in CBCT, for p≤2.0 and θ≤6°, indicating that it seems very promising for accurate image reconstruction even for large-pitch and few-view data. We expect the proposed method to be applicable to developing a cost-effective, volumetric dental X-ray imaging system. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Assessment of three-dimensional setup errors in image-guided pelvic radiotherapy for uterine and cervical cancer using kilovoltage cone-beam computed tomography and its effect on planning target volume margins.

PubMed

Patni, Nidhi; Burela, Nagarjuna; Pasricha, Rajesh; Goyal, Jaishree; Soni, Tej Prakash; Kumar, T Senthil; Natarajan, T

2017-01-01

To achieve the best possible therapeutic ratio using high-precision techniques (image-guided radiation therapy/volumetric modulated arc therapy [IGRT/VMAT]) of external beam radiation therapy in cases of carcinoma cervix using kilovoltage cone-beam computed tomography (kV-CBCT). One hundred and five patients of gynecological malignancies who were treated with IGRT (IGRT/VMAT) were included in the study. CBCT was done once a week for intensity-modulated radiation therapy and daily in IGRT/VMAT. These images were registered with the planning CT scan images and translational errors were applied and recorded. In all, 2078 CBCT images were studied. The margins of planning target volume were calculated from the variations in the setup. The setup variation was 5.8, 10.3, and 5.6 mm in anteroposterior, superoinferior, and mediolateral direction. This allowed adequate dose delivery to the clinical target volume and the sparing of organ at risks. Daily kV-CBCT is a satisfactory method of accurate patient positioning in treating gynecological cancers with high-precision techniques. This resulted in avoiding geographic miss.

Apical root resorption due to orthodontic treatment detected by cone beam computed tomography.

PubMed

Castro, Iury O; Alencar, Ana H G; Valladares-Neto, José; Estrela, Carlos

2013-03-01

To determine the frequency of apical root resorption (ARR) due to orthodontic treatment using cone beam computed tomography (CBCT) in a sample of 1256 roots from 30 patients. All patients had Class I malocclusion with crowding. Of the 30 patients evaluated, 11 were boys and 19 were girls; their mean age was 13 years (11 to 16 years). Orthodontic treatment followed the nonextraction treatment. CBCT images were obtained before and after orthodontic treatment, and ARR was determined using Axial Guided Navigation of CBCT images. All patients had ARR. No statistically significant association was found between resorption frequency, gender, and age. ARR was detected using CBCT in 46% of all roots that underwent orthodontic treatment. CBCT was effective for detecting in vivo even minimal degrees of ARR due to orthodontic treatment and allowed three-dimensional evaluation of dental roots and visualization of palatine roots of maxillary molars. The highest frequencies and the most significant ARR occurred in incisors and distal roots of first maxillary and mandibular molars.

SU-D-BRA-02: Motion Assessment During Open Face Mask SRS Using CBCT and Surface Monitoring

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, BB; Fox, CJ; Hartford, AC

Purpose: To assess the robustness of immobilization using open-face mask technology for linac-based stereotactic radiosurgery (SRS) with multiple non-coplanar arcs via repeated CBCT acquisition, with comparison to contemporaneous optical surface tracking data. Methods: 25 patients were treated in open faced masks with cranial SRS using 3–4 non-coplanar arcs. Repeated CBCT imaging was performed to verify the maintenance of proper patient positioning during treatment. Initial patient positioning was performed based on prescribed shifts and optical surface tracking. Positioning refinements employed rigid 3D-matching of the planning CT and CBCT images and were implemented via automated 6DOF couch control. CBCT imaging was repeatedmore » following the treatment of all non-transverse beams with associated couch kicks. Detected patient translations and rotations were recorded and automatically corrected. Optical surface tracking was applied throughout the treatments to monitor motion, and this contemporaneous patient positioning data was recorded to compare against CBCT data and 6DOF couch adjustments. Results: Initial patient positions were refined on average by translations of 3±1mm and rotations of ±0.9-degrees. Optical surface tracking corroborated couch corrections to within 1±1mm and ±0.4-degrees. Following treatment of the transverse and subsequent superior-oblique beam, average translations of 0.6±0.4mm and rotations of ±0.4-degrees were reported via CBCT, with optical surface tracking in agreement to within 1.1±0.6mm and ±0.6-degrees. Following treatment of the third beam, CBCT indicated additional translations of 0.4±0.2mm and rotations of ±0.3-degrees. Cumulative couch corrections resulted in 0.7 ± 0.4mm average magnitude translations and rotations of ±0.4-degrees. Conclusion: Based on CBCT measurements of patients during SRS, the open face mask maintained patient positioning to within 1.5mm and 1-degree with >95% confidence. Patient positioning determined by optical surface tracking agreed with CBCT assessment to within 1±1mm and ±0.6-degree rotations. These data support the use of 1–2mm PTV margins and repeated CBCT to maintain stereotactic positioning tolerances.« less

Analysis of axial spatial resolution in a variable resolution x-ray cone beam CT (VRX-CBCT) system

NASA Astrophysics Data System (ADS)

Dahi, Bahram; Keyes, Gary S.; Rendon, David A.; DiBianca, Frank A.

2008-03-01

The Variable Resolution X-ray (VRX) technique has been successfully used in a Cone-Beam CT (CBCT) system to increase the spatial resolution of CT images in the transverse plane. This was achieved by tilting the Flat Panel Detector (FPD) to smaller vrx y angles in a VRX Cone Beam CT (VRX-CBCT) system. In this paper, the effect on the axial spatial resolution of CT images created by the VRX-CBCT system is examined at different vrx x angles, where vrx x is the tilting angle of the FPD about its x-axis. An amorphous silicon FPD with a CsI scintillator is coupled with a micro-focus x-ray tube to form a CBCT. The FPD is installed on a rotating frame that allows rotation of up to 90° about x and y axes of the FPD. There is no rotation about the z-axis (i.e. normal to the imaging surface). Tilting the FPD about its x-axis (i.e. decreasing the vrx x angle) reduces both the width of the line-spread function and the sampling distance by a factor of sin vrx x, thereby increasing the theoretical detector pre-sampling spatial resolution proportionately. This results in thinner CT slices that in turn help increase the axial spatial resolution of the CT images. An in-house phantom is used to measure the MTF of the reconstructed CT images at different vrx x angles.

A study of respiration-correlated cone-beam CT scans to correct target positioning errors in radiotherapy of thoracic cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santoro, J. P.; McNamara, J.; Yorke, E.

2012-10-15

Purpose: There is increasingly widespread usage of cone-beam CT (CBCT) for guiding radiation treatment in advanced-stage lung tumors, but difficulties associated with daily CBCT in conventionally fractionated treatments include imaging dose to the patient, increased workload and longer treatment times. Respiration-correlated cone-beam CT (RC-CBCT) can improve localization accuracy in mobile lung tumors, but further increases the time and workload for conventionally fractionated treatments. This study investigates whether RC-CBCT-guided correction of systematic tumor deviations in standard fractionated lung tumor radiation treatments is more effective than 2D image-based correction of skeletal deviations alone. A second study goal compares respiration-correlated vs respiration-averaged imagesmore » for determining tumor deviations. Methods: Eleven stage II-IV nonsmall cell lung cancer patients are enrolled in an IRB-approved prospective off-line protocol using RC-CBCT guidance to correct for systematic errors in GTV position. Patients receive a respiration-correlated planning CT (RCCT) at simulation, daily kilovoltage RC-CBCT scans during the first week of treatment and weekly scans thereafter. Four types of correction methods are compared: (1) systematic error in gross tumor volume (GTV) position, (2) systematic error in skeletal anatomy, (3) daily skeletal corrections, and (4) weekly skeletal corrections. The comparison is in terms of weighted average of the residual GTV deviations measured from the RC-CBCT scans and representing the estimated residual deviation over the treatment course. In the second study goal, GTV deviations computed from matching RCCT and RC-CBCT are compared to deviations computed from matching respiration-averaged images consisting of a CBCT reconstructed using all projections and an average-intensity-projection CT computed from the RCCT. Results: Of the eleven patients in the GTV-based systematic correction protocol, two required no correction, seven required a single correction, one required two corrections, and one required three corrections. Mean residual GTV deviation (3D distance) following GTV-based systematic correction (mean {+-} 1 standard deviation 4.8 {+-} 1.5 mm) is significantly lower than for systematic skeletal-based (6.5 {+-} 2.9 mm, p= 0.015), and weekly skeletal-based correction (7.2 {+-} 3.0 mm, p= 0.001), but is not significantly lower than daily skeletal-based correction (5.4 {+-} 2.6 mm, p= 0.34). In two cases, first-day CBCT images reveal tumor changes-one showing tumor growth, the other showing large tumor displacement-that are not readily observed in radiographs. Differences in computed GTV deviations between respiration-correlated and respiration-averaged images are 0.2 {+-} 1.8 mm in the superior-inferior direction and are of similar magnitude in the other directions. Conclusions: An off-line protocol to correct GTV-based systematic error in locally advanced lung tumor cases can be effective at reducing tumor deviations, although the findings need confirmation with larger patient statistics. In some cases, a single cone-beam CT can be useful for assessing tumor changes early in treatment, if more than a few days elapse between simulation and the start of treatment. Tumor deviations measured with respiration-averaged CT and CBCT images are consistent with those measured with respiration-correlated images; the respiration-averaged method is more easily implemented in the clinic.« less

Basic principles of cone beam computed tomography.

PubMed

Abramovitch, Kenneth; Rice, Dwight D

2014-07-01

At the end of the millennium, cone-beam computed tomography (CBCT) heralded a new dental technology for the next century. Owing to the dramatic and positive impact of CBCT on implant dentistry and orthognathic/orthodontic patient care, additional applications for this technology soon evolved. New software programs were developed to improve the applicability of, and access to, CBCT for dental patients. Improved, rapid, and cost-effective computer technology, combined with the ability of software engineers to develop multiple dental imaging applications for CBCT with broad diagnostic capability, have played a large part in the rapid incorporation of CBCT technology into dentistry. Copyright © 2014 Elsevier Inc. All rights reserved.

SU-E-J-24: Image-Guidance Using Cone-Beam CT for Stereotactic Body Radiotherapy (SBRT) of Lung Cancer Patients: Bony Alignment or Soft Tissue Alignment?

PubMed

Wang, L; Turaka, A; Meyer, J; Spoka, D; Jin, L; Fan, J; Ma, C

2012-06-01

To assess the reliability of soft tissue alignment by comparing pre- and post-treatment cone-beam CT (CBCT) for image guidance in stereotactic body radiotherapy (SBRT) of lung cancers. Our lung SBRT procedures require all patients undergo 4D CT scan in order to obtain patient-specific target motion information through reconstructed 4D data using the maximum-intensity projection (MIP) algorithm. The internal target volume (ITV) was outlined directly from the MIP images and a 3-5 mm margin expansion was then applied to the ITV to create the PTV. Conformal treatment planning was performed on the helical images, to which the MIP images were fused. Prior to each treatment, CBCT was used for image guidance by comparing with the simulation CT and for patient relocalization based on the bony anatomy. Any displacement of the patient bony structure would be considered as setup errors and would be corrected by couch shifts. Theoretically, as the PTV definition included target internal motion, no further shifts other than setup corrections should be made. However, it is our practice to have treating physicians further check target localization within the PTV. Whenever the shifts based on the soft-tissue alignment (that is, target alignment) exceeded a certain value (e.g. 5 mm), a post-treatment CBCT was carried out to ensure that the tissue alignment is reliable by comparing between pre- and post-treatment CBCT. Pre- and post-CBCT has been performed for 7 patients so far who had shifts beyond 5 mm despite bony alignment. For all patients, post CBCT confirmed that the visualized target position was kept in the same position as before treatment after adjusting for soft-tissue alignment. For the patient population studied, it is shown that soft-tissue alignment is necessary and reliable in the lung SBRT for individual cases. © 2012 American Association of Physicists in Medicine.

Qualitative Evaluation of Fiducial Markers for Radiotherapy Imaging

PubMed Central

Chan, Maria F.; Cohen, Gil’ad N.; Deasy, Joseph O.

2016-01-01

Purpose To evaluate visibility, artifacts, and distortions of various commercial markers in magnetic resonance imaging (MRI), computer tomography (CT), and ultrasound imaging used for radiotherapy planning and treatment guidance. Methods We compare 2 solid gold markers, 4 gold coils, and 1 polymer marker from 3 vendors. Imaging modalities used were 3-T and 1.5-T GE MRIs, Siemens Sequoia 512 Ultrasound, Phillips Big Bore CT, Varian Trilogy linear accelerator (cone-beam CT [CBCT], on-board imager kilovoltage [OBI-kV], electronic portal imaging device megavoltage [EPID-MV]), and Medtronic O-ARM CBCT. Markers were imaged in a 30 × 30 × 10 cm3 custom bolus phantom. In one experiment, Surgilube was used around the markers to reduce air gaps. Images were saved in Digital Imaging and Communications in Medicine (DICOM) format and analyzed using an in-house software. Profiles across the markers were used for objective comparison of the markers’ signals. The visibility and artifacts/distortions produced by each marker were assessed qualitatively and quantitatively. Results All markers are visible in CT, CBCT, OBI-kV, and ultrasound. Gold markers below 0.75 mm in diameter are not visible in EPID-MV images. The larger the markers, the more CT and CBCT image artifacts there are, yet the degree of the artifact depends on scan parameters and the scanner itself. Visibility of gold coils of 0.75 mm diameter or larger is comparable across all imaging modalities studied. The polymer marker causes minimal artifacts in CT and CBCT but has poor visibility in EPID-MV. Gold coils of 0.5 mm exhibit poor visibility in MRI and EPID-MV due to their small size. Gold markers are more visible in 3-T T1 gradient-recalled echo than in 1.5-T T1 fast spin-echo, depending on the scan sequence. In this study, all markers are clearly visible on ultrasound. Conclusion All gold markers are visible in CT, CBCT, kV, and ultrasound; however, only the large diameter markers are visible in MV. When MR and EPID-MV imagers are used, the selection of fiducial markers is not straightforward. For hybrid kV/MV image-guided radiotherapy imaging, larger diameter markers are suggested. If using kV imaging alone, smaller sized markers may be used in smaller sized patients in order to reduce artifacts. Only larger diameter gold markers are visible across all imaging modalities. PMID:25230715

Measurement of cone beam CT coincidence with megavoltage isocentre and image sharpness using the QUASAR Penta-Guide phantom.

PubMed

Sykes, J R; Lindsay, R; Dean, C J; Brettle, D S; Magee, D R; Thwaites, D I

2008-10-07

For image-guided radiotherapy (IGRT) systems based on cone beam CT (CBCT) integrated into a linear accelerator, the reproducible alignment of imager to x-ray source is critical to the registration of both the x-ray-volumetric image with the megavoltage (MV) beam isocentre and image sharpness. An enhanced method of determining the CBCT to MV isocentre alignment using the QUASAR Penta-Guide phantom was developed which improved both precision and accuracy. This was benchmarked against our existing method which used software and a ball-bearing (BB) phantom provided by Elekta. Additionally, a method of measuring an image sharpness metric (MTF(50)) from the edge response function of a spherical air cavity within the Penta-Guide phantom was developed and its sensitivity was tested by simulating misalignments of the kV imager. Reproducibility testing of the enhanced Penta-Guide method demonstrated a systematic error of <0.2 mm when compared to the BB method with near equivalent random error (s=0.15 mm). The mean MTF(50) for five measurements was 0.278+/-0.004 lp mm(-1) with no applied misalignment. Simulated misalignments exhibited a clear peak in the MTF(50) enabling misalignments greater than 0.4 mm to be detected. The Penta-Guide phantom can be used to precisely measure CBCT-MV coincidence and image sharpness on CBCT-IGRT systems.

Registration area and accuracy when integrating laser-scanned and maxillofacial cone-beam computed tomography images.

PubMed

Sun, LiJun; Hwang, Hyeon-Shik; Lee, Kyung-Min

2018-03-01

The purpose of this study was to examine changes in registration accuracy after including occlusal surface and incisal edge areas in addition to the buccal surface when integrating laser-scanned and maxillofacial cone-beam computed tomography (CBCT) dental images. CBCT scans and maxillary dental casts were obtained from 30 patients. Three methods were used to integrate the images: R1, only the buccal and labial surfaces were used; R2, the incisal edges of the anterior teeth and the buccal and distal marginal ridges of the second molars were used; and R3, labial surfaces, including incisal edges of anterior teeth, and buccal surfaces, including buccal and distal marginal ridges of the second molars, were used. Differences between the 2 images were evaluated by color-mapping methods and average surface distances by measuring the 3-dimensional Euclidean distances between the surface points on the 2 images. The R1 method showed more discrepancies between the laser-scanned and CBCT images than did the other methods. The R2 method did not show a significant difference in registration accuracy compared with the R3 method. The results of this study indicate that accuracy when integrating laser-scanned dental images into maxillofacial CBCT images can be increased by including occlusal surface and incisal edge areas as registration areas. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Evaluating the periapical status of teeth with irreversible pulpitis by using cone-beam computed tomography scanning and periapical radiographs.

PubMed

Abella, Francesc; Patel, Shanon; Duran-Sindreu, Fernando; Mercadé, Montse; Bueno, Rufino; Roig, Miguel

2012-12-01

The purpose of this study was to compare the prevalence of apical periodontitis (AP) on individual roots of teeth with irreversible pulpitis viewed with periapical (PA) radiographs and cone-beam computed tomography (CBCT) scans. PA radiographs and CBCT scans were taken of 138 teeth in 130 patients diagnosed with irreversible pulpitis (symptomatic and asymptomatic). Two calibrated examiners assessed the presence or absence of AP lesions by analyzing the PA and CBCT images. A consensus was reached in the event of any disagreement. The data were analyzed using the hypothesis test, and significance was set at P ≤ .05. Three hundred seven paired roots were assessed with both PA and CBCT images. A comparison of the 307 paired roots revealed that AP lesions were present in 10 (3.3%) and absent in 297 (96.7%) pairs of roots when assessed with PA radiography. When the same 307 sets of roots were assessed with CBCT scans, AP lesions were present in 42 (13.7%) and absent in 265 (86.3%) paired roots. The prevalence of AP lesions detected with CBCT was significantly higher in the symptomatic group compared with the asymptomatic group (P < .05). An additional 22 roots were identified with CBCT alone. The present study highlights the advantages of using CBCT for detecting AP lesions, especially in teeth with symptomatic irreversible pulpitis. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Clinical applications of cone beam computed tomography in endodontics: A comprehensive review.

PubMed

Cohenca, Nestor; Shemesh, Hagay

2015-06-01

Cone beam computed tomography (CBCT) is a new technology that produces three-dimensional (3D) digital imaging at reduced cost and less radiation for the patient than traditional CT scans. It also delivers faster and easier image acquisition. By providing a 3D representation of the maxillofacial tissues in a cost- and dose-efficient manner, a better preoperative assessment can be obtained for diagnosis and treatment. This comprehensive review presents current applications of CBCT in endodontics. Specific case examples illustrate the difference in treatment planning with traditional periapical radiography versus CBCT technology.

Preliminary Studies for a CBCT Imaging Protocol for Offline Organ Motion Analysis: Registration Software Validation and CTDI Measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Falco, Maria Daniela, E-mail: mdanielafalco@hotmail.co; Fontanarosa, Davide; Miceli, Roberto

2011-04-01

Cone-beam X-ray volumetric imaging in the treatment room, allows online correction of set-up errors and offline assessment of residual set-up errors and organ motion. In this study the registration algorithm of the X-ray volume imaging software (XVI, Elekta, Crawley, United Kingdom), which manages a commercial cone-beam computed tomography (CBCT)-based positioning system, has been tested using a homemade and an anthropomorphic phantom to: (1) assess its performance in detecting known translational and rotational set-up errors and (2) transfer the transformation matrix of its registrations into a commercial treatment planning system (TPS) for offline organ motion analysis. Furthermore, CBCT dose index hasmore » been measured for a particular site (prostate: 120 kV, 1028.8 mAs, approximately 640 frames) using a standard Perspex cylindrical body phantom (diameter 32 cm, length 15 cm) and a 10-cm-long pencil ionization chamber. We have found that known displacements were correctly calculated by the registration software to within 1.3 mm and 0.4{sup o}. For the anthropomorphic phantom, only translational displacements have been considered. Both studies have shown errors within the intrinsic uncertainty of our system for translational displacements (estimated as 0.87 mm) and rotational displacements (estimated as 0.22{sup o}). The resulting table translations proposed by the system to correct the displacements were also checked with portal images and found to place the isocenter of the plan on the linac isocenter within an error of 1 mm, which is the dimension of the spherical lead marker inserted at the center of the homemade phantom. The registration matrix translated into the TPS image fusion module correctly reproduced the alignment between planning CT scans and CBCT scans. Finally, measurements on the CBCT dose index indicate that CBCT acquisition delivers less dose than conventional CT scans and electronic portal imaging device portals. The registration software was found to be accurate, and its registration matrix can be easily translated into the TPS and a low dose is delivered to the patient during image acquisition. These results can help in designing imaging protocols for offline evaluations.« less

Comparative Accuracy of Facial Models Fabricated Using Traditional and 3D Imaging Techniques.

PubMed

Lincoln, Ketu P; Sun, Albert Y T; Prihoda, Thomas J; Sutton, Alan J

2016-04-01

The purpose of this investigation was to compare the accuracy of facial models fabricated using facial moulage impression methods to the three-dimensional printed (3DP) fabrication methods using soft tissue images obtained from cone beam computed tomography (CBCT) and 3D stereophotogrammetry (3D-SPG) scans. A reference phantom model was fabricated using a 3D-SPG image of a human control form with ten fiducial markers placed on common anthropometric landmarks. This image was converted into the investigation control phantom model (CPM) using 3DP methods. The CPM was attached to a camera tripod for ease of image capture. Three CBCT and three 3D-SPG images of the CPM were captured. The DICOM and STL files from the three 3dMD and three CBCT were imported to the 3DP, and six testing models were made. Reversible hydrocolloid and dental stone were used to make three facial moulages of the CPM, and the impressions/casts were poured in type IV gypsum dental stone. A coordinate measuring machine (CMM) was used to measure the distances between each of the ten fiducial markers. Each measurement was made using one point as a static reference to the other nine points. The same measuring procedures were accomplished on all specimens. All measurements were compared between specimens and the control. The data were analyzed using ANOVA and Tukey pairwise comparison of the raters, methods, and fiducial markers. The ANOVA multiple comparisons showed significant difference among the three methods (p < 0.05). Further, the interaction of methods versus fiducial markers also showed significant difference (p < 0.05). The CBCT and facial moulage method showed the greatest accuracy. 3DP models fabricated using 3D-SPG showed statistical difference in comparison to the models fabricated using the traditional method of facial moulage and 3DP models fabricated from CBCT imaging. 3DP models fabricated using 3D-SPG were less accurate than the CPM and models fabricated using facial moulage and CBCT imaging techniques. © 2015 by the American College of Prosthodontists.

A motion algorithm to extract physical and motion parameters of mobile targets from cone-beam computed tomographic images.

PubMed

Alsbou, Nesreen; Ahmad, Salahuddin; Ali, Imad

2016-05-17

A motion algorithm has been developed to extract length, CT number level and motion amplitude of a mobile target from cone-beam CT (CBCT) images. The algorithm uses three measurable parameters: Apparent length and blurred CT number distribution of a mobile target obtained from CBCT images to determine length, CT-number value of the stationary target, and motion amplitude. The predictions of this algorithm are tested with mobile targets having different well-known sizes that are made from tissue-equivalent gel which is inserted into a thorax phantom. The phantom moves sinusoidally in one-direction to simulate respiratory motion using eight amplitudes ranging 0-20 mm. Using this motion algorithm, three unknown parameters are extracted that include: Length of the target, CT number level, speed or motion amplitude for the mobile targets from CBCT images. The motion algorithm solves for the three unknown parameters using measured length, CT number level and gradient for a well-defined mobile target obtained from CBCT images. The motion model agrees with the measured lengths which are dependent on the target length and motion amplitude. The gradient of the CT number distribution of the mobile target is dependent on the stationary CT number level, the target length and motion amplitude. Motion frequency and phase do not affect the elongation and CT number distribution of the mobile target and could not be determined. A motion algorithm has been developed to extract three parameters that include length, CT number level and motion amplitude or speed of mobile targets directly from reconstructed CBCT images without prior knowledge of the stationary target parameters. This algorithm provides alternative to 4D-CBCT without requirement of motion tracking and sorting of the images into different breathing phases. The motion model developed here works well for tumors that have simple shapes, high contrast relative to surrounding tissues and move nearly in regular motion pattern that can be approximated with a simple sinusoidal function. This algorithm has potential applications in diagnostic CT imaging and radiotherapy in terms of motion management.

CBCT volumetric coverage extension using a pair of complementary circular scans with complementary kV detector lateral and longitudinal offsets

NASA Astrophysics Data System (ADS)

Yang, Deshan; Li, H. Harold; Goddu, S. Murty; Tan, Jun

2014-10-01

Onboard cone-beam CT (CBCT) has been widely used in image guided radiation therapy. However, the longitudinal coverage is only 15.5 cm in the pelvis scan mode. As a result, a single CBCT scan cannot cover the planning target volume in the longitudinal direction for over 80% of the patients. The common approach is to use double- or multiple-circular scans and then combine multiple CBCT volumes after reconstruction. However it raises concerns regarding doubled imaging dose at the imaging beam junctions due to beam divergence. In this work, we present a new method, DSCS (Dual Scan with Complementary Shifts), to address the CBCT coverage problem using a pair of complementary circular scans. In DSCS, two circular scans were performed at 39.5 cm apart longitudinally. In the superior scan, the detector panel was offset by 16 cm to the left, 15 cm to the inferior. In the inferior scan, the detector panel was shifted 16 cm to the right and 15 cm to the superior. The effective imaging volume is 39.5 cm longitudinally with a 45 cm lateral field-of-view (FOV). Half beam blocks were used to confine the imaging radiation inside the volume of interest. A new image reconstruction algorithm was developed, based on the Feldkamp-Davis-Kress cone-beam CT reconstruction algorithm, to support the DSCS scanning geometry. Digital phantom simulations were performed to demonstrate the feasibility of DSCS. Physical phantom studies were performed using an anthropomorphic phantom on a commercial onboard CBCT system. With basic scattering corrections, the reconstruction results were acceptable. Other issues, including the discrepancy in couch vertical at different couch longitudinal positions, and the inaccuracy in couch table longitudinal movement, were manually corrected during the reconstruction process. In conclusion, the phantom studies showed that, using DSCS, a 39.5 cm longitudinal coverage with a 45 cm FOV was accomplished. The efficiency of imaging dose usage was near 100%. This proposed method could be potentially useful for image guidance and subsequent treatment plan adaptation.

[Preliminary safety and stability assessment of orthodontic miniscrew implantation guided by surgical template based on cone-beam CT images].

PubMed

Qiu, L L; Li, S; Bai, Y X

2016-06-01

To develop surgical templates for orthodontic miniscrew implantation based on cone-beam CT(CBCT)three-dimensional(3D)images and to evaluate the safety and stability of implantation guided by the templates. DICOM data obtained in patients who had CBCT scans taken were processed using Mimics software, and 3D images of teeth and maxillary bone were acquired. Meanwhile, 3D images of miniscrews were acquired using Solidworks software and processed with Mimics software. Virtual position of miniscrews was determined based on 3D images of teeth, bone, and miniscrews. 3D virtual templates were designed according to the virtual implantation plans. STL files were output and the real templates were fabricated with stereolithographic appliance(SLA). Postoperative CBCT scans were used to evaluate the implantation safety and the stability of miniscrews were investigated. All the templates were positioned accurately and kept stable throughout the implantation process. No root damage was found. The deviations were(1.73±0.65)mm at the corona, and(1.28±0.82)mm at the apex, respectively. The stability of miniscrews was fairly well. Surgical templates for miniscrew implantation could be acquired based on 3D CBCT images and fabricated with SLA. Implantation guided by these templates was safe and stable.

Comparison of Results of Measurement of Dimensions of the Placed Dental Implants on Cone Beam Computed Tomography with Dimensions of the Producers of the Implants.

PubMed

Repesa, Merisa; Sofic, Amela; Jakupovic, Selma; Tosum, Selma; Kazazic, Lejla; Dervisevic, Almir

2017-06-01

One of the most frequently used method for scanning patients with indication for dental implantation in dentistry is cone beam computed tomography. Implantation, CBCT imaging and implant programme are inevitable when planning a successful replacement of lost teeth. CBCT offers exact information about available bone and its density, adjacent tooth roots, the place of mandibular canal and maxillary sinus and adjacent anatomical structure. The goal of this study is to estimate accuracy of measurements on CBCT images ofpatients who have implants of different producers and determine if there is any statistically significant correlation between four test groups regardless of the alloy of which implants are made. The study was a prospective-comparative, and included fifteen patients with hundred dental implants divided in four groups depending on the producer. Over dimensioning in the gained measurements of the whole sample on CBCT images in relation to dimensions of producers is between 0.1006mm and 0.368mm. Even though over dimensioning is measured in millimetres, it has to be taken into consideration in clinical practice when planning an implant placement, and we can recommend safety zone of 0.5mm. There have been no statistically significant differences in the gained results in over dimensioning of implants of different alloys for horizontal and vertical measurements on CBCT images of Astra Tech, Brendet titanium implants and Straumann titanium-zirconium implants. Based on the goals of the study there have been confirmed statistically significant correlations of great value (from 0.841 to 0.936) of high level of importance between manufactured value of dimensions and average dimensions values gained through CBCT imaging in four types of implants (four test groups). The total exactness of measurements on CBCT scan in this research is 96.66% for horizontal measuring and 96.92% for vertical measuring. Therefore, we can conclude that CBCT as radiological method has an unavoidable importance in planning and successful realisation of dental implant procedure. Cone Beam Computed Tomography provides exact measurements of dimensions of placed dental implant in relation to dimensions of the producers of the implant because the material from which dental implants have been made does not significantly affect the precision of the measurement.

Time-resolved C-arm cone beam CT angiography (TR-CBCTA) imaging from a single short-scan C-arm cone beam CT acquisition with intra-arterial contrast injection

NASA Astrophysics Data System (ADS)

Li, Yinsheng; Garrett, John W.; Li, Ke; Wu, Yijing; Johnson, Kevin; Schafer, Sebastian; Strother, Charles; Chen, Guang-Hong

2018-04-01

Time-resolved C-arm cone-beam CT (CBCT) angiography (TR-CBCTA) images can be generated from a series of CBCT acquisitions that satisfy data sufficiency condition in analytical image reconstruction theory. In this work, a new technique was developed to generate TR-CBCTA images from a single short-scan CBCT data acquisition with contrast media injection. The reconstruction technique enabling this application is a previously developed image reconstruction technique, synchronized multi-artifact reduction with tomographic reconstruction (SMART-RECON). In this new application, the acquired short-scan CBCT projection data were sorted into a union of several sub-sectors of view angles and each sub-sector of view angles corresponds to an individual image volume to be reconstructed. The SMART-RECON method was then used to jointly reconstruct all of these individual image volumes under two constraints: (1) each individual image volume is maximally consistent with the measured cone-beam projection data within the corresponding view angle sector and (2) the nuclear norm of the image matrix is minimized. The difference between these reconstructed individual image volumes is used to generated the desired subtracted angiograms. To validate the technique, numerical simulation data generated from a fractal tree angiogram phantom were used to quantitatively study the accuracy of the proposed method and retrospective in vivo human subject studies were used to demonstrate the feasibility of generating TR-CBCTA in clinical practice.

Absorbed dose measurements for kV-cone beam computed tomography in image-guided radiation therapy

NASA Astrophysics Data System (ADS)

Hioki, Kazunari; Araki, Fujio; Ohno, Takeshi; Nakaguchi, Yuji; Tomiyama, Yuuki

2014-12-01

In this study, we develope a novel method to directly evaluate an absorbed dose-to-water for kilovoltage-cone beam computed tomography (kV-CBCT) in image-guided radiation therapy (IGRT). Absorbed doses for the kV-CBCT systems of the Varian On-Board Imager (OBI) and the Elekta X-ray Volumetric Imager (XVI) were measured by a Farmer ionization chamber with a 60Co calibration factor. The chamber measurements were performed at the center and four peripheral points in body-type (30 cm diameter and 51 cm length) and head-type (16 cm diameter and 33 cm length) cylindrical water phantoms. The measured ionization was converted to the absorbed dose-to-water by using a 60Co calibration factor and a Monte Carlo (MC)-calculated beam quality conversion factor, kQ, for 60Co to kV-CBCT. The irradiation for OBI and XVI was performed with pelvis and head modes for the body- and the head-type phantoms, respectively. In addition, the dose distributions in the phantom for both kV-CBCT systems were calculated with MC method and were compared with measured values. The MC-calculated doses were calibrated at the center in the water phantom and compared with measured doses at four peripheral points. The measured absorbed doses at the center in the body-type phantom were 1.96 cGy for OBI and 0.83 cGy for XVI. The peripheral doses were 2.36-2.90 cGy for OBI and 0.83-1.06 cGy for XVI. The doses for XVI were lower up to approximately one-third of those for OBI. Similarly, the measured doses at the center in the head-type phantom were 0.48 cGy for OBI and 0.21 cGy for XVI. The peripheral doses were 0.26-0.66 cGy for OBI and 0.16-0.30 cGy for XVI. The calculated peripheral doses agreed within 3% in the pelvis mode and within 4% in the head mode with measured doses for both kV-CBCT systems. In addition, the absorbed dose determined in this study was approximately 4% lower than that in TG-61 but the absorbed dose by both methods was in agreement within their combined uncertainty. This method is more robust and accurate compared to the dosimetry based on a conventional air-kerma calibration factor. Therefore, it is possible to be used as a standard dosimetry protocol for kV-CBCT in IGRT.

SU-E-J-153: Reconstructing 4D Cone Beam CT Images for Clinical QA of Lung SABR Treatments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beaudry, J; Bergman, A; British Columbia Cancer Agency, Vancouver, BC

Purpose: To verify that the planned Primary Target Volume (PTV) and Internal Gross Tumor Volume (IGTV) fully enclose a moving lung tumor volume as visualized on a pre-SABR treatment verification 4D Cone Beam CT. Methods: Daily 3DCBCT image sets were acquired immediately prior to treatment for 10 SABR lung patients using the on-board imaging system integrated into a Varian TrueBeam (v1.6: no 4DCBCT module available). Respiratory information was acquired during the scan using the Varian RPM system. The CBCT projections were sorted into 8 bins offline, both by breathing phase and amplitude, using in-house software. An iterative algorithm based onmore » total variation minimization, implemented in the open source reconstruction toolkit (RTK), was used to reconstruct the binned projections into 4DCBCT images. The relative tumor motion was quantified by tracking the centroid of the tumor volume from each 4DCBCT image. Following CT-CBCT registration, the planning CT volumes were compared to the location of the CBCT tumor volume as it moves along its breathing trajectory. An overlap metric quantified the ability of the planned PTV and IGTV to contain the tumor volume at treatment. Results: The 4DCBCT reconstructed images visibly show the tumor motion. The mean overlap between the planned PTV (IGTV) and the 4DCBCT tumor volumes was 100% (94%), with an uncertainty of 5% from the 4DCBCT tumor volume contours. Examination of the tumor motion and overlap metric verify that the IGTV drawn at the planning stage is a good representation of the tumor location at treatment. Conclusion: It is difficult to compare GTV volumes from a 4DCBCT and a planning CT due to image quality differences. However, it was possible to conclude the GTV remained within the PTV 100% of the time thus giving the treatment staff confidence that SABR lung treatements are being delivered accurately.« less

Comparative evaluation of the accuracy of linear measurements between cone beam computed tomography and 3D microtomography.

PubMed

Mangione, Francesca; Meleo, Deborah; Talocco, Marco; Pecci, Raffaella; Pacifici, Luciano; Bedini, Rossella

2013-01-01

The aim of this study was to evaluate the influence of artifacts on the accuracy of linear measurements estimated with a common cone beam computed tomography (CBCT) system used in dental clinical practice, by comparing it with microCT system as standard reference. Ten bovine bone cylindrical samples containing one implant each, able to provide both points of reference and image quality degradation, have been scanned by CBCT and microCT systems. Thanks to the software of the two systems, for each cylindrical sample, two diameters taken at different levels, by using implants different points as references, have been measured. Results have been analyzed by ANOVA and a significant statistically difference has been found. Due to the obtained results, in this work it is possible to say that the measurements made with the two different instruments are still not statistically comparable, although in some samples were obtained similar performances and therefore not statistically significant. With the improvement of the hardware and software of CBCT systems, in the near future the two instruments will be able to provide similar performances.

SU-E-J-135: Feasibility of Using Quantitative Cone Beam CT for Proton Adaptive Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jingqian, W; Wang, Q; Zhang, X

2015-06-15

Purpose: To investigate the feasibility of using scatter corrected cone beam CT (CBCT) for proton adaptive planning. Methods: Phantom study was used to evaluate the CT number difference between the planning CT (pCT), quantitative CBCT (qCBCT) with scatter correction and calibrated Hounsfield units using adaptive scatter kernel superposition (ASKS) technique, and raw CBCT (rCBCT). After confirming the CT number accuracy, prostate patients, each with a pCT and several sets of weekly CBCT, were investigated for this study. Spot scanning proton treatment plans were independently generated on pCT, qCBCT and rCBCT. The treatment plans were then recalculated on all images. Dose-volume-histogrammore » (DVH) parameters and gamma analysis were used to compare between dose distributions. Results: Phantom study suggested that Hounsfield unit accuracy for different materials are within 20 HU for qCBCT and over 250 HU for rCBCT. For prostate patients, proton dose could be calculated accurately on qCBCT but not on rCBCT. When the original plan was recalculated on qCBCT, tumor coverage was maintained when anatomy was consistent with pCT. However, large dose variance was observed when patient anatomy change. Adaptive plan using qCBCT was able to recover tumor coverage and reduce dose to normal tissue. Conclusion: It is feasible to use qu antitative CBCT (qCBCT) with scatter correction and calibrated Hounsfield units for proton dose calculation and adaptive planning in proton therapy. Partly supported by Varian Medical Systems.« less

SU-E-I-02: Characterizing Low-Contrast Resolution for Non-Circular CBCT Trajectories

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davis, A; Pan, X; Pelizzari, C

Purpose: The use of non-circular scanning trajectories with optimization-basedreconstruction algorithms can be used in conjunction with non-planaracquisition geometries for axial field-of-view (FOV) extension incone-beam CT (CBCT). To evaluate the utility of these trajectories,quantitative image quality metrics should be evaluated. Low-contrastresolution (LCR) and CT number accuracy are significant challenges forCBCT. With unprecedented axial coverage provided by thesetrajectories, measuring such metrics throughout the axial range iscritical. There are currently no phantoms designed to measurelow-contrast resolution over such an extended volume. Methods: The CATPHAN (The Phantom Laboratory, Salem NY) is the current standardfor image quality evaluation. While providing several useful modulesfor different evaluationmore » metrics, each module was designed to beevaluated in a single slice and not for comparison across axialpositions. To characterize the LCR and HU accuracy over an extendedaxial length, we have designed and built a phantom with evaluationmodules at multiple and adjustable axial positions. Results: The modules were made from a cast polyurethane resin. Holes rangingfrom 1/8 to 5/8 inch were added at a constant radius from the modulecenter into which rods of two different plastic materials were pressedto provide two nominal levels of contrast (1.0% and 0.5%). Largerholes were bored to accept various RMI plugs with known electrondensities for HU accuracy evaluation. The modules can be inserted intoan acrylic tube long enough to cover the entire axial FOV and theirpositions adjusted to desired evaluation points. Conclusion: This phantom allows us to measure the LCR and HU accuracy across theaxial coverage within a single acquisition. These metrics can be usedto characterize the impact different trajectories and reconstructionparameters have on clinically relevant image quality performancemetrics. Funding was provided in part by Varian Medical Systems and NIH R01 Grants Nos. CA158446, CA182264, EB018102, and EB000225. The contents of this poster are solely the responsibility of the authors and do not necessarily represent the official view of any of the supporting organizations.« less

SU-G-JeP4-14: Assessment of Inter- and Intra-Fractional Motion for Extremity Soft Tissue Sarcoma Patients by Using In-House Real-Time Optical Image-Based Monitoring System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, H; Kim, I; Ye, S

Purpose: This study aimed to assess inter- and intra-fractional motion for extremity Soft Tissue Sarcoma (STS) patients, by using in-house real-time optical image-based monitoring system (ROIMS) with infra-red (IR) external markers. Methods: Inter- and intra-fractional motions for five extremity (1 upper, 4 lower) STS patients received postoperative 3D conformal radiotherapy (3D-CRT) were measured by registering the image acquired by ROIMS with the planning CT image (REG-ROIMS). To compare with the X-ray image-based monitoring, pre- and post-treatment cone beam computed tomography (CBCT) scans were performed once per week and registered with planning CT image as well (REG-CBCT). If the CBCT scanmore » is not feasible due to the large couch shift, AP and LR on-board imager (OBI) images were acquired. The comparison was done by calculating mutual information (MI) of those registered images. Results: The standard deviation (SD) of the inter-fractional motion was 2.6 mm LR, 2.8 mm SI, and 2.0 mm AP, and the SD of the intra-fractional motion was 1.4 mm, 2.1 mm, and 1.3 mm in each axis, respectively. The SD of rotational inter-fractional motion was 0.6° pitch, 0.9° yaw, and 0.8° roll and the SD of rotational intra-fractional motion was 0.4° pitch, 0.9° yaw, and 0.7° roll. The derived averaged MI values were 0.83, 0.92 for REG-CBCT without rotation and REG-ROIMS with rotation, respectively. Conclusion: The in-house real-time optical image-based monitoring system was implemented clinically and confirmed the feasibility to assess inter- and intra-fractional motion for extremity STS patients while the daily basis and real-time CBCT scan is not feasible in clinic.« less

WE-AB-207A-01: BEST IN PHYSICS (IMAGING): High-Resolution Cone-Beam CT of the Extremities and Cancellous Bone Architecture with a CMOS Detector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cao, Q; Brehler, M; Sisniega, A

Purpose: Extremity cone-beam CT (CBCT) with an amorphous silicon (aSi) flat-panel detector (FPD) provides low-dose volumetric imaging with high spatial resolution. We investigate the performance of the newer complementary metal-oxide semiconductor (CMOS) detectors to enhance resolution of extremities CBCT to ∼0.1 mm, enabling morphological analysis of trabecular bone. Quantitative in-vivo imaging of bone microarchitecture could present an important advance for osteoporosis and osteoarthritis diagnosis and therapy assessment. Methods: Cascaded systems models of CMOS- and FPD-based extremities CBCT were implemented. Performance was compared for a range of pixel sizes (0.05–0.4 mm), focal spot sizes (0.3–0.6 FS), and x-ray techniques (0.05–0.8 mAs/projection)more » using detectability of high-, low-, and all-frequency tasks for a nonprewhitening observer. Test-bench implementation of CMOS-based extremity CBCT involved a Teledyne DALSA Xineos3030HR detector with 0.099 mm pixels and a compact rotating anode x-ray source with 0.3 FS (IMD RTM37). Metrics of bone morphology obtained using CMOS-based CBCT were compared in cadaveric specimens to FPD-based system using a Varian PaxScan4030 (0.194 mm pixels). Results: Finer pixel size and reduced electronic noise for CMOS (136 e compared to 2000 e for FPD) resulted in ∼1.9× increase in detectability for high-frequency tasks and ∼1.1× increase for all-frequency tasks. Incorporation of the new x-ray source with reduced focal spot size (0.3 FS vs. 0.5 FS used on current extremities CBCT) improved detectability for CMOS-based CBCT by ∼1.7× for high-frequency tasks. Compared to FPD CBCT, the CMOS detector yielded improved agreement with micro-CT in measurements of trabecular thickness (∼1.7× reduction in relative error), bone volume (∼1.5× reduction), and trabecular spacing (∼3.5× reduction). Conclusion: Imaging performance modelling and experimentation indicate substantial improvements for high-frequency imaging tasks through adoption of the CMOS detector and small FS x-ray source, motivating the use of these components in a new system for quantitative in-vivo imaging of trabecular bone. Financial Support: US NIH grant R01EB018896. Qian Cao is a Howard Hughes Medical Institute International Student Research Fellow. Disclosures: W Zbijewski, J Siewerdsen and A Sisniega receive research funding from Carestream Health.« less

Assessment of the primary stability of root analog zirconia implants designed using cone beam computed tomography software by means of the Periotest® device: An ex vivo study. A preliminary report.

PubMed

Matys, Jacek; Świder, Katarzyna; Flieger, Rafał; Dominiak, Marzena

2017-08-01

The implant primary stability is a fundamental prerequisite for a success of osseointegration process which determines the prosthetic reconstruction time. The aim of the present study was to assess the quality and precision of modern conical bone computer tomography (CBCT) software in preparing root analog zirconia implants (RAZIs) by measuring its primary stability by means of the Periotest device. Thirteen pig jaws with proper erupted first premolar (P1) teeth were used in the study. The CBCT examination was conducted in the area of the P1 tooth in each mandible. The 3-dimensional (3D) view of each tooth was designed from CBCT scan. The created 3D images were used to prepare root analog zirconia implants milled from a medical-grade zirconia block by means of laboratory milling. The RAZIs and titanium implants were placed into an alveolar socket after the tooth had been removed. The primary stability of the teeth before their extraction (G1), RAZIs (G2) and titanium implants (G3) were checked by Periotest devices. The mean results in PTV were: 15.9, 3.35, 12.7 for G1, G2 and G3 group, respectively. RAZIs during immediate loading achieved a significantly higher primary stability (lower Periotest value) as compared to the teeth and implants. The modern CBCT device allows us to design a precise image of an extracted tooth for the purpose of manufacturing a root analog implant. The additional feature of the surgical protocol using RAZI is the possibility of avoiding the augmentation procedure, which reduces the whole cost of the treatment.

Deformable registration of CT and cone-beam CT with local intensity matching.

PubMed

Park, Seyoun; Plishker, William; Quon, Harry; Wong, John; Shekhar, Raj; Lee, Junghoon

2017-02-07

Cone-beam CT (CBCT) is a widely used intra-operative imaging modality in image-guided radiotherapy and surgery. A short scan followed by a filtered-backprojection is typically used for CBCT reconstruction. While data on the mid-plane (plane of source-detector rotation) is complete, off-mid-planes undergo different information deficiency and the computed reconstructions are approximate. This causes different reconstruction artifacts at off-mid-planes depending on slice locations, and therefore impedes accurate registration between CT and CBCT. In this paper, we propose a method to accurately register CT and CBCT by iteratively matching local CT and CBCT intensities. We correct CBCT intensities by matching local intensity histograms slice by slice in conjunction with intensity-based deformable registration. The correction-registration steps are repeated in an alternating way until the result image converges. We integrate the intensity matching into three different deformable registration methods, B-spline, demons, and optical flow that are widely used for CT-CBCT registration. All three registration methods were implemented on a graphics processing unit for efficient parallel computation. We tested the proposed methods on twenty five head and neck cancer cases and compared the performance with state-of-the-art registration methods. Normalized cross correlation (NCC), structural similarity index (SSIM), and target registration error (TRE) were computed to evaluate the registration performance. Our method produced overall NCC of 0.96, SSIM of 0.94, and TRE of 2.26 → 2.27 mm, outperforming existing methods by 9%, 12%, and 27%, respectively. Experimental results also show that our method performs consistently and is more accurate than existing algorithms, and also computationally efficient.

Deformable registration of CT and cone-beam CT with local intensity matching

NASA Astrophysics Data System (ADS)

Park, Seyoun; Plishker, William; Quon, Harry; Wong, John; Shekhar, Raj; Lee, Junghoon

2017-02-01

Cone-beam CT (CBCT) is a widely used intra-operative imaging modality in image-guided radiotherapy and surgery. A short scan followed by a filtered-backprojection is typically used for CBCT reconstruction. While data on the mid-plane (plane of source-detector rotation) is complete, off-mid-planes undergo different information deficiency and the computed reconstructions are approximate. This causes different reconstruction artifacts at off-mid-planes depending on slice locations, and therefore impedes accurate registration between CT and CBCT. In this paper, we propose a method to accurately register CT and CBCT by iteratively matching local CT and CBCT intensities. We correct CBCT intensities by matching local intensity histograms slice by slice in conjunction with intensity-based deformable registration. The correction-registration steps are repeated in an alternating way until the result image converges. We integrate the intensity matching into three different deformable registration methods, B-spline, demons, and optical flow that are widely used for CT-CBCT registration. All three registration methods were implemented on a graphics processing unit for efficient parallel computation. We tested the proposed methods on twenty five head and neck cancer cases and compared the performance with state-of-the-art registration methods. Normalized cross correlation (NCC), structural similarity index (SSIM), and target registration error (TRE) were computed to evaluate the registration performance. Our method produced overall NCC of 0.96, SSIM of 0.94, and TRE of 2.26 → 2.27 mm, outperforming existing methods by 9%, 12%, and 27%, respectively. Experimental results also show that our method performs consistently and is more accurate than existing algorithms, and also computationally efficient.

Two examples of indication specific radiation dose calculations in dental CBCT and Multidetector CT scanners.

PubMed

Stratis, Andreas; Zhang, Guozhi; Lopez-Rendon, Xochitl; Politis, Constantinus; Hermans, Robert; Jacobs, Reinhilde; Bogaerts, Ria; Shaheen, Eman; Bosmans, Hilde

2017-09-01

To calculate organ doses and estimate the effective dose for justification purposes in patients undergoing orthognathic treatment planning purposes and temporal bone imaging in dental cone beam CT (CBCT) and Multidetector CT (MDCT) scanners. The radiation dose to the ICRP reference male voxel phantom was calculated for dedicated orthognathic treatment planning acquisitions via Monte Carlo simulations in two dental CBCT scanners, Promax 3D Max (Planmeca, FI) and NewTom VGi evo (QR s.r.l, IT) and in Somatom Definition Flash (Siemens, DE) MDCT scanner. For temporal bone imaging, radiation doses were calculated via MC simulations for a CBCT protocol in NewTom 5G (QR s.r.l, IT) and with the use of a software tool (CT-expo) for Somatom Force (Siemens, DE). All procedures had been optimized at the acceptance tests of the devices. For orthognathic protocols, dental CBCT scanners deliver lower doses compared to MDCT scanners. The estimated effective dose (ED) was 0.32mSv for a normal resolution operation mode in Promax 3D Max, 0.27mSv in VGi-evo and 1.18mSv in the Somatom Definition Flash. For temporal bone protocols, the Somatom Force resulted in an estimated ED of 0.28mSv while for NewTom 5G the ED was 0.31 and 0.22mSv for monolateral and bilateral imaging respectively. Two clinical exams which are carried out with both a CBCT or a MDCT scanner were compared in terms of radiation dose. Dental CBCT scanners deliver lower doses for orthognathic patients whereas for temporal bone procedures the doses were similar. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Reconstruction-of-difference (RoD) imaging for cone-beam CT neuro-angiography

NASA Astrophysics Data System (ADS)

Wu, P.; Stayman, J. W.; Mow, M.; Zbijewski, W.; Sisniega, A.; Aygun, N.; Stevens, R.; Foos, D.; Wang, X.; Siewerdsen, J. H.

2018-06-01

Timely evaluation of neurovasculature via CT angiography (CTA) is critical to the detection of pathology such as ischemic stroke. Cone-beam CTA (CBCT-A) systems provide potential advantages in the timely use at the point-of-care, although challenges of a relatively slow gantry rotation speed introduce tradeoffs among image quality, data consistency and data sparsity. This work describes and evaluates a new reconstruction-of-difference (RoD) approach that is robust to such challenges. A fast digital simulation framework was developed to test the performance of the RoD over standard reference reconstruction methods such as filtered back-projection (FBP) and penalized likelihood (PL) over a broad range of imaging conditions, grouped into three scenarios to test the trade-off between data consistency, data sparsity and peak contrast. Two experiments were also conducted using a CBCT prototype and an anthropomorphic neurovascular phantom to test the simulation findings in real data. Performance was evaluated primarily in terms of normalized root mean square error (NRMSE) in comparison to truth, with reconstruction parameters chosen to optimize performance in each case to ensure fair comparison. The RoD approach reduced NRMSE in reconstructed images by up to 50%–53% compared to FBP and up to 29%–31% compared to PL for each scenario. Scan protocols well suited to the RoD approach were identified that balance tradeoffs among data consistency, sparsity and peak contrast—for example, a CBCT-A scan with 128 projections acquired in 8.5 s over a 180°  +  fan angle half-scan for a time attenuation curve with ~8.5 s time-to-peak and 600 HU peak contrast. With imaging conditions such as the simulation scenarios of fixed data sparsity (i.e. varying levels of data consistency and peak contrast), the experiments confirmed the reduction of NRMSE by 34% and 17% compared to FBP and PL, respectively. The RoD approach demonstrated superior performance in 3D angiography compared to FBP and PL in all simulation and physical experiments, suggesting the possibility of CBCT-A on low-cost, mobile imaging platforms suitable to the point-of-care. The algorithm demonstrated accurate reconstruction with a high degree of robustness against data sparsity and inconsistency.

Does additional cone beam computed tomography decrease the risk of inferior alveolar nerve injury in high-risk cases undergoing third molar surgery?Does CBCT decrease the risk of IAN injury?

PubMed

Korkmaz, Y T; Kayıpmaz, S; Senel, F C; Atasoy, K T; Gumrukcu, Z

2017-05-01

The objectives of this study were to evaluate the efficacy of additional cone beam computed tomography (CBCT) imaging on decreasing the risk of inferior alveolar nerve (IAN) injury during third molar removal in patients at high risk and to assess the surgical outcomes. The study sample included patients considered at high risk for IAN injury based on panoramic radiography (PAN) evaluation. The primary predictor was the type of imaging method (PAN only or with additional CBCT). The other variables were demographic and anatomical/radiographic factors. The primary outcome variable was IAN injury. The secondary outcome variables were the preoperative surgical plan and surgical results including IAN exposure and duration of surgery. The sample comprised 122 patients (139 teeth) aged 18-48 years. Postoperative temporary IAN injury was present in three (4.2%) cases in the CBCT group and 11 (16.4%) in the PAN group at 7 days after surgery. However, none of the patients had a permanent IAN injury at the 6-month follow-up. Additional CBCT imaging was not superior to PAN in reducing IAN injury after third molar surgery during long-term follow-up. Nonetheless, CBCT may decrease the prevalence of temporary IAN injury and improve the surgical outcomes in high-risk patients. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Effects of online cone-beam computed tomography with active breath control in determining planning target volume during accelerated partial breast irradiation.

PubMed

Li, Y; Zhong, R; Wang, X; Ai, P; Henderson, F; Chen, N; Luo, F

2017-04-01

To test if active breath control during cone-beam computed tomography (CBCT) could improve planning target volume during accelerated partial breast radiotherapy for breast cancer. Patients who were more than 40 years old, underwent breast-conserving dissection and planned for accelerated partial breast irradiation, and with postoperative staging limited to T1-2 N0 M0, or postoperative staging T2 lesion no larger than 3cm with a negative surgical margin greater than 2mm were enrolled. Patients with lobular carcinoma or extensive ductal carcinoma in situ were excluded. CBCT images were obtained pre-correction, post-correction and post-treatment. Set-up errors were recorded at left-right, anterior-posterior and superior-inferior directions. The differences between these CBCT images, as well as calculated radiation doses, were compared between patients with active breath control or free breathing. Forty patients were enrolled, among them 25 had active breath control. A total of 836 CBCT images were obtained for analysis. CBCT significantly reduced planning target volume. However, active breath control did not show significant benefit in decreasing planning target volume margin and the doses of organ-at-risk when compared to free breathing. CBCT, but not active breath control, could reduce planning target volume during accelerated partial breast irradiation. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.