SU-E-I-98: Dose Comparison for Pulmonary Embolism CT Studies: Single Energy Vs. Dual Energy

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

Mahmood, U; Erdi, Y

Purpose: The purpose of this study was to assess and compare the size specific dose estimate (SSDE), dose length product (DLP) and noise relationship for pulmonary embolism studies evaluated by single source dual energy computed tomography (DECT) against conventional CT (CCT) studies in a busy cancer center and to determine the dose savings provided by DECT. Methods: An IRB-approved retrospective study was performed to determine the CTDIvol and DLP from a subset of patients scanned with both DECT and CCT over the past five years. We were able to identify 30 breast cancer patients (6 male, 24 female, age rangemore » 24 to 81) who had both DECT and CCT studies performed. DECT scans were performed with a GE HD 750 scanner (140/80 kVp, 480 mAs and 40 mm) and CCT scans were performed with a GE Lightspeed 16 slice scanner (120 kVp, 352 mAs, 20 mm). Image noise was measured by placing an ROI and recording the standard deviation of the mean HU along the descending aorta. Results: The average DECT patient size specific dose estimate was to be 14.2 ± 1.7 mGy as compared to 22.4 ± 2.7 mGy from CCT PE studies, which is a 37% reduction in the SSDE. The average DECT DLP was 721.8 ± 84.6 mGy-cm as compared to 981.8 ± 106.1 mGy-cm for CCT, which is a 26% decrease. Compared to CCT the image noise was found to decrease by 19% when using DECT for PE studies. Conclusion: DECT SSDE and DLP measurements indicate dose savings and image noise reduction when compared to CCT. In an environment that heavily debates CT patient doses, this study confirms the effectiveness of DECT in PE imaging.« less

TU-F-18A-06: Dual Energy CT Using One Full Scan and a Second Scan with Very Few Projections

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

Wang, T; Zhu, L

Purpose: The conventional dual energy CT (DECT) requires two full CT scans at different energy levels, resulting in dose increase as well as imaging errors from patient motion between the two scans. To shorten the scan time of DECT and thus overcome these drawbacks, we propose a new DECT algorithm using one full scan and a second scan with very few projections by preserving structural information. Methods: We first reconstruct a CT image on the full scan using a standard filtered-backprojection (FBP) algorithm. We then use a compressed sensing (CS) based iterative algorithm on the second scan for reconstruction frommore » very few projections. The edges extracted from the first scan are used as weights in the Objectives: function of the CS-based reconstruction to substantially improve the image quality of CT reconstruction. The basis material images are then obtained by an iterative image-domain decomposition method and an electron density map is finally calculated. The proposed method is evaluated on phantoms. Results: On the Catphan 600 phantom, the CT reconstruction mean error using the proposed method on 20 and 5 projections are 4.76% and 5.02%, respectively. Compared with conventional iterative reconstruction, the proposed edge weighting preserves object structures and achieves a better spatial resolution. With basis materials of Iodine and Teflon, our method on 20 projections obtains similar quality of decomposed material images compared with FBP on a full scan and the mean error of electron density in the selected regions of interest is 0.29%. Conclusion: We propose an effective method for reducing projections and therefore scan time in DECT. We show that a full scan plus a 20-projection scan are sufficient to provide DECT images and electron density with similar quality compared with two full scans. Our future work includes more phantom studies to validate the performance of our method.« less

Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer.

PubMed

Chen, Xiaoliang; Xu, Yanyan; Duan, Jianghui; Li, Chuandong; Sun, Hongliang; Wang, Wu

2017-07-01

To investigate the potential relationship between perfusion parameters from first-pass dual-input perfusion computed tomography (DI-PCT) and iodine uptake levels estimated from dual-energy CT (DE-CT).The pre-experimental part of this study included a dynamic DE-CT protocol in 15 patients to evaluate peak arterial enhancement of lung cancer based on time-attenuation curves, and the scan time of DE-CT was determined. In the prospective part of the study, 28 lung cancer patients underwent whole-volume perfusion CT and single-source DE-CT using 320-row CT. Pulmonary flow (PF, mL/min/100 mL), aortic flow (AF, mL/min/100 mL), and a perfusion index (PI = PF/[PF + AF]) were automatically generated by in-house commercial software using the dual-input maximum slope method for DI-PCT. For the dual-energy CT data, iodine uptake was estimated by the difference (λ) and the slope (λHU). λ was defined as the difference of CT values between 40 and 70 KeV monochromatic images in lung lesions. λHU was calculated by the following equation: λHU = |λ/(70 - 40)|. The DI-PCT and DE-CT parameters were analyzed by Pearson/Spearman correlation analysis, respectively.All subjects were pathologically proved as lung cancer patients (including 16 squamous cell carcinoma, 8 adenocarcinoma, and 4 small cell lung cancer) by surgery or CT-guided biopsy. Interobserver reproducibility in DI-PCT (PF, AF, PI) and DE-CT (λ, λHU) were relatively good to excellent (intraclass correlation coefficient [ICC]Inter = 0.8726-0.9255, ICCInter = 0.8179-0.8842; ICCInter = 0.8881-0.9177, ICCInter = 0.9820-0.9970, ICCInter = 0.9780-0.9971, respectively). Correlation coefficient between λ and AF, and PF were as follows: 0.589 (P < .01) and 0.383 (P < .05). Correlation coefficient between λHU and AF, and PF were as follows: 0.564 (P < .01) and 0.388 (P < .05).Both the single-source DE-CT and dual-input CT perfusion analysis method can be applied to assess blood supply of lung cancer patients. Preliminary results demonstrated that the iodine uptake relevant parameters derived from DE-CT significantly correlated with perfusion parameters derived from DI-PCT.

SU-G-TeP2-11: Initial Evaluation of a Novel Split-Filter Dual-Energy CT for Use in Radiation Oncology

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

Miller, J; Huang, J; Szczykutowicz, T

2016-06-15

Purpose: To perform an initial evaluation of a novel split-filter dual-energy CT (DECT) system with the goal of understanding the clinical utility and limitations of the system for radiation therapy. Methods: Several phantoms were imaged using the split-filter DECT technique on the Siemens Edge CT scanner using a range of clinically-relevant doses. The optimum-contrast reconstruction, the mixed reconstruction, and the monoenergetic reconstructions (ranging from 40 keV to 190 keV) were evaluated. Each image was analyzed for CT number accuracy, uniformity, noise, low-contrast visibility (LCV), spatial resolution and geometric distortion. For comparison purposes, all parameters were evaluated on 120 kVp single-energymore » CT (SECT) scans used for treatment planning, as well as, a sequential-scan DECT technique for corresponding doses. Results: For all DECT reconstructions no observable geometric distortion was found. Both the optimal-contrast and mixed images demonstrated slight improvements in LCV and noise when compared to the SECT, and slight reductions in CT number accuracy and spatial resolution. The CT numbers trended as expected for the monoenergetic reconstructions, with CT number accuracy within 50 HU for materials of density <2 g/cm3. Spatial resolution increased with energy, and for monoenergetic reconstructions >70 keV the spatial resolution exceeded that of the SECT. The noise in the monoenergetic reconstructions increased with decreasing energy. Thus, the image uniformity, signal-to-noise ratio and LCV were diminished at lower energies (70 keV). Applying iterative reconstruction techniques to the low-energy images reduced noise and improved LCV. The signal-to-noise ratio was stable for energies >100 keV. Conclusion: The initial commissioning of the novel split-filter DECT technology demonstrated favorable results for clinical implementation. The mixed reconstruction showed potential as a replacement for the treatment planning SECT. The image parameters for the monoenergetic reconstructions varied appropriately with energy. This work provides an initial understanding of the limitations and potential applications for monoenergetic imaging.« less

Dual-energy CT with virtual monochromatic images and metal artifact reduction software for reducing metallic dental artifacts.

PubMed

Cha, Jihoon; Kim, Hyung-Jin; Kim, Sung Tae; Kim, Yi Kyung; Kim, Ha Youn; Park, Gyeong Min

2017-11-01

Background Metallic dental prostheses may degrade image quality on head and neck computed tomography (CT). However, there is little information available on the use of dual-energy CT (DECT) and metal artifact reduction software (MARS) in the head and neck regions to reduce metallic dental artifacts. Purpose To assess the usefulness of DECT with virtual monochromatic imaging and MARS to reduce metallic dental artifacts. Material and Methods DECT was performed using fast kilovoltage (kV)-switching between 80-kV and 140-kV in 20 patients with metallic dental prostheses. CT data were reconstructed with and without MARS, and with synthesized monochromatic energy in the range of 40-140-kiloelectron volt (keV). For quantitative analysis, the artifact index of the tongue, buccal, and parotid areas was calculated for each scan. For qualitative analysis, two radiologists evaluated 70-keV and 100-keV images with and without MARS for tongue, buccal, parotid areas, and metallic denture. The locations and characteristics of the MARS-related artifacts, if any, were also recorded. Results DECT with MARS markedly reduced metallic dental artifacts and improved image quality in the buccal area ( P < 0.001) and the tongue ( P < 0.001), but not in the parotid area. The margin and internal architecture of the metallic dentures were more clearly delineated with MARS ( P < 0.001) and in the higher-energy images than in the lower-energy images ( P = 0.042). MARS-related artifacts most commonly occurred in the deep center of the neck. Conclusion DECT with MARS can reduce metallic dental artifacts and improve delineation of the metallic prosthesis and periprosthetic region.

Comparison of proton therapy treatment planning for head tumors with a pencil beam algorithm on dual and single energy CT images

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

Hudobivnik, Nace; Dedes, George; Parodi, Katia

2016-01-15

Purpose: Dual energy CT (DECT) has recently been proposed as an improvement over single energy CT (SECT) for stopping power ratio (SPR) estimation for proton therapy treatment planning (TP), thereby potentially reducing range uncertainties. Published literature investigated phantoms. This study aims at performing proton therapy TP on SECT and DECT head images of the same patients and at evaluating whether the reported improved DECT SPR accuracy translates into clinically relevant range shifts in clinical head treatment scenarios. Methods: Two phantoms were scanned at a last generation dual source DECT scanner at 90 and 150 kVp with Sn filtration. The firstmore » phantom (Gammex phantom) was used to calibrate the scanner in terms of SPR while the second served as evaluation (CIRS phantom). DECT images of five head trauma patients were used as surrogate cancer patient images for TP of proton therapy. Pencil beam algorithm based TP was performed on SECT and DECT images and the dose distributions corresponding to the optimized proton plans were calculated using a Monte Carlo (MC) simulation platform using the same patient geometry for both plans obtained from conversion of the 150 kVp images. Range shifts between the MC dose distributions from SECT and DECT plans were assessed using 2D range maps. Results: SPR root mean square errors (RMSEs) for the inserts of the Gammex phantom were 1.9%, 1.8%, and 1.2% for SECT phantom calibration (SECT{sub phantom}), SECT stoichiometric calibration (SECT{sub stoichiometric}), and DECT calibration, respectively. For the CIRS phantom, these were 3.6%, 1.6%, and 1.0%. When investigating patient anatomy, group median range differences of up to −1.4% were observed for head cases when comparing SECT{sub stoichiometric} with DECT. For this calibration the 25th and 75th percentiles varied from −2% to 0% across the five patients. The group median was found to be limited to 0.5% when using SECT{sub phantom} and the 25th and 75th percentiles varied from −1% to 2%. Conclusions: Proton therapy TP using a pencil beam algorithm and DECT images was performed for the first time. Given that the DECT accuracy as evaluated by two phantoms was 1.2% and 1.0% RMSE, it is questionable whether the range differences reported here are significant.« less

SU-F-J-195: On the Performance of Four Dual Energy CT Formalisms for Extracting Proton Stopping Powers

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

Baer, E; Royle, G; Lalonde, A

Purpose: Dual energy CT can predict stopping power ratios (SPR) for ion therapy treatment planning. Several approaches have been proposed recently, however accuracy and practicability in a clinical workflow are unaddressed. The aim of this work is to provide a fair comparison of available approaches in a human-like phantom to find the optimal method for tissue characterization in a clinical situation. Methods: The SPR determination accuracy is investigated using simulated DECT images. A virtual human-like phantom is created containing 14 different standard human tissues. SECT (120 kV) and DECT images (100 kV and 140 kV Sn) are simulated using themore » software ImaSim. The single energy CT (SECT) stoichiometric calibration method and four recently published calibration-based DECT methods are implemented and used to predict the SPRs from simulated images. The difference between SPR predictions and theoretical SPR are compared pixelwize. Mean, standard deviation and skewness of the SPR difference distributions are used as measures for bias, dispersion and symmetry. Results: The average SPR differences and standard deviations are (0.22 ± 1.27)% for SECT, and A) (−0.26 ± 1.30)%, B) (0.08 ± 1.12)%, C) (0.06 ± 1.15)% and D) (−0.05 ± 1.05)% for the four DECT methods. While SPR prediction using SECT is showing a systematic error on SPR, the DECT methods B, C and D are unbiased. The skewness of the SECT distribution is 0.57%, and A) −0.19%, B) −0.56%, C) −0.29% and D) −0.07% for DECT methods respectively. Conclusion: The here presented DECT methods B, C and D outperform the commonly used SECT stoichiometric calibration. These methods predict SPR accurately without a bias and within ± 1.2% (68th percentile). This indicates that DECT potentially improves accuracy of range predictions in proton therapy. A validation of these findings using clinical CT images of real tissues is necessary.« less

A general framework of noise suppression in material decomposition for dual-energy CT

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

Petrongolo, Michael; Dong, Xue; Zhu, Lei, E-mail: leizhu@gatech.edu

Purpose: As a general problem of dual-energy CT (DECT), noise amplification in material decomposition severely reduces the signal-to-noise ratio on the decomposed images compared to that on the original CT images. In this work, the authors propose a general framework of noise suppression in material decomposition for DECT. The method is based on an iterative algorithm recently developed in their group for image-domain decomposition of DECT, with an extension to include nonlinear decomposition models. The generalized framework of iterative DECT decomposition enables beam-hardening correction with simultaneous noise suppression, which improves the clinical benefits of DECT. Methods: The authors propose tomore » suppress noise on the decomposed images of DECT using convex optimization, which is formulated in the form of least-squares estimation with smoothness regularization. Based on the design principles of a best linear unbiased estimator, the authors include the inverse of the estimated variance–covariance matrix of the decomposed images as the penalty weight in the least-squares term. Analytical formulas are derived to compute the variance–covariance matrix for decomposed images with general-form numerical or analytical decomposition. As a demonstration, the authors implement the proposed algorithm on phantom data using an empirical polynomial function of decomposition measured on a calibration scan. The polynomial coefficients are determined from the projection data acquired on a wedge phantom, and the signal decomposition is performed in the projection domain. Results: On the Catphan{sup ®}600 phantom, the proposed noise suppression method reduces the average noise standard deviation of basis material images by one to two orders of magnitude, with a superior performance on spatial resolution as shown in comparisons of line-pair images and modulation transfer function measurements. On the synthesized monoenergetic CT images, the noise standard deviation is reduced by a factor of 2–3. By using nonlinear decomposition on projections, the authors’ method effectively suppresses the streaking artifacts of beam hardening and obtains more uniform images than their previous approach based on a linear model. Similar performance of noise suppression is observed in the results of an anthropomorphic head phantom and a pediatric chest phantom generated by the proposed method. With beam-hardening correction enabled by their approach, the image spatial nonuniformity on the head phantom is reduced from around 10% on the original CT images to 4.9% on the synthesized monoenergetic CT image. On the pediatric chest phantom, their method suppresses image noise standard deviation by a factor of around 7.5, and compared with linear decomposition, it reduces the estimation error of electron densities from 33.3% to 8.6%. Conclusions: The authors propose a general framework of noise suppression in material decomposition for DECT. Phantom studies have shown the proposed method improves the image uniformity and the accuracy of electron density measurements by effective beam-hardening correction and reduces noise level without noticeable resolution loss.« less

Motion artifacts in kidney stone imaging using single-source and dual-source dual-energy CT scanners: a phantom study.

PubMed

Ibrahim, El-Sayed H; Cernigliaro, Joseph G; Pooley, Robert A; Williams, James C; Haley, William E

2015-10-01

Dual-energy computed tomography (DECT) has shown the capability of differentiating uric acid (UA) from non-UA stones with 90-100% accuracy. With the invention of dual-source (DS) scanners, both low- and high-energy images are acquired simultaneously. However, DECT can also be performed by sequential acquisition of both images on single-source (SS) scanners. The objective of this study is to investigate the effects of motion artifacts on stone classification using both SS-DECT and DS-DECT. 114 kidney stones of different types and sizes were imaged on both DS-DECT and SS-DECT scanners with tube voltages of 80 and 140 kVp with and without induced motion. Postprocessing was conducted to create material-specific images from corresponding low- and high-energy images. The dual-energy ratio (DER) and stone material were determined and compared among different scans. For the motionless scans, all stones were correctly classified with SS-DECT, while two cystine stones were misclassified with DS-DECT. When motion was induced, 94% of the stones were misclassified with SS-DECT versus 11% with DS-DECT (P < 0.0001). Stone size was not a factor in stone misclassification under motion. Stone type was not a factor in stone misclassification under motion with SS-DECT, although with DS-DECT, cystine showed higher number of stone misclassification. Motion artifacts could result in stone misclassification in DECT. This effect is more pronounced in SS-DECT versus DS-DECT, especially if stones of different types lie in close proximity to each other. Further, possible misinterpretation of the number of stones (i.e., missing one, or thinking that there are two) in DS-DECT could be a potentially significant problem.

Comparison of diffraction-enhanced computed tomography and monochromatic synchrotron radiation computed tomography of human trabecular bone.

PubMed

Connor, D M; Hallen, H D; Lalush, D S; Sumner, D R; Zhong, Z

2009-10-21

Diffraction-enhanced imaging (DEI) is an x-ray-based medical imaging modality that, when used in tomography mode (DECT), can generate a three-dimensional map of both the apparent absorption coefficient and the out-of-plane gradient of the index of refraction of the sample. DECT is known to have contrast gains over monochromatic synchrotron radiation CT (SRCT) for soft tissue structures. The goal of this experiment was to compare contrast-to-noise ratio (CNR) and resolution in images of human trabecular bone acquired using SRCT with images acquired using DECT. All images were acquired at the National Synchrotron Light Source (Upton, NY, USA) at beamline X15 A at an x-ray energy of 40 keV and the silicon [3 3 3] reflection. SRCT, apparent absorption DECT and refraction DECT slice images of the trabecular bone were created. The apparent absorption DECT images have significantly higher spatial resolution and CNR than the corresponding SRCT images. Thus, DECT will prove to be a useful tool for imaging applications in which high contrast and high spatial resolution are required for both soft tissue features and bone.

Dosimetric impact of dual-energy CT tissue segmentation for low-energy prostate brachytherapy: a Monte Carlo study

NASA Astrophysics Data System (ADS)

Remy, Charlotte; Lalonde, Arthur; Béliveau-Nadeau, Dominic; Carrier, Jean-François; Bouchard, Hugo

2018-01-01

The purpose of this study is to evaluate the impact of a novel tissue characterization method using dual-energy over single-energy computed tomography (DECT and SECT) on Monte Carlo (MC) dose calculations for low-dose rate (LDR) prostate brachytherapy performed in a patient like geometry. A virtual patient geometry is created using contours from a real patient pelvis CT scan, where known elemental compositions and varying densities are overwritten in each voxel. A second phantom is made with additional calcifications. Both phantoms are the ground truth with which all results are compared. Simulated CT images are generated from them using attenuation coefficients taken from the XCOM database with a 100 kVp spectrum for SECT and 80 and 140Sn kVp for DECT. Tissue segmentation for Monte Carlo dose calculation is made using a stoichiometric calibration method for the simulated SECT images. For the DECT images, Bayesian eigentissue decomposition is used. A LDR prostate brachytherapy plan is defined with 125I sources and then calculated using the EGSnrc user-code Brachydose for each case. Dose distributions and dose-volume histograms (DVH) are compared to ground truth to assess the accuracy of tissue segmentation. For noiseless images, DECT-based tissue segmentation outperforms the SECT procedure with a root mean square error (RMS) on relative errors on dose distributions respectively of 2.39% versus 7.77%, and provides DVHs closest to the reference DVHs for all tissues. For a medium level of CT noise, Bayesian eigentissue decomposition still performs better on the overall dose calculation as the RMS error is found to be of 7.83% compared to 9.15% for SECT. Both methods give a similar DVH for the prostate while the DECT segmentation remains more accurate for organs at risk and in presence of calcifications, with less than 5% of RMS errors within the calcifications versus up to 154% for SECT. In a patient-like geometry, DECT-based tissue segmentation provides dose distributions with the highest accuracy and the least bias compared to SECT. When imaging noise is considered, benefits of DECT are noticeable if important calcifications are found within the prostate.

Diagnostic performance of dual-energy CT stress myocardial perfusion imaging: direct comparison with cardiovascular MRI.

PubMed

Ko, Sung Min; Song, Meong Gun; Chee, Hyun Kun; Hwang, Hweung Kon; Feuchtner, Gudrun Maria; Min, James K

2014-12-01

The purpose of this study was to assess the diagnostic performance of stress perfusion dual-energy CT (DECT) and its incremental value when used with coronary CT angiography (CTA) for identifying hemodynamically significant coronary artery disease. One hundred patients with suspected or known coronary artery disease without chronic myocardial infarction detected with coronary CTA underwent stress perfusion DECT, stress cardiovascular perfusion MRI, and invasive coronary angiography (ICA). Stress perfusion DECT and cardiovascular stress perfusion MR images were used for detecting perfusion defects. Coronary CTA and ICA were evaluated in the detection of ≥50% coronary stenosis. The diagnostic performance of coronary CTA for detecting hemo-dynamically significant stenosis was assessed before and after stress perfusion DECT on a per-vessel basis with ICA and cardiovascular stress perfusion MRI as the reference standard. The performance of stress perfusion DECT compared with cardiovascular stress perfusion MRI on a per-vessel basis in the detection of perfusion defects was sensitivity, 89%; specificity, 74%; positive predictive value, 73%; negative predictive value, 90%. Per segment, these values were sensitivity, 76%; specificity, 80%; positive predictive value, 63%; and negative predictive value, 88%. Compared with ICA and cardiovascular stress perfusion MRI per vessel territory the sensitivity, specificity, positive predictive value, and negative predictive value of coronary CTA were 95%, 61%, 61%, and 95%. The values for stress perfusion DECT were 92%, 72%, 68%, and 94%. The values for coronary CTA and stress perfusion DECT were 88%, 79%, 73%, and 91%. The ROC AUC increased from 0.78 to 0.84 (p=0.02) with the use of coronary CTA and stress perfusion DECT compared with coronary CTA alone. Stress perfusion DECT plays a complementary role in enhancing the accuracy of coronary CTA for identifying hemodynamically significant coronary stenosis.

Water/cortical bone decomposition: A new approach in dual energy CT imaging for bone marrow oedema detection. A feasibility study.

PubMed

Biondi, M; Vanzi, E; De Otto, G; Banci Buonamici, F; Belmonte, G M; Mazzoni, L N; Guasti, A; Carbone, S F; Mazzei, M A; La Penna, A; Foderà, E; Guerreri, D; Maiolino, A; Volterrani, L

2016-12-01

Many studies aimed at validating the application of Dual Energy Computed Tomography (DECT) in clinical practice where conventional CT is not exhaustive. An example is given by bone marrow oedema detection, in which DECT based on water/calcium (W/Ca) decomposition was applied. In this paper a new DECT approach, based on water/cortical bone (W/CB) decomposition, was investigated. Eight patients suffering from marrow oedema were scanned with MRI and DECT. Two-materials density decomposition was performed in ROIs corresponding to normal bone marrow and oedema. These regions were drawn on DECT images using MRI informations. Both W/Ca and W/CB were considered as material basis. Scatter plots of W/Ca and W/CB concentrations were made for each ROI in order to evaluate if oedema could be distinguished from normal bone marrow. Thresholds were defined on the scatter plots in order to produce DECT images where oedema regions were highlighted through color maps. The agreement between these images and MR was scored by two expert radiologists. For all the patients, the best scores were obtained using W/CB density decomposition. In all cases, DECT color map images based on W/CB decomposition showed better agreement with MR in bone marrow oedema identification with respect to W/Ca decomposition. This result encourages further studies in order to evaluate if DECT based on W/CB decomposition could be an alternative technique to MR, which would be important when short scanning duration is relevant, as in the case of aged or traumatic patients. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Optimization of the scan protocols for CT-based material extraction in small animal PET/CT studies

NASA Astrophysics Data System (ADS)

Yang, Ching-Ching; Yu, Jhih-An; Yang, Bang-Hung; Wu, Tung-Hsin

2013-12-01

We investigated the effects of scan protocols on CT-based material extraction to minimize radiation dose while maintaining sufficient image information in small animal studies. The phantom simulation experiments were performed with the high dose (HD), medium dose (MD) and low dose (LD) protocols at 50, 70 and 80 kVp with varying mA s. The reconstructed CT images were segmented based on Hounsfield unit (HU)-physical density (ρ) calibration curves and the dual-energy CT-based (DECT) method. Compared to the (HU;ρ) method performed on CT images acquired with the 80 kVp HD protocol, a 2-fold improvement in segmentation accuracy and a 7.5-fold reduction in radiation dose were observed when the DECT method was performed on CT images acquired with the 50/80 kVp LD protocol, showing the possibility to reduce radiation dose while achieving high segmentation accuracy.

Dual-Energy CT: Basic Principles, Technical Approaches, and Applications in Musculoskeletal Imaging (Part 1).

PubMed

Omoumi, Patrick; Becce, Fabio; Racine, Damien; Ott, Julien G; Andreisek, Gustav; Verdun, Francis R

2015-12-01

In recent years, technological advances have allowed manufacturers to implement dual-energy computed tomography (DECT) on clinical scanners. With its unique ability to differentiate basis materials by their atomic number, DECT has opened new perspectives in imaging. DECT has been used successfully in musculoskeletal imaging with applications ranging from detection, characterization, and quantification of crystal and iron deposits; to simulation of noncalcium (improving the visualization of bone marrow lesions) or noniodine images. Furthermore, the data acquired with DECT can be postprocessed to generate monoenergetic images of varying kiloelectron volts, providing new methods for image contrast optimization as well as metal artifact reduction. The first part of this article reviews the basic principles and technical aspects of DECT including radiation dose considerations. The second part focuses on applications of DECT to musculoskeletal imaging including gout and other crystal-induced arthropathies, virtual noncalcium images for the study of bone marrow lesions, the study of collagenous structures, applications in computed tomography arthrography, as well as the detection of hemosiderin and metal particles. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Dual-Energy CT: Basic Principles, Technical Approaches, and Applications in Musculoskeletal Imaging (Part 2).

PubMed

Omoumi, Patrick; Verdun, Francis R; Guggenberger, Roman; Andreisek, Gustav; Becce, Fabio

2015-12-01

In recent years, technological advances have allowed manufacturers to implement dual-energy computed tomography (DECT) on clinical scanners. With its unique ability to differentiate basis materials by their atomic number, DECT has opened new perspectives in imaging. DECT has been successfully used in musculoskeletal imaging with applications ranging from detection, characterization, and quantification of crystal and iron deposits, to simulation of noncalcium (improving the visualization of bone marrow lesions) or noniodine images. Furthermore, the data acquired with DECT can be postprocessed to generate monoenergetic images of varying kiloelectron volts, providing new methods for image contrast optimization as well as metal artifact reduction. The first part of this article reviews the basic principles and technical aspects of DECT including radiation dose considerations. The second part focuses on applications of DECT to musculoskeletal imaging including gout and other crystal-induced arthropathies, virtual noncalcium images for the study of bone marrow lesions, the study of collagenous structures, applications in computed tomography arthrography, as well as the detection of hemosiderin and metal particles. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Combined iterative reconstruction and image-domain decomposition for dual energy CT using total-variation regularization

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

Dong, Xue; Niu, Tianye; Zhu, Lei, E-mail: leizhu@gatech.edu

2014-05-15

Purpose: Dual-energy CT (DECT) is being increasingly used for its capability of material decomposition and energy-selective imaging. A generic problem of DECT, however, is that the decomposition process is unstable in the sense that the relative magnitude of decomposed signals is reduced due to signal cancellation while the image noise is accumulating from the two CT images of independent scans. Direct image decomposition, therefore, leads to severe degradation of signal-to-noise ratio on the resultant images. Existing noise suppression techniques are typically implemented in DECT with the procedures of reconstruction and decomposition performed independently, which do not explore the statistical propertiesmore » of decomposed images during the reconstruction for noise reduction. In this work, the authors propose an iterative approach that combines the reconstruction and the signal decomposition procedures to minimize the DECT image noise without noticeable loss of resolution. Methods: The proposed algorithm is formulated as an optimization problem, which balances the data fidelity and total variation of decomposed images in one framework, and the decomposition step is carried out iteratively together with reconstruction. The noise in the CT images from the proposed algorithm becomes well correlated even though the noise of the raw projections is independent on the two CT scans. Due to this feature, the proposed algorithm avoids noise accumulation during the decomposition process. The authors evaluate the method performance on noise suppression and spatial resolution using phantom studies and compare the algorithm with conventional denoising approaches as well as combined iterative reconstruction methods with different forms of regularization. Results: On the Catphan©600 phantom, the proposed method outperforms the existing denoising methods on preserving spatial resolution at the same level of noise suppression, i.e., a reduction of noise standard deviation by one order of magnitude. This improvement is mainly attributed to the high noise correlation in the CT images reconstructed by the proposed algorithm. Iterative reconstruction using different regularization, including quadratic orq-generalized Gaussian Markov random field regularization, achieves similar noise suppression from high noise correlation. However, the proposed TV regularization obtains a better edge preserving performance. Studies of electron density measurement also show that our method reduces the average estimation error from 9.5% to 7.1%. On the anthropomorphic head phantom, the proposed method suppresses the noise standard deviation of the decomposed images by a factor of ∼14 without blurring the fine structures in the sinus area. Conclusions: The authors propose a practical method for DECT imaging reconstruction, which combines the image reconstruction and material decomposition into one optimization framework. Compared to the existing approaches, our method achieves a superior performance on DECT imaging with respect to decomposition accuracy, noise reduction, and spatial resolution.« less

MO-FG-204-06: A New Algorithm for Gold Nano-Particle Concentration Identification in Dual Energy CT

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

Chen, L; Shen, C; Ng, M

Purpose: Gold nano-particle (GNP) has recently attracted a lot of attentions due to its potential as an imaging contrast agent and radiotherapy sensitiser. Imaging the GNP at its low contraction is a challenging problem. We propose a new algorithm to improve the identification of GNP based on dual energy CT (DECT). Methods: We consider three base materials: water, bone, and gold. Determining three density images from two images in DECT is an under-determined problem. We propose to solve this problem by exploring image domain sparsity via an optimization approach. The objective function contains four terms. A data-fidelity term ensures themore » fidelity between the identified material densities and the DECT images, while the other three terms enforces the sparsity in the gradient domain of the three images corresponding to the density of the base materials by using total variation (TV) regularization. A primal-dual algorithm is applied to solve the proposed optimization problem. We have performed simulation studies to test this model. Results: Our digital phantom in the tests contains water, bone regions and gold inserts of different sizes and densities. The gold inserts contain mixed material consisting of water with 1g/cm3 and gold at a certain density. At a low gold density of 0.0008 g/cm3, the insert is hardly visible in DECT images, especially for those with small sizes. Our algorithm is able to decompose the DECT into three density images. Those gold inserts at a low density can be clearly visualized in the density image. Conclusion: We have developed a new algorithm to decompose DECT images into three different material density images, in particular, to retrieve density of gold. Numerical studies showed promising results.« less

Dual energy CT with one full scan and a second sparse-view scan using structure preserving iterative reconstruction (SPIR)

NASA Astrophysics Data System (ADS)

Wang, Tonghe; Zhu, Lei

2016-09-01

Conventional dual-energy CT (DECT) reconstruction requires two full-size projection datasets with two different energy spectra. In this study, we propose an iterative algorithm to enable a new data acquisition scheme which requires one full scan and a second sparse-view scan for potential reduction in imaging dose and engineering cost of DECT. A bilateral filter is calculated as a similarity matrix from the first full-scan CT image to quantify the similarity between any two pixels, which is assumed unchanged on a second CT image since DECT scans are performed on the same object. The second CT image from reduced projections is reconstructed by an iterative algorithm which updates the image by minimizing the total variation of the difference between the image and its filtered image by the similarity matrix under data fidelity constraint. As the redundant structural information of the two CT images is contained in the similarity matrix for CT reconstruction, we refer to the algorithm as structure preserving iterative reconstruction (SPIR). The proposed method is evaluated on both digital and physical phantoms, and is compared with the filtered-backprojection (FBP) method, the conventional total-variation-regularization-based algorithm (TVR) and prior-image-constrained-compressed-sensing (PICCS). SPIR with a second 10-view scan reduces the image noise STD by a factor of one order of magnitude with same spatial resolution as full-view FBP image. SPIR substantially improves over TVR on the reconstruction accuracy of a 10-view scan by decreasing the reconstruction error from 6.18% to 1.33%, and outperforms TVR at 50 and 20-view scans on spatial resolution with a higher frequency at the modulation transfer function value of 10% by an average factor of 4. Compared with the 20-view scan PICCS result, the SPIR image has 7 times lower noise STD with similar spatial resolution. The electron density map obtained from the SPIR-based DECT images with a second 10-view scan has an average error of less than 1%.

Reconstruction of limited-angle dual-energy CT using mutual learning and cross-estimation (MLCE)

NASA Astrophysics Data System (ADS)

Zhang, Huayu; Xing, Yuxiang

2016-03-01

Dual-energy CT (DECT) imaging has gained a lot of attenuation because of its capability to discriminate materials. We proposes a flexible DECT scan strategy which can be realized on a system with general X-ray sources and detectors. In order to lower dose and scanning time, our DECT acquires two projections data sets on two arcs of limited-angular coverage (one for each energy) respectively. Meanwhile, a certain number of rays from two data sets form conjugate sampling pairs. Our reconstruction method for such a DECT scan mainly tackles the consequent limited-angle problem. Using the idea of artificial neural network, we excavate the connection between projections at two different energies by constructing a relationship between the linear attenuation coefficient of the high energy and that of the low one. We use this relationship to cross-estimate missing projections and reconstruct attenuation images from an augmented data set including projections at views covered by itself (projections collected in scanning) and by the other energy (projections estimated) for each energy respectively. Validated by our numerical experiment on a dental phantom with rather complex structures, our DECT is effective in recovering small structures in severe limited-angle situations. This DECT scanning strategy can much broaden DECT design in reality.

Monte Carlo proton dose calculations using a radiotherapy specific dual-energy CT scanner for tissue segmentation and range assessment

NASA Astrophysics Data System (ADS)

Almeida, Isabel P.; Schyns, Lotte E. J. R.; Vaniqui, Ana; van der Heyden, Brent; Dedes, George; Resch, Andreas F.; Kamp, Florian; Zindler, Jaap D.; Parodi, Katia; Landry, Guillaume; Verhaegen, Frank

2018-06-01

Proton beam ranges derived from dual-energy computed tomography (DECT) images from a dual-spiral radiotherapy (RT)-specific CT scanner were assessed using Monte Carlo (MC) dose calculations. Images from a dual-source and a twin-beam DECT scanner were also used to establish a comparison to the RT-specific scanner. Proton ranges extracted from conventional single-energy CT (SECT) were additionally performed to benchmark against literature values. Using two phantoms, a DECT methodology was tested as input for GEANT4 MC proton dose calculations. Proton ranges were calculated for different mono-energetic proton beams irradiating both phantoms; the results were compared to the ground truth based on the phantom compositions. The same methodology was applied in a head-and-neck cancer patient using both SECT and dual-spiral DECT scans from the RT-specific scanner. A pencil-beam-scanning plan was designed, which was subsequently optimized by MC dose calculations, and differences in proton range for the different image-based simulations were assessed. For phantoms, the DECT method yielded overall better material segmentation with  >86% of the voxel correctly assigned for the dual-spiral and dual-source scanners, but only 64% for a twin-beam scanner. For the calibration phantom, the dual-spiral scanner yielded range errors below 1.2 mm (0.6% of range), like the errors yielded by the dual-source scanner (<1.1 mm, <0.5%). With the validation phantom, the dual-spiral scanner yielded errors below 0.8 mm (0.9%), whereas SECT yielded errors up to 1.6 mm (2%). For the patient case, where the absolute truth was missing, proton range differences between DECT and SECT were on average in  ‑1.2  ±  1.2 mm (‑0.5%  ±  0.5%). MC dose calculations were successfully performed on DECT images, where the dual-spiral scanner resulted in media segmentation and range accuracy as good as the dual-source CT. In the patient, the various methods showed relevant range differences.

Comparison of image quality and radiation dose between split-filter dual-energy images and single-energy images in single-source abdominal CT.

PubMed

Euler, André; Obmann, Markus M; Szucs-Farkas, Zsolt; Mileto, Achille; Zaehringer, Caroline; Falkowski, Anna L; Winkel, David J; Marin, Daniele; Stieltjes, Bram; Krauss, Bernhard; Schindera, Sebastian T

2018-02-19

To compare image quality and radiation dose of abdominal split-filter dual-energy CT (SF-DECT) combined with monoenergetic imaging to single-energy CT (SECT) with automatic tube voltage selection (ATVS). Two-hundred single-source abdominal CT scans were performed as SECT with ATVS (n = 100) and SF-DECT (n = 100). SF-DECT scans were reconstructed and subdivided into composed images (SF-CI) and monoenergetic images at 55 keV (SF-MI). Objective and subjective image quality were compared among single-energy images (SEI), SF-CI and SF-MI. CNR and FOM were separately calculated for the liver (e.g. CNR liv ) and the portal vein (CNR pv ). Radiation dose was compared using size-specific dose estimate (SSDE). Results of the three groups were compared using non-parametric tests. Image noise of SF-CI was 18% lower compared to SEI and 48% lower compared to SF-MI (p < 0.001). Composed images yielded higher CNR liv over single-energy images (23.4 vs. 20.9; p < 0.001), whereas CNR pv was significantly lower (3.5 vs. 5.2; p < 0.001). Monoenergetic images overcame this inferiority in CNR pv and achieved similar results compared to single-energy images (5.1 vs. 5.2; p > 0.628). Subjective sharpness was equal between single-energy and monoenergetic images and diagnostic confidence was equal between single-energy and composed images. FOM liv was highest for SF-CI. FOM pv was equal for SEI and SF-MI (p = 0.78). SSDE was significant lower for SF-DECT compared to SECT (p < 0.022). The combined use of split-filter dual-energy CT images provides comparable objective and subjective image quality at lower radiation dose compared to single-energy CT with ATVS. • Split-filter dual-energy results in 18% lower noise compared to single-energy with ATVS. • Split-filter dual-energy results in 11% lower SSDE compared to single-energy with ATVS. • Spectral shaping of split-filter dual-energy leads to an increased dose-efficiency.

Comprehensive analysis of proton range uncertainties related to stopping-power-ratio estimation using dual-energy CT imaging

NASA Astrophysics Data System (ADS)

Li, B.; Lee, H. C.; Duan, X.; Shen, C.; Zhou, L.; Jia, X.; Yang, M.

2017-09-01

The dual-energy CT-based (DECT) approach holds promise in reducing the overall uncertainty in proton stopping-power-ratio (SPR) estimation as compared to the conventional stoichiometric calibration approach. The objective of this study was to analyze the factors contributing to uncertainty in SPR estimation using the DECT-based approach and to derive a comprehensive estimate of the range uncertainty associated with SPR estimation in treatment planning. Two state-of-the-art DECT-based methods were selected and implemented on a Siemens SOMATOM Force DECT scanner. The uncertainties were first divided into five independent categories. The uncertainty associated with each category was estimated for lung, soft and bone tissues separately. A single composite uncertainty estimate was eventually determined for three tumor sites (lung, prostate and head-and-neck) by weighting the relative proportion of each tissue group for that specific site. The uncertainties associated with the two selected DECT methods were found to be similar, therefore the following results applied to both methods. The overall uncertainty (1σ) in SPR estimation with the DECT-based approach was estimated to be 3.8%, 1.2% and 2.0% for lung, soft and bone tissues, respectively. The dominant factor contributing to uncertainty in the DECT approach was the imaging uncertainties, followed by the DECT modeling uncertainties. Our study showed that the DECT approach can reduce the overall range uncertainty to approximately 2.2% (2σ) in clinical scenarios, in contrast to the previously reported 1%.

Dual-energy computed tomography for detection of coronary artery disease

PubMed Central

Danad, Ibrahim; Ó Hartaigh, Bríain; Min, James K.

2016-01-01

Recent technological advances in computed tomography (CT) technology have fulfilled the prerequisites for the cardiac application of dual-energy CT (DECT) imaging. By exploiting the unique characteristics of materials when exposed to two different x-ray energies, DECT holds great promise for the diagnosis and management of coronary artery disease. It allows for the assessment of myocardial perfusion to discern the hemodynamic significance of coronary disease and possesses high accuracy for the detection and characterization of coronary plaques, while facilitating reductions in radiation dose. As such, DECT enabled cardiac CT to advance beyond the mere detection of coronary stenosis expanding its role in the evaluation and management of coronary atherosclerosis. PMID:26549789

TU-FG-BRB-02: The Impact of Using Dual-Energy CT for Determining Proton Stopping Powers: Comparison Between Theory and Experiments

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

Baer, E; Jee, K; Zhang, R

Purpose: To evaluate the clinical performance of dual-energy CT (DECT) in determining proton stopping power ratios (SPR) and demonstrate advantages over conventional single-energy CT (SECT). Methods: SECT and DECT scans of tissue-equivalent plastics as well as animal meat samples are performed with a Siemens SOMATOM Definition Flash. The methods of Schneider et al. (1996) and Bourque et al. (2014) are used to determine proton SPR on SECT and DECT images, respectively. Waterequivalent path length (WEPL) measurements of plastics and tissue samples are performed with a 195 MeV proton beam. WEPL values are determined experimentally using the depth-dose shift and dosemore » extinction methods. Results: Comparison between CT-based and experimental WEPL is performed for 12 tissue-equivalent plastic as well as 6 meat boxes containing animal liver, kidney, heart, stomach, muscle and bones. For plastic materials, results show a systematic improvement in determining SPR with DECT, with a mean absolute error of 0.4% compared to 1.7% for SECT. For the meat samples, preliminary results show the ability for DECT to determine WEPL with a mean absolute value of 1.1% over all meat boxes. Conclusion: This work demonstrates the potential in using DECT for determining proton SPR with plastic materials in a clinical context. Further work is required to show the benefits of DECT for tissue samples. While experimental uncertainties could be a limiting factor to show the benefits of DECT over SECT for the meat samples, further work is required to adapt the DECT formalism in the context of clinical use, where noise and artifacts play an important role.« less

Metal artefact reduction in gemstone spectral imaging dual-energy CT with and without metal artefact reduction software.

PubMed

Lee, Young Han; Park, Kwan Kyu; Song, Ho-Taek; Kim, Sungjun; Suh, Jin-Suck

2012-06-01

To assess the usefulness of gemstone spectral imaging (GSI) dual-energy CT (DECT) with/without metal artefact reduction software (MARs). The DECTs were performed using fast kV-switching GSI between 80 and 140 kV. The CT data were retro-reconstructed with/without MARs, by different displayed fields-of-view (DFOV), and with synthesised monochromatic energy in the range 40-140 keV. A phantom study of size and CT numbers was performed in a titanium plate and a stainless steel plate. A clinical study was performed in 26 patients with metallic hardware. All images were retrospectively reviewed in terms of the visualisation of periprosthetic regions and the severity of beam-hardening artefacts by using a five-point scale. The GSI-MARs reconstruction can markedly reduce the metal-related artefacts, and the image quality was affected by the prosthesis composition and DFOV. The spectral CT numbers of the prosthesis and periprosthetic regions showed different patterns on stainless steel and titanium plates. Dual-energy CT with GSI-MARs can reduce metal-related artefacts and improve the delineation of the prosthesis and periprosthetic region. We should be cautious when using GSI-MARs because the image quality was affected by the prosthesis composition, energy (in keV) and DFOV. The metallic composition and size should be considered in metallic imaging with GSI-MARs reconstruction. • Metal-related artefacts can be troublesome on musculoskeletal computed tomography (CT). • Gemstone spectral imaging (GSI) with dual-energy CT (DECT) offers a novel solution • GSI and metallic artefact reduction software (GSI-MAR) can markedly reduce these artefacts. • However image quality is influenced by the prosthesis composition and other parameters. • We should be aware about potential overcorrection when using GSI-MARs.

Technical Note: Improving proton stopping power ratio determination for a deformable silicone-based 3D dosimeter using dual energy CT

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

Taasti, Vicki Trier, E-mail: victaa@rm.dk; Høye, Ellen Marie; Hansen, David Christoffer

Purpose: The aim of this study was to investigate whether the stopping power ratio (SPR) of a deformable, silicone-based 3D dosimeter could be determined more accurately using dual energy (DE) CT compared to using conventional methods based on single energy (SE) CT. The use of SECT combined with the stoichiometric calibration method was therefore compared to DECT-based determination. Methods: The SPR of the dosimeter was estimated based on its Hounsfield units (HUs) in both a SECT image and a DECT image set. The stoichiometric calibration method was used for converting the HU in the SECT image to a SPR valuemore » for the dosimeter while two published SPR calibration methods for dual energy were applied on the DECT images. Finally, the SPR of the dosimeter was measured in a 60 MeV proton by quantifying the range difference with and without the dosimeter in the beam path. Results: The SPR determined from SECT and the stoichiometric method was 1.10, compared to 1.01 with both DECT calibration methods. The measured SPR for the dosimeter material was 0.97. Conclusions: The SPR of the dosimeter was overestimated by 13% using the stoichiometric method and by 3% when using DECT. If the stoichiometric method should be applied for the dosimeter, the HU of the dosimeter must be manually changed in the treatment planning system in order to give a correct SPR estimate. Using a wrong SPR value will cause differences between the calculated and the delivered treatment plans.« less

Impact of low-energy CT imaging on selection of positive oral contrast media concentration.

PubMed

Patino, Manuel; Murcia, Diana J; Iamurri, Andrea Prochowski; Kambadakone, Avinash R; Hahn, Peter F; Sahani, Dushyant V

2017-05-01

To determine to what extent low-energy CT imaging affects attenuation of gastrointestinal tract (GIT) opacified with positive oral contrast media (OCM). Second, to establish optimal OCM concentrations for low-energy diagnostic CT exams. One hundred patients (38 men and 62 women; age 62 ± 11 years; BMI 26 ± 5) with positive OCM-enhanced 120-kVp single-energy CT (SECT), and follow-up 100-kVp acquisitions (group A; n = 50), or 40-70-keV reconstructions from rapid kV switching-single-source dual-energy CT (ssDECT) (group B; n = 50) were included. Luminal attenuation from different GIT segments was compared between exams. Standard dose of three OCM and diluted solutions (75%, 50%, and 25% concentrations) were introduced serially in a gastrointestinal phantom and scanned using SECT (120, 100, and 80 kVp) and DECT (80/140 kVp) acquisitions on a ssDECT scanner. Luminal attenuation was obtained on SECT and DECT images (40-70 keV), and compared to 120-kVp scans with standard OCM concentrations. Luminal attenuation was higher on 100-kVp (328 HU) and on 40-60-keV images (410-924 HU) in comparison to 120-kVp scans (298 HU) in groups A and B (p < 0.05). Phantom: There was an inverse correlation between luminal attenuation and X-ray energy, increasing up to 527 HU on low-kVp and 999 HU on low-keV images (p < 0.05). 25% and 50% diluted OCM solutions provided similar or higher attenuation than 120 kVp, at low kVp and keV, respectively. Low-energy CT imaging increases the attenuation of GIT opacified with positive OCM, permitting reduction of 25%-75% OCM concentration.

Ex vivo validation of a stoichiometric dual energy CT proton stopping power ratio calibration

NASA Astrophysics Data System (ADS)

Xie, Yunhe; Ainsley, Christopher; Yin, Lingshu; Zou, Wei; McDonough, James; Solberg, Timothy D.; Lin, Alexander; Teo, Boon-Keng Kevin

2018-03-01

A major source of uncertainty in proton therapy is the conversion of Hounsfield unit (HU) to proton stopping power ratio relative to water (SPR). In this study, we measured and quantified the accuracy of a stoichiometric dual energy CT (DECT) SPR calibration. We applied a stoichiometric DECT calibration method to derive the SPR using CT images acquired sequentially at 80 kVp and 140 kVp . The dual energy index was derived based on the HUs of the paired spectral images and used to calculate the effective atomic number (Z eff), relative electron density ({{ρ }e} ), and SPRs of phantom and biological materials. Two methods were used to verify the derived SPRs. The first method measured the sample’s water equivalent thicknesses to deduce the SPRs using a multi-layer ion chamber (MLIC) device. The second method utilized Gafchromic EBT3 film to directly compare relative ranges between sample and water after proton pencil beam irradiation. Ex vivo validation was performed using five different types of frozen animal tissues with the MLIC and three types of fresh animal tissues using film. In addition, the residual ranges recorded on the film were used to compare with those from the treatment planning system using both DECT and SECT derived SPRs. Bland-Altman analysis indicates that the differences between DECT and SPR measurement of tissue surrogates, frozen and fresh animal tissues has a mean of 0.07% and standard deviation of 0.58% compared to 0.55% and 1.94% respectively for single energy CT (SECT) and SPR measurement. Our ex vivo study indicates that the stoichiometric DECT SPR calibration method has the potential to be more accurate than SECT calibration under ideal conditions although beam hardening effects and other image artifacts may increase this uncertainty.

Iodine concentration calculated by dual-energy computed tomography (DECT) as a functional parameter to evaluate thyroid metabolism in patients with hyperthyroidism.

PubMed

Binh, Duong Duc; Nakajima, Takahito; Otake, Hidenori; Higuchi, Tetsuya; Tsushima, Yoshito

2017-07-19

Thyroid function in patients with Grave's disease is usually evaluated by thyroid scintigraphy with radioactive iodine. Recently, dual-energy computed tomography (DECT) with two different energy X-rays can calculate iodine concentrations and can be applied for iodine measurements in thyroid glands. This study aimed to assess the potential use of DECT for the functional assessment of the thyroid gland. Thirteen patients with Grave's disease treated at our hospital from May to September 2015 were included in this retrospective study. Before treatments, all subjects had undergone both iodine scintigraphy [three and 24 h after oral administration of 123 I (20 μCi)] and non-enhanced DECT. The region of interests (ROIs) were placed in both lobes of the thyroid glands, and CT values (HU: Hounsfield unit) and iodine concentrations (mg/mL) calculated from DECT images were measured. The correlation between CT values and iodine concentrations from DECT in the thyroid gland was evaluated and then the iodine concentrations were compared with radioactive iodine uptake ratios by thyroid scintigraphy. Mean (±SD) 123 I uptake increased from 46.3 (±22.2) % (range, 11.1-80.1) at 3 h, to 66.5 (±15.2) % (range, 40.0-86.1) at 24 h (p < 0.01). CT values ranged from 34.5 to 98.7 HU [mean: 67.8 (±18.6)], while the iodine concentrations calculated with DECT ranged from 0.0 to 1.3 mg/mL [mean: 0.5 (±0.4)]. A moderate positive correlation between CT values and the calculated iodine concentrations in the thyroid gland was seen (R = 0.429, p < 0.05). A significant negative correlation between 123 I uptake at 3 h and iodine concentration by DECT were seen (R = -0.680, p < 0.05), although no correlation was observed between 123 I uptake at 3 h and CT values (p = 0.087). No correlation was observed between 123 I uptake at 24 h and CT values (p = 0.153) or that between 123 I uptake at 24 h and iodine concentration by DECT (p = 0.073). The negative correlation of 123 I uptake at 3 h with iodine concentration evaluated by DECT was better than that observed with simple CT value. DECT may have a potential role in the evaluation of iodine turnover in hyperthyroid patients.

Differentiating Calcium Oxalate and Hydroxyapatite Stones In Vivo Using Dual-Energy CT and Urine Supersaturation and pH Values

PubMed Central

Liu, Yu; Qu, Mingliang; Carter, Rickey E.; Leng, Shuai; Ramirez-Giraldo, Juan Carlos; Jaramillo, Giselle; Krambeck, Amy E.; Lieske, John C.; Vrtiska, Terri J.; McCollough, Cynthia H.

2014-01-01

Rationale and Objectives Knowledge of urinary stone composition can guide therapeutic intervention for patients with calcium oxalate (CaOx) or hydroxyapatite (HA) stones. In this study, we determined the accuracy of noninvasive differentiation of these two stone types using dual-energy CT (DECT) and urine supersaturation (SS) and pH values. Materials and Methods Patients who underwent clinically indicated DECT scanning for stone disease and subsequent surgical intervention were enrolled. Stone composition was determined using infrared spectroscopy. DECT images were processed using custom-developed software that evaluated the ratio of CT numbers between low- and high-energy images. Clinical information, including patient age, gender, and urine pH and supersaturation profile, was obtained from electronic medical records. Simple and multiple logistic regressions were used to determine if the ratio of CT numbers could discriminate CaOx from HA stones alone or in conjunction with urine supersaturation and pH. Results Urinary stones (CaOx n = 43, HA n = 18) from 61 patients were included in this study. In a univariate model, DECT data, urine SS-HA, and urine pH had an area under the receiver operating characteristic curve of 0.78 (95% confidence interval [CI] 0.66–0.91, P = .016), 0.76 (95%CI 0.61–0.91, P = .003), and 0.60 (95% CI 0.44–0.75, P = .20), respectively, for predicting stone composition. The combination of CT data and the urinary SS-HA had an area under the receiver operating characteristic curve of 0.79 (95%CI 0.66–0.92, P = .007) for correctly differentiating these two stone types. Conclusions DECT differentiated between CaOx and HA stones similarly to SS-HA, whereas pH was a poor discriminator. The combination of DECT and urine SS or pH data did not improve this performance. PMID:24200478

Extracting atomic numbers and electron densities from a dual source dual energy CT scanner: experiments and a simulation model.

PubMed

Landry, Guillaume; Reniers, Brigitte; Granton, Patrick Vincent; van Rooijen, Bart; Beaulieu, Luc; Wildberger, Joachim E; Verhaegen, Frank

2011-09-01

Dual energy CT (DECT) imaging can provide both the electron density ρ(e) and effective atomic number Z(eff), thus facilitating tissue type identification. This paper investigates the accuracy of a dual source DECT scanner by means of measurements and simulations. Previous simulation work suggested improved Monte Carlo dose calculation accuracy when compared to single energy CT for low energy photon brachytherapy, but lacked validation. As such, we aim to validate our DECT simulation model in this work. A cylindrical phantom containing tissue mimicking inserts was scanned with a second generation dual source scanner (SOMATOM Definition FLASH) to obtain Z(eff) and ρ(e). A model of the scanner was designed in ImaSim, a CT simulation program, and was used to simulate the experiment. Accuracy of measured Z(eff) (labelled Z) was found to vary from -10% to 10% from low to high Z tissue substitutes while the accuracy on ρ(e) from DECT was about 2.5%. Our simulation reproduced the experiments within ±5% for both Z and ρ(e). A clinical DECT scanner was able to extract Z and ρ(e) of tissue substitutes. Our simulation tool replicates the experiments within a reasonable accuracy. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Robust x-ray based material identification using multi-energy sinogram decomposition

NASA Astrophysics Data System (ADS)

Yuan, Yaoshen; Tracey, Brian; Miller, Eric

2016-05-01

There is growing interest in developing X-ray computed tomography (CT) imaging systems with improved ability to discriminate material types, going beyond the attenuation imaging provided by most current systems. Dual- energy CT (DECT) systems can partially address this problem by estimating Compton and photoelectric (PE) coefficients of the materials being imaged, but DECT is greatly degraded by the presence of metal or other materials with high attenuation. Here we explore the advantages of multi-energy CT (MECT) systems based on photon-counting detectors. The utility of MECT has been demonstrated in medical applications where photon- counting detectors allow for the resolution of absorption K-edges. Our primary concern is aviation security applications where K-edges are rare. We simulate phantoms with differing amounts of metal (high, medium and low attenuation), both for switched-source DECT and for MECT systems, and include a realistic model of detector energy 0 resolution. We extend the DECT sinogram decomposition method of Ying et al. to MECT, allowing estimation of separate Compton and photoelectric sinograms. We furthermore introduce a weighting based on a quadratic approximation to the Poisson likelihood function that deemphasizes energy bins with low signal. Simulation results show that the proposed approach succeeds in estimating material properties even in high-attenuation scenarios where the DECT method fails, improving the signal to noise ratio of reconstructions by over 20 dB for the high-attenuation phantom. Our work demonstrates the potential of using photon counting detectors for stably recovering material properties even when high attenuation is present, thus enabling the development of improved scanning systems.

Dual-Energy Computed Tomography Gemstone Spectral Imaging: A Novel Technique to Determine Human Cardiac Calculus Composition.

PubMed

Cheng, Ching-Li; Chang, Hsiao-Huang; Ko, Shih-Chi; Huang, Pei-Jung; Lin, Shan-Yang

2016-01-01

Understanding the chemical composition of any calculus in different human organs is essential for choosing the best treatment strategy for patients. The purpose of this study was to assess the capability of determining the chemical composition of a human cardiac calculus using gemstone spectral imaging (GSI) mode on a single-source dual-energy computed tomography (DECT) in vitro. The cardiac calculus was directly scanned on the Discovery CT750 HD FREEdom Edition using GSI mode, in vitro. A portable fiber-optic Raman spectroscopy was also applied to verify the quantitative accuracy of the DECT measurements. The results of spectral DECT measurements indicate that effective Z values in 3 designated positions located in this calculus were 15.02 to 15.47, which are close to values of 15.74 to 15.86, corresponding to the effective Z values of calcium apatite and hydroxyapatite. The Raman spectral data were also reflected by the predominant Raman peak at 960 cm for hydroxyapatite and the minor peak at 875 cm for calcium apatite. A potential single-source DECT with GSI mode was first used to examine the morphological characteristics and chemical compositions of a giant human cardiac calculus, in vitro. The CT results were consistent with the Raman spectral data, suggesting that spectral CT imaging techniques could be accurately used to diagnose and characterize the compositional materials in the cardiac calculus.

WE-D-BRF-05: Quantitative Dual-Energy CT Imaging for Proton Stopping Power Computation

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

Han, D; Williamson, J; Siebers, J

2014-06-15

Purpose: To extend the two-parameter separable basis-vector model (BVM) to estimation of proton stopping power from dual-energy CT (DECT) imaging. Methods: BVM assumes that the photon cross sections of any unknown material can be represented as a linear combination of the corresponding quantities for two bracketing basis materials. We show that both the electron density (ρe) and mean excitation energy (Iex) can be modeled by BVM, enabling stopping power to be estimated from the Bethe-Bloch equation. We have implemented an idealized post-processing dual energy imaging (pDECT) simulation consisting of monogenetic 45 keV and 80 keV scanning beams with polystyrene-water andmore » water-CaCl2 solution basis pairs for soft tissues and bony tissues, respectively. The coefficients of 24 standard ICRU tissue compositions were estimated by pDECT. The corresponding ρe, Iex, and stopping power tables were evaluated via BVM and compared to tabulated ICRU 44 reference values. Results: BVM-based pDECT was found to estimate ρe and Iex with average and maximum errors of 0.5% and 2%, respectively, for the 24 tissues. Proton stopping power values at 175 MeV, show average/maximum errors of 0.8%/1.4%. For adipose, muscle and bone, these errors result range prediction accuracies less than 1%. Conclusion: A new two-parameter separable DECT model (BVM) for estimating proton stopping power was developed. Compared to competing parametric fit DECT models, BVM has the comparable prediction accuracy without necessitating iterative solution of nonlinear equations or a sample-dependent empirical relationship between effective atomic number and Iex. Based on the proton BVM, an efficient iterative statistical DECT reconstruction model is under development.« less

SU-F-T-398: Improving Radiotherapy Treatment Planning Using Dual Energy Computed Tomography Based Tissue Characterization

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

Tomic, N; Bekerat, H; Seuntjens, J

Purpose: Both kVp settings and geometric distribution of various materials lead to significant change of the HU values, showing the largest discrepancy for high-Z materials and for the lowest CT scanning kVp setting. On the other hand, the dose distributions around low-energy brachytherapy sources are highly dependent on the architecture and composition of tissue heterogeneities in and around the implant. Both measurements and Monte Carlo calculations show that improper tissue characterization may lead to calculated dose errors of 90% for low energy and around 10% for higher energy photons. We investigated the ability of dual-energy CT (DECT) to characterize moremore » accurately tissue equivalent materials. Methods: We used the RMI-467 heterogeneity phantom scanned in DECT mode with 3 different set-ups: first, we placed high electron density (ED) plugs within the outer ring of the phantom; then we arranged high ED plugs within the inner ring; and finally ED plugs were randomly distributed. All three setups were scanned with the same DECT technique using a single-source DECT scanner with fast kVp switching (Discovery CT750HD; GE Healthcare). Images were transferred to a GE Advantage workstation for DECT analysis. Spectral Hounsfield unit curves (SHUACs) were then generated from 50 to 140-keV, in 10-keV increments, for each plug. Results: The dynamic range of Hounsfield units shrinks with increased photon energy as the attenuation coefficients decrease. Our results show that the spread of HUs for the three different geometrical setups is the smallest at 80 keV. Furthermore, among all the energies and all materials presented, the largest difference appears at high Z tissue equivalent plugs. Conclusion: Our results suggest that dose calculations at both megavoltage and low photon energies could benefit in the vicinity of bony structures if the 80 keV reconstructed monochromatic CT image is used with the DECT protocol utilized in this work.« less

Comparison of the sensitivity and specificity of 5 image sets of dual-energy computed tomography for detecting first-pass myocardial perfusion defects compared with positron emission tomography.

PubMed

Li, Wenhuan; Zhu, Xiaolian; Li, Jing; Peng, Cheng; Chen, Nan; Qi, Zhigang; Yang, Qi; Gao, Yan; Zhao, Yang; Sun, Kai; Li, Kuncheng

2014-12-01

The sensitivity and specificity of 5 different image sets of dual-energy computed tomography (DECT) for the detection of first-pass myocardial perfusion defects have not systematically been compared using positron emission tomography (PET) as a reference standard. Forty-nine consecutive patients, with known or strongly suspected of coronary artery disease, were prospectively enrolled in our study. Cardiac DECT was performed at rest state using a second-generation 128-slice dual-source CT. The DECT data were reconstructed to iodine maps, monoenergetic images, 100 kV images, nonlinearly blended images, and linearly blended images by different postprocessing techniques. The myocardial perfusion defects on DECT images were visually assessed by 5 observers, using standard 17-segment model. Diagnostic accuracy of 5 image sets was assessed using nitrogen-13 ammonia PET as the gold standard. Discrimination was quantified using the area under the receiver operating characteristic curve (AUC), and AUCs were compared using the method of DeLong. The DECT and PET examinations were successfully completed in 30 patients and a total of 90 territories and 510 segments were analyzed. Cardiac PET revealed myocardial perfusion defects in 56 territories (62%) and 209 segments (41%). The AUC of iodine maps, monoenergetic images, 100 kV images, nonlinearly blended images, and linearly blended images were 0.986, 0.934, 0.913, 0.881, and 0.871, respectively, on a per-territory basis. These values were 0.922, 0.813, 0.779, 0.763, and 0.728, respectively, on a per-segment basis. DECT iodine maps shows high sensitivity and specificity, and is superior to other DECT image sets for the detection of myocardial perfusion defects in the first-pass myocardial perfusion.

Determining the composition of urinary tract calculi using stone-targeted dual-energy CT: evaluation of a low-dose scanning protocol in a clinical environment

PubMed Central

Chaytor, Richard J; Rajbabu, Krishnamoorthy; Jones, Paul A

2016-01-01

Objective: This study will evaluate the accuracy of dual-energy CT (DECT) in characterizing urinary tract stone composition on patients presenting to a UK hospital with renal colic. The study will also assess the additional radiation dose burden of DECT over standard protocol. Methods: Data from 106 DECTs between October 2011 and October 2015 were retrospectively analyzed. Patients were imaged using a Toshiba Aquilion ONE™ CT scanner (Toshiba Medical Systems, Otawara-shi, Japan). All patients received a low-dose non-contrast CT of the abdomen and pelvis prior to stone-targeted DECT at 80 and 135 kVp and 40-mm field of view. Radiation dose output was evaluated using dose–length product (DLP). 19 stones were recovered and their compositions were analyzed using Fourier transform infrared spectroscopy. Results: 137 stones were characterized. Mean stone diameter was 8.8 mm (range 3–48 mm). There was an 18.7% increase in mean DLP for DECT over standard CT protocol (319.4 vs 269.1 mGy cm; p < 0.001). Infrared spectroscopy analysis of 19 recovered stones identified 15 stones as calcium, 2 stones as cystine and 2 stones as mixed composition. Dual energy correctly predicted 11 (78.6%) of 14 calcium stones, 2 (100%) of 2 mixed composition stones and 0 (0%) of 2 cystine stones, resulting in a fair agreement (Cohen's κ = 0.374, p = 0.009). Conclusion: DECT is able to determine the composition of urinary tract stones with fair accuracy. Its utility is offset by a small but significant supplementary radiation exposure. Advances in knowledge: DECT can provide urological surgeons with useful diagnostic stone material information prior to planning optimal management of stone disease. PMID:27587309

MO-FG-CAMPUS-JeP1-04: Evaluating DECT Vs SECT Range Differences in Proton Therapy Using Clinical Data

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

Hudobivnik, N; Dedes, G; Parodi, K

Purpose: Range uncertainty from X-ray CT number conversion to stopping power ratio (SPR) is one of the key factors limiting the potential of proton therapy. The large margins required for deep seated tumors degrade the organ sparing achievable with the technology. Of interest is the application of dual energy CT (DECT) to SPR estimation. In this planning study proton range differences between SECT and DECT have been quantified for brain cases. Methods: A last generation dual source DECT scanner was used to acquire SECT (150 kVp with Sn filtration) and DECT (additionally 90 kVp) scans of phantoms and 5 headmore » trauma patients, acting as surrogate cancer patients. Phantom materials were characterized in terms of SPR in a particle beam to obtain reference values. IMPT treatment plans were generated on the basis of SECT and DECT SPR images for hypothetical brain tumors using a short and a long beam path. Range differences between SECT and DECT from plan recalculations were evaluated in beam-eye-view (BEV) by comparing the 80% isodose. Results: For the 18 phantom materials the SECT RMS SPR errors were 2.6% compared to 1.1% for DECT. Group median relative range differences between SECT and DECT plans were −1.0% for the short beam path over the 5 patients investigated in this study. For the long beam path the median difference was −1.4%. These relative range differences corresponded to −0.5 mm and −1.4 mm shifts respectively. Conclusion: This is the first study performing proton therapy treatment planning on DECT patient images. Important range differences of more than 1 mm were observed between SECT and DECT treatment plans, and DECT SPR accuracy was found superior on the basis of phantom measurements. While the patients investigated in this study did not have brain tumors, the findings we observed should apply to cancer patients. Deutsche Forschungsgemeinschaft (MAP); Bundesministerium fur Bildung und Forschung (01IB13001)« less

Analysis of pulmonary pure ground-glass nodule in enhanced dual energy CT imaging for predicting invasive adenocarcinoma: comparing with conventional thin-section CT imaging

PubMed Central

Zhang, Ying; Tang, Jian; Xu, Jianrong

2017-01-01

Background To investigate the value of dual energy computed tomography (DECT) parameters (including iodine concentration and monochromatic CT numbers) for predicting pure ground-glass nodules (pGGNs) of invasive adenocarcinoma (IA). Methods A total of 55 resected pGGNs evaluated with both unenhanced thin-section CT (TSCT) and enhanced DECT scans were included. Correlations between histopathology [adenocarcinoma in situ (AIS), minimally IA (MIA), and IA] and CT scan characteristics were examined. CT scan and clinicodemographic data were investigated by univariate and multivariate analysis to identify features that helped distinguish IA from AIS or MIA. Results Both normalized iodine concentration (NIC) of IA and slope of spectral curve [slope(k)] were not significantly different between IA and AIS or MIA. Size, performance of pleural retraction and enhanced monochromatic CT attenuation values of 120–140 keV were significantly higher for IA. In multivariate regression analysis, size and enhanced monochromatic CT number of 140 keV were independent predictors for IA. Using the two parameters together, the diagnostic capacity of IA could be improved from 0.697 or 0.635 to 0.713. Conclusions DECT could help demonstrate blood supply and indicate invasion extent of pGGNs, and monochromatic CT number of higher energy (especially 140 keV) would be better for diagnosing IA than lower energies. Together with size of pGGNs, the diagnostic capacity of IA could be better. PMID:29312701

Image enhancement by spectral-error correction for dual-energy computed tomography.

PubMed

Park, Kyung-Kook; Oh, Chang-Hyun; Akay, Metin

2011-01-01

Dual-energy CT (DECT) was reintroduced recently to use the additional spectral information of X-ray attenuation and aims for accurate density measurement and material differentiation. However, the spectral information lies in the difference between low and high energy images or measurements, so that it is difficult to acquire accurate spectral information due to amplification of high pixel noise in the resulting difference image. In this work, an image enhancement technique for DECT is proposed, based on the fact that the attenuation of a higher density material decreases more rapidly as X-ray energy increases. We define as spectral error the case when a pixel pair of low and high energy images deviates far from the expected attenuation trend. After analyzing the spectral-error sources of DECT images, we propose a DECT image enhancement method, which consists of three steps: water-reference offset correction, spectral-error correction, and anti-correlated noise reduction. It is the main idea of this work that makes spectral errors distributed like random noise over the true attenuation and suppressed by the well-known anti-correlated noise reduction. The proposed method suppressed noise of liver lesions and improved contrast between liver lesions and liver parenchyma in DECT contrast-enhanced abdominal images and their two-material decomposition.

Determination of ureter stent appearance on dual-energy computed tomography scan.

PubMed

Jepperson, Maria A; Thiel, David D; Cernigliaro, Joesph G; Broderick, Gregory A; Parker, Alexander S; Haley, William E

2012-11-01

To examine the dual-energy computed tomography (DECT) properties of 7 commonly used ureteral stents to optimize stent selection for calculi monitored using DECT. The use of DECT to evaluate renal and ureteral calculi has recently increased. Seven stents were individually placed in a fish bowl phantom and imaged using a Siemens Somatom Definition Flash CT scanner. DECT peak tube potentials of 80 and 140 kVp and 100 and 140 kVp were used, reflecting our current dual-energy protocols. These were compared to 31 in vivo stents of known composition. The data were reconstructed on a multimodality WorkPlace (Siemens) using CT syngo Post-Processing Suite software. The average patient age was 64 years (range 27-90). The average body mass index was 31.9 kg/m(2) (range 24-51.6). Of the 27 patients, 4 had uric acid stones and 22 had calcium-based stones; 1 patient had undergone renal transplantation. No difference was seen in the dual-energy characterization of stents from the same manufacturer. All imaged Cook and Bard stents had a dual-energy characterization that approached that of calcium stones (blue). All Boston Scientific and Gyrus ACMI stents had a dual-energy characterization resembling that of uric acid stones (red). The present study evaluated the stent appearance on DECT for various stent manufacturers. This information will aid in the optimal stent selection for patients undergoing treatment of renal calculi and followed up with DECT. Copyright © 2012 Elsevier Inc. All rights reserved.

Dual energy exposure control (DEEC) for computed tomography: algorithm and simulation study.

PubMed

Stenner, Philip; Kachelriess, Marc

2008-11-01

DECT means acquiring the same object at two different energies, respectively two different tube voltages U1 and U2. The raw data q1 and q2 undergo a decomposition process of type p = p(q1,q2). The raw data p are reconstructed to obtain monochromatic images of the attenuation mu, of the object density rho, or of a specific material distribution. Recent advances in DECT focus on noise reduction techniques [S. Richard and J. H. Siewerdsen, Med. Phys. 35(2), 586-600 (2008)] and enable high performance DECT such as lung nodule detection [Shkumat et al., Med. Phys. 35(2), 629-632 (2008)]. Given p and a raw data-based projection-wise patient dose estimation D(alpha) the authors determine the optimal tube current curves I1(alpha) and I2(alpha), with alpha being the view angle, which minimizes image noise for a given patient dose level. DEEC can perform online; I1(alpha) and I2(alpha) can be determined during the scan. Simulation studies using semianthropomorphic phantom data were carried out. In particular, functions p that generate mu-images and density images were evaluated. Image quality was compared to standard scans at U0=120 kV (clinical CT) and U0=45 kV (micro-CT) that were taken at the same dose level (D0=D1 + D2) and identical spatial resolution. Appropriate choice of p(q1, q2) allows to obtain mu-images that show fewer artifacts and yield image noise levels comparable to the noise of the standard scan. The authors compared the standard scan to mu-images at 70 keV, which is the effective energy used in clinical CT, and found optimal results with mu-images at 25 keV for micro-CT. Nonoptimal choice of the decomposition function will, however, significantly increase image noise. In particular mu-images at 511 keV, as needed for PET/CT attenuation correction, exhibit more than twice as much image noise as the standard scan. With DEEC, which guarantees best dose usage possible, monochromatic images are generated with only slightly increased noise levels at the same dose compared to a standard scan. The benefit of significantly decreased artifacts appears to allow using DEEC-generated monochromatic images in daily routine. Furthermore, DEEC is not restricted to DECT and the inherent tube current modulation algorithm may also be applied to single energy CT.

Dual energy exposure control (DEEC) for computed tomography: Algorithm and simulation study

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

Stenner, Philip; Kachelriess, Marc

2008-11-15

DECT means acquiring the same object at two different energies, respectively two different tube voltages U{sub 1} and U{sub 2}. The raw data q{sub 1} and q{sub 2} undergo a decomposition process of type p=p(q{sub 1},q{sub 2}). The raw data p are reconstructed to obtain monochromatic images of the attenuation {mu}, of the object density {rho}, or of a specific material distribution. Recent advances in DECT focus on noise reduction techniques [S. Richard and J. H. Siewerdsen, Med. Phys. 35(2), 586-600 (2008)] and enable high performance DECT such as lung nodule detection [Shkumat et al., Med. Phys. 35(2), 629-632 (2008)].more » Given p and a raw data-based projection-wise patient dose estimation D({alpha}) the authors determine the optimal tube current curves I{sub 1}({alpha}) and I{sub 2}({alpha}), with {alpha} being the view angle, which minimizes image noise for a given patient dose level. DEEC can perform online; I{sub 1}({alpha}) and I{sub 2}({alpha}) can be determined during the scan. Simulation studies using semianthropomorphic phantom data were carried out. In particular, functions p that generate {mu}-images and density images were evaluated. Image quality was compared to standard scans at U{sub 0}=120 kV (clinical CT) and U{sub 0}=45 kV (micro-CT) that were taken at the same dose level (D{sub 0}=D{sub 1}+D{sub 2}) and identical spatial resolution. Appropriate choice of p(q{sub 1},q{sub 2}) allows to obtain {mu}-images that show fewer artifacts and yield image noise levels comparable to the noise of the standard scan. The authors compared the standard scan to {mu}-images at 70 keV, which is the effective energy used in clinical CT, and found optimal results with {mu}-images at 25 keV for micro-CT. Nonoptimal choice of the decomposition function will, however, significantly increase image noise. In particular {mu}-images at 511 keV, as needed for PET/CT attenuation correction, exhibit more than twice as much image noise as the standard scan. With DEEC, which guarantees best dose usage possible, monochromatic images are generated with only slightly increased noise levels at the same dose compared to a standard scan. The benefit of significantly decreased artifacts appears to allow using DEEC-generated monochromatic images in daily routine. Furthermore, DEEC is not restricted to DECT and the inherent tube current modulation algorithm may also be applied to single energy CT.« less

A Novel Imaging Technique (X-Map) to Identify Acute Ischemic Lesions Using Noncontrast Dual-Energy Computed Tomography.

PubMed

Noguchi, Kyo; Itoh, Toshihide; Naruto, Norihito; Takashima, Shutaro; Tanaka, Kortaro; Kuroda, Satoshi

2017-01-01

We evaluated whether X-map, a novel imaging technique, can visualize ischemic lesions within 20 hours after the onset in patients with acute ischemic stroke, using noncontrast dual-energy computed tomography (DECT). Six patients with acute ischemic stroke were included in this study. Noncontrast head DECT scans were acquired with 2 X-ray tubes operated at 80 kV and Sn150 kV between 32 minutes and 20 hours after the onset. Using these DECT scans, the X-map was reconstructed based on 3-material decomposition and compared with a simulated standard (120 kV) computed tomography (CT) and diffusion-weighted imaging (DWI). The X-map showed more sensitivity to identify the lesions as an area of lower attenuation value than a simulated standard CT in all 6 patients. The lesions on the X-map correlated well with those on DWI. In 3 of 6 patients, the X-map detected a transient decrease in the attenuation value in the peri-infarct area within 1 day after the onset. The X-map is a powerful tool to supplement a simulated standard CT and characterize acute ischemic lesions. However, the X-map cannot replace a simulated standard CT to diagnose acute cerebral infarction. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

MO-FG-204-03: Using Edge-Preserving Algorithm for Significantly Improved Image-Domain Material Decomposition in Dual Energy CT

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

Zhao, W; Niu, T; Xing, L

2015-06-15

Purpose: To significantly improve dual energy CT (DECT) imaging by establishing a new theoretical framework of image-domain material decomposition with incorporation of edge-preserving techniques. Methods: The proposed algorithm, HYPR-NLM, combines the edge-preserving non-local mean filter (NLM) with the HYPR-LR (Local HighlY constrained backPRojection Reconstruction) framework. Image denoising using HYPR-LR framework depends on the noise level of the composite image which is the average of the different energy images. For DECT, the composite image is the average of high- and low-energy images. To further reduce noise, one may want to increase the window size of the filter of the HYPR-LR, leadingmore » resolution degradation. By incorporating the NLM filtering and the HYPR-LR framework, HYPR-NLM reduces the boost material decomposition noise using energy information redundancies as well as the non-local mean. We demonstrate the noise reduction and resolution preservation of the algorithm with both iodine concentration numerical phantom and clinical patient data by comparing the HYPR-NLM algorithm to the direct matrix inversion, HYPR-LR and iterative image-domain material decomposition (Iter-DECT). Results: The results show iterative material decomposition method reduces noise to the lowest level and provides improved DECT images. HYPR-NLM significantly reduces noise while preserving the accuracy of quantitative measurement and resolution. For the iodine concentration numerical phantom, the averaged noise levels are about 2.0, 0.7, 0.2 and 0.4 for direct inversion, HYPR-LR, Iter- DECT and HYPR-NLM, respectively. For the patient data, the noise levels of the water images are about 0.36, 0.16, 0.12 and 0.13 for direct inversion, HYPR-LR, Iter-DECT and HYPR-NLM, respectively. Difference images of both HYPR-LR and Iter-DECT show edge effect, while no significant edge effect is shown for HYPR-NLM, suggesting spatial resolution is well preserved for HYPR-NLM. Conclusion: HYPR-NLM provides an effective way to reduce the generic magnified image noise of dual–energy material decomposition while preserving resolution. This work is supported in part by NIH grants 7R01HL111141 and 1R01-EB016777. This work is also supported by the Natural Science Foundation of China (NSFC Grant No. 81201091), Fundamental Research Funds for the Central Universities in China, and Fund Project for Excellent Abroad Scholar Personnel in Science and Technology.« less

Dose heterogeneity correction for low-energy brachytherapy sources using dual-energy CT images

NASA Astrophysics Data System (ADS)

Mashouf, S.; Lechtman, E.; Lai, P.; Keller, B. M.; Karotki, A.; Beachey, D. J.; Pignol, J. P.

2014-09-01

Permanent seed implant brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose around brachytherapy sources is based on the AAPM TG-43 formalism, which generates the dose in a homogeneous water medium. Recently, AAPM TG-186 emphasized the importance of accounting for tissue heterogeneities. We have previously reported on a methodology where the absorbed dose in tissue can be obtained by multiplying the dose, calculated by the TG-43 formalism, by an inhomogeneity correction factor (ICF). In this work we make use of dual energy CT (DECT) images to extract ICF parameters. The advantage of DECT over conventional CT is that it eliminates the need for tissue segmentation as well as assignment of population based atomic compositions. DECT images of a heterogeneous phantom were acquired and the dose was calculated using both TG-43 and TG-43 × \\text{ICF} formalisms. The results were compared to experimental measurements using Gafchromic films in the mid-plane of the phantom. For a seed implant configuration of 8 seeds spaced 1.5 cm apart in a cubic structure, the gamma passing score for 2%/2 mm criteria improved from 40.8% to 90.5% when ICF was applied to TG-43 dose distributions.

TU-FG-BRB-01: Dual Energy CT Proton Stopping Power Ratio Calibration and Validation with Animal Tissues

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

Xie, Y; Yin, L; Ainsley, C

Purpose: The conversion of Hounsfield Unit (HU) to proton stopping power ratio (SPR) is a main source of uncertainty in proton therapy. In this study, the SPRs of animal tissues were measured and compared with prediction from dual energy CT (DECT) and single energy CT (SECT) calibrations. Methods: A stoichiometric calibration method for DECT was applied to predict the SPR using CT images acquired at 80 kVp and 140 kVp. The dual energy index was derived based on the HUs of the paired spectral images and used to calculate the SPRs of the materials. Tissue surrogates with known chemical compositionsmore » were used for calibration, and animal tissues (pig brain, liver, kidney; veal shank, muscle) were used for validation. The materials were irradiated with proton pencil beams, and SPRs were deduced from the residual proton range measured using a multi-layer ion chamber device. In addition, Gafchromic EBT3 films were used to measure the distal dose profiles after irradiation through the tissue samples and compared with those calculated by the treatment planning system using both DECT and SECT predicted SPRs. Results: The differences in SPR between DECT prediction and measurement were −0.31±0.36% for bone, 0.47±0.42% for brain, 0.67±0.15% for liver, 0.51±0.52% for kidney, and −0.96±0.15% for muscle. The corresponding results using SECT were 3.1±0.12%, 1.90±0.45%, −0.66±0.11%, 2.33±0.21%, and −1.70±0.17%. In the film measurements, average distances between film and calculated distal dose profiles were 0.35±0.12 mm for DECT calibration and −1.22±0.12 mm for SECT calibration for a beam with a range of 15.79 cm. Conclusion: Our study indicates that DECT is superior to SECT for proton SPR prediction and has the potential to reduce the range uncertainty to less than 2%. DECT may permit the use of tighter distal and proximal range uncertainty margins for treatment, thereby increasing the precision of proton therapy.« less

A phase I feasibility study of multi-modality imaging assessing rapid expansion of marrow fat and decreased bone mineral density in cancer patients

PubMed Central

Hui, Susanta K; Arentsen, Luke; Sueblinvong, Thanasak; Brown, Keenan; Bolan, Pat; Ghebre, Rahel G; Downs, Levi; Shanley, Ryan; Hansen, Karen E.; Minenko, Anne G.; Takhashi, Yutaka; Yagi, Masashi; Zhang, Yan; Geller, Melissa; Reynolds, Margaret; Lee, Chung K; Blaes, Anne H.; Allen, Sharon; Zobel, Bruno Beomonte; Le, Chap; Froelich, Jerry; Rosen, Clifford; Yee, Douglas

2014-01-01

Purpose Cancer survivors are at an increased risk for fractures, but lack of effective and economical biomarkers limits quantitative assessments of marrow fat (MF), bone mineral density (BMD) and their relation in response to cytotoxic cancer treatment. We report dual energy CT (DECT) imaging, commonly used for cancer diagnosis, treatment and surveillance, as a novel biomarker of MF and BMD. Methods We validated DECT in pre-clinical and Phase I clinical trials and verified with water-fat MRI (WF-MRI), quantitative CT (QCT) and dual-energy X-ray absorptiometry (DXA). Basis material composition framework was validated using water and small-chain alcohols simulating different components of bone marrow. Histologic validation was achieved by measuring percent adipocyte in cadaver vertebrae and compared with DECT and WF-MRI. For a Phase I trial, sixteen patients with gynecologic malignancies (treated with oophorectomy, radiotherapy or chemotherapy) underwent DECT, QCT, WF-MRI and DXA before and 12 months after treatment. BMD and MF percent and distribution were quantified in lumbar vertebrae and the right femoral neck. Results Measured precision (3 mg/cm3) was sufficient to distinguish test solutions. Adiposity in cadaver bone histology was highly correlated with MF measured using DECT and WF-MRI (r = 0.80 and 0.77, respectively). In the clinical trial, DECT showed high overall correlation (r = 0.77, 95% CI: 0.69, 0.83) with WF-MRI. MF increased significantly after treatment (p<0.002). Chemotherapy and radiation caused greater increases in MF than oophorectomy (p<0.032). L4 BMD decreased 14% by DECT, 20% by QCT, but only by 5% by DXA (p<0.002 for all). At baseline, we observed a statistically significant inverse association between MF and BMD which was dramatically attenuated after treatment. Conclusion Our study demonstrated that DECT, similar to WF-MRI, can accurately measure marrow adiposity. Both imaging modalities show rapid increase in MF following cancer treatment. Our results suggest that MF and BMD cannot be used interchangeably to monitor skeletal health following cancer therapy. PMID:25536285

A phase I feasibility study of multi-modality imaging assessing rapid expansion of marrow fat and decreased bone mineral density in cancer patients.

PubMed

Hui, Susanta K; Arentsen, Luke; Sueblinvong, Thanasak; Brown, Keenan; Bolan, Pat; Ghebre, Rahel G; Downs, Levi; Shanley, Ryan; Hansen, Karen E; Minenko, Anne G; Takhashi, Yutaka; Yagi, Masashi; Zhang, Yan; Geller, Melissa; Reynolds, Margaret; Lee, Chung K; Blaes, Anne H; Allen, Sharon; Zobel, Bruno Beomonte; Le, Chap; Froelich, Jerry; Rosen, Clifford; Yee, Douglas

2015-04-01

Cancer survivors are at an increased risk for fractures, but lack of effective and economical biomarkers limits quantitative assessments of marrow fat (MF), bone mineral density (BMD) and their relation in response to cytotoxic cancer treatment. We report dual energy CT (DECT) imaging, commonly used for cancer diagnosis, treatment and surveillance, as a novel biomarker of MF and BMD. We validated DECT in pre-clinical and phase I clinical trials and verified with water-fat MRI (WF-MRI), quantitative CT (QCT) and dual-energy X-ray absorptiometry (DXA). Basis material composition framework was validated using water and small-chain alcohols simulating different components of bone marrow. Histologic validation was achieved by measuring percent adipocyte in the cadaver vertebrae and compared with DECT and WF-MRI. For a phase I trial, sixteen patients with gynecologic malignancies (treated with oophorectomy, radiotherapy or chemotherapy) underwent DECT, QCT, WF-MRI and DXA before and 12months after treatment. BMD and MF percent and distribution were quantified in the lumbar vertebrae and the right femoral neck. Measured precision (3mg/cm(3)) was sufficient to distinguish test solutions. Adiposity in cadaver bone histology was highly correlated with MF measured using DECT and WF-MRI (r=0.80 and 0.77, respectively). In the clinical trial, DECT showed high overall correlation (r=0.77, 95% CI: 0.69, 0.83) with WF-MRI. MF increased significantly after treatment (p<0.002). Chemotherapy and radiation caused greater increases in MF than oophorectomy (p<0.032). L4 BMD decreased 14% by DECT, 20% by QCT, but only 5% by DXA (p<0.002 for all). At baseline, we observed a statistically significant inverse association between MF and BMD which was dramatically attenuated after treatment. Our study demonstrated that DECT, similar to WF-MRI, can accurately measure marrow adiposity. Both imaging modalities show rapid increase in MF following cancer treatment. Our results suggest that MF and BMD cannot be used interchangeably to monitor skeletal health following cancer therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

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

Nute, J; Jacobsen, M; Popnoe, D

Purpose: Intracranial hemorrhage and calcification with Single-Energy CT (SECT) attenuation below 100HU cannot be reliably identified using currently clinically available means. Calcification is typically benign but hemorrhage can carry a risk of intracranial bleeding and contraindicate use of anticoagulant therapies. A biologically-relevant phantom was used to investigate identification of unknown intracranial lesions using dual-energy CT (DECT) as a verification of prior lesion differentiation results. Methods: Prior phantom work investigating calcification and hemorrhage differentiation resulted in 3D-DECT raw data (water density, calcium density, 68keV) for a range of DECT protocol variations: image thicknesses (1.25, 2.5, 3.75, 5mm), CTDIvol (36.7 to 132.6mGy)more » and reconstruction algorithms (Soft, Standard, Detail). Acquisition-specific raw data were used to create a plane of optimal differentiation based on the geometric bisector of 3D-linear regression of the two lesion distributions. Verification hemorrhage and calcification lesions, ranging in size from 0.5 to 1.5cm, were created at varying attenuation from 50 to 100HU. Lesions were inserted into a biologically-relevant brain phantom and scanned using SECT (3.75mm images, Standard, 67mGy) and a range of DECT protocols (3.75mm images, Standard, [67, 105.6, 132.6mGy]). 3D-DECT data were collected and blinded for analysis. The 3D-DECT distribution of the lesion was then compared to the acquisition-matched geometric bisector plane and the mean lesion value’s position relative to the plane, indicating lesion identity, and the percentage of voxels on the identified side of the plane, indicating identification confidence, were derived. Results: 98% of the 120 lesions investigated were identified correctly as hemorrhage or calcification. 74% were identified with greater than 80% confidence. Increases in CTDIvol and lesion diameter were associated with increased identification confidence. Conclusion: Intracranial lesions of unknown etiology were identified with 80% confidence for 74% of lesions investigated. These phantom data suggest that the identification of intracranial lesions below 100HU is clinically feasible using DECT. This research was conducted at the MD Anderson Center for Advanced Biomedical Imaging in-part with equipment support from General Electric Healthcare.« less

Dual Energy CT (DECT) Monochromatic Imaging: Added Value of Adaptive Statistical Iterative Reconstructions (ASIR) in Portal Venography.

PubMed

Zhao, Liqin; Winklhofer, Sebastian; Jiang, Rong; Wang, Xinlian; He, Wen

2016-01-01

To investigate the effect of the adaptive statistical iterative reconstructions (ASIR) on image quality in portal venography by dual energy CT (DECT) imaging. DECT scans of 45 cirrhotic patients obtained in the portal venous phase were analyzed. Monochromatic images at 70keV were reconstructed with the following 4 ASIR percentages: 0%, 30%, 50%, and 70%. The image noise (IN) (standard deviation, SD) of portal vein (PV), the contrast-to-noise-ratio (CNR), and the subjective score for the sharpness of PV boundaries, and the diagnostic acceptability (DA) were obtained. The IN, CNR, and the subjective scores were compared among the four ASIR groups. The IN (in HU) of PV (10.05±3.14, 9.23±3.05, 8.44±2.95 and 7.83±2.90) decreased and CNR values of PV (8.04±3.32, 8.95±3.63, 9.80±4.12 and 10.74±4.73) increased with the increase in ASIR percentage (0%, 30%, 50%, and 70%, respectively), and were statistically different for the 4 ASIR groups (p<0.05). The subjective scores showed that the sharpness of portal vein boundaries (3.13±0.59, 2.82±0.44, 2.73±0.54 and 2.07±0.54) decreased with higher ASIR percentages (p<0.05). The subjective diagnostic acceptability was highest at 30% ASIR (p<0.05). 30% ASIR addition in DECT portal venography could improve the 70 keV monochromatic image quality.

Dual Energy CT (DECT) Monochromatic Imaging: Added Value of Adaptive Statistical Iterative Reconstructions (ASIR) in Portal Venography

PubMed Central

Winklhofer, Sebastian; Jiang, Rong; Wang, Xinlian; He, Wen

2016-01-01

Objective To investigate the effect of the adaptive statistical iterative reconstructions (ASIR) on image quality in portal venography by dual energy CT (DECT) imaging. Materials and Methods DECT scans of 45 cirrhotic patients obtained in the portal venous phase were analyzed. Monochromatic images at 70keV were reconstructed with the following 4 ASIR percentages: 0%, 30%, 50%, and 70%. The image noise (IN) (standard deviation, SD) of portal vein (PV), the contrast-to-noise-ratio (CNR), and the subjective score for the sharpness of PV boundaries, and the diagnostic acceptability (DA) were obtained. The IN, CNR, and the subjective scores were compared among the four ASIR groups. Results The IN (in HU) of PV (10.05±3.14, 9.23±3.05, 8.44±2.95 and 7.83±2.90) decreased and CNR values of PV (8.04±3.32, 8.95±3.63, 9.80±4.12 and 10.74±4.73) increased with the increase in ASIR percentage (0%, 30%, 50%, and 70%, respectively), and were statistically different for the 4 ASIR groups (p<0.05). The subjective scores showed that the sharpness of portal vein boundaries (3.13±0.59, 2.82±0.44, 2.73±0.54 and 2.07±0.54) decreased with higher ASIR percentages (p<0.05). The subjective diagnostic acceptability was highest at 30% ASIR (p<0.05). Conclusions 30% ASIR addition in DECT portal venography could improve the 70 keV monochromatic image quality. PMID:27315158

Material elemental decomposition in dual and multi-energy CT via a sparsity-dictionary approach for proton stopping power ratio calculation.

PubMed

Shen, Chenyang; Li, Bin; Chen, Liyuan; Yang, Ming; Lou, Yifei; Jia, Xun

2018-04-01

Accurate calculation of proton stopping power ratio (SPR) relative to water is crucial to proton therapy treatment planning, since SPR affects prediction of beam range. Current standard practice derives SPR using a single CT scan. Recent studies showed that dual-energy CT (DECT) offers advantages to accurately determine SPR. One method to further improve accuracy is to incorporate prior knowledge on human tissue composition through a dictionary approach. In addition, it is also suggested that using CT images with multiple (more than two) energy channels, i.e., multi-energy CT (MECT), can further improve accuracy. In this paper, we proposed a sparse dictionary-based method to convert CT numbers of DECT or MECT to elemental composition (EC) and relative electron density (rED) for SPR computation. A dictionary was constructed to include materials generated based on human tissues of known compositions. For a voxel with CT numbers of different energy channels, its EC and rED are determined subject to a constraint that the resulting EC is a linear non-negative combination of only a few tissues in the dictionary. We formulated this as a non-convex optimization problem. A novel algorithm was designed to solve the problem. The proposed method has a unified structure to handle both DECT and MECT with different number of channels. We tested our method in both simulation and experimental studies. Average errors of SPR in experimental studies were 0.70% in DECT, 0.53% in MECT with three energy channels, and 0.45% in MECT with four channels. We also studied the impact of parameter values and established appropriate parameter values for our method. The proposed method can accurately calculate SPR using DECT and MECT. The results suggest that using more energy channels may improve the SPR estimation accuracy. © 2018 American Association of Physicists in Medicine.

Single-phase dual-energy CT allows for characterization of renal masses as benign or malignant.

PubMed

Graser, Anno; Becker, Christoph R; Staehler, Michael; Clevert, Dirk A; Macari, Michael; Arndt, Niko; Nikolaou, Konstantin; Sommer, Wieland; Stief, Christian; Reiser, Maximilian F; Johnson, Thorsten R C

2010-07-01

To evaluate the diagnostic accuracy of dual-energy CT (DECT) in renal mass characterization using a single-phase acquisition. A total of 202 patients (148 males, 54 females; 63 +/- 13 years) with ultrasound-based suspicion of a renal mass underwent unenhanced single energy and nephrographic phase DECT on a dual source scanner (Siemens Somatom Definition Dual Source, n = 174; Somatom Definition Flash, n = 28). Scan parameters for DECT were: tube potential, 80/100 and 100/Sn140 kVp; exposure, 404/300 and 96/232 effective mAs; collimation, 14 x 1.2/32 x 0.6 mm. Two abdominal radiologists assessed DECT and SECT image quality and noise on a 5-point visual analogue scale. Using solely the DE acquisition including virtual nonenhanced (VNE) and color coded iodine images that enable direct visualization of iodine, masses were characterized as benign or malignant. In a second reading session after 34 to 72 (average: 55) days, the same assessment was again performed using both the true nonenhanced (TNE) and nephrographic phase scans thereby simulating conventional single-energy CT. Sensitivities, specificities, diagnostic accuracies, and interpretation times and were recorded for both reading paradigms. Dose reduction of a single-phase over a dual-phase protocol was calculated. Results were tested for statistical significance using the paired Wilcoxon signed rank test and student t test. Differences in sensitivities were tested for significance using the McNemar test. Of the 202 patients, 115 (56.9%) underwent surgical resection of renal masses. Histopathology showed malignancy in 99 and benign tumors in 18 patients, in 48 patients (23.7%), follow-up imaging showed size stability of lesions diagnosed as benign, and 37 patients (18.3%) had no mass. Based on DECT only, 95/99 (96.0%) patients with malignancy and 96/103 (93.2%) patients without malignancy were correctly identified, for an overall accuracy of 94.6%. The dual-phase approach identified 96/99 (97.0%) and 98/103 (95.1%), accuracy 96.0%, P > 0.05 for both. Mean interpretation time was 2.2 +/- 0.8 minutes for DECT, and 3.5 +/- 1.0 minutes for the dual-phase protocol, P < 0.001. Mean VNE/TNE image quality was 1.68 +/- 0.65/1.30 +/- 0.59, noise was 2.03 +/- 0.57/1.18 +/- 0.29, P < 0.001 for both. Omission of the true unenhanced phase lead to a 48.9 +/- 7.0% dose reduction. DECT allows for fast and accurate characterization of renal masses in a single-phase acquisition. Interpretation of color coded images significantly reduces interpretation time. Omission of a nonenhanced acquisition can reduce radiation exposure by almost 50%.

Impact of joint statistical dual-energy CT reconstruction of proton stopping power images: Comparison to image- and sinogram-domain material decomposition approaches.

PubMed

Zhang, Shuangyue; Han, Dong; Politte, David G; Williamson, Jeffrey F; O'Sullivan, Joseph A

2018-05-01

The purpose of this study was to assess the performance of a novel dual-energy CT (DECT) approach for proton stopping power ratio (SPR) mapping that integrates image reconstruction and material characterization using a joint statistical image reconstruction (JSIR) method based on a linear basis vector model (BVM). A systematic comparison between the JSIR-BVM method and previously described DECT image- and sinogram-domain decomposition approaches is also carried out on synthetic data. The JSIR-BVM method was implemented to estimate the electron densities and mean excitation energies (I-values) required by the Bethe equation for SPR mapping. In addition, image- and sinogram-domain DECT methods based on three available SPR models including BVM were implemented for comparison. The intrinsic SPR modeling accuracy of the three models was first validated. Synthetic DECT transmission sinograms of two 330 mm diameter phantoms each containing 17 soft and bony tissues (for a total of 34) of known composition were then generated with spectra of 90 and 140 kVp. The estimation accuracy of the reconstructed SPR images were evaluated for the seven investigated methods. The impact of phantom size and insert location on SPR estimation accuracy was also investigated. All three selected DECT-SPR models predict the SPR of all tissue types with less than 0.2% RMS errors under idealized conditions with no reconstruction uncertainties. When applied to synthetic sinograms, the JSIR-BVM method achieves the best performance with mean and RMS-average errors of less than 0.05% and 0.3%, respectively, for all noise levels, while the image- and sinogram-domain decomposition methods show increasing mean and RMS-average errors with increasing noise level. The JSIR-BVM method also reduces statistical SPR variation by sixfold compared to other methods. A 25% phantom diameter change causes up to 4% SPR differences for the image-domain decomposition approach, while the JSIR-BVM method and sinogram-domain decomposition methods are insensitive to size change. Among all the investigated methods, the JSIR-BVM method achieves the best performance for SPR estimation in our simulation phantom study. This novel method is robust with respect to sinogram noise and residual beam-hardening effects, yielding SPR estimation errors comparable to intrinsic BVM modeling error. In contrast, the achievable SPR estimation accuracy of the image- and sinogram-domain decomposition methods is dominated by the CT image intensity uncertainties introduced by the reconstruction and decomposition processes. © 2018 American Association of Physicists in Medicine.

Validation of proton stopping power ratio estimation based on dual energy CT using fresh tissue samples

NASA Astrophysics Data System (ADS)

Taasti, Vicki T.; Michalak, Gregory J.; Hansen, David C.; Deisher, Amanda J.; Kruse, Jon J.; Krauss, Bernhard; Muren, Ludvig P.; Petersen, Jørgen B. B.; McCollough, Cynthia H.

2018-01-01

Dual energy CT (DECT) has been shown, in theoretical and phantom studies, to improve the stopping power ratio (SPR) determination used for proton treatment planning compared to the use of single energy CT (SECT). However, it has not been shown that this also extends to organic tissues. The purpose of this study was therefore to investigate the accuracy of SPR estimation for fresh pork and beef tissue samples used as surrogates of human tissues. The reference SPRs for fourteen tissue samples, which included fat, muscle and femur bone, were measured using proton pencil beams. The tissue samples were subsequently CT scanned using four different scanners with different dual energy acquisition modes, giving in total six DECT-based SPR estimations for each sample. The SPR was estimated using a proprietary algorithm (syngo.via DE Rho/Z Maps, Siemens Healthcare, Forchheim, Germany) for extracting the electron density and the effective atomic number. SECT images were also acquired and SECT-based SPR estimations were performed using a clinical Hounsfield look-up table. The mean and standard deviation of the SPR over large volume-of-interests were calculated. For the six different DECT acquisition methods, the root-mean-square errors (RMSEs) for the SPR estimates over all tissue samples were between 0.9% and 1.5%. For the SECT-based SPR estimation the RMSE was 2.8%. For one DECT acquisition method, a positive bias was seen in the SPR estimates, having a mean error of 1.3%. The largest errors were found in the very dense cortical bone from a beef femur. This study confirms the advantages of DECT-based SPR estimation although good results were also obtained using SECT for most tissues.

Correlation of quantitative dual-energy computed tomography iodine maps and abdominal computed tomography perfusion measurements: are single-acquisition dual-energy computed tomography iodine maps more than a reduced-dose surrogate of conventional computed tomography perfusion?

PubMed

Stiller, Wolfram; Skornitzke, Stephan; Fritz, Franziska; Klauss, Miriam; Hansen, Jens; Pahn, Gregor; Grenacher, Lars; Kauczor, Hans-Ulrich

2015-10-01

Study objectives were the quantitative evaluation of whether conventional abdominal computed tomography (CT) perfusion measurements mathematically correlate with quantitative single-acquisition dual-energy CT (DECT) iodine concentration maps, the determination of the optimum time of acquisition for achieving maximum correlation, and the estimation of the potential for radiation exposure reduction when replacing conventional CT perfusion by single-acquisition DECT iodine concentration maps. Dual-energy CT perfusion sequences were dynamically acquired over 51 seconds (34 acquisitions every 1.5 seconds) in 24 patients with histologically verified pancreatic carcinoma using dual-source DECT at tube potentials of 80 kVp and 140 kVp. Using software developed in-house, perfusion maps were calculated from 80-kVp image series using the maximum slope model after deformable motion correction. In addition, quantitative iodine maps were calculated for each of the 34 DECT acquisitions per patient. Within a manual segmentation of the pancreas, voxel-by-voxel correlation between the perfusion map and each of the iodine maps was calculated for each patient to determine the optimum time of acquisition topt defined as the acquisition time of the iodine map with the highest correlation coefficient. Subsequently, regions of interest were placed inside the tumor and inside healthy pancreatic tissue, and correlation between mean perfusion values and mean iodine concentrations within these regions of interest at topt was calculated for the patient sample. The mean (SD) topt was 31.7 (5.4) seconds after the start of contrast agent injection. The mean (SD) perfusion values for healthy pancreatic and tumor tissues were 67.8 (26.7) mL per 100 mL/min and 43.7 (32.2) mL per 100 mL/min, respectively. At topt, the mean (SD) iodine concentrations were 2.07 (0.71) mg/mL in healthy pancreatic and 1.69 (0.98) mg/mL in tumor tissue, respectively. Overall, the correlation between perfusion values and iodine concentrations was high (0.77), with correlation of 0.89 in tumor and of 0.56 in healthy pancreatic tissue at topt. Comparing radiation exposure associated with a single DECT acquisition at topt (0.18 mSv) to that of an 80 kVp CT perfusion sequence (2.96 mSv) indicates that an average reduction of Deff by 94% could be achieved by replacing conventional CT perfusion with a single-acquisition DECT iodine concentration map. Quantitative iodine concentration maps obtained with DECT correlate well with conventional abdominal CT perfusion measurements, suggesting that quantitative iodine maps calculated from a single DECT acquisition at an organ-specific and patient-specific optimum time of acquisition might be able to replace conventional abdominal CT perfusion measurements if the time of acquisition is carefully calibrated. This could lead to large reductions of radiation exposure to the patients while offering quantitative perfusion data for diagnosis.

Computation of Calcium Score with Dual Energy CT: A Phantom Study

PubMed Central

Kumar, Vidhya; Min, James K.; He, Xin; Raman, Subha V.

2016-01-01

Dual energy computed tomography (DECT) improves material and tissue characterization compared to single energy CT (SECT); we sought to validate coronary calcium quantification in advancing cardiovascular DECT. In an anthropomorphic phantom, agreement between measurements was excellent, and Bland-Altman analysis demonstrated minimal bias. Compared to the known calcium mass for each phantom, calcium mass by DECT was highly accurate. Noncontrast DECT yields accurate calcium measures, and warrants consideration in cardiac protocols for additional tissue characterizations. PMID:27680414

TH-CD-202-05: DECT Based Tissue Segmentation as Input to Monte Carlo Simulations for Proton Treatment Verification Using PET Imaging

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

Berndt, B; Wuerl, M; Dedes, G

Purpose: To improve agreement of predicted and measured positron emitter yields in patients, after proton irradiation for PET-based treatment verification, using a novel dual energy CT (DECT) tissue segmentation approach, overcoming known deficiencies from single energy CT (SECT). Methods: DECT head scans of 5 trauma patients were segmented and compared to existing decomposition methods with a first focus on the brain. For validation purposes, three brain equivalent solutions [water, white matter (WM) and grey matter (GM) – equivalent with respect to their reference carbon and oxygen contents and CT numbers at 90kVp and 150kVp] were prepared from water, ethanol, sucrosemore » and salt. The activities of all brain solutions, measured during a PET scan after uniform proton irradiation, were compared to Monte Carlo simulations. Simulation inputs were various solution compositions obtained from different segmentation approaches from DECT, SECT scans, and known reference composition. Virtual GM solution salt concentration corrections were applied based on DECT measurements of solutions with varying salt concentration. Results: The novel tissue segmentation showed qualitative improvements in %C for patient brain scans (ground truth unavailable). The activity simulations based on reference solution compositions agree with the measurement within 3–5% (4–8Bq/ml). These reference simulations showed an absolute activity difference between WM (20%C) and GM (10%C) to H2O (0%C) of 43 Bq/ml and 22 Bq/ml, respectively. Activity differences between reference simulations and segmented ones varied from −6 to 1 Bq/ml for DECT and −79 to 8 Bq/ml for SECT. Conclusion: Compared to the conventionally used SECT segmentation, the DECT based segmentation indicates a qualitative and quantitative improvement. In controlled solutions, a MC input based on DECT segmentation leads to better agreement with the reference. Future work will address the anticipated improvement of quantification accuracy in patients, comparing different tissue decomposition methods with an MR brain segmentation. Acknowledgement: DFG-MAP and HIT-Heidelberg Deutsche Forschungsgemeinschaft (MAP); Bundesministerium fur Bildung und Forschung (01IB13001)« less

Clinical Utility of Dual-Energy CT Analysis of Bone Marrow Edema in Acute Wrist Fractures.

PubMed

Ali, Ismail T; Wong, William D; Liang, Teresa; Khosa, Faisal; Mian, Memoona; Jalal, Sabeena; Nicolaou, Savvas

2018-04-01

The purpose of this study is to determine the utility of dual-energy CT (DECT) for assessing carpal fractures and to obtain an attenuation value cutoff (in Hounsfield units) to identify bone marrow edema due to an acute carpal fracture. In this retrospective study, 24 patients who presented with wrist fractures from September 3, 2014, through March 9, 2015, underwent imaging with DECT (80 and 140 kVp). Using the three-material decomposition algorithm specific for virtual noncalcium to construct images, two radiologists identified carpal fractures and associated bone marrow edema. Readers noted the attenuation at areas with and without bone marrow edema. The cutoff value was obtained by ROC analysis and was internally validated on 13 separate patients with suspected wrist fractures. A p < 0.05 was considered statistically significant. CT attenuation was significantly higher in areas of bone marrow edema than in areas without it (p < 0.0001, t test). A cutoff of 5.90 HU allows detection of bone marrow edema associated with acute wrist fractures with 100% sensitivity and 99.5% specificity, compared with visual DECT interpretation. In the 13 validation cases, the cutoff of 5.90 HU identified bone marrow edema with 100% accuracy, compared with visual interpretation. Kappa values were 0.83 between the two readings by reader 1, and 0.73 and 0.96 comparing the two readings of reader 1 with the reading by reader 2. DECT is a useful tool for identifying bone marrow edema in the setting of acute wrist fractures, providing an alternative to MRI. A cutoff value of 5.90 HU can be used for accurate diagnosis and exclusion of carpal fractures.

Making the invisible visible: improving conspicuity of noncalcified gallstones using dual-energy CT.

PubMed

Uyeda, Jennifer W; Richardson, Ian J; Sodickson, Aaron D

2017-12-01

To determine whether virtual monochromatic imaging (VMI) increases detectability of noncalcified gallstones on dual-energy CT (DECT) compared with conventional CT imaging. This retrospective IRB-approved, HIPAA-compliant study included consecutive patients who underwent DECT of the abdomen in the Emergency Department during a 30-month period (July 1, 2013-December 31, 2015), with a comparison US or MR within 1-year. 51 patients (36F, 15M; mean age 52 years) fulfilled the inclusion criteria. All DECT were acquired on a dual-source 128 × 2 slice scanner using either 80/Sn140 or 100/Sn140 kVp pairs. Source images at high and low kVp were used for DE post-processing with VMI. Within 3 mm reconstructed images, regions of interest of 0.5 cm 2 were placed on noncalcified gallstones and bile to record hounsfield units (HU) at VMI energy levels ranging between 40 and 190 keV. Noncalcified gallstones uniformly demonstrated lowest HU at 40 keV and increase at higher keV; the HU of bile varied at higher keV. Few of the noncalcified stones are visible at 70 keV (simulating a conventional 120 kVp scan), with measured contrast (bile-stone HU difference) <10 HU in 78%, 10-20 HU in 20%, and >20 HU in 2%. Contrast was maximal at 40 keV, where 100% demonstrated >20 HU difference from surrounding bile, 75% >44 HU difference, and 50% >60 HU difference. A paired t test demonstrated a significant difference (p < 0.0001) between this stone-bile contrast at 40 vs. 70 keV and 70 vs. 190 keV. Low keV virtual monochromatic imaging increased conspicuity of noncalcified gallstones, improving their detectability.

Xenon-enhanced CT using subtraction CT: Basic and preliminary clinical studies for comparison of its efficacy with that of dual-energy CT and ventilation SPECT/CT to assess regional ventilation and pulmonary functional loss in smokers.

PubMed

Ohno, Yoshiharu; Yoshikawa, Takeshi; Takenaka, Daisuke; Fujisawa, Yasuko; Sugihara, Naoki; Kishida, Yuji; Seki, Shinichiro; Koyama, Hisanobu; Sugimura, Kazuro

2017-01-01

To prospectively and directly compare the capability for assessments of regional ventilation and pulmonary functional loss in smokers of xenon-ventilation CT obtained with the dual-energy CT (DE-CT) and subtraction CT (Sub-CT) MATERIALS AND METHODS: Twenty-three consecutive smokers (15 men and 8 women, mean age: 69.7±8.7years) underwent prospective unenhanced and xenon-enhanced CTs, the latter by Sub-CT and DE-CT methods, ventilation SPECT and pulmonary function tests. Sub-CT was generated from unenhanced and xenon-enhanced CT, and all co-registered SPECT/CT data were produced from SPECT and unenhanced CT data. For each method, regional ventilation was assessed by using a 11-point scoring system on a per-lobe basis. To determine the functional lung volume by each method, it was also calculated for individual sublets with a previously reported method. To determine inter-observer agreement for each method, ventilation defect assessment was evaluated by using the χ2 test with weighted kappa statistics. For evaluation of the efficacy of each method for pulmonary functional loss assessment, functional lung volume was correlated with%FEV 1 . Each inter-observer agreement was rated as substantial (Sub-CT: κ=0.69, p<0.0001; DE-CT: κ=0.64, p<0.0001; SPECT/CT: κ=0.64, p<0.0001). Functional lung volume for each method showed significant to good correlation with%FEV 1 (Sub-CT: r=0.72, p=0.0001; DE-CT: r=0.74, p<0.0001; SPECT/CT: r=0.66, p=0.0006). Xenon-enhanced CT obtained by Sub-CT can be considered at least as efficacious as that obtained by DE-CT and SPECT/CT for assessment of ventilation abnormality and pulmonary functional loss in smokers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Recent Advances in Cardiac Computed Tomography: Dual Energy, Spectral and Molecular CT Imaging

PubMed Central

Danad, Ibrahim; Fayad, Zahi A.; Willemink, Martin J.; Min, James K.

2015-01-01

Computed tomography (CT) evolved into a powerful diagnostic tool and it is impossible to imagine current clinical practice without CT imaging. Due to its widespread availability, ease of clinical application, superb sensitivity for detection of CAD, and non-invasive nature, CT has become a valuable tool within the armamentarium of the cardiologist. In the last few years, numerous technological advances in CT have occurred—including dual energy CT (DECT), spectral CT and CT-based molecular imaging. By harnessing the advances in technology, cardiac CT has advanced beyond the mere evaluation of coronary stenosis to an imaging modality tool that permits accurate plaque characterization, assessment of myocardial perfusion and even probing of molecular processes that are involved in coronary atherosclerosis. Novel innovations in CT contrast agents and pre-clinical spectral CT devices have paved the way for CT-based molecular imaging. PMID:26068288

Dual-energy computed tomography of the head: a phantom study assessing axial dose distribution, eye lens dose, and image noise level

NASA Astrophysics Data System (ADS)

Matsubara, Kosuke; Kawashima, Hiroki; Hamaguchi, Takashi; Takata, Tadanori; Kobayashi, Masanao; Ichikawa, Katsuhiro; Koshida, Kichiro

2016-03-01

The aim of this study was to propose a calibration method for small dosimeters to measure absorbed doses during dual- source dual-energy computed tomography (DECT) and to compare the axial dose distribution, eye lens dose, and image noise level between DE and standard, single-energy (SE) head CT angiography. Three DE (100/Sn140 kVp 80/Sn140 kVp, and 140/80 kVp) and one SE (120 kVp) acquisitions were performed using a second-generation dual-source CT device and a female head phantom, with an equivalent volumetric CT dose index. The axial absorbed dose distribution at the orbital level and the absorbed doses for the eye lens were measured using radiophotoluminescent glass dosimeters. CT attenuation numbers were obtained in the DE composite images and the SE images of the phantom at the orbital level. The doses absorbed at the orbital level and in the eye lens were lower and standard deviations for the CT attenuation numbers were slightly higher in the DE acquisitions than those in the SE acquisition. The anterior surface dose was especially higher in the SE acquisition than that in the DE acquisitions. Thus, DE head CT angiography can be performed with a radiation dose lower than that required for a standard SE head CT angiography, with a slight increase in the image noise level. The 100/Sn140 kVp acquisition revealed the most balanced axial dose distribution. In addition, our proposed method was effective for calibrating small dosimeters to measure absorbed doses in DECT.

TU-FG-BRB-03: Basis Vector Model Based Method for Proton Stopping Power Estimation From Experimental Dual Energy CT Data

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

Zhang, S; Politte, D; O’Sullivan, J

2016-06-15

Purpose: This work aims at reducing the uncertainty in proton stopping power (SP) estimation by a novel combination of a linear, separable basis vector model (BVM) for stopping power calculation (Med Phys 43:600) and a statistical, model-based dual-energy CT (DECT) image reconstruction algorithm (TMI 35:685). The method was applied to experimental data. Methods: BVM assumes the photon attenuation coefficients, electron densities, and mean excitation energies (I-values) of unknown materials can be approximated by a combination of the corresponding quantities of two reference materials. The DECT projection data for a phantom with 5 different known materials was collected on a Philipsmore » Brilliance scanner using two scans at 90 kVp and 140 kVp. The line integral alternating minimization (LIAM) algorithm was used to recover the two BVM coefficient images using the measured source spectra. The proton stopping powers are then estimated from the Bethe-Bloch equation using electron densities and I-values derived from the BVM coefficients. The proton stopping powers and proton ranges for the phantom materials estimated via our BVM based DECT method are compared to ICRU reference values and a post-processing DECT analysis (Yang PMB 55:1343) applied to vendorreconstructed images using the Torikoshi parametric fit model (tPFM). Results: For the phantom materials, the average stopping power estimations for 175 MeV protons derived from our method are within 1% of the ICRU reference values (except for Teflon with a 1.48% error), with an average standard deviation of 0.46% over pixels. The resultant proton ranges agree with the reference values within 2 mm. Conclusion: Our principled DECT iterative reconstruction algorithm, incorporating optimal beam hardening and scatter corrections, in conjunction with a simple linear BVM model, achieves more accurate and robust proton stopping power maps than the post-processing, nonlinear tPFM based DECT analysis applied to conventional reconstructions of low and high energy scans. Funding Support: NIH R01CA 75371; NCI grant R01 CA 149305.« less

Statistical image-domain multimaterial decomposition for dual-energy CT.

PubMed

Xue, Yi; Ruan, Ruoshui; Hu, Xiuhua; Kuang, Yu; Wang, Jing; Long, Yong; Niu, Tianye

2017-03-01

Dual-energy CT (DECT) enhances tissue characterization because of its basis material decomposition capability. In addition to conventional two-material decomposition from DECT measurements, multimaterial decomposition (MMD) is required in many clinical applications. To solve the ill-posed problem of reconstructing multi-material images from dual-energy measurements, additional constraints are incorporated into the formulation, including volume and mass conservation and the assumptions that there are at most three materials in each pixel and various material types among pixels. The recently proposed flexible image-domain MMD method decomposes pixels sequentially into multiple basis materials using a direct inversion scheme which leads to magnified noise in the material images. In this paper, we propose a statistical image-domain MMD method for DECT to suppress the noise. The proposed method applies penalized weighted least-square (PWLS) reconstruction with a negative log-likelihood term and edge-preserving regularization for each material. The statistical weight is determined by a data-based method accounting for the noise variance of high- and low-energy CT images. We apply the optimization transfer principles to design a serial of pixel-wise separable quadratic surrogates (PWSQS) functions which monotonically decrease the cost function. The separability in each pixel enables the simultaneous update of all pixels. The proposed method is evaluated on a digital phantom, Catphan©600 phantom and three patients (pelvis, head, and thigh). We also implement the direct inversion and low-pass filtration methods for a comparison purpose. Compared with the direct inversion method, the proposed method reduces noise standard deviation (STD) in soft tissue by 95.35% in the digital phantom study, by 88.01% in the Catphan©600 phantom study, by 92.45% in the pelvis patient study, by 60.21% in the head patient study, and by 81.22% in the thigh patient study, respectively. The overall volume fraction accuracy is improved by around 6.85%. Compared with the low-pass filtration method, the root-mean-square percentage error (RMSE(%)) of electron densities in the Catphan©600 phantom is decreased by 20.89%. As modulation transfer function (MTF) magnitude decreased to 50%, the proposed method increases the spatial resolution by an overall factor of 1.64 on the digital phantom, and 2.16 on the Catphan©600 phantom. The overall volume fraction accuracy is increased by 6.15%. We proposed a statistical image-domain MMD method using DECT measurements. The method successfully suppresses the magnified noise while faithfully retaining the quantification accuracy and anatomical structure in the decomposed material images. The proposed method is practical and promising for advanced clinical applications using DECT imaging. © 2017 American Association of Physicists in Medicine.

Image quality improvements using adaptive statistical iterative reconstruction for evaluating chronic myocardial infarction using iodine density images with spectral CT.

PubMed

Kishimoto, Junichi; Ohta, Yasutoshi; Kitao, Shinichiro; Watanabe, Tomomi; Ogawa, Toshihide

2018-04-01

Single-source dual-energy CT (ssDECT) allows the reconstruction of iodine density images (IDIs) from projection based computing. We hypothesized that adding adaptive statistical iterative reconstruction (ASiR) could improve image quality. The aim of our study was to evaluate the effect and determine the optimal blend percentages of ASiR for IDI of myocardial late iodine enhancement (LIE) in the evaluation of chronic myocardial infarction using ssDECT. A total of 28 patients underwent cardiac LIE using a ssDECT scanner. IDIs between 0 and 100% of ASiR contributions in 10% increments were reconstructed. The signal-to-noise ratio (SNR) of remote myocardia and the contrast-to-noise ratio (CNR) of infarcted myocardia were measured. Transmural extent of infarction was graded using a 5-point scale. The SNR, CNR, and transmural extent were assessed for each ASiR contribution ratio. The transmural extents were compared with MRI as a reference standard. Compared to 0% ASiR, the use of 20-100% ASiR resulted in a reduction of image noise (p < 0.01) without significant differences in the signal. Compared with 0% ASiR images, reconstruction with 100% ASiR image showed the highest improvement in SNR (229%; p < 0.001) and CNR (199%; p < 0.001). ASiR above 80% showed the highest ratio (73.7%) of accurate transmural extent classification. In conclusion, ASiR intensity of 80-100% in IDIs can improve image quality without changes in signal and maximizes the accuracy of transmural extent in infarcted myocardium.

MO-FG-204-01: Improved Noise Suppression for Dual-Energy CT Through Entropy Minimization

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

Petrongolo, M; Zhu, L

2015-06-15

Purpose: In dual energy CT (DECT), noise amplification during signal decomposition significantly limits the utility of basis material images. Since clinically relevant objects contain a limited number of materials, we propose to suppress noise for DECT based on image entropy minimization. An adaptive weighting scheme is employed during noise suppression to improve decomposition accuracy with limited effect on spatial resolution and image texture preservation. Methods: From decomposed images, we first generate a 2D plot of scattered data points, using basis material densities as coordinates. Data points representing the same material generate a highly asymmetric cluster. We orient an axis bymore » minimizing the entropy in a 1D histogram of these points projected onto the axis. To suppress noise, we replace pixel values of decomposed images with center-of-mass values in the direction perpendicular to the optimal axis. To limit errors due to cluster overlap, we weight each data point’s contribution based on its high and low energy CT values and location within the image. The proposed method’s performance is assessed on physical phantom studies. Electron density is used as the quality metric for decomposition accuracy. Our results are compared to those without noise suppression and with a recently developed iterative method. Results: The proposed method reduces noise standard deviations of the decomposed images by at least one order of magnitude. On the Catphan phantom, this method greatly preserves the spatial resolution and texture of the CT images and limits induced error in measured electron density to below 1.2%. In the head phantom study, the proposed method performs the best in retaining fine, intricate structures. Conclusion: The entropy minimization based algorithm with adaptive weighting substantially reduces DECT noise while preserving image spatial resolution and texture. Future investigations will include extensive investigations on material decomposition accuracy that go beyond the current electron density calculations. This work was supported in part by the National Institutes of Health (NIH) under Grant Number R21 EB012700.« less

Dual-energy bone removal computed tomography (BRCT): preliminary report of efficacy of acute intracranial hemorrhage detection.

PubMed

Naruto, Norihito; Tannai, Hidenori; Nishikawa, Kazuma; Yamagishi, Kentaro; Hashimoto, Masahiko; Kawabe, Hideto; Kamisaki, Yuichi; Sumiya, Hisashi; Kuroda, Satoshi; Noguchi, Kyo

2018-02-01

One of the major applications of dual-energy computed tomography (DECT) is automated bone removal (BR). We hypothesized that the visualization of acute intracranial hemorrhage could be improved on BRCT by removing bone as it has the highest density tissue in the head. This preliminary study evaluated the efficacy of a DE BR algorithm for the head CT of trauma patients. Sixteen patients with acute intracranial hemorrhage within 1 day after head trauma were enrolled in this study. All CT examinations were performed on a dual-source dual-energy CT scanner. BRCT images were generated using the Bone Removal Application. Simulated standard CT and BRCT images were visually reviewed in terms of detectability (presence or absence) of acute hemorrhagic lesions. DECT depicted 28 epidural/subdural hemorrhages, 17 contusional hemorrhages, and 7 subarachnoid hemorrhages. In detecting epidural/subdural hemorrhage, BRCT [28/28 (100%)] was significantly superior to simulated standard CT [17/28 (61%)] (p = .001). In detecting contusional hemorrhage, BRCT [17/17 (100%)] was also significantly superior to simulated standard CT [11/17 (65%)] (p = .0092). BRCT was superior to simulated standard CT in detecting acute intracranial hemorrhage. BRCT could improve the detection of small intracranial hemorrhages, particularly those adjacent to bone, by removing bone that can interfere with the visualization of small acute hemorrhage. In an emergency such as head trauma, BRCT can be used as support imaging in combination with simulated standard CT and bone scale CT, although BRCT cannot replace a simulated standard CT.

A linear, separable two-parameter model for dual energy CT imaging of proton stopping power computation

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

Han, Dong, E-mail: radon.han@gmail.com; Williamson, Jeffrey F.; Siebers, Jeffrey V.

2016-01-15

Purpose: To evaluate the accuracy and robustness of a simple, linear, separable, two-parameter model (basis vector model, BVM) in mapping proton stopping powers via dual energy computed tomography (DECT) imaging. Methods: The BVM assumes that photon cross sections (attenuation coefficients) of unknown materials are linear combinations of the corresponding radiological quantities of dissimilar basis substances (i.e., polystyrene, CaCl{sub 2} aqueous solution, and water). The authors have extended this approach to the estimation of electron density and mean excitation energy, which are required parameters for computing proton stopping powers via the Bethe–Bloch equation. The authors compared the stopping power estimation accuracymore » of the BVM with that of a nonlinear, nonseparable photon cross section Torikoshi parametric fit model (VCU tPFM) as implemented by the authors and by Yang et al. [“Theoretical variance analysis of single- and dual-energy computed tomography methods for calculating proton stopping power ratios of biological tissues,” Phys. Med. Biol. 55, 1343–1362 (2010)]. Using an idealized monoenergetic DECT imaging model, proton ranges estimated by the BVM, VCU tPFM, and Yang tPFM were compared to International Commission on Radiation Units and Measurements (ICRU) published reference values. The robustness of the stopping power prediction accuracy of tissue composition variations was assessed for both of the BVM and VCU tPFM. The sensitivity of accuracy to CT image uncertainty was also evaluated. Results: Based on the authors’ idealized, error-free DECT imaging model, the root-mean-square error of BVM proton stopping power estimation for 175 MeV protons relative to ICRU reference values for 34 ICRU standard tissues is 0.20%, compared to 0.23% and 0.68% for the Yang and VCU tPFM models, respectively. The range estimation errors were less than 1 mm for the BVM and Yang tPFM models, respectively. The BVM estimation accuracy is not dependent on tissue type and proton energy range. The BVM is slightly more vulnerable to CT image intensity uncertainties than the tPFM models. Both the BVM and tPFM prediction accuracies were robust to uncertainties of tissue composition and independent of the choice of reference values. This reported accuracy does not include the impacts of I-value uncertainties and imaging artifacts and may not be achievable on current clinical CT scanners. Conclusions: The proton stopping power estimation accuracy of the proposed linear, separable BVM model is comparable to or better than that of the nonseparable tPFM models proposed by other groups. In contrast to the tPFM, the BVM does not require an iterative solving for effective atomic number and electron density at every voxel; this improves the computational efficiency of DECT imaging when iterative, model-based image reconstruction algorithms are used to minimize noise and systematic imaging artifacts of CT images.« less

Personalized assessment of radiation risks from the one-stop-shop myocardial 256-slice CT examination.

PubMed

Perisinakis, Kostas; Seimenis, Ioannis; Tzedakis, Antonis; Pagonidis, Kostas; Papadakis, Antonios E; Damilakis, John

2013-10-15

This study provides data on the cumulative life attributable risk (LAR) of radiation-induced cancer from the combination of coronary CT angiography (CCTA), dynamic CT perfusion (CTP) and delayed enhancement (DE) CT scans, required for reliable risk-benefit analysis of the one-stop-shop CCTA + CTP + DECT cardiac examination. Monte Carlo simulation of the dynamic CTP and DECT exposures on 62 adult individuals was employed to determine radiation absorbed dose to exposed radiosensitive organs. Corresponding data for CCTA were derived using patient chest circumference and previously published data. Individual-specific LARs of cancer were estimated using organ/tissue-specific radiogenic cancer risk factors. Total LAR from CCTA + CTP + DECT scans' sequence were estimated and compared to nominal intrinsic risk of cancer. The main contribution, up to 80%, to cumulative radiation burden from CCTA + CTP + DECT scan-sequence was found to originate from the CTP scan. The total LAR from CCTA + CTP + DECT for females was found 4-6 times higher, compared to males. The mean cumulative risk of radiogenic cancer associated with the complete CCTA + CTP + DECT scan sequence was found to marginally increase the intrinsic risk for cancer induction by less than 0.6% and 0.1% for females and males, respectively. The radiation risk from the 256-slice CCTA + CTP + DECT scan sequence may be considered low and should not constitute an obstacle for the clinical endorsement of the one-stop-shop cardiac CT examination, given that its clinical value has been well verified. Nevertheless, every effort should be made towards optimization of the dynamic CTP component which is the main contributor to patient radiation burden. © 2013.

Empirical dual energy calibration (EDEC) for cone-beam computed tomography.

PubMed

Stenner, Philip; Berkus, Timo; Kachelriess, Marc

2007-09-01

Material-selective imaging using dual energy CT (DECT) relies heavily on well-calibrated material decomposition functions. These require the precise knowledge of the detected x-ray spectra, and even if they are exactly known the reliability of DECT will suffer from scattered radiation. We propose an empirical method to determine the proper decomposition function. In contrast to other decomposition algorithms our empirical dual energy calibration (EDEC) technique requires neither knowledge of the spectra nor of the attenuation coefficients. The desired material-selective raw data p1 and p2 are obtained as functions of the measured attenuation data q1 and q2 (one DECT scan = two raw data sets) by passing them through a polynomial function. The polynomial's coefficients are determined using a general least squares fit based on thresholded images of a calibration phantom. The calibration phantom's dimension should be of the same order of magnitude as the test object, but other than that no assumptions on its exact size or positioning are made. Once the decomposition coefficients are determined DECT raw data can be decomposed by simply passing them through the polynomial. To demonstrate EDEC simulations of an oval CTDI phantom, a lung phantom, a thorax phantom and a mouse phantom were carried out. The method was further verified by measuring a physical mouse phantom, a half-and-half-cylinder phantom and a Yin-Yang phantom with a dedicated in vivo dual source micro-CT scanner. The raw data were decomposed into their components, reconstructed, and the pixel values obtained were compared to the theoretical values. The determination of the calibration coefficients with EDEC is very robust and depends only slightly on the type of calibration phantom used. The images of the test phantoms (simulations and measurements) show a nearly perfect agreement with the theoretical micro values and density values. Since EDEC is an empirical technique it inherently compensates for scatter components. The empirical dual energy calibration technique is a pragmatic, simple, and reliable calibration approach that produces highly quantitative DECT images.

Deriving concentrations of oxygen and carbon in human tissues using single- and dual-energy CT for ion therapy applications

NASA Astrophysics Data System (ADS)

Landry, Guillaume; Parodi, Katia; Wildberger, Joachim E.; Verhaegen, Frank

2013-08-01

Dedicated methods of in-vivo verification of ion treatment based on the detection of secondary emitted radiation, such as positron-emission-tomography and prompt gamma detection require high accuracy in the assignment of the elemental composition. This especially concerns the content in carbon and oxygen, which are the most abundant elements of human tissue. The standard single-energy computed tomography (SECT) approach to carbon and oxygen concentration determination has been shown to introduce significant discrepancies in the carbon and oxygen content of tissues. We propose a dual-energy CT (DECT)-based approach for carbon and oxygen content assignment and investigate the accuracy gains of the method. SECT and DECT Hounsfield units (HU) were calculated using the stoichiometric calibration procedure for a comprehensive set of human tissues. Fit parameters for the stoichiometric calibration were obtained from phantom scans. Gaussian distributions with standard deviations equal to those derived from phantom scans were subsequently generated for each tissue for several values of the computed tomography dose index (CTDIvol). The assignment of %weight carbon and oxygen (%wC,%wO) was performed based on SECT and DECT. The SECT scheme employed a HU versus %wC,O approach while for DECT we explored a Zeff versus %wC,O approach and a (Zeff, ρe) space approach. The accuracy of each scheme was estimated by calculating the root mean square (RMS) error on %wC,O derived from the input Gaussian distribution of HU for each tissue and also for the noiseless case as a limiting case. The (Zeff, ρe) space approach was also compared to SECT by comparing RMS error for hydrogen and nitrogen (%wH,%wN). Systematic shifts were applied to the tissue HU distributions to assess the robustness of the method against systematic uncertainties in the stoichiometric calibration procedure. In the absence of noise the (Zeff, ρe) space approach showed more accurate %wC,O assignment (largest error of 2%) than the Zeff versus %wC,O and HU versus %wC,O approaches (largest errors of 15% and 30%, respectively). When noise was present, the accuracy of the (Zeff, ρe) space (DECT approach) was decreased but the RMS error over all tissues was lower than the HU versus %wC,O (SECT approach) (5.8%wC versus 7.5%wC at CTDIvol = 20 mGy). The DECT approach showed decreasing RMS error with decreasing image noise (or increasing CTDIvol). At CTDIvol = 80 mGy the RMS error over all tissues was 3.7% for DECT and 6.2% for SECT approaches. However, systematic shifts greater than ±5HU undermined the accuracy gains afforded by DECT at any dose level. DECT provides more accurate %wC,O assignment than SECT when imaging noise and systematic uncertainties in HU values are not considered. The presence of imaging noise degrades the DECT accuracy on %wC,O assignment but it remains superior to SECT. However, DECT was found to be sensitive to systematic shifts of human tissue HU.

Predictive value of low tube voltage and dual-energy CT for successful shock wave lithotripsy: an in vitro study.

PubMed

Largo, Remo; Stolzmann, Paul; Fankhauser, Christian D; Poyet, Cédric; Wolfsgruber, Pirmin; Sulser, Tullio; Alkadhi, Hatem; Winklhofer, Sebastian

2016-06-01

This study investigates the capabilities of low tube voltage computed tomography (CT) and dual-energy CT (DECT) for predicting successful shock wave lithotripsy (SWL) of urinary stones in vitro. A total of 33 urinary calculi (six different chemical compositions; mean size 6 ± 3 mm) were scanned using a dual-source CT machine with single- (120 kVp) and dual-energy settings (80/150, 100/150 Sn kVp) resulting in six different datasets. The attenuation (Hounsfield Units) of calculi was measured on single-energy CT images and the dual-energy indices (DEIs) were calculated from DECT acquisitions. Calculi underwent SWL and the number of shock waves for successful disintegration was recorded. The prediction of required shock waves regarding stone attenuation/DEI was calculated using regression analysis (adjusted for stone size and composition) and the correlation between CT attenuation/DEI and the number of shock waves was assessed for all datasets. The median number of shock waves for successful stone disintegration was 72 (interquartile range 30-361). CT attenuation/DEI of stones was a significant, independent predictor (P < 0.01) for the number of required shock waves with the best prediction at 80 kVp (β estimate 0.576) (P < 0.05). Correlation coefficients between attenuation/DEI and the number of required shock waves ranged between ρ = 0.31 and 0.68 showing the best correlation at 80 kVp (P < 0.001). The attenuation of urinary stones at low tube voltage CT is the best predictor for successful stone disintegration, being independent of stone composition and size. DECT shows no added value for predicting the success of SWL.

Learning-Based Object Identification and Segmentation Using Dual-Energy CT Images for Security.

PubMed

Martin, Limor; Tuysuzoglu, Ahmet; Karl, W Clem; Ishwar, Prakash

2015-11-01

In recent years, baggage screening at airports has included the use of dual-energy X-ray computed tomography (DECT), an advanced technology for nondestructive evaluation. The main challenge remains to reliably find and identify threat objects in the bag from DECT data. This task is particularly hard due to the wide variety of objects, the high clutter, and the presence of metal, which causes streaks and shading in the scanner images. Image noise and artifacts are generally much more severe than in medical CT and can lead to splitting of objects and inaccurate object labeling. The conventional approach performs object segmentation and material identification in two decoupled processes. Dual-energy information is typically not used for the segmentation, and object localization is not explicitly used to stabilize the material parameter estimates. We propose a novel learning-based framework for joint segmentation and identification of objects directly from volumetric DECT images, which is robust to streaks, noise and variability due to clutter. We focus on segmenting and identifying a small set of objects of interest with characteristics that are learned from training images, and consider everything else as background. We include data weighting to mitigate metal artifacts and incorporate an object boundary field to reduce object splitting. The overall formulation is posed as a multilabel discrete optimization problem and solved using an efficient graph-cut algorithm. We test the method on real data and show its potential for producing accurate labels of the objects of interest without splits in the presence of metal and clutter.

Noise suppression for dual-energy CT via penalized weighted least-square optimization with similarity-based regularization

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

Harms, Joseph; Wang, Tonghe; Petrongolo, Michael

Purpose: Dual-energy CT (DECT) expands applications of CT imaging in its capability to decompose CT images into material images. However, decomposition via direct matrix inversion leads to large noise amplification and limits quantitative use of DECT. Their group has previously developed a noise suppression algorithm via penalized weighted least-square optimization with edge-preservation regularization (PWLS-EPR). In this paper, the authors improve method performance using the same framework of penalized weighted least-square optimization but with similarity-based regularization (PWLS-SBR), which substantially enhances the quality of decomposed images by retaining a more uniform noise power spectrum (NPS). Methods: The design of PWLS-SBR is basedmore » on the fact that averaging pixels of similar materials gives a low-noise image. For each pixel, the authors calculate the similarity to other pixels in its neighborhood by comparing CT values. Using an empirical Gaussian model, the authors assign high/low similarity value to one neighboring pixel if its CT value is close/far to the CT value of the pixel of interest. These similarity values are organized in matrix form, such that multiplication of the similarity matrix to the image vector reduces image noise. The similarity matrices are calculated on both high- and low-energy CT images and averaged. In PWLS-SBR, the authors include a regularization term to minimize the L-2 norm of the difference between the images without and with noise suppression via similarity matrix multiplication. By using all pixel information of the initial CT images rather than just those lying on or near edges, PWLS-SBR is superior to the previously developed PWLS-EPR, as supported by comparison studies on phantoms and a head-and-neck patient. Results: On the line-pair slice of the Catphan{sup ©}600 phantom, PWLS-SBR outperforms PWLS-EPR and retains spatial resolution of 8 lp/cm, comparable to the original CT images, even at 90% reduction in noise standard deviation (STD). Similar performance on spatial resolution is observed on an anthropomorphic head phantom. In addition, results of PWLS-SBR show substantially improved image quality due to preservation of image NPS. On the Catphan{sup ©}600 phantom, NPS using PWLS-SBR has a correlation of 93% with that via direct matrix inversion, while the correlation drops to −52% for PWLS-EPR. Electron density measurement studies indicate high accuracy of PWLS-SBR. On seven different materials, the measured electron densities calculated from the decomposed material images using PWLS-SBR have a root-mean-square error (RMSE) of 1.20%, while the results of PWLS-EPR have a RMSE of 2.21%. In the study on a head-and-neck patient, PWLS-SBR is shown to reduce noise STD by a factor of 3 on material images with image qualities comparable to CT images, whereas fine structures are lost in the PWLS-EPR result. Additionally, PWLS-SBR better preserves low contrast on the tissue image. Conclusions: The authors propose improvements to the regularization term of an optimization framework which performs iterative image-domain decomposition for DECT with noise suppression. The regularization term avoids calculation of image gradient and is based on pixel similarity. The proposed method not only achieves a high decomposition accuracy, but also improves over the previous algorithm on NPS as well as spatial resolution.« less

Noise suppression for dual-energy CT via penalized weighted least-square optimization with similarity-based regularization

PubMed Central

Harms, Joseph; Wang, Tonghe; Petrongolo, Michael; Niu, Tianye; Zhu, Lei

2016-01-01

Purpose: Dual-energy CT (DECT) expands applications of CT imaging in its capability to decompose CT images into material images. However, decomposition via direct matrix inversion leads to large noise amplification and limits quantitative use of DECT. Their group has previously developed a noise suppression algorithm via penalized weighted least-square optimization with edge-preservation regularization (PWLS-EPR). In this paper, the authors improve method performance using the same framework of penalized weighted least-square optimization but with similarity-based regularization (PWLS-SBR), which substantially enhances the quality of decomposed images by retaining a more uniform noise power spectrum (NPS). Methods: The design of PWLS-SBR is based on the fact that averaging pixels of similar materials gives a low-noise image. For each pixel, the authors calculate the similarity to other pixels in its neighborhood by comparing CT values. Using an empirical Gaussian model, the authors assign high/low similarity value to one neighboring pixel if its CT value is close/far to the CT value of the pixel of interest. These similarity values are organized in matrix form, such that multiplication of the similarity matrix to the image vector reduces image noise. The similarity matrices are calculated on both high- and low-energy CT images and averaged. In PWLS-SBR, the authors include a regularization term to minimize the L-2 norm of the difference between the images without and with noise suppression via similarity matrix multiplication. By using all pixel information of the initial CT images rather than just those lying on or near edges, PWLS-SBR is superior to the previously developed PWLS-EPR, as supported by comparison studies on phantoms and a head-and-neck patient. Results: On the line-pair slice of the Catphan©600 phantom, PWLS-SBR outperforms PWLS-EPR and retains spatial resolution of 8 lp/cm, comparable to the original CT images, even at 90% reduction in noise standard deviation (STD). Similar performance on spatial resolution is observed on an anthropomorphic head phantom. In addition, results of PWLS-SBR show substantially improved image quality due to preservation of image NPS. On the Catphan©600 phantom, NPS using PWLS-SBR has a correlation of 93% with that via direct matrix inversion, while the correlation drops to −52% for PWLS-EPR. Electron density measurement studies indicate high accuracy of PWLS-SBR. On seven different materials, the measured electron densities calculated from the decomposed material images using PWLS-SBR have a root-mean-square error (RMSE) of 1.20%, while the results of PWLS-EPR have a RMSE of 2.21%. In the study on a head-and-neck patient, PWLS-SBR is shown to reduce noise STD by a factor of 3 on material images with image qualities comparable to CT images, whereas fine structures are lost in the PWLS-EPR result. Additionally, PWLS-SBR better preserves low contrast on the tissue image. Conclusions: The authors propose improvements to the regularization term of an optimization framework which performs iterative image-domain decomposition for DECT with noise suppression. The regularization term avoids calculation of image gradient and is based on pixel similarity. The proposed method not only achieves a high decomposition accuracy, but also improves over the previous algorithm on NPS as well as spatial resolution. PMID:27147376

Detection of different kidney stone types: an ex vivo comparison of ultrashort echo time MRI to reference standard CT.

PubMed

Ibrahim, El-Sayed H; Cernigliaro, Joseph G; Pooley, Robert A; Bridges, Mellena D; Giesbrandt, Jamie G; Williams, James C; Haley, William E

2016-01-01

With the development of ultrashort echo time (UTE) sequences, it may now be possible to detect kidney stones by using magnetic resonance imaging (MRI). In this study, kidney stones of varying composition and sizes were imaged using both UTE MRI as well as the reference standard of computed tomography (CT), with different surrounding materials and scan setups. One hundred and fourteen kidney stones were inserted into agarose and urine phantoms and imaged both on a dual-energy CT (DECT) scanner using a standard renal stone imaging protocol and on an MRI scanner using the UTE sequence with both head and body surface coils. A subset of the stones representing all composition types and sizes was then inserted into the collecting system of porcine kidneys and imaged in vitro with both CT and MRI. All of the stones were visible on both CT and MRI imaging. DECT was capable of differentiating between uric acid and nonuric acid stones. In MRI imaging, the choice of coil and large field of view (FOV) did not affect stone detection or image quality. The MRI images showed good visualization of the stones' shapes, and the stones' dimensions measured from MRI were in good agreement with the actual values (R(2)=0.886, 0.895, and 0.81 in the agarose phantom, urine phantom, and pig kidneys, respectively). The measured T2 relaxation times ranged from 4.2 to 7.5ms, but did not show significant differences among different stone composition types. UTE MRI compared favorably with the reference standard CT for imaging stones of different composition types and sizes using body surface coil and large FOV, which suggests potential usefulness of UTE MRI in imaging kidney stones in vivo. Copyright © 2015 Elsevier Inc. All rights reserved.

Virtual non-contrast in second-generation, dual-energy computed tomography: reliability of attenuation values.

PubMed

Toepker, Michael; Moritz, Thomas; Krauss, Bernhard; Weber, Michael; Euller, Gordon; Mang, Thomas; Wolf, Florian; Herold, Christian J; Ringl, Helmut

2012-03-01

To evaluate the reliability of attenuation values in virtual non-contrast images (VNC) reconstructed from contrast-enhanced, dual-energy scans performed on a second-generation dual-energy CT scanner, compared to single-energy, non-contrast images (TNC). Sixteen phantoms containing a mixture of contrast agent and water at different attenuations (0-1400 HU) were investigated on a Definition Flash-CT scanner using a single-energy scan at 120 kV and a DE-CT protocol (100 kV/SN140 kV). For clinical assessment, 86 patients who received a dual-phase CT, containing an unenhanced single-energy scan at 120 kV and a contrast enhanced (110 ml Iomeron 400 mg/ml; 4 ml/s) DE-CT (100 kV/SN140 kV) in an arterial (n=43) or a venous phase, were retrospectively analyzed. Mean attenuation was measured within regions of interest of the phantoms and in different tissue types of the patients within the corresponding VNC and TNC images. Paired t-tests and Pearson correlation were used for statistical analysis. For all phantoms, mean attenuation in VNC was 5.3±18.4 HU, with respect to water. In 86 patients overall, 2637 regions were measured in TNC and VNC images, with a mean difference between TNC and VNC of -3.6±8.3 HU. In 91.5% (n=2412) of all cases, absolute differences between TNC and VNC were under 15HU, and, in 75.3% (n=1986), differences were under 10 HU. Second-generation dual-energy CT based VNC images provide attenuation values close to those of TNC. To avoid possible outliers multiple measurements are recommended especially for measurements in the spleen, the mesenteric fat, and the aorta. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Effect of a Noise-Optimized Second-Generation Monoenergetic Algorithm on Image Noise and Conspicuity of Hypervascular Liver Tumors: An In Vitro and In Vivo Study.

PubMed

Marin, Daniele; Ramirez-Giraldo, Juan Carlos; Gupta, Sonia; Fu, Wanyi; Stinnett, Sandra S; Mileto, Achille; Bellini, Davide; Patel, Bhavik; Samei, Ehsan; Nelson, Rendon C

2016-06-01

The purpose of this study is to investigate whether the reduction in noise using a second-generation monoenergetic algorithm can improve the conspicuity of hypervascular liver tumors on dual-energy CT (DECT) images of the liver. An anthropomorphic liver phantom in three body sizes and iodine-containing inserts simulating hypervascular lesions was imaged with DECT and single-energy CT at various energy levels (80-140 kV). In addition, a retrospective clinical study was performed in 31 patients with 66 hypervascular liver tumors who underwent DECT during the late hepatic arterial phase. Datasets at energy levels ranging from 40 to 80 keV were reconstructed using first- and second-generation monoenergetic algorithms. Noise, tumor-to-liver contrast-to-noise ratio (CNR), and CNR with a noise constraint (CNRNC) set with a maximum noise increase of 50% were calculated and compared among the different reconstructed datasets. The maximum CNR for the second-generation monoenergetic algorithm, which was attained at 40 keV in both phantom and clinical datasets, was statistically significantly higher than the maximum CNR for the first-generation monoenergetic algorithm (p < 0.001) or single-energy CT acquisitions across a wide range of kilovoltage values. With the second-generation monoenergetic algorithm, the optimal CNRNC occurred at 55 keV, corresponding to lower energy levels compared with first-generation algorithm (predominantly at 70 keV). Patient body size did not substantially affect the selection of the optimal energy level to attain maximal CNR and CNRNC using the second-generation monoenergetic algorithm. A noise-optimized second-generation monoenergetic algorithm significantly improves the conspicuity of hypervascular liver tumors.

Methodological accuracy of image-based electron density assessment using dual-energy computed tomography.

PubMed

Möhler, Christian; Wohlfahrt, Patrick; Richter, Christian; Greilich, Steffen

2017-06-01

Electron density is the most important tissue property influencing photon and ion dose distributions in radiotherapy patients. Dual-energy computed tomography (DECT) enables the determination of electron density by combining the information on photon attenuation obtained at two different effective x-ray energy spectra. Most algorithms suggested so far use the CT numbers provided after image reconstruction as input parameters, i.e., are imaged-based. To explore the accuracy that can be achieved with these approaches, we quantify the intrinsic methodological and calibration uncertainty of the seemingly simplest approach. In the studied approach, electron density is calculated with a one-parametric linear superposition ('alpha blending') of the two DECT images, which is shown to be equivalent to an affine relation between the photon attenuation cross sections of the two x-ray energy spectra. We propose to use the latter relation for empirical calibration of the spectrum-dependent blending parameter. For a conclusive assessment of the electron density uncertainty, we chose to isolate the purely methodological uncertainty component from CT-related effects such as noise and beam hardening. Analyzing calculated spectrally weighted attenuation coefficients, we find universal applicability of the investigated approach to arbitrary mixtures of human tissue with an upper limit of the methodological uncertainty component of 0.2%, excluding high-Z elements such as iodine. The proposed calibration procedure is bias-free and straightforward to perform using standard equipment. Testing the calibration on five published data sets, we obtain very small differences in the calibration result in spite of different experimental setups and CT protocols used. Employing a general calibration per scanner type and voltage combination is thus conceivable. Given the high suitability for clinical application of the alpha-blending approach in combination with a very small methodological uncertainty, we conclude that further refinement of image-based DECT-algorithms for electron density assessment is not advisable. © 2017 American Association of Physicists in Medicine.

Differentiation of uric acid versus non-uric acid kidney stones in the presence of iodine using dual-energy CT

NASA Astrophysics Data System (ADS)

Wang, J.; Qu, M.; Leng, S.; McCollough, C. H.

2010-04-01

In this study, the feasibility of differentiating uric acid from non-uric acid kidney stones in the presence of iodinated contrast material was evaluated using dual-energy CT (DECT). Iodine subtraction was accomplished with a commercial three material decomposition algorithm to create a virtual non-contrast (VNC) image set. VNC images were then used to segment stone regions from tissue background. The DE ratio of each stone was calculated using the CT images acquired at two different energies with DECT using the stone map generated from the VNC images. The performance of DE ratio-based stone differentiation was evaluated at five different iodine concentrations (21, 42, 63, 84 and 105 mg/ml). The DE ratio of stones in iodine solution was found larger than those obtained in non-iodine cases. This is mainly caused by the partial volume effect around the boundary between the stone and iodine solution. The overestimation of the DE ratio leads to substantial overlap between different stone types. To address the partial volume effect, an expectation-maximization (EM) approach was implemented to estimate the contribution of iodine and stone within each image pixel in their mixture area. The DE ratio of each stone was corrected to maximally remove the influence of iodine solutions. The separation of uric-acid and non-uric-acid stone was improved in the presence of iodine solution.

Accuracy of Liver Fat Quantification With Advanced CT, MRI, and Ultrasound Techniques: Prospective Comparison With MR Spectroscopy.

PubMed

Kramer, Harald; Pickhardt, Perry J; Kliewer, Mark A; Hernando, Diego; Chen, Guang-Hong; Zagzebski, James A; Reeder, Scott B

2017-01-01

The purpose of this study was to prospectively evaluate the accuracy of proton-density fat-fraction, single- and dual-energy CT (SECT and DECT), gray-scale ultrasound (US), and US shear-wave elastography (US-SWE) in the quantification of hepatic steatosis with MR spectroscopy (MRS) as the reference standard. Fifty adults who did not have symptoms (23 men, 27 women; mean age, 57 ± 5 years; body mass index, 27 ± 5) underwent liver imaging with un-enhanced SECT, DECT, gray-scale US, US-SWE, proton-density fat-fraction MRI, and MRS for this prospective trial. MRS voxels for the reference standard were colocalized with all other modalities under investigation. For SECT (120 kVp), attenuation values were recorded. For rapid-switching DECT (80/140 kVp), monochromatic images (70-140 keV) and fat density-derived material decomposition images were reconstructed. For proton-density fat fraction MRI, a quantitative chemical shift-encoded method was used. For US, echogenicity was evaluated on a qualitative 0-3 scale. Quantitative US shear-wave velocities were also recorded. Data were analyzed by linear regression for each technique compared with MRS. There was excellent correlation between MRS and both proton-density fat-fraction MRI (r 2 = 0.992; slope, 0.974; intercept, -0.943) and SECT (r 2 = 0.856; slope, -0.559; intercept, 35.418). DECT fat attenuation had moderate correlation with MRS measurements (r 2 = 0.423; slope, 0.034; intercept, 8.459). There was good correlation between qualitative US echogenicity and MRS measurements with a weighted kappa value of 0.82. US-SWE velocity did not have reliable correlation with MRS measurements (r 2 = 0.004; slope, 0.069; intercept, 6.168). Quantitative MRI proton-density fat fraction and SECT fat attenuation have excellent linear correlation with MRS measurements and can serve as accurate noninvasive biomarkers for quantifying steatosis. Material decomposition with DECT does not improve the accuracy of fat quantification over conventional SECT attenuation. US-SWE has poor accuracy for liver fat quantification.

Pulmonary embolism detection using localized vessel-based features in dual energy CT

NASA Astrophysics Data System (ADS)

Dicente Cid, Yashin; Depeursinge, Adrien; Foncubierta Rodríguez, Antonio; Platon, Alexandra; Poletti, Pierre-Alexandre; Müller, Henning

2015-03-01

Pulmonary embolism (PE) affects up to 600,000 patients and contributes to at least 100,000 deaths every year in the United States alone. Diagnosis of PE can be difficult as most symptoms are unspecific and early diagnosis is essential for successful treatment. Computed Tomography (CT) images can show morphological anomalies that suggest the existence of PE. Various image-based procedures have been proposed for improving computer-aided diagnosis of PE. We propose a novel method for detecting PE based on localized vessel-based features computed in Dual Energy CT (DECT) images. DECT provides 4D data indexed by the three spatial coordinates and the energy level. The proposed features encode the variation of the Hounsfield Units across the different levels and the CT attenuation related to the amount of iodine contrast in each vessel. A local classification of the vessels is obtained through the classification of these features. Moreover, the localization of the vessel in the lung provides better comparison between patients. Results show that the simple features designed are able to classify pulmonary embolism patients with an AUC (area under the receiver operating curve) of 0.71 on a lobe basis. Prior segmentation of the lung lobes is not necessary because an automatic atlas-based segmentation obtains similar AUC levels (0.65) for the same dataset. The automatic atlas reaches 0.80 AUC in a larger dataset with more control cases.

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

Niu, T; Dong, X; Petrongolo, M

Purpose: Dual energy CT (DECT) imaging plays an important role in advanced imaging applications due to its material decomposition capability. Direct decomposition via matrix inversion suffers from significant degradation of image signal-to-noise ratios, which reduces clinical value. Existing de-noising algorithms achieve suboptimal performance since they suppress image noise either before or after the decomposition and do not fully explore the noise statistical properties of the decomposition process. We propose an iterative image-domain decomposition method for noise suppression in DECT, using the full variance-covariance matrix of the decomposed images. Methods: The proposed algorithm is formulated in the form of least-square estimationmore » with smoothness regularization. It includes the inverse of the estimated variance-covariance matrix of the decomposed images as the penalty weight in the least-square term. Performance is evaluated using an evaluation phantom (Catphan 600) and an anthropomorphic head phantom. Results are compared to those generated using direct matrix inversion with no noise suppression, a de-noising method applied on the decomposed images, and an existing algorithm with similar formulation but with an edge-preserving regularization term. Results: On the Catphan phantom, our method retains the same spatial resolution as the CT images before decomposition while reducing the noise standard deviation of decomposed images by over 98%. The other methods either degrade spatial resolution or achieve less low-contrast detectability. Also, our method yields lower electron density measurement error than direct matrix inversion and reduces error variation by over 97%. On the head phantom, it reduces the noise standard deviation of decomposed images by over 97% without blurring the sinus structures. Conclusion: We propose an iterative image-domain decomposition method for DECT. The method combines noise suppression and material decomposition into an iterative process and achieves both goals simultaneously. The proposed algorithm shows superior performance on noise suppression with high image spatial resolution and low-contrast detectability. This work is supported by a Varian MRA grant.« less

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

Dong, X; Petrongolo, M; Wang, T

Purpose: A general problem of dual-energy CT (DECT) is that the decomposition is sensitive to noise in the two sets of dual-energy projection data, resulting in severely degraded qualities of decomposed images. We have previously proposed an iterative denoising method for DECT. Using a linear decomposition function, the method does not gain the full benefits of DECT on beam-hardening correction. In this work, we expand the framework of our iterative method to include non-linear decomposition models for noise suppression in DECT. Methods: We first obtain decomposed projections, which are free of beam-hardening artifacts, using a lookup table pre-measured on amore » calibration phantom. First-pass material images with high noise are reconstructed from the decomposed projections using standard filter-backprojection reconstruction. Noise on the decomposed images is then suppressed by an iterative method, which is formulated in the form of least-square estimation with smoothness regularization. Based on the design principles of a best linear unbiased estimator, we include the inverse of the estimated variance-covariance matrix of the decomposed images as the penalty weight in the least-square term. Analytical formulae are derived to compute the variance-covariance matrix from the measured decomposition lookup table. Results: We have evaluated the proposed method via phantom studies. Using non-linear decomposition, our method effectively suppresses the streaking artifacts of beam-hardening and obtains more uniform images than our previous approach based on a linear model. The proposed method reduces the average noise standard deviation of two basis materials by one order of magnitude without sacrificing the spatial resolution. Conclusion: We propose a general framework of iterative denoising for material decomposition of DECT. Preliminary phantom studies have shown the proposed method improves the image uniformity and reduces noise level without resolution loss. In the future, we will perform more phantom studies to further validate the performance of the purposed method. This work is supported by a Varian MRA grant.« less

Spectral multi-energy CT texture analysis with machine learning for tissue classification: an investigation using classification of benign parotid tumours as a testing paradigm.

PubMed

Al Ajmi, Eiman; Forghani, Behzad; Reinhold, Caroline; Bayat, Maryam; Forghani, Reza

2018-06-01

There is a rich amount of quantitative information in spectral datasets generated from dual-energy CT (DECT). In this study, we compare the performance of texture analysis performed on multi-energy datasets to that of virtual monochromatic images (VMIs) at 65 keV only, using classification of the two most common benign parotid neoplasms as a testing paradigm. Forty-two patients with pathologically proven Warthin tumour (n = 25) or pleomorphic adenoma (n = 17) were evaluated. Texture analysis was performed on VMIs ranging from 40 to 140 keV in 5-keV increments (multi-energy analysis) or 65-keV VMIs only, which is typically considered equivalent to single-energy CT. Random forest (RF) models were constructed for outcome prediction using separate randomly selected training and testing sets or the entire patient set. Using multi-energy texture analysis, tumour classification in the independent testing set had accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 92%, 86%, 100%, 100%, and 83%, compared to 75%, 57%, 100%, 100%, and 63%, respectively, for single-energy analysis. Multi-energy texture analysis demonstrates superior performance compared to single-energy texture analysis of VMIs at 65 keV for classification of benign parotid tumours. • We present and validate a paradigm for texture analysis of DECT scans. • Multi-energy dataset texture analysis is superior to single-energy dataset texture analysis. • DECT texture analysis has high accura\\cy for diagnosis of benign parotid tumours. • DECT texture analysis with machine learning can enhance non-invasive diagnostic tumour evaluation.

Technical Note: Improved CT number stability across patient size using dual-energy CT virtual monoenergetic imaging

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

Michalak, Gregory; Grimes, Joshua; Fletcher, Joel

2016-01-15

Purpose: The purpose of this study was to evaluate, over a wide range of phantom sizes, CT number stability achieved using two techniques for generating dual-energy computed tomography (DECT) virtual monoenergetic images. Methods: Water phantoms ranging in lateral diameter from 15 to 50 cm and containing a CT number test object were scanned on a DSCT scanner using both single-energy (SE) and dual-energy (DE) techniques. The SE tube potentials were 70, 80, 90, 100, 110, 120, 130, 140, and 150 kV; the DE tube potential pairs were 80/140, 70/150Sn, 80/150Sn, 90/150Sn, and 100/150Sn kV (Sn denotes that the 150 kVmore » beam was filtered with a 0.6 mm tin filter). Virtual monoenergetic images at energies ranging from 40 to 140 keV were produced from the DECT data using two algorithms, monoenergetic (mono) and monoenergetic plus (mono+). Particularly in large phantoms, water CT number errors and/or artifacts were observed; thus, datasets with water CT numbers outside ±10 HU or with noticeable artifacts were excluded from the study. CT numbers were measured to determine CT number stability across all phantom sizes. Results: Data exclusions were generally limited to cases when a SE or DE technique with a tube potential of less than 90 kV was used to scan a phantom larger than 30 cm. The 90/150Sn DE technique provided the most accurate water background over the large range of phantom sizes evaluated. Mono and mono+ provided equally improved CT number stability as a function of phantom size compared to SE; the average deviation in CT number was only 1.4% using 40 keV and 1.8% using 70 keV, while SE had an average deviation of 11.8%. Conclusions: The authors’ report demonstrates, across all phantom sizes, the improvement in CT number stability achieved with mono and mono+ relative to SE.« less

Technical Note: Improved CT number stability across patient size using dual-energy CT virtual monoenergetic imaging.

PubMed

Michalak, Gregory; Grimes, Joshua; Fletcher, Joel; Halaweish, Ahmed; Yu, Lifeng; Leng, Shuai; McCollough, Cynthia

2016-01-01

The purpose of this study was to evaluate, over a wide range of phantom sizes, CT number stability achieved using two techniques for generating dual-energy computed tomography (DECT) virtual monoenergetic images. Water phantoms ranging in lateral diameter from 15 to 50 cm and containing a CT number test object were scanned on a DSCT scanner using both single-energy (SE) and dual-energy (DE) techniques. The SE tube potentials were 70, 80, 90, 100, 110, 120, 130, 140, and 150 kV; the DE tube potential pairs were 80/140, 70/150Sn, 80/150Sn, 90/150Sn, and 100/150Sn kV (Sn denotes that the 150 kV beam was filtered with a 0.6 mm tin filter). Virtual monoenergetic images at energies ranging from 40 to 140 keV were produced from the DECT data using two algorithms, monoenergetic (mono) and monoenergetic plus (mono+). Particularly in large phantoms, water CT number errors and/or artifacts were observed; thus, datasets with water CT numbers outside ±10 HU or with noticeable artifacts were excluded from the study. CT numbers were measured to determine CT number stability across all phantom sizes. Data exclusions were generally limited to cases when a SE or DE technique with a tube potential of less than 90 kV was used to scan a phantom larger than 30 cm. The 90/150Sn DE technique provided the most accurate water background over the large range of phantom sizes evaluated. Mono and mono+ provided equally improved CT number stability as a function of phantom size compared to SE; the average deviation in CT number was only 1.4% using 40 keV and 1.8% using 70 keV, while SE had an average deviation of 11.8%. The authors' report demonstrates, across all phantom sizes, the improvement in CT number stability achieved with mono and mono+ relative to SE.

Accuracy of iodine quantification using dual energy CT in latest generation dual source and dual layer CT.

PubMed

Pelgrim, Gert Jan; van Hamersvelt, Robbert W; Willemink, Martin J; Schmidt, Bernhard T; Flohr, Thomas; Schilham, Arnold; Milles, Julien; Oudkerk, Matthijs; Leiner, Tim; Vliegenthart, Rozemarijn

2017-09-01

To determine the accuracy of iodine quantification with dual energy computed tomography (DECT) in two high-end CT systems with different spectral imaging techniques. Five tubes with different iodine concentrations (0, 5, 10, 15, 20 mg/ml) were analysed in an anthropomorphic thoracic phantom. Adding two phantom rings simulated increased patient size. For third-generation dual source CT (DSCT), tube voltage combinations of 150Sn and 70, 80, 90, 100 kVp were analysed. For dual layer CT (DLCT), 120 and 140 kVp were used. Scans were repeated three times. Median normalized values and interquartile ranges (IQRs) were calculated for all kVp settings and phantom sizes. Correlation between measured and known iodine concentrations was excellent for both systems (R = 0.999-1.000, p < 0.0001). For DSCT, median measurement errors ranged from -0.5% (IQR -2.0, 2.0%) at 150Sn/70 kVp and -2.3% (IQR -4.0, -0.1%) at 150Sn/80 kVp to -4.0% (IQR -6.0, -2.8%) at 150Sn/90 kVp. For DLCT, median measurement errors ranged from -3.3% (IQR -4.9, -1.5%) at 140 kVp to -4.6% (IQR -6.0, -3.6%) at 120 kVp. Larger phantom sizes increased variability of iodine measurements (p < 0.05). Iodine concentration can be accurately quantified with state-of-the-art DECT systems from two vendors. The lowest absolute errors were found for DSCT using the 150Sn/70 kVp or 150Sn/80 kVp combinations, which was slightly more accurate than 140 kVp in DLCT. • High-end CT scanners allow accurate iodine quantification using different DECT techniques. • Lowest measurement error was found in scans with largest photon energy separation. • Dual-source CT quantified iodine slightly more accurately than dual layer CT.

Iterative image-domain decomposition for dual-energy CT

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

Niu, Tianye; Dong, Xue; Petrongolo, Michael

2014-04-15

Purpose: Dual energy CT (DECT) imaging plays an important role in advanced imaging applications due to its capability of material decomposition. Direct decomposition via matrix inversion suffers from significant degradation of image signal-to-noise ratios, which reduces clinical values of DECT. Existing denoising algorithms achieve suboptimal performance since they suppress image noise either before or after the decomposition and do not fully explore the noise statistical properties of the decomposition process. In this work, the authors propose an iterative image-domain decomposition method for noise suppression in DECT, using the full variance-covariance matrix of the decomposed images. Methods: The proposed algorithm ismore » formulated in the form of least-square estimation with smoothness regularization. Based on the design principles of a best linear unbiased estimator, the authors include the inverse of the estimated variance-covariance matrix of the decomposed images as the penalty weight in the least-square term. The regularization term enforces the image smoothness by calculating the square sum of neighboring pixel value differences. To retain the boundary sharpness of the decomposed images, the authors detect the edges in the CT images before decomposition. These edge pixels have small weights in the calculation of the regularization term. Distinct from the existing denoising algorithms applied on the images before or after decomposition, the method has an iterative process for noise suppression, with decomposition performed in each iteration. The authors implement the proposed algorithm using a standard conjugate gradient algorithm. The method performance is evaluated using an evaluation phantom (Catphan©600) and an anthropomorphic head phantom. The results are compared with those generated using direct matrix inversion with no noise suppression, a denoising method applied on the decomposed images, and an existing algorithm with similar formulation as the proposed method but with an edge-preserving regularization term. Results: On the Catphan phantom, the method maintains the same spatial resolution on the decomposed images as that of the CT images before decomposition (8 pairs/cm) while significantly reducing their noise standard deviation. Compared to that obtained by the direct matrix inversion, the noise standard deviation in the images decomposed by the proposed algorithm is reduced by over 98%. Without considering the noise correlation properties in the formulation, the denoising scheme degrades the spatial resolution to 6 pairs/cm for the same level of noise suppression. Compared to the edge-preserving algorithm, the method achieves better low-contrast detectability. A quantitative study is performed on the contrast-rod slice of Catphan phantom. The proposed method achieves lower electron density measurement error as compared to that by the direct matrix inversion, and significantly reduces the error variation by over 97%. On the head phantom, the method reduces the noise standard deviation of decomposed images by over 97% without blurring the sinus structures. Conclusions: The authors propose an iterative image-domain decomposition method for DECT. The method combines noise suppression and material decomposition into an iterative process and achieves both goals simultaneously. By exploring the full variance-covariance properties of the decomposed images and utilizing the edge predetection, the proposed algorithm shows superior performance on noise suppression with high image spatial resolution and low-contrast detectability.« less

Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT.

PubMed

Shi, Bowen; Lin, Huimin; Zhang, Miao; Lu, Wei; Qu, Ying; Zhang, Huan

2018-01-22

Gastric cancer remains fourth in cancer incidence worldwide with a five-year survival of only 20%-30%. Peritoneal metastasis is the most frequent type of metastasis that accompanies unresectable gastric cancer and is a definitive determinant of prognosis. Preventing and controlling the development of peritoneal metastasis could play a role in helping to prolong the survival of gastric cancer patients. A non-invasive and efficient imaging technique will help us to identify the invasion and metastasis process of peritoneal metastasis and to monitor the changes in tumor nodules in response to treatments. This will enable us to obtain an accurate description of the development process and molecular mechanisms of gastric cancer. We have recently described experiment using dual energy CT (DECT) and positron emission tomography/computed tomography (PET/CT) platforms for the detection and monitoring of gastric tumor metastasis in nude mice models. We have shown that weekly continuous monitoring with DECT and PET/CT can identify dynamic changes in peritoneal metastasis. The sFRP1-overexpression in gastric cancer mice models showed positive radiological performance, a higher FDG uptake and increasing enhancement, and the SUVmax (standardized uptake value) of nodules demonstrated an obvious alteration trend in response to targeted therapy of TGF-β1 inhibitor. In this article, we described the detailed non-invasive imaging procedures to conduct more complex research on gastric cancer peritoneal metastasis using animal models and provided representative imaging results. The use of non-invasive imaging techniques should enable us to better understand the mechanisms of tumorigenesis, monitor tumor growth, and evaluate the effect of therapeutic interventions for gastric cancer.

Can dual-energy CT replace perfusion CT for the functional evaluation of advanced hepatocellular carcinoma?

PubMed

Mulé, Sébastien; Pigneur, Frédéric; Quelever, Ronan; Tenenhaus, Arthur; Baranes, Laurence; Richard, Philippe; Tacher, Vania; Herin, Edouard; Pasquier, Hugo; Ronot, Maxime; Rahmouni, Alain; Vilgrain, Valérie; Luciani, Alain

2018-05-01

To determine the degree of relationship between iodine concentrations derived from dual-energy CT (DECT) and perfusion CT parameters in patients with advanced HCC under treatment. In this single-centre IRB approved study, 16 patients with advanced HCC treated with sorafenib or radioembolization who underwent concurrent dynamic perfusion CT and multiphase DECT using a single source, fast kV switching DECT scanner were included. Written informed consent was obtained for all patients. HCC late-arterial and portal iodine concentrations, blood flow (BF)-related and blood volume (BV)-related perfusion parameters maps were calculated. Mixed-effects models of the relationship between iodine concentrations and perfusion parameters were computed. An adjusted p value (Bonferroni method) < 0.05 was considered significant. Mean HCC late-arterial and portal iodine concentrations were 22.7±12.7 mg/mL and 18.7±8.3 mg/mL, respectively. Late-arterial iodine concentration was significantly related to BV (mixed-effects model F statistic (F)=28.52, p<0.0001), arterial BF (aBF, F=17.62, p<0.0001), hepatic perfusion index (F=28.24, p<0.0001), positive enhancement integral (PEI, F=66.75, p<0.0001) and mean slope of increase (F=32.96, p<0.0001), while portal-venous iodine concentration was mainly related to BV (F=29.68, p<0.0001) and PEI (F=66.75, p<0.0001). In advanced HCC lesions, DECT-derived late-arterial iodine concentration is strongly related to both aBF and BV, while portal iodine concentration mainly reflects BV, offering DECT the ability to evaluate both morphological and perfusion changes. • Late-arterial iodine concentration is highly related to arterial BF and BV. • Portal iodine concentration mainly reflects tumour blood volume. • Dual-energy CT offers significantly decreased radiation dose compared with perfusion CT.

Lung perfusion characteristics in pulmonary arterial hypertension (PAH) and peripheral forms of chronic thromboembolic pulmonary hypertension (pCTEPH): Dual-energy CT experience in 31 patients.

PubMed

Giordano, Jessica; Khung, Suonita; Duhamel, Alain; Hossein-Foucher, Claude; Bellèvre, Dimitri; Lamblin, Nicolas; Remy, Jacques; Remy-Jardin, Martine

2017-04-01

To compare lung perfusion in PAH and pCTEPH on dual-energy CT (DECT) examinations. Thirty-one patients with PAH (group 1; n = 19) and pCTEPH (group 2; n = 12) underwent a dual-energy chest CTA with reconstruction of diagnostic and perfusion images. Perfusion alterations were analysed at a segmental level. V/Q scintigraphy was available in 22 patients (group 1: 13/19; group 2: 9/12). CT perfusion was abnormal in 52.6 % of group 1 patients and in 100 % of group 2 patients (p = 0.0051). The patterns of perfusion alteration significantly differed between the two groups (p < 0.0001): (1) in group 1, 96.6 % of segments with abnormal perfusion showed patchy defects; (2) in group 2, the most frequent abnormalities consisted of patchy (58.5 %) and PE-type (37.5 %) defects. Paired comparison of CT perfusion and scintigraphy showed concordant findings in 76.9 % of group 1 (10/13) and 100 % of group 2 (9/9) patients, with a predominant or an exclusive patchy pattern in group 1 and a mixed pattern of abnormalities in group 2. Lung perfusion alterations at DECT are less frequent and more homogeneous in PAH than in pCTEPH, with a high level of concordant findings with V/Q scintigraphy. • Depiction of chronic pulmonary embolism exclusively located on peripheral arteries is difficult. • The main differential diagnosis of pCTEPH is PAH. • The pattern of DECT perfusion changes can help differentiate PAH and pCETPH. • In PAH, almost all segments with abnormal perfusion showed patchy defects. • In pCTEPH, patchy and PE-type defects were the most frequent abnormalities.

TU-G-204-02: Automatic Sclerotic Bone Metastases Detection in the Pelvic Region From Dual Energy CT

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

Fehr, D; Schmidtlein, C; Hwang, S

Purpose: To automatically detect sclerotic bone metastases in the pelvic region using dual energy computed tomography (DECT). Methods: We developed a two stage algorithm to automatically detect sclerotic bone metastases in the pelvis from DECT for patients with multiple bone metastatic lesions and with hip implants. The first stage consists of extracting the bone and marrow regions by using a support vector machine (SVM) classifier. We employed a novel representation of the DECT images using multi-material decomposition, which represents each voxel as a mixture of different physical materials (e.g. bone+water+fat). Following the extraction of bone and marrow, in the secondmore » stage, a bi -histogram equalization method was employed to enhance the contrast to reveal the bone metastases. Next, meanshift segmentation was performed to separate the voxels by their intensity levels. Finally, shape-based filtering was performed to extract the possible locations of the metastatic lesions using multiple shape criteria. We used the following shape parameters: area, eccentricity, major and minor axis, perimeter and skeleton. Results: A radiologist with several years of experience with DECT manually labeled 64 regions consisting of metastatic lesions from 10 different patients. However, the patients had many more metastasic lesions throughout the pelvis. Our method correctly identified 46 of the marked 64 regions (72%). In addition, our method also identified several other lesions, which can then be validated by the radiologist. The missed lesions were typically very large elongated regions consisting of several islands of very small (<4mm) lesions. Conclusion: We developed an algorithm to automatically detect sclerotic lesions in the pelvic region from DECT. Preliminary assessment shows that our algorithm generated lesions agreeing with the radiologist generated candidate regions. Furthermore, our method reveals additional lesions that can be inspected by the radiologist, thereby, reducing radiologist effort in identifying all the lesions with poor contrast from the DECT images.« less

Virtual monochromatic imaging in dual-source and dual-energy CT for visualization of acute ischemic stroke

NASA Astrophysics Data System (ADS)

Hara, Hidetake; Muraishi, Hiroshi; Matsuzawa, Hiroki; Inoue, Toshiyuki; Nakajima, Yasuo; Satoh, Hitoshi; Abe, Shinji

2015-07-01

We have recently developed a phantom that simulates acute ischemic stroke. We attempted to visualize an acute-stage cerebral infarction by using dual-energy Computed tomography (DECT) to obtain virtual monochromatic images of this phantom. Virtual monochromatic images were created by using DECT voltages from 40 to 100 keV in steps of 10 keV and from 60 to 80 keV in steps of 1 keV, under three conditions of the tube voltage with thin (Sn) filters. Calculation of the CNR values allowed us to evaluate the visualization of acute-stage cerebral infarction. The CNR value of a virtual monochromatic image was the highest at 68 keV under 80 kV / Sn 140 kV, at 72 keV under 100 kV / Sn 140 kV, and at 67 keV under 140 kV / 80 kV. The CNR values of virtual monochromatic images at voltages between 65 and 75 keV were significantly higher than those obtained for all other created images. Therefore, the optimal conditions for visualizing acute ischemic stroke were achievable.

Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study.

PubMed

Bongartz, Tim; Glazebrook, Katrina N; Kavros, Steven J; Murthy, Naveen S; Merry, Stephen P; Franz, Walter B; Michet, Clement J; Veetil, Barath M Akkara; Davis, John M; Mason, Thomas G; Warrington, Kenneth J; Ytterberg, Steven R; Matteson, Eric L; Crowson, Cynthia S; Leng, Shuai; McCollough, Cynthia H

2015-06-01

To assess the accuracy of dual-energy CT (DECT) for diagnosing gout, and to explore whether it can have any impact on clinical decision making beyond the established diagnostic approach using polarising microscopy of synovial fluid (diagnostic yield). Diagnostic single-centre study of 40 patients with active gout, and 41 individuals with other types of joint disease. Sensitivity and specificity of DECT for diagnosing gout was calculated against a combined reference standard (polarising and electron microscopy of synovial fluid). To explore the diagnostic yield of DECT scanning, a third cohort was assembled consisting of patients with inflammatory arthritis and risk factors for gout who had negative synovial fluid polarising microscopy results. Among these patients, the proportion of subjects with DECT findings indicating a diagnosis of gout was assessed. The sensitivity and specificity of DECT for diagnosing gout was 0.90 (95% CI 0.76 to 0.97) and 0.83 (95% CI 0.68 to 0.93), respectively. All false negative patients were observed among patients with acute, recent-onset gout. All false positive patients had advanced knee osteoarthritis. DECT in the diagnostic yield cohort revealed evidence of uric acid deposition in 14 out of 30 patients (46.7%). DECT provides good diagnostic accuracy for detection of monosodium urate (MSU) deposits in patients with gout. However, sensitivity is lower in patients with recent-onset disease. DECT has a significant impact on clinical decision making when gout is suspected, but polarising microscopy of synovial fluid fails to demonstrate the presence of MSU crystals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Fused monochromatic imaging acquired by single source dual energy CT in hepatocellular carcinoma during arterial phase: an initial experience.

PubMed

Gao, Shun-Yu; Zhang, Xiao-Peng; Cui, Yong; Sun, Ying-Shi; Tang, Lei; Li, Xiao-Ting; Zhang, Xiao-Yan; Shan, Jun

2014-08-01

To explore whether single and fused monochromatic images can improve liver tumor detection and delineation by single source dual energy CT (ssDECT) in patients with hepatocellular carcinoma (HCC) during arterial phase. Fifty-seven patients with HCC who underwent ssDECT scanning at Beijing Cancer Hospital were enrolled retrospectively. Twenty-one sets of monochromatic images from 40 to 140 keV were reconstructed at 5 keV intervals in arterial phase. The optimal contrast-noise ratio (CNR) monochromatic images of the liver tumor and the lowest-noise monochromatic images were selected for image fusion. We evaluated the image quality of the optimal-CNR monochromatic images, the lowest-noise monochromatic images and the fused monochromatic images, respectively. The evaluation indicators included the spatial resolution of the anatomical structure, the noise level, the contrast and CNR of the tumor. In arterial phase, the anatomical structure of the liver can be displayed most clearly in the 65-keV monochromatic images, with the lowest image noise. The optimal-CNR monochromatic images of HCC tumor were 50-keV monochromatic images in which the internal structural features of the liver tumors were displayed most clearly and meticulously. For tumor detection, the fused monochromatic images and the 50-keV monochromatic images had similar performances, and were more sensitive than 65-keV monochromatic images. We achieved good arterial phase images by fusing the optimal-CNR monochromatic images of the HCC tumor and the lowest-noise monochromatic images. The fused images displayed liver tumors and anatomical structures more clearly, which is potentially helpful for identifying more and smaller HCC tumors.

Dual-Energy Computed Tomography for the Characterization of Intracranial Hemorrhage and Calcification: A Systematic Approach in a Phantom System.

PubMed

Nute, Jessica L; Jacobsen, Megan C; Chandler, Adam; Cody, Dianna D; Schellingerhout, Dawid

2017-01-01

The aim of this study was to develop a diagnostic framework for distinguishing calcific from hemorrhagic cerebral lesions using dual-energy computed tomography (DECT) in an anthropomorphic phantom system. An anthropomorphic phantom was designed to mimic the CT imaging characteristics of the human head. Cylindrical lesion models containing either calcium or iron, mimicking calcification or hemorrhage, respectively, were developed to exhibit matching, and therefore indistinguishable, single-energy CT (SECT) attenuation values from 40 to 100 HU. These lesion models were fabricated at 0.5, 1, and 1.5 cm in diameter and positioned in simulated cerebrum and skull base locations within the anthropomorphic phantom. All lesion sizes were modeled in the cerebrum, while only 1.5-cm lesions were modeled in the skull base. Images were acquired using a GE 750HD CT scanner and an expansive dual-energy protocol that covered variations in dose (36.7-132.6 mGy CTDIvol, n = 12), image thickness (0.625-5 mm, n = 4), and reconstruction filter (soft, standard, detail, n = 3) for a total of 144 unique technique combinations. Images representing each technique combination were reconstructed into water and calcium material density images, as well as a monoenergetic image chosen to mimic the attenuation of a 120-kVp SECT scan. A true single-energy routine brain protocol was also included for verification of lesion SECT attenuation. Points representing the 3 dual-energy reconstructions were plotted into a 3-dimensional space (water [milligram/milliliter], calcium [milligram/milliliter], monoenergetic Hounsfield unit as x, y, and z axes, respectively), and the distribution of points analyzed using 2 approaches: support vector machines and a simple geometric bisector (GB). Each analysis yielded a plane of optimal differentiation between the calcification and hemorrhage lesion model distributions. By comparing the predicted lesion composition to the known lesion composition, we identified the optimal combination of CTDIvol, image thickness, and reconstruction filter to maximize differentiation between the lesion model types. To validate these results, a new set of hemorrhage and calcification lesion models were created, scanned in a blinded fashion, and prospectively classified using the planes of differentiation derived from support vector machine and GB methods. Accuracy of differentiation improved with increasing dose (CTDIvol) and image thickness. Reconstruction filter had no effect on the accuracy of differentiation. Using an optimized protocol consisting of the maximum CTDIvol of 132.6 mGy, 5-mm-thick images, and a standard filter, hemorrhagic and calcific lesion models with equal SECT attenuation (Hounsfield unit) were differentiated with over 90% accuracy down to 70 HU for skull base lesions of 1.5 cm, and down to 100 HU, 60 HU, and 60 HU for cerebrum lesions of 0.5, 1.0, and 1.5 cm, respectively. The analytic method that yielded the best results was a simple GB plane through the 3-dimensional DECT space. In the validation study, 96% of unknown lesions were correctly classified across all lesion sizes and locations investigated. We define the optimal scan parameters and expected limitations for the accurate classification of hemorrhagic versus calcific cerebral lesions in an anthropomorphic phantom with DECT. Although our proposed DECT protocol represents an increase in dose compared with routine brain CT, this method is intended as a specialized evaluation of potential brain hemorrhage and is thus counterbalanced by increased diagnostic benefit. This work provides justification for the application of this technique in human clinical trials.

Value of a noise-optimized virtual monoenergetic reconstruction technique in dual-energy CT for planning of transcatheter aortic valve replacement.

PubMed

Martin, Simon S; Albrecht, Moritz H; Wichmann, Julian L; Hüsers, Kristina; Scholtz, Jan-Erik; Booz, Christian; Bodelle, Boris; Bauer, Ralf W; Metzger, Sarah C; Vogl, Thomas J; Lehnert, Thomas

2017-02-01

To evaluate objective and subjective image quality of a noise-optimized virtual monoenergetic imaging (VMI+) reconstruction technique in dual-energy computed tomography (DECT) angiography prior to transcatheter aortic valve replacement (TAVR). Datasets of 47 patients (35 men; 64.1 ± 10.9 years) who underwent DECT angiography of heart and vascular access prior to TAVR were reconstructed with standard linear blending (F_0.5), VMI+, and traditional monoenergetic (VMI) algorithms in 10-keV intervals from 40-100 keV. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of 564 arterial segments were evaluated. Subjective analysis was rated by three blinded observers using a Likert scale. Mean SNR and CNR were highest in 40 keV VMI+ series (SNR, 27.8 ± 13.0; CNR, 26.3 ± 12.7), significantly (all p < 0.001) superior to all VMI series, which showed highest values at 70 keV (SNR, 18.5 ± 7.6; CNR, 16.0 ± 7.4), as well as linearly-blended F_0.5 series (SNR, 16.8 ± 7.3; CNR, 13.6 ± 6.9). Highest subjective image quality scores were observed for 40, 50, and 60 keV VMI+ reconstructions (all p > 0.05), significantly superior to all VMI and standard linearly-blended images (all p < 0.01). Low-keV VMI+ reconstructions significantly increase CNR and SNR compared to VMI and standard linear-blending image reconstruction and improve subjective image quality in preprocedural DECT angiography in the context of TAVR planning. • VMI+ combines increased contrast with reduced image noise. • VMI+ shows substantially less image noise than traditional VMI. • 40-keV reconstructions show highest SNR/CNR of the aortic and iliofemoral access route. • Observers overall prefer 60 keV VMI+ images. • VMI+ DECT imaging helps improve image quality for TAVR planning.

In Vivo Differentiation of Uric Acid Versus Non-Uric Acid Urinary Calculi With Third-Generation Dual-Source Dual-Energy CT at Reduced Radiation Dose.

PubMed

Franken, Axelle; Gevenois, Pierre Alain; Muylem, Alain Van; Howarth, Nigel; Keyzer, Caroline

2018-02-01

The objective of our study was to evaluate in vivo urinary calculus characterization with third-generation dual-source dual-energy CT (DECT) at reduced versus standard radiation dose. One hundred fifty-three patients requiring unenhanced CT for suspected or known urolithiasis were prospectively included in our study. They underwent two acquisitions at reduced-dose CT (90 kV and 50 mAs ref ; Sn150 kV and 31 mAs ref , where Sn denotes the interposition of a tin filter in the high-energy beam) and standard-dose CT (90 kV and 50 mAs ref ; Sn150 kV and 94 mAs ref ). One radiologist interpreted the reduced-dose examinations before the standard-dose examinations during the same session. Among 103 patients (23 women, 80 men; mean age ± SD, 50 ± 15 years; age range, 18-82 years) with urolithiasis, dedicated DECT software measured the maximal diameter and CT numbers, calculated the DECT number ratio, and labeled with a color code each calculus visualized by the radiologist as uric acid (UA) or non-UA. Volume CT dose index (CTDI vol ) and dose-length product (DLP) were recorded. The radiologist visualized 279 calculi on standard-dose CT and 262 on reduced-dose CT; 17 calculi were missed on reduced-dose CT, all of which were ≤ 3 mm. Among the 262 calculi visualized at both doses, the CT number ratio was obtained with the software for 227 calculi and was not different between the doses (p = 0.093). Among these 262 calculi, 197 were labeled at both doses; 194 of the 197 labeled calculi were labeled with the same color code. Among the 65 remaining calculi, 48 and 61 (all ≤ 5 mm) were not labeled at standard-dose and reduced-dose CT (p = 0.005), respectively. At reduced-dose CT, the mean CTDI vol was 2.67 mGy and the mean DLP was 102.2 mGy × cm. With third-generation dual-source DECT, a larger proportion of calculi ≤ 5 mm are not characterized as UA or non-UA at a reduced dose.

Dual-energy X-ray micro-CT imaging of hybrid Ni/Al open-cell foam

NASA Astrophysics Data System (ADS)

Fíla, T.; Kumpová, I.; Koudelka, P.; Zlámal, P.; Vavřík, D.; Jiroušek, O.; Jung, A.

2016-01-01

In this paper, we employ dual-energy X-ray microfocus tomography (DECT) measurement to develop high-resolution finite element (FE) models that can be used for the numerical assessment of the deformation behaviour of hybrid Ni/Al foam subjected to both quasi-static and dynamic compressive loading. Cubic samples of hybrid Ni/Al open-cell foam with an edge length of [15]mm were investigated by the DECT measurement. The material was prepared using AlSi7Mg0.3 aluminium foam with a mean pore size of [0.85]mm, coated with nanocrystalline nickel (crystallite size of approx. [50]nm) to form a surface layer with a theoretical thickness of [0.075]mm. CT imaging was carried out using state-of-the-art DSCT/DECT X-ray scanner developed at Centre of Excellence Telč. The device consists of a modular orthogonal assembly of two tube-detector imaging pairs, with an independent geometry setting and shared rotational stage mounted on a complex 16-axis CNC positioning system to enable unprecedented measurement variability for highly-detailed tomographical measurements. A sample of the metal foam was simultaneously irradiated using an XWT-240-SE reflection type X-ray tube and an XWT-160-TCHR transmission type X-ray tube. An enhanced dual-source sampling strategy was used for data acquisition. X-ray images were taken using XRD1622 large area GOS scintillator flat panel detectors with an active area of [410 × 410]mm and resolution [2048 × 2048]pixels. Tomographic scanning was performed in 1,200 projections with a 0.3 degree angular step to improve the accuracy of the generated models due to the very complex microstructure and high attenuation of the investigated material. Reconstructed data was processed using a dual-energy algorithm, and was used for the development of a 3D model and voxel model of the foam. The selected parameters of the models were compared with nominal parameters of the actual foam and showed good correlation.

TU-A-12A-08: Computing Longitudinal Material Changes in Bone Metastases Using Dual Energy Computed Tomography

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

Schmidtlein, CR; Hwang, S; Veeraraghavan, H

Purpose: This study demonstrates a methodology for tracking changes in metastatic bone disease using trajectories in material basis space in serial dual energy computed tomography (DECT) studies. Methods: This study includes patients with bone metastases from breast cancer that had clinical surveillance CT scans using a General Electric CT750HD in dual energy mode. A radiologist defined regions-of-interested (ROI) for bone metastasis, normal bone, and marrow across the serial DECT scans. Our approach employs a Radon transform to forward-projection the basis images, namely, water and iodine, into sinogram space. This data is then repartitioned into fat/bone and effective density/Z image pairsmore » using assumed energy spectrums for the x-ray energies. This approach both helps remove negative material densities and avoids adding spectrum-hardening artifacts. These new basis data sets were then reconstructed via filtered back-projection to create new material basis pair images. The trajectories of these pairs were then plotted in the new basis space providing a means to both visualize and quantitatively measure changes in the material properties of the tumors. Results: ROI containing radiologist defined metastatic bone disease showed well-defined trajectories in both fat/bone and effective density/Z space. ROI that contained radiologist defined normal bone and marrow did not exhibit any discernible trajectories and were stable from scan to scan. Conclusions: The preliminary results show that changes in material composition and effective density/Z image pairs were seen primarily in metastasis and not in normal tissue. This study indicates that by using routine clinical DECT it may be possible to monitor therapy response of bone metastases because healing or worsening bone metastases change material composition of bone. Additional studies are needed to further validate these results and to test for their correlation with outcome.« less

White Paper of the Society of Computed Body Tomography and Magnetic Resonance on Dual-Energy CT, Part 1: Technology and Terminology.

PubMed

Siegel, Marilyn J; Kaza, Ravi K; Bolus, David N; Boll, Daniel T; Rofsky, Neil M; De Cecco, Carlo N; Foley, W Dennis; Morgan, Desiree E; Schoepf, U Joseph; Sahani, Dushyant V; Shuman, William P; Vrtiska, Terri J; Yeh, Benjamin M; Berland, Lincoln L

This is the first of a series of 4 white papers that represent Expert Consensus Documents developed by the Society of Computed Body Tomography and Magnetic Resonance through its task force on dual-energy computed tomography (DECT). This article, part 1, describes the fundamentals of the physical basis for DECT and the technology of DECT and proposes uniform nomenclature to account for differences in proprietary terms among manufacturers.

Application of single- and dual-energy CT brain tissue segmentation to PET monitoring of proton therapy.

PubMed

Berndt, Bianca; Landry, Guillaume; Schwarz, Florian; Tessonnier, Thomas; Kamp, Florian; Dedes, George; Thieke, Christian; Würl, Matthias; Kurz, Christopher; Ganswindt, Ute; Verhaegen, Frank; Debus, Jürgen; Belka, Claus; Sommer, Wieland; Reiser, Maximilian; Bauer, Julia; Parodi, Katia

2017-03-21

The purpose of this work was to evaluate the ability of single and dual energy computed tomography (SECT, DECT) to estimate tissue composition and density for usage in Monte Carlo (MC) simulations of irradiation induced β + activity distributions. This was done to assess the impact on positron emission tomography (PET) range verification in proton therapy. A DECT-based brain tissue segmentation method was developed for white matter (WM), grey matter (GM) and cerebrospinal fluid (CSF). The elemental composition of reference tissues was assigned to closest CT numbers in DECT space (DECT dist ). The method was also applied to SECT data (SECT dist ). In a validation experiment, the proton irradiation induced PET activity of three brain equivalent solutions (BES) was compared to simulations based on different tissue segmentations. Five patients scanned with a dual source DECT scanner were analyzed to compare the different segmentation methods. A single magnetic resonance (MR) scan was used for comparison with an established segmentation toolkit. Additionally, one patient with SECT and post-treatment PET scans was investigated. For BES, DECT dist and SECT dist reduced differences to the reference simulation by up to 62% when compared to the conventional stoichiometric segmentation (SECT Schneider ). In comparison to MR brain segmentation, Dice similarity coefficients for WM, GM and CSF were 0.61, 0.67 and 0.66 for DECT dist and 0.54, 0.41 and 0.66 for SECT dist . MC simulations of PET treatment verification in patients showed important differences between DECT dist /SECT dist and SECT Schneider for patients with large CSF areas within the treatment field but not in WM and GM. Differences could be misinterpreted as PET derived range shifts of up to 4 mm. DECT dist and SECT dist yielded comparable activity distributions, and comparison of SECT dist to a measured patient PET scan showed improved agreement when compared to SECT Schneider . The agreement between predicted and measured PET activity distributions was improved by employing a brain specific segmentation applicable to both DECT and SECT data.

Ultrasound scans and dual energy CT identify tendons as preferred anatomical location of MSU crystal depositions in gouty joints.

PubMed

Yuan, Yuan; Liu, Chang; Xiang, Xi; Yuan, Tong-Ling; Qiu, Li; Liu, Yi; Luo, Yu-Bin; Zhao, Y; Herrmann, Martin

2018-05-01

The present study was performed to localize the articular deposition of monosodium urate (MSU) crystal in joints. We compare the detection efficiencies of dual-energy CT (DECT) and ultrasound scans. Analyses by DECT and ultrasound were performed with 184 bilateral joints of the lower limbs of 54 consecutive gout patients. All joints were categorized into (1) knee, (2) ankle, (3) MTP1, and (4) MTP2, and sorted into those with and those without detectable MSU deposition. The comparison of the positive rate between DECT and ultrasound and the agreement was performed using the McNemar test and the Cohen's κ coefficient, respectively. Next, we listed the MSU crystal deposition as assessed by ultrasound between the DECT-positive and -negative joints according to their interior structure. We included tendons, synovia, cartilage, subcutaneous tissue, etc. RESULTS: Among all joints, the percentages with MSU crystal deposition detected by DECT (99/184, 53.8%) and ultrasound (106/184, 57.6%) were comparable (P = 0.530 > 0.05). For MTP1 (21/34, 61.8%; 12/34, 35.3%; P < 0.05) and MTP2-5 (17/34, 50.0%; 10/34, 29.4%, P < 0.05), ultrasound and DECT were more efficient, respectively. The data concordance in 46 of 50 joints (92.00%; κ = 0.769, P < 0.05) for knee; and 27 of 34 joints (79.41%; κ = 0.588, P < 0.05) for MTP2-5 and suggested that tendons were the most frequent anatomical location of MSU crystal deposition. The tendons are the most frequent anatomical location of MSU crystal depositions. The concordance rate of knee joints and MTP2-5 joints shows good agreement between DECT and ultrasound depending on the location.

Quantitative Comparison of Virtual Monochromatic Images of Dual Energy Computed Tomography Systems: Beam Hardening Artifact Correction and Variance in Computed Tomography Numbers: A Phantom Study.

PubMed

Wu, Rongli; Watanabe, Yoshiyuki; Satoh, Kazuhiko; Liao, Yen-Peng; Takahashi, Hiroto; Tanaka, Hisashi; Tomiyama, Noriyuki

2018-05-21

The aim of this study was to quantitatively compare the reduction in beam hardening artifact (BHA) and variance in computed tomography (CT) numbers of virtual monochromatic energy (VME) images obtained with 3 dual-energy computed tomography (DECT) systems at a given radiation dose. Five different iodine concentrations were scanned using dual-energy and single-energy (120 kVp) modes. The BHA and CT number variance were evaluated. For higher iodine concentrations, 40 and 80 mgI/mL, BHA on VME imaging was significantly decreased when the energy was higher than 50 keV (P = 0.003) and 60 keV (P < 0.001) for GE, higher than 80 keV (P < 0.001) and 70 keV (P = 0.002) for Siemens, and higher than 40 keV (P < 0.001) and 60 keV (P < 0.001) for Toshiba, compared with single-energy CT imaging. Virtual monochromatic energy imaging can decrease BHA and improve CT number accuracy in different dual-energy computed tomography systems, depending on energy levels and iodine concentrations.

Effect of slice thickness on image noise and diagnostic content of single-source-dual energy computed tomography

NASA Astrophysics Data System (ADS)

Alshipli, Marwan; Kabir, Norlaili A.

2017-05-01

Computed tomography (CT) employs X-ray radiation to create cross-sectional images. Dual-energy CT acquisition includes the images acquired from an alternating voltage of X-ray tube: a low- and a high-peak kilovoltage. The main objective of this study is to determine the best slice thickness that reduces image noise with adequate diagnostic information using dual energy CT head protocol. The study used the ImageJ software and statistical analyses to aid the medical image analysis of dual-energy CT. In this study, ImageJ software and F-test were utilised as the combination methods to analyse DICOM CT images. They were used to investigate the effect of slice thickness on noise and visibility in dual-energy CT head protocol images. Catphan-600 phantom was scanned at different slice thickness values;.6, 1, 2, 3, 4, 5 and 6 mm, then quantitative analyses were carried out. The DECT operated in helical mode with another fixed scan parameter values. Based on F-test statistical analyses, image noise at 0.6, 1, and 2 mm were significantly different compared to the other images acquired at slice thickness of 3, 4, 5, and 6 mm. However, no significant differences of image noise were observed at 3, 4, 5, and 6 mm. As a result, better diagnostic image value, image visibility, and lower image noise in dual-energy CT head protocol was observed at a slice thickness of 3 mm.

SU-F-J-91: Sparing Lung Function in Treatment Planning Using Dual Energy Tomography

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

Lapointe, A; Bahig, H; Zerouali, K

2016-06-15

Purpose: To propose an alternate treatment plan that minimizes the dose to the functional lung tissues. In clinical situation, the evaluation of the lung functionality is typically derived from perfusion scintigraphy. However, such technique has spatial and temporal resolutions generally inferior to those of a CT scan. Alternatively, it is possible to evaluate pulmonary function by analysing the iodine concentration determined via contrast-enhanced dual energy CT (DECT) scan. Methods: Five lung cancer patients underwent a scintigraphy and a contrast-enhanced DECT scan (SOMATOM Definition Flash, Siemens). The iodine concentration was evaluated using the two-material decomposition method to produce a functional mapmore » of the lung. The validation of the approach is realized by comparison between the differential function computed by DECT and scintigraphy. The functional map is then used to redefine the V5 (volume of the organ that received more than 5 Gy during a radiotherapy treatment) to a novel functional parameter, the V5f. The V5f, that uses a volume weighted by its function level, can assist in evaluating optimal beam entry points for a specific treatment plan. Results: The results show that the differential functions obtained by scintigraphy and DECT are in good agreement with a mean difference of 6%. In specific cases, we are able to visually correlate low iodine concentration with abnormal pulmonary lung or cancerous tumors. The comparison between V5f and V5 has shown that some entry points can be better exploited and that new ones are now accessible, 2.34 times more in average, without increasing the V5f - thus allowing easier optimization of other planning objectives. Conclusion: In addition to the high-resolution DECT images, the iodine map provides local information used to detect potential functional heterogeneities in the 3D space. We propose that this information be used to calculate new functional dose parameters such as the V5f. The presenting author, Andreanne Lapointe, received a canadian scholarship from MITACS. Part of the funding is from the compagny Siemens.« less

Range prediction for tissue mixtures based on dual-energy CT

NASA Astrophysics Data System (ADS)

Möhler, Christian; Wohlfahrt, Patrick; Richter, Christian; Greilich, Steffen

2016-06-01

The use of dual-energy CT (DECT) potentially decreases range uncertainties in proton and ion therapy treatment planning via determination of the involved physical target quantities. For eventual clinical application, the correct treatment of tissue mixtures and heterogeneities is an essential feature, as they naturally occur within a patient’s CT. Here, we present how existing methods for DECT-based ion-range prediction can be modified in order to incorporate proper mixing behavior on several structural levels. Our approach is based on the factorization of the stopping-power ratio into the relative electron density and the relative stopping number. The latter is confined for tissue between about 0.95 and 1.02 at a therapeutic beam energy of 200 MeV u-1 and depends on the I-value. We show that convenient mixing and averaging properties arise by relating the relative stopping number to the relative cross section obtained by DECT. From this, a maximum uncertainty of the stopping-power ratio prediction below 1% is suggested for arbitrary mixtures of human body tissues.

Rationale and design of the dual-energy computed tomography for ischemia determination compared to "gold standard" non-invasive and invasive techniques (DECIDE-Gold): A multicenter international efficacy diagnostic study of rest-stress dual-energy computed tomography angiography with perfusion.

PubMed

Truong, Quynh A; Knaapen, Paul; Pontone, Gianluca; Andreini, Daniele; Leipsic, Jonathon; Carrascosa, Patricia; Lu, Bin; Branch, Kelley; Raman, Subha; Bloom, Stephen; Min, James K

2015-10-01

Dual-energy CT (DECT) has potential to improve myocardial perfusion for physiologic assessment of coronary artery disease (CAD). Diagnostic performance of rest-stress DECT perfusion (DECTP) is unknown. DECIDE-Gold is a prospective multicenter study to evaluate the accuracy of DECT to detect hemodynamic (HD) significant CAD, as compared to fractional flow reserve (FFR) as a reference standard. Eligible participants are subjects with symptoms of CAD referred for invasive coronary angiography (ICA). Participants will undergo DECTP, which will be performed by pharmacological stress, and participants will subsequently proceed to ICA and FFR. HD-significant CAD will be defined as FFR ≤ 0.80. In those undergoing myocardial stress imaging (MPI) by positron emission tomography (PET), single photon emission computed tomography (SPECT) or cardiac magnetic resonance (CMR) imaging, ischemia will be graded by % ischemic myocardium. Blinded core laboratory interpretation will be performed for CCTA, DECTP, MPI, ICA, and FFR. Primary endpoint is accuracy of DECTP to detect ≥1 HD-significant stenosis at the subject level when compared to FFR. Secondary and tertiary endpoints are accuracies of combinations of DECTP at the subject and vessel levels compared to FFR and MPI. DECIDE-Gold will determine the performance of DECTP for diagnosing ischemia.

Development of a dual-energy computed tomography quality control program: Characterization of scanner response and definition of relevant parameters for a fast-kVp switching dual-energy computed tomography system.

PubMed

Nute, Jessica L; Jacobsen, Megan C; Stefan, Wolfgang; Wei, Wei; Cody, Dianna D

2018-04-01

A prototype QC phantom system and analysis process were developed to characterize the spectral capabilities of a fast kV-switching dual-energy computed tomography (DECT) scanner. This work addresses the current lack of quantitative oversight for this technology, with the goal of identifying relevant scan parameters and test metrics instrumental to the development of a dual-energy quality control (DEQC). A prototype elliptical phantom (effective diameter: 35 cm) was designed with multiple material inserts for DECT imaging. Inserts included tissue equivalent and material rods (including iodine and calcium at varying concentrations). The phantom was scanned on a fast kV-switching DECT system using 16 dual-energy acquisitions (CTDIvol range: 10.3-62 mGy) with varying pitch, rotation time, and tube current. The circular head phantom (22 cm diameter) was scanned using a similar protocol (12 acquisitions; CTDIvol range: 36.7-132.6 mGy). All acquisitions were reconstructed at 50, 70, 110, and 140 keV and using a water-iodine material basis pair. The images were evaluated for iodine quantification accuracy, stability of monoenergetic reconstruction CT number, noise, and positional constancy. Variance component analysis was used to identify technique parameters that drove deviations in test metrics. Variances were compared to thresholds derived from manufacturer tolerances to determine technique parameters that had a nominally significant effect on test metrics. Iodine quantification error was largely unaffected by any of the technique parameters investigated. Monoenergetic HU stability was found to be affected by mAs, with a threshold under which spectral separation was unsuccessful, diminishing the utility of DECT imaging. Noise was found to be affected by CTDIvol in the DEQC body phantom, and CTDIvol and mA in the DEQC head phantom. Positional constancy was found to be affected by mAs in the DEQC body phantom and mA in the DEQC head phantom. A streamlined scan protocol was developed to further investigate the effects of CTDIvol and rotation time while limiting data collection to the DEQC body phantom. Further data collection will be pursued to determine baseline values and statistically based failure thresholds for the validation of long-term DECT scanner performance. © 2018 American Association of Physicists in Medicine.

Qualitative and quantitative evaluation of rigid and deformable motion correction algorithms using dual-energy CT images in view of application to CT perfusion measurements in abdominal organs affected by breathing motion

PubMed Central

Skornitzke, S; Fritz, F; Klauss, M; Pahn, G; Hansen, J; Hirsch, J; Grenacher, L; Kauczor, H-U

2015-01-01

Objective: To compare six different scenarios for correcting for breathing motion in abdominal dual-energy CT (DECT) perfusion measurements. Methods: Rigid [RRComm(80 kVp)] and non-rigid [NRComm(80 kVp)] registration of commercially available CT perfusion software, custom non-rigid registration [NRCustom(80 kVp], demons algorithm) and a control group [CG(80 kVp)] without motion correction were evaluated using 80 kVp images. Additionally, NRCustom was applied to dual-energy (DE)-blended [NRCustom(DE)] and virtual non-contrast [NRCustom(VNC)] images, yielding six evaluated scenarios. After motion correction, perfusion maps were calculated using a combined maximum slope/Patlak model. For qualitative evaluation, three blinded radiologists independently rated motion correction quality and resulting perfusion maps on a four-point scale (4 = best, 1 = worst). For quantitative evaluation, relative changes in metric values, R2 and residuals of perfusion model fits were calculated. Results: For motion-corrected images, mean ratings differed significantly [NRCustom(80 kVp) and NRCustom(DE), 3.3; NRComm(80 kVp), 3.1; NRCustom(VNC), 2.9; RRComm(80 kVp), 2.7; CG(80 kVp), 2.7; all p < 0.05], except when comparing NRCustom(80 kVp) with NRCustom(DE) and RRComm(80 kVp) with CG(80 kVp). NRCustom(80 kVp) and NRCustom(DE) achieved the highest reduction in metric values [NRCustom(80 kVp), 48.5%; NRCustom(DE), 45.6%; NRComm(80 kVp), 29.2%; NRCustom(VNC), 22.8%; RRComm(80 kVp), 0.6%; CG(80 kVp), 0%]. Regarding perfusion maps, NRCustom(80 kVp) and NRCustom(DE) were rated highest [NRCustom(80 kVp), 3.1; NRCustom(DE), 3.0; NRComm(80 kVp), 2.8; NRCustom(VNC), 2.6; CG(80 kVp), 2.5; RRComm(80 kVp), 2.4] and had significantly higher R2 and lower residuals. Correlation between qualitative and quantitative evaluation was low to moderate. Conclusion: Non-rigid motion correction improves spatial alignment of the target region and fit of CT perfusion models. Using DE-blended and DE-VNC images for deformable registration offers no significant improvement. Advances in knowledge: Non-rigid algorithms improve the quality of abdominal CT perfusion measurements but do not benefit from DECT post processing. PMID:25465353

Reduction of dark-band-like metal artifacts caused by dental implant bodies using hypothetical monoenergetic imaging after dual-energy computed tomography.

PubMed

Tanaka, Ray; Hayashi, Takafumi; Ike, Makiko; Noto, Yoshiyuki; Goto, Tazuko K

2013-06-01

The aim of this study was to evaluate the usefulness of hypothetical monoenergetic images after dual-energy computed tomography (DECT) for assessment of the bone encircling dental implant bodies. Seventy-two axial images of implantation sites clipped out from image data scanned using DECT in dual-energy mode were used. Subjective assessment on reduction of dark-band-like artifacts (R-DBAs) and diagnosability of adjacent bone condition (D-ABC) in 3 sets of DECT images-a fused image set (DE120) and 2 sets of hypothetical monoenergetic images (ME100, ME190)-was performed and the results were statistically analyzed. With regards to R-DBAs and D-ABC, significant differences among DE120, ME100, and ME190 were observed. The ME100 and ME190 images revealed more artifact reduction and diagnosability than those of DE120. DECT imaging followed by hypothetical monoenergetic image construction can cause R-DBAs and increase D-ABC and may be potentially used for the evaluation of postoperative changes in the bone encircling implant bodies. Copyright © 2013 Elsevier Inc. All rights reserved.

Impact of dual energy characterization of urinary calculus on management.

PubMed

Habashy, David; Xia, Ryan; Ridley, William; Chan, Lewis; Ridley, Lloyd

2016-10-01

Dual energy CT (DECT) is a recent technique that is increasingly being used to differentiate between calcium and uric acid urinary tract calculi. The aim of this study is to determine if urinary calculi composition analysis determined by DECT scanning results in a change of patient management. All patients presenting with symptoms of renal colic, who had not previously undergone DECT scanning underwent DECT KUB. DECT data of all patients between September 2013 and July 2015 were reviewed. Urinary calculi composition based on dual energy characterization was cross-matched with patient management and outcome. A total of 585 DECT KUB were performed. 393/585 (67%) DECT scans revealed urinary tract calculi. After excluding those with isolated bladder or small asymptomatic renal stones, 303 patients were found to have symptomatic stone(s) as an explanation for their presentation. Of these 303 patients, there were 273 (90.1%) calcium calculi, 19 (6.3%) uric acid calculi and 11 (3.4%) mixed calculi. Of those with uric acid calculi, 15 were commenced on dissolution therapy. Twelve of those commenced on dissolution therapy had a successful outcome, avoiding need for surgical intervention (lithotripsy or stone retrieval). Three patients failed dissolution therapy and required operative intervention for definitive management of the stone. Predicting urinary tract calculi composition by DECT plays an important role in identifying patients who may be managed with dissolution therapy. Identification of uric acid stone composition altered management in 15 of 303 (5.0%) patients, and was successful in 12, thereby avoiding surgery and its attendant risks. © 2016 The Royal Australian and New Zealand College of Radiologists.

Accuracies of the synthesized monochromatic CT numbers and effective atomic numbers obtained with a rapid kVp switching dual energy CT scanner

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

Goodsitt, Mitchell M.; Christodoulou, Emmanuel G.; Larson, Sandra C.

2011-04-15

Purpose: This study was performed to investigate the accuracies of the synthesized monochromatic images and effective atomic number maps obtained with the new GE Discovery CT750 HD CT scanner. Methods: A Gammex-RMI model 467 tissue characterization phantom and the CT number linearity section of a Phantom Laboratory Catphan 600 phantom were scanned using the dual energy (DE) feature on the GE CT750 HD scanner. Synthesized monochromatic images at various energies between 40 and 120 keV and effective atomic number (Z{sub eff}) maps were generated. Regions of interest were placed within these images/maps to measure the average monochromatic CT numbers andmore » average Z{sub eff} of the materials within these phantoms. The true Z{sub eff} values were either supplied by the phantom manufacturer or computed using Mayneord's equation. The linear attenuation coefficients for the true CT numbers were computed using the NIST XCOM program with the input of manufacturer supplied elemental compositions and densities. The effects of small variations in the assumed true densities of the materials were also investigated. Finally, the effect of body size on the accuracies of the synthesized monochromatic CT numbers was investigated using a custom lumbar section phantom with and without an external fat-mimicking ring. Results: Other than the Z{sub eff} of the simulated lung inserts in the tissue characterization phantom, which could not be measured by DECT, the Z{sub eff} values of all of the other materials in the tissue characterization and Catphan phantoms were accurate to 15%. The accuracies of the synthesized monochromatic CT numbers of the materials in both phantoms varied with energy and material. For the 40-120 keV range, RMS errors between the measured and true CT numbers in the Catphan are 8-25 HU when the true CT numbers were computed using the nominal plastic densities. These RMS errors improve to 3-12 HU for assumed true densities within the nominal density {+-}0.02 g/cc range. The RMS errors between the measured and true CT numbers of the tissue mimicking materials in the tissue characterization phantom over the 40-120 keV range varied from about 6 HU-248 HU and did not improve as dramatically with small changes in assumed true density. Conclusions: Initial tests indicate that the Z{sub eff} values computed with DECT on this scanner are reasonably accurate; however, the synthesized monochromatic CT numbers can be very inaccurate, especially for dense tissue mimicking materials at low energies. Furthermore, the synthesized monochromatic CT numbers of materials still depend on the amount of the surrounding tissues especially at low keV, demonstrating that the numbers are not truly monochromatic. Further research is needed to develop DE methods that produce more accurate synthesized monochromatic CT numbers.« less

Phantom-less bone mineral density (BMD) measurement using dual energy computed tomography-based 3-material decomposition

NASA Astrophysics Data System (ADS)

Hofmann, Philipp; Sedlmair, Martin; Krauss, Bernhard; Wichmann, Julian L.; Bauer, Ralf W.; Flohr, Thomas G.; Mahnken, Andreas H.

2016-03-01

Osteoporosis is a degenerative bone disease usually diagnosed at the manifestation of fragility fractures, which severely endanger the health of especially the elderly. To ensure timely therapeutic countermeasures, noninvasive and widely applicable diagnostic methods are required. Currently the primary quantifiable indicator for bone stability, bone mineral density (BMD), is obtained either by DEXA (Dual-energy X-ray absorptiometry) or qCT (quantitative CT). Both have respective advantages and disadvantages, with DEXA being considered as gold standard. For timely diagnosis of osteoporosis, another CT-based method is presented. A Dual Energy CT reconstruction workflow is being developed to evaluate BMD by evaluating lumbar spine (L1-L4) DE-CT images. The workflow is ROI-based and automated for practical use. A dual energy 3-material decomposition algorithm is used to differentiate bone from soft tissue and fat attenuation. The algorithm uses material attenuation coefficients on different beam energy levels. The bone fraction of the three different tissues is used to calculate the amount of hydroxylapatite in the trabecular bone of the corpus vertebrae inside a predefined ROI. Calibrations have been performed to obtain volumetric bone mineral density (vBMD) without having to add a calibration phantom or to use special scan protocols or hardware. Accuracy and precision are dependent on image noise and comparable to qCT images. Clinical indications are in accordance with the DEXA gold standard. The decomposition-based workflow shows bone degradation effects normally not visible on standard CT images which would induce errors in normal qCT results.

Dual-energy CT in patients with abdominal malignant lymphoma: impact of noise-optimised virtual monoenergetic imaging on objective and subjective image quality.

PubMed

Lenga, L; Czwikla, R; Wichmann, J L; Leithner, D; Albrecht, M H; D'Angelo, T; Arendt, C T; Booz, C; Hammerstingl, R; Vogl, T J; Martin, S S

2018-06-05

To investigate the impact of noise-optimised virtual monoenergetic imaging (VMI+) reconstructions on quantitative and qualitative image parameters in patients with malignant lymphoma at dual-energy computed tomography (DECT) examinations of the abdomen. Thirty-five consecutive patients (mean age, 53.8±18.6 years; range, 21-82 years) with histologically proven malignant lymphoma of the abdomen were included retrospectively. Images were post-processed with standard linear blending (M_0.6), traditional VMI, and VMI+ technique at energy levels ranging from 40 to 100 keV in 10 keV increments. Signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were objectively measured in lymphoma lesions. Image quality, lesion delineation, and image noise were rated subjectively by three blinded observers using five-point Likert scales. Quantitative image quality parameters peaked at 40-keV VMI+ (SNR, 15.77±7.74; CNR, 18.27±8.04) with significant differences compared to standard linearly blended M_0.6 (SNR, 7.96±3.26; CNR, 13.55±3.47) and all traditional VMI series (p<0.001). Qualitative image quality assessment revealed significantly superior ratings for image quality at 60-keV VMI+ (median, 5) in comparison with all other image series (p<0.001). Assessment of lesion delineation showed the highest rating scores for 40-keV VMI+ series (median, 5), while lowest subjective image noise was found for 100-keV VMI+ reconstructions (median, 5). Low-keV VMI+ reconstructions led to improved image quality and lesion delineation of malignant lymphoma lesions compared to standard image reconstruction and traditional VMI at abdominal DECT examinations. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Numerical observer for atherosclerotic plaque classification in spectral computed tomography

PubMed Central

Lorsakul, Auranuch; Fakhri, Georges El; Worstell, William; Ouyang, Jinsong; Rakvongthai, Yothin; Laine, Andrew F.; Li, Quanzheng

2016-01-01

Abstract. Spectral computed tomography (SCT) generates better image quality than conventional computed tomography (CT). It has overcome several limitations for imaging atherosclerotic plaque. However, the literature evaluating the performance of SCT based on objective image assessment is very limited for the task of discriminating plaques. We developed a numerical-observer method and used it to assess performance on discrimination vulnerable-plaque features and compared the performance among multienergy CT (MECT), dual-energy CT (DECT), and conventional CT methods. Our numerical observer was designed to incorporate all spectral information and comprised two-processing stages. First, each energy-window domain was preprocessed by a set of localized channelized Hotelling observers (CHO). In this step, the spectral image in each energy bin was decorrelated using localized prewhitening and matched filtering with a set of Laguerre–Gaussian channel functions. Second, the series of the intermediate scores computed from all the CHOs were integrated by a Hotelling observer with an additional prewhitening and matched filter. The overall signal-to-noise ratio (SNR) and the area under the receiver operating characteristic curve (AUC) were obtained, yielding an overall discrimination performance metric. The performance of our new observer was evaluated for the particular binary classification task of differentiating between alternative plaque characterizations in carotid arteries. A clinically realistic model of signal variability was also included in our simulation of the discrimination tasks. The inclusion of signal variation is a key to applying the proposed observer method to spectral CT data. Hence, the task-based approaches based on the signal-known-exactly/background-known-exactly (SKE/BKE) framework and the clinical-relevant signal-known-statistically/background-known-exactly (SKS/BKE) framework were applied for analytical computation of figures of merit (FOM). Simulated data of a carotid-atherosclerosis patient were used to validate our methods. We used an extended cardiac-torso anthropomorphic digital phantom and three simulated plaque types (i.e., calcified plaque, fatty-mixed plaque, and iodine-mixed blood). The images were reconstructed using a standard filtered backprojection (FBP) algorithm for all the acquisition methods and were applied to perform two different discrimination tasks of: (1) calcified plaque versus fatty-mixed plaque and (2) calcified plaque versus iodine-mixed blood. MECT outperformed DECT and conventional CT systems for all cases of the SKE/BKE and SKS/BKE tasks (all p<0.01). On average of signal variability, MECT yielded the SNR improvements over other acquisition methods in the range of 46.8% to 65.3% (all p<0.01) for FBP-Ramp images and 53.2% to 67.7% (all p<0.01) for FBP-Hanning images for both identification tasks. This proposed numerical observer combined with our signal variability framework is promising for assessing material characterization obtained through the additional energy-dependent attenuation information of SCT. These methods can be further extended to other clinical tasks such as kidney or urinary stone identification applications. PMID:27429999

Application of single- and dual-energy CT brain tissue segmentation to PET monitoring of proton therapy

NASA Astrophysics Data System (ADS)

Berndt, Bianca; Landry, Guillaume; Schwarz, Florian; Tessonnier, Thomas; Kamp, Florian; Dedes, George; Thieke, Christian; Würl, Matthias; Kurz, Christopher; Ganswindt, Ute; Verhaegen, Frank; Debus, Jürgen; Belka, Claus; Sommer, Wieland; Reiser, Maximilian; Bauer, Julia; Parodi, Katia

2017-03-01

The purpose of this work was to evaluate the ability of single and dual energy computed tomography (SECT, DECT) to estimate tissue composition and density for usage in Monte Carlo (MC) simulations of irradiation induced β + activity distributions. This was done to assess the impact on positron emission tomography (PET) range verification in proton therapy. A DECT-based brain tissue segmentation method was developed for white matter (WM), grey matter (GM) and cerebrospinal fluid (CSF). The elemental composition of reference tissues was assigned to closest CT numbers in DECT space (DECTdist). The method was also applied to SECT data (SECTdist). In a validation experiment, the proton irradiation induced PET activity of three brain equivalent solutions (BES) was compared to simulations based on different tissue segmentations. Five patients scanned with a dual source DECT scanner were analyzed to compare the different segmentation methods. A single magnetic resonance (MR) scan was used for comparison with an established segmentation toolkit. Additionally, one patient with SECT and post-treatment PET scans was investigated. For BES, DECTdist and SECTdist reduced differences to the reference simulation by up to 62% when compared to the conventional stoichiometric segmentation (SECTSchneider). In comparison to MR brain segmentation, Dice similarity coefficients for WM, GM and CSF were 0.61, 0.67 and 0.66 for DECTdist and 0.54, 0.41 and 0.66 for SECTdist. MC simulations of PET treatment verification in patients showed important differences between DECTdist/SECTdist and SECTSchneider for patients with large CSF areas within the treatment field but not in WM and GM. Differences could be misinterpreted as PET derived range shifts of up to 4 mm. DECTdist and SECTdist yielded comparable activity distributions, and comparison of SECTdist to a measured patient PET scan showed improved agreement when compared to SECTSchneider. The agreement between predicted and measured PET activity distributions was improved by employing a brain specific segmentation applicable to both DECT and SECT data.

Optimization of window settings for standard and advanced virtual monoenergetic imaging in abdominal dual-energy CT angiography.

PubMed

Caruso, Damiano; Parinella, Ashley H; Schoepf, U Joseph; Stroebel, Maxwell H; Mangold, Stefanie; Wichmann, Julian L; Varga-Szemes, Akos; Ball, B Devon; De Santis, Domenico; Laghi, Andrea; De Cecco, Carlo N

2017-03-01

To determine the optimal window setting for displaying virtual monoenergetic reconstructions of third generation dual-source, dual-energy CT (DECT) angiography of the abdomen. Forty-five patients were evaluated with DECT angiography (90/150 kV, 180/90 ref. mAs). Three datasets were reconstructed: standard linear blending (M_0.6), 70 keV traditional virtual monoenergetic (M70), and 40 keV advanced noise-optimized virtual monoenergetic (M40+). The best window setting (width and level, W/L) was assessed by two blinded observers and was correlated with aortic attenuation to obtain the Optimized W/L setting (O-W/L). Subjective image quality was assessed, and vessel diameters were measured to determine any possible influences between different W/L settings. Repeated measures of variance were used to evaluate comparison of W/L values, image quality, and vessel sizing between M_0.6, M70, and M40+. The Best W/L (B-W/L) for M70 and M40+ was 880/280 and 1410/450, respectively. Results from regression analysis inferred an O-W/L of 850/270 for M70 and 1350/430 for M40+. Significant differences for W and L were found between the Best and the Optimized W/L for M40+, and between M70 and M40+ for both the Best and Optimized W/L. No significant differences for vessel measurements were found using the O-W/L for M40+ compared to the standard M_0.6 (p ≥ 0.16), and significant differences were observed when using the B-W/L with M40+ compared to M_0.6 (p ≤ 0.04). In order to optimize virtual monoenergetic imaging with both traditional M70 and advanced M40+, adjusting the W/L settings is necessary. Our results suggest a W/L setting of 850/270 for M70 and 1350/430 for M40+.

Adaptive noise correction of dual-energy computed tomography images.

PubMed

Maia, Rafael Simon; Jacob, Christian; Hara, Amy K; Silva, Alvin C; Pavlicek, William; Mitchell, J Ross

2016-04-01

Noise reduction in material density images is a necessary preprocessing step for the correct interpretation of dual-energy computed tomography (DECT) images. In this paper we describe a new method based on a local adaptive processing to reduce noise in DECT images An adaptive neighborhood Wiener (ANW) filter was implemented and customized to use local characteristics of material density images. The ANW filter employs a three-level wavelet approach, combined with the application of an anisotropic diffusion filter. Material density images and virtual monochromatic images are noise corrected with two resulting noise maps. The algorithm was applied and quantitatively evaluated in a set of 36 images. From that set of images, three are shown here, and nine more are shown in the online supplementary material. Processed images had higher signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) than the raw material density images. The average improvements in SNR and CNR for the material density images were 56.5 and 54.75%, respectively. We developed a new DECT noise reduction algorithm. We demonstrate throughout a series of quantitative analyses that the algorithm improves the quality of material density images and virtual monochromatic images.

Optimal Adaptive Statistical Iterative Reconstruction Percentage in Dual-energy Monochromatic CT Portal Venography.

PubMed

Zhao, Liqin; Winklhofer, Sebastian; Yang, Zhenghan; Wang, Keyang; He, Wen

2016-03-01

The aim of this article was to study the influence of different adaptive statistical iterative reconstruction (ASIR) percentages on the image quality of dual-energy computed tomography (DECT) portal venography in portal hypertension patients. DECT scans of 40 patients with cirrhosis (mean age, 56 years) at the portal venous phase were retrospectively analyzed. Monochromatic images at 60 and 70 keV were reconstructed with four ASIR percentages: 0%, 30%, 50%, and 70%. Computed tomography (CT) numbers of the portal veins (PVs), liver parenchyma, and subcutaneous fat tissue in the abdomen were measured. The standard deviation from the region of interest of the liver parenchyma was interpreted as the objective image noise (IN). The contrast-noise ratio (CNR) between PV and liver parenchyma was calculated. The diagnostic acceptability (DA) and sharpness of PV margins were obtained using a 5-point score. The IN, CNR, DA, and sharpness of PV were compared among the eight groups with different keV + ASIR level combinations. The IN, CNR, DA, and sharpness of PV of different keV + ASIR groups were all statistically different (P < 0.05). In the eight groups, the best and worst CNR were obtained in the 60 keV + 70% ASIR and 70 keV + 0% ASIR (filtered back-projection [FBP]) combination, respectively, whereas the largest and smallest objective IN were obtained in the 60 keV + 0% ASIR (FBP) and 70 keV + 70% combination. The highest DA and sharpness values of PV were obtained at 50% ASIR for 60 keV. An optimal ASIR percentage (50%) combined with an appropriate monochromatic energy level (60 keV) provides the highest DA in portal venography imaging, whereas for the higher monochromatic energy (70 keV) images, 30% ASIR provides the highest image quality, with less IN than 60 keV with 50% ASIR. Copyright © 2015 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Technical note: optimization for improved tube-loading efficiency in the dual-energy computed tomography coupled with balanced filter method.

PubMed

Saito, Masatoshi

2010-08-01

This article describes the spectral optimization of dual-energy computed tomography using balanced filters (bf-DECT) to reduce the tube loadings and dose by dedicating to the acquisition of electron density information, which is essential for treatment planning in radiotherapy. For the spectral optimization of bf-DECT, the author calculated the beam-hardening error and air kerma required to achieve a desired noise level in an electron density image of a 50-cm-diameter cylindrical water phantom. The calculation enables the selection of beam parameters such as tube voltage, balanced filter material, and its thickness. The optimal combination of tube voltages was 80 kV/140 kV in conjunction with Tb/Hf and Bi/Mo filter pairs; this combination agrees with that obtained in a previous study [M. Saito, "Spectral optimization for measuring electron density by the dual-energy computed tomography coupled with balanced filter method," Med. Phys. 36, 3631-3642 (2009)], although the thicknesses of the filters that yielded a minimum tube output were slightly different from those obtained in the previous study. The resultant tube loading of a low-energy scan of the present bf-DECT significantly decreased from 57.5 to 4.5 times that of a high-energy scan for conventional DECT. Furthermore, the air kerma of bf-DECT could be reduced to less than that of conventional DECT, while obtaining the same figure of merit for the measurement of electron density and effective atomic number. The tube-loading and dose efficiencies of bf-DECT were considerably improved by sacrificing the quality of the noise level in the images of effective atomic number.

Improved tissue assignment using dual-energy computed tomography in low-dose rate prostate brachytherapy for Monte Carlo dose calculation

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

Côté, Nicolas; Bedwani, Stéphane; Carrier, Jean-François, E-mail: jean-francois.carrier.chum@ssss.gouv.qc.ca

Purpose: An improvement in tissue assignment for low-dose rate brachytherapy (LDRB) patients using more accurate Monte Carlo (MC) dose calculation was accomplished with a metallic artifact reduction (MAR) method specific to dual-energy computed tomography (DECT). Methods: The proposed MAR algorithm followed a four-step procedure. The first step involved applying a weighted blend of both DECT scans (I {sub H/L}) to generate a new image (I {sub Mix}). This action minimized Hounsfield unit (HU) variations surrounding the brachytherapy seeds. In the second step, the mean HU of the prostate in I {sub Mix} was calculated and shifted toward the mean HUmore » of the two original DECT images (I {sub H/L}). The third step involved smoothing the newly shifted I {sub Mix} and the two original I {sub H/L}, followed by a subtraction of both, generating an image that represented the metallic artifact (I {sub A,(H/L)}) of reduced noise levels. The final step consisted of subtracting the original I {sub H/L} from the newly generated I {sub A,(H/L)} and obtaining a final image corrected for metallic artifacts. Following the completion of the algorithm, a DECT stoichiometric method was used to extract the relative electronic density (ρ{sub e}) and effective atomic number (Z {sub eff}) at each voxel of the corrected scans. Tissue assignment could then be determined with these two newly acquired physical parameters. Each voxel was assigned the tissue bearing the closest resemblance in terms of ρ{sub e} and Z {sub eff}, comparing with values from the ICRU 42 database. A MC study was then performed to compare the dosimetric impacts of alternative MAR algorithms. Results: An improvement in tissue assignment was observed with the DECT MAR algorithm, compared to the single-energy computed tomography (SECT) approach. In a phantom study, tissue misassignment was found to reach 0.05% of voxels using the DECT approach, compared with 0.40% using the SECT method. Comparison of the DECT and SECT D {sub 90} dose parameter (volume receiving 90% of the dose) indicated that D {sub 90} could be underestimated by up to 2.3% using the SECT method. Conclusions: The DECT MAR approach is a simple alternative to reduce metallic artifacts found in LDRB patient scans. Images can be processed quickly and do not require the determination of x-ray spectra. Substantial information on density and atomic number can also be obtained. Furthermore, calcifications within the prostate are detected by the tissue assignment algorithm. This enables more accurate, patient-specific MC dose calculations.« less

A simple formulation for deriving effective atomic numbers via electron density calibration from dual-energy CT data in the human body.

PubMed

Saito, Masatoshi; Sagara, Shota

2017-06-01

The main objective of this study is to propose a simple formulation (which we called DEEDZ) for deriving effective atomic numbers (Z eff ) via electron density (ρ e ) calibration from dual-energy (DE) CT data. We carried out numerical analysis of this DEEDZ method for a large variety of materials with known elemental compositions and mass densities using an available photon cross sections database. The new conversion approach was also applied to previously published experimental DECT data to validate its practical feasibility. We performed numerical analysis of the DEEDZ conversion method for tissue surrogates that have the same chemical compositions and mass densities as a commercial tissue-characterization phantom in order to determine the parameters necessary for the ρ e and Z eff calibrations in the DEEDZ conversion. These parameters were then applied to the human-body-equivalent tissues of ICRU Report 46 as objects of interest with unknown ρ e and Z eff . The attenuation coefficients of these materials were calculated using the XCOM photon cross sections database. We also applied the DEEDZ conversion to experimental DECT data available in the literature, which was measured for two commercial phantoms of different shapes and sizes using a dual-source CT scanner at 80 kV and 140 kV/Sn. The simulated Z eff 's were in excellent agreement with the reference values for almost all of the ICRU-46 human tissues over the Z eff range from 5.83 (gallstones-cholesterol) to 16.11 (bone mineral-hydroxyapatite). The relative deviations from the reference Z eff were within ± 0.3% for all materials, except for one outlier that presented a -3.1% deviation, namely, the thyroid. The reason for this discrepancy is that the thyroid contains a small amount of iodine, an element with a large atomic number (Z = 53). In the experimental case, we confirmed that the simple formulation with less fit parameters enable to calibrate Z eff as accurately as the existing calibration procedure. The DEEDZ conversion method based on the simple formulation proposed could facilitate the construction of ρ e and Z eff images from acquired DECT data. © 2017 American Association of Physicists in Medicine.

Delayed enhancement cardiac computed tomography for the assessment of myocardial infarction: from bench to bedside

PubMed Central

2017-01-01

A large number of studies support the increasingly relevant prognostic value of the presence and extent of delayed enhancement (DE), a surrogate marker of fibrosis, in diverse etiologies. Gadolinium and iodinated based contrast agents share similar kinetics, thus leading to comparable myocardial characterization with cardiac magnetic resonance (CMR) and cardiac computed tomography (CT) at both first-pass perfusion and DE imaging. We review the available evidence of DE imaging for the assessment of myocardial infarction (MI) using cardiac CT (CTDE), from animal to clinical studies, and from 16-slice CT to dual-energy CT systems (DECT). Although both CMR and gadolinium agents have been originally deemed innocuous, a number of concerns (though inconclusive and very rare) have been recently issued regarding safety issues, including DNA double-strand breaks related to CMR, and gadolinium-associated nephrogenic systemic fibrosis and deposition in the skin and certain brain structures. These concerns have to be considered in the context of non-negligible rates of claustrophobia, increasing rates of patients with implantable cardiac devices, and a number of logistic drawbacks compared with CTDE, such as higher costs, longer scanning times, and difficulties to scan patients with impaired breath-holding capabilities. Overall, these issues might encourage the role of CTDE as an alternative for DE-CMR in selected populations. PMID:28540211

Systematic implementation of spectral CT with a photon counting detector for liquid security inspection

NASA Astrophysics Data System (ADS)

Xu, Xiaofei; Xing, Yuxiang; Wang, Sen; Zhang, Li

2018-06-01

X-ray liquid security inspection system plays an important role in homeland security, while the conventional dual-energy CT (DECT) system may have a big deviation in extracting the atomic number and the electron density of materials in various conditions. Photon counting detectors (PCDs) have the capability of discriminating the incident photons of different energy. The technique becomes more and more mature in nowadays. In this work, we explore the performance of a multi-energy CT imaging system with a PCD for liquid security inspection in material discrimination. We used a maximum-likelihood (ML) decomposition method with scatter correction based on a cross-energy response model (CERM) for PCDs so that to improve the accuracy of atomic number and electronic density imaging. Experimental study was carried to examine the effectiveness and robustness of the proposed system. Our results show that the concentration of different solutions in physical phantoms can be reconstructed accurately, which could improve the material identification compared to current available dual-energy liquid security inspection systems. The CERM-base decomposition and reconstruction method can be easily used to different applications such as medical diagnosis.

Quantification of lung perfusion blood volume (lung PBV) by dual-energy CT in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after balloon pulmonary angioplasty (BPA): Preliminary results.

PubMed

Koike, Hirofumi; Sueyoshi, Eijun; Sakamoto, Ichiro; Uetani, Masataka; Nakata, Tomoo; Maemura, Kouji

2016-09-01

Balloon pulmonary angioplasty (BPA) is a treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Its effect on pulmonary perfusion has not been quantified; we examined the clinical significance of pulmonary blood volume (PBV) using dual-energy computed tomography (DECT) in patients with CTEPH undergoing BPA. In this retrospective study of 16 BPAs in eight female patients with CTEPH, we evaluated both-lung (n=16), right- or left-lung (n=32), and three right- or left-segment (upper, middle, and lower) (n=96) PBVs before and after BPA, using DECT. We evaluated the relationships between improvement in lung PBV and pulmonary artery (PA) pressure (PAP), cardiac index (CI), pulmonary vascular resistance (PVR), and 6-min walking distance. We measured PA enhancement (PAenh) on DECT images and calculated lung PBV/PAenh to adjust timing. Pre- and post-BPA 6-segment lung PBV/PAenh were 0.067±0.021 and 0.077±0.019, respectively, in the treated segment (p<0.0001). There were significant positive correlations between pre- to post-BPA improvements in both-lung PBV/PAenh and PAP (R=0.69, p=0.005), PVR (R=0.56, p=0.03), and 6-min walking distance (R=0.67, p=0.01). Improved PBV after BPA, reflecting increased lung perfusion, was positively correlated with PAP, PVR, and 6-min walking distance. Lung PBV may be an indicator of BPA treatment effect. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Experimental verification of stopping-power prediction from single- and dual-energy computed tomography in biological tissues

NASA Astrophysics Data System (ADS)

Möhler, Christian; Russ, Tom; Wohlfahrt, Patrick; Elter, Alina; Runz, Armin; Richter, Christian; Greilich, Steffen

2018-01-01

An experimental setup for consecutive measurement of ion and x-ray absorption in tissue or other materials is introduced. With this setup using a 3D-printed sample container, the reference stopping-power ratio (SPR) of materials can be measured with an uncertainty of below 0.1%. A total of 65 porcine and bovine tissue samples were prepared for measurement, comprising five samples each of 13 tissue types representing about 80% of the total body mass (three different muscle and fatty tissues, liver, kidney, brain, heart, blood, lung and bone). Using a standard stoichiometric calibration for single-energy CT (SECT) as well as a state-of-the-art dual-energy CT (DECT) approach, SPR was predicted for all tissues and then compared to the measured reference. With the SECT approach, the SPRs of all tissues were predicted with a mean error of (-0.84  ±  0.12)% and a mean absolute error of (1.27  ±  0.12)%. In contrast, the DECT-based SPR predictions were overall consistent with the measured reference with a mean error of (-0.02  ±  0.15)% and a mean absolute error of (0.10  ±  0.15)%. Thus, in this study, the potential of DECT to decrease range uncertainty could be confirmed in biological tissue.

TU-AB-BRC-03: Accurate Tissue Characterization for Monte Carlo Dose Calculation Using Dual-and Multi-Energy CT Data

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

Lalonde, A; Bouchard, H

Purpose: To develop a general method for human tissue characterization with dual-and multi-energy CT and evaluate its performance in determining elemental compositions and the associated proton stopping power relative to water (SPR) and photon mass absorption coefficients (EAC). Methods: Principal component analysis is used to extract an optimal basis of virtual materials from a reference dataset of tissues. These principal components (PC) are used to perform two-material decomposition using simulated DECT data. The elemental mass fraction and the electron density in each tissue is retrieved by measuring the fraction of each PC. A stoichiometric calibration method is adapted to themore » technique to make it suitable for clinical use. The present approach is compared with two others: parametrization and three-material decomposition using the water-lipid-protein (WLP) triplet. Results: Monte Carlo simulations using TOPAS for four reference tissues shows that characterizing them with only two PC is enough to get a submillimetric precision on proton range prediction. Based on the simulated DECT data of 43 references tissues, the proposed method is in agreement with theoretical values of protons SPR and low-kV EAC with a RMS error of 0.11% and 0.35%, respectively. In comparison, parametrization and WLP respectively yield RMS errors of 0.13% and 0.29% on SPR, and 2.72% and 2.19% on EAC. Furthermore, the proposed approach shows potential applications for spectral CT. Using five PC and five energy bins reduces the SPR RMS error to 0.03%. Conclusion: The proposed method shows good performance in determining elemental compositions from DECT data and physical quantities relevant to radiotherapy dose calculation and generally shows better accuracy and unbiased results compared to reference methods. The proposed method is particularly suitable for Monte Carlo calculations and shows promise in using more than two energies to characterize human tissue with CT.« less

Spectral optimization for measuring electron density by the dual-energy computed tomography coupled with balanced filter method.

PubMed

Saito, Masatoshi

2009-08-01

Dual-energy computed tomography (DECT) has the potential for measuring electron density distribution in a human body to predict the range of particle beams for treatment planning in proton or heavy-ion radiotherapy. However, thus far, a practical dual-energy method that can be used to precisely determine electron density for treatment planning in particle radiotherapy has not been developed. In this article, another DECT technique involving a balanced filter method using a conventional x-ray tube is described. For the spectral optimization of DECT using balanced filters, the author calculates beam-hardening error and air kerma required to achieve a desired noise level in electron density and effective atomic number images of a cylindrical water phantom with 50 cm diameter. The calculation enables the selection of beam parameters such as tube voltage, balanced filter material, and its thickness. The optimized parameters were applied to cases with different phantom diameters ranging from 5 to 50 cm for the calculations. The author predicts that the optimal combination of tube voltages would be 80 and 140 kV with Tb/Hf and Bi/Mo filter pairs for the 50-cm-diameter water phantom. When a single phantom calibration at a diameter of 25 cm was employed to cover all phantom sizes, maximum absolute beam-hardening errors were 0.3% and 0.03% for electron density and effective atomic number, respectively, over a range of diameters of the water phantom. The beam-hardening errors were 1/10 or less as compared to those obtained by conventional DECT, although the dose was twice that of the conventional DECT case. From the viewpoint of beam hardening and the tube-loading efficiency, the present DECT using balanced filters would be significantly more effective in measuring the electron density than the conventional DECT. Nevertheless, further developments of low-exposure imaging technology should be necessary as well as x-ray tubes with higher outputs to apply DECT coupled with the balanced filter method for clinical use.

SU-F-207-07: Dual-Energy Computed Tomography Detection Limit of Various Radiopaque Contrast Agents That Can Be Infused Within Absorbable Inferior Vena Cava Filters

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

Melancon, A; Jacobsen, M; Salatan, F

Purpose: Absorbable IVC filters are shown to be safe and efficacious in preventing pulmonary embolism. These absorbable filters disappear from the body after their required duration, alleviating costly removal procedures and downstream complications. Monitoring the positioning and integrity of absorbable devices using dual-energy computed tomography (DECT) would improve treatment efficacy. The purpose of this study is to determine the limit of detection and the energy dependence of DECT for various contrast agents that may be infused within the IVC filters including gold nanoparticles (AuNP) having diameters of 2 and 4 nm. Methods: All imaging studies were performed on a GEmore » Discovery CT750 system in Gemstone Spectral Imaging (GSI) mode. Plastic vials containing the contrast agent solutions of water and blood were placed in a water bath, and images were acquired with the GSI-5 preset. The images were reformatted into the coronal plane and 5mm diameter ROIs were placed within each solution on a GE Advantage Workstation. Monoenergetic reconstructions were generated from 40 – 140 keV. Results: Mass attenuation (contrast per unit density) for AuNPs was greater than iron, but less than barium and iodine. Contrast was 10.2 (± 3.6) HU for 4 nm AuNP at 0.72 mg/ml and 12.1 (± 4.2) for 2 nm AuNP at 0.31 mg/ml at 70 keV suggesting reasonable chance of visualization at these concentrations for 70 keV reconstruction. The contrast as a function of CT energy is similar in both water and blood. Iodine is most dependent, followed closely by barium and iron, and trailed by a large margin by the AuNP. This was unexpected given Au’s large atomic number and the predominance of photoelectric effect at low energy. Conclusion: Infusion of IVC filters with AuNP is feasible. Discrimination of AuNP-infused IVC filters from surrounding anatomy warrants further investigation.« less

Application of dual-energy CT to suppression of metal artefact caused by pedicle screw fixation in radiotherapy: a feasibility study using original phantom

NASA Astrophysics Data System (ADS)

Wang, Tianyuan; Ishihara, Takeaki; Kono, Atsushi; Yoshida, Naoki; Akasaka, Hiroaki; Mukumoto, Naritoshi; Yada, Ryuichi; Ejima, Yasuo; Yoshida, Kenji; Miyawaki, Daisuke; Kakutani, Kenichiro; Nishida, Kotaro; Negi, Noriyuki; Minami, Toshiaki; Aoyama, Yuuichi; Takahashi, Satoru; Sasaki, Ryohei

2017-08-01

The objective of the present study was the determination of the potential dosimetric benefits of using metal-artefact-suppressed dual-energy computed tomography (DECT) images for cases involving pedicle screw implants in spinal sites. A heterogeneous spinal phantom was designed for the investigation of the dosimetric effect of the pedicle-screw-related artefacts. The dosimetric comparisons were first performed using a conventional two-directional opposed (AP-PA) plan, and then a volumetric modulated arc therapy (VMAT) plan, which are both used for the treatment of spinal metastases in our institution. The results of Acuros® XB dose-to-medium (Dm) and dose-to-water (Dw) calculations using different imaging options were compared with experimental measurements including the chamber and film dosimetries in the spinal phantom. A dual-energy composition image with a weight factor of  -0.2 and a dual-energy monochromatic image (DEMI) with an energy level of 180 keV were found to have superior abilities for artefact suppression. The Dm calculations revealed greater dosimetric effects of the pedicle screw-related artefacts compared to the Dw calculations. The results of conventional single-energy computed tomography showed that, although the pedicle screws were made from low-Z titanium alloy, the metal artefacts still have dosimetric effects, namely, an average (maximum) Dm error of 4.4% (5.6%) inside the spinal cord for a complex VMAT treatment plan. Our findings indicate that metal-artefact suppression using the proposed DECT (DEMI) approach is promising for improving the dosimetric accuracy near the implants and inside the spinal cord (average (maximum) Dm error of 1.1% (2.0%)).

Dual-energy CT for the characterization of urinary calculi: In vitro and in vivo evaluation of a low-dose scanning protocol.

PubMed

Thomas, C; Patschan, O; Ketelsen, D; Tsiflikas, I; Reimann, A; Brodoefel, H; Buchgeister, M; Nagele, U; Stenzl, A; Claussen, C; Kopp, A; Heuschmid, M; Schlemmer, H-P

2009-06-01

The efficiency and radiation dose of a low-dose dual-energy (DE) CT protocol for the evaluation of urinary calculus disease were evaluated. A low-dose dual-source DE-CT renal calculi protocol (140 kV, 46 mAs; 80 kV, 210 mAs) was derived from the single-energy (SE) CT protocol used in our institution for the detection of renal calculi (120 kV, 75 mAs). An Alderson-Rando phantom was equipped with thermoluminescence dosimeters and examined by CT with both protocols. The effective doses were calculated. Fifty-one patients with suspected or known urinary calculus disease underwent DE-CT. DE analysis was performed if calculi were detected using a dedicated software tool. Results were compared to chemical analysis after invasive calculus extraction. An effective dose of 3.43 mSv (male) and 5.30 mSv (female) was measured in the phantom for the DE protocol (vs. 3.17/4.57 mSv for the SE protocol). Urinary calculi were found in 34 patients; in 28 patients, calculi were removed and analyzed (23 patients with calcified calculi, three with uric acid calculi, one with 2,8-dihyxdroxyadenine-calculi, one patient with a mixed struvite calculus). DE analysis was able to distinguish between calcified and non-calcified calculi in all cases. In conclusion, dual-energy urinary calculus analysis is effective also with a low-dose protocol. The protocol tested in this study reliably identified calcified urinary calculi in vivo.

In vivo characterization of urinary calculi on dual-energy CT: going a step ahead with sub-differentiation of calcium stones.

PubMed

Acharya, Sudeep; Goyal, Ankur; Bhalla, Ashu Seith; Sharma, Raju; Seth, Amlesh; Gupta, Arun Kumar

2015-07-01

The role of dual-energy computed tomography (DECT) in characterization of urinary calculi is evolving and literature regarding differentiation of calcium calculi is sparse and confounding. To evaluate the capability of DECT in assessing the urinary calculi composition in vivo, especially in differentiating various types of calcium calculi. One hundred and twenty patients underwent DECT for characterization of urinary calculi. Seventy patients with 114 calculi, including 93 calcium stones, were retrospectively analyzed. DE ratios and attenuation differences were compared using ANOVA and receiver-operating-characteristic (ROC) analysis was done to predict cut-off values, in particular for detecting calcium-oxalate-monohydrate (COM) stones. DE ratio ≤1.14 accurately detected uric acid calculi, ≥1.29 was definitive for calcium and intermediate values were characteristic of cystine stones. DE ratios were significantly different between group 1 (COM [n = 32]; mean 1.376 ± 0.041), group 2 ([calcium oxalate dihydrate (COD) + COM] [n = 51]; 1.416 ± 0.048), and group 3 ([carbonate apatite (CaP) + COD + COM] [n = 10]; 1.468 ± 0.038) (group 1 vs. 2, P = 0.001; 1 vs. 3, P = 0.000; 2 vs. 3, P = 0.004). More importantly, pure COM calculi (group 1) had significantly lower DE ratio compared with mixed calcium calculi (groups 2 and 3) (P = 0.000). Attenuation differences (between low and high kV images) could not distinguish between COM and mixed calculi. ROC analysis for detection of COM calculi yielded AUC of 0.770 with cut-off DE ratio 1.385 (sensitivity 65.6%, specificity 82%) and value <1.335 was seen only with COM calculi (100% specificity). DECT can be employed for in vivo differentiation of various types of calculi and for detection of relatively lithotripsy-resistant COM calculi. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Differentiation of low-attenuation intracranial hemorrhage and calcification using dual-energy computed tomography in a phantom system

PubMed Central

Nute, Jessica L.; Roux, Lucia Le; Chandler, Adam G.; Baladandayuthapani, Veera; Schellingerhout, Dawid; Cody, Dianna D.

2015-01-01

Objectives Calcific and hemorrhagic intracranial lesions with attenuation levels of <100 Hounsfield Units (HU) cannot currently be reliably differentiated by single-energy computed tomography (SECT). The proper differentiation of these lesion types would have a multitude of clinical applications. A phantom model was used to test the ability of dual-energy CT (DECT) to differentiate such lesions. Materials and Methods Agar gel-bound ferric oxide and hydroxyapatite were used to model hemorrhage and calcification, respectively. Gel models were scanned using SECT and DECT and organized into SECT attenuation-matched pairs at 16 attenuation levels between 0 and 100 HU. DECT data were analyzed using 3D Gaussian mixture models (GMMs), as well as a simplified threshold plane metric derived from the 3D GMM, to assign voxels to hemorrhagic or calcific categories. Accuracy was calculated by comparing predicted voxel assignments with actual voxel identities. Results We measured 6,032 voxels from each gel model, for a total of 193,024 data points (16 matched model pairs). Both the 3D GMM and its more clinically implementable threshold plane derivative yielded similar results, with >90% accuracy at matched SECT attenuation levels ≥50 HU. Conclusions Hemorrhagic and calcific lesions with attenuation levels between 50 and 100 HU were differentiable using DECT in a clinically relevant phantom system with >90% accuracy. This method warrants further testing for potential clinical applications. PMID:25162534

Dual energy CT: How well can pseudo-monochromatic imaging reduce metal artifacts?

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

Kuchenbecker, Stefan, E-mail: stefan.kuchenbecker@dkfz.de; Faby, Sebastian; Sawall, Stefan

2015-02-15

Purpose: Dual Energy CT (DECT) provides so-called monoenergetic images based on a linear combination of the original polychromatic images. At certain patient-specific energy levels, corresponding to certain patient- and slice-dependent linear combination weights, e.g., E = 160 keV corresponds to α = 1.57, a significant reduction of metal artifacts may be observed. The authors aimed at analyzing the method for its artifact reduction capabilities to identify its limitations. The results are compared with raw data-based processing. Methods: Clinical DECT uses a simplified version of monochromatic imaging by linearly combining the low and the high kV images and by assigning an energymore » to that linear combination. Those pseudo-monochromatic images can be used by radiologists to obtain images with reduced metal artifacts. The authors analyzed the underlying physics and carried out a series expansion of the polychromatic attenuation equations. The resulting nonlinear terms are responsible for the artifacts, but they are not linearly related between the low and the high kV scan: A linear combination of both images cannot eliminate the nonlinearities, it can only reduce their impact. Scattered radiation yields additional noncanceling nonlinearities. This method is compared to raw data-based artifact correction methods. To quantify the artifact reduction potential of pseudo-monochromatic images, they simulated the FORBILD abdomen phantom with metal implants, and they assessed patient data sets of a clinical dual source CT system (100, 140 kV Sn) containing artifacts induced by a highly concentrated contrast agent bolus and by metal. In each case, they manually selected an optimal α and compared it to a raw data-based material decomposition in case of simulation, to raw data-based material decomposition of inconsistent rays in case of the patient data set containing contrast agent, and to the frequency split normalized metal artifact reduction in case of the metal implant. For each case, the contrast-to-noise ratio (CNR) was assessed. Results: In the simulation, the pseudo-monochromatic images yielded acceptable artifact reduction results. However, the CNR in the artifact-reduced images was more than 60% lower than in the original polychromatic images. In contrast, the raw data-based material decomposition did not significantly reduce the CNR in the virtual monochromatic images. Regarding the patient data with beam hardening artifacts and with metal artifacts from small implants the pseudo-monochromatic method was able to reduce the artifacts, again with the downside of a significant CNR reduction. More intense metal artifacts, e.g., as those caused by an artificial hip joint, could not be suppressed. Conclusions: Pseudo-monochromatic imaging is able to reduce beam hardening, scatter, and metal artifacts in some cases but it cannot remove them. In all cases, the CNR is significantly reduced, thereby rendering the method questionable, unless special post processing algorithms are implemented to restore the high CNR from the original images (e.g., by using a frequency split technique). Raw data-based dual energy decomposition methods should be preferred, in particular, because the CNR penalty is almost negligible.« less

Optimization of dual-energy CT acquisitions for proton therapy using projection-based decomposition.

PubMed

Vilches-Freixas, Gloria; Létang, Jean Michel; Ducros, Nicolas; Rit, Simon

2017-09-01

Dual-energy computed tomography (DECT) has been presented as a valid alternative to single-energy CT to reduce the uncertainty of the conversion of patient CT numbers to proton stopping power ratio (SPR) of tissues relative to water. The aim of this work was to optimize DECT acquisition protocols from simulations of X-ray images for the treatment planning of proton therapy using a projection-based dual-energy decomposition algorithm. We have investigated the effect of various voltages and tin filtration combinations on the SPR map accuracy and precision, and the influence of the dose allocation between the low-energy (LE) and the high-energy (HE) acquisitions. For all spectra combinations, virtual CT projections of the Gammex phantom were simulated with a realistic energy-integrating detector response model. Two situations were simulated: an ideal case without noise (infinite dose) and a realistic situation with Poisson noise corresponding to a 20 mGy total central dose. To determine the optimal dose balance, the proportion of LE-dose with respect to the total dose was varied from 10% to 90% while keeping the central dose constant, for four dual-energy spectra. SPR images were derived using a two-step projection-based decomposition approach. The ranges of 70 MeV, 90 MeV, and 100 MeV proton beams onto the adult female (AF) reference computational phantom of the ICRP were analytically determined from the reconstructed SPR maps. The energy separation between the incident spectra had a strong impact on the SPR precision. Maximizing the incident energy gap reduced image noise. However, the energy gap was not a good metric to evaluate the accuracy of the SPR. In terms of SPR accuracy, a large variability of the optimal spectra was observed when studying each phantom material separately. The SPR accuracy was almost flat in the 30-70% LE-dose range, while the precision showed a minimum slightly shifted in favor of lower LE-dose. Photon noise in the SPR images (20 mGy dose) had lower impact on the proton range accuracy as comparable results were obtained for the noiseless situation (infinite dose). Root-mean-square range errors averaged over all irradiation angles associated to dual-energy imaging were comprised between 0.50 mm and 0.72 mm for the noiseless situation and between 0.51 mm and 0.77 mm for the realistic scenario. The impact of the dual-energy spectra and the dose allocation between energy levels on the SPR accuracy and precision determined through a projection-based dual-energy algorithm were evaluated to guide the choice of spectra for dual-energy CT for proton therapy. The dose balance between energy levels was not found to be sensitive for the SPR estimation. The optimal pair of dual-energy spectra was material dependent but on a heterogeneous anthropomorphic phantom, there was no significant difference in range accuracy and the choice of spectra could be driven by the precision, i.e., the energy gap. © 2017 American Association of Physicists in Medicine.

Carotid dual-energy CT angiography: Evaluation of low keV calculated monoenergetic datasets by means of a frequency-split approach for noise reduction at low keV levels.

PubMed

Riffel, Philipp; Haubenreisser, Holger; Meyer, Mathias; Sudarski, Sonja; Morelli, John N; Schmidt, Bernhard; Schoenberg, Stefan O; Henzler, Thomas

2016-04-01

Calculated monoenergetic ultra-low keV datasets did not lead to improved contrast-to-noise ratio (CNR) due to the dramatic increase in image noise. The aim of the present study was to evaluate the objective image quality of ultra-low keV monoenergetic images (MEIs) calculated from carotid DECT angiography data with a new monoenergetic imaging algorithm using a frequency-split technique. 20 patients (12 male; mean age 53±17 years) were retrospectively analyzed. MEIs from 40 to 120 keV were reconstructed using the monoenergetic split frequency approach (MFSA). Additionally MEIs were reconstructed for 40 and 50 keV using a conventional monoenergetic (CM) software application. Signal intensity, noise, signal-to-noise ratio (SNR) and CNR were assessed in the basilar, common, internal carotid arteries. Ultra-low keV MEIs at 40 keV and 50 keV demonstrated highest vessel attenuation, significantly greater than those of the polyenergetic images (PEI) (all p-values <0.05). The highest SNR level and CNR level was found at 40 keV and 50 keV (all p-values <0.05). MEIs with MFSA showed significantly lower noise levels than those processed with CM (all p-values <0.05) and no significant differences in vessel attenuation (p>0.05). Thus MEIs with MFSA showed significantly higher SNR and CNR compared to MEIs with CM. Combining the lower spatial frequency stack for contrast at low keV levels with the high spatial frequency stack for noise at high keV levels (frequency-split technique) leads to improved image quality of ultra-low keV monoenergetic DECT datasets when compared to previous monoenergetic reconstruction techniques without the frequency-split technique. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Quantitative image variables reflect the intratumoral pathologic heterogeneity of lung adenocarcinoma.

PubMed

Choi, E-Ryung; Lee, Ho Yun; Jeong, Ji Yun; Choi, Yoon-La; Kim, Jhingook; Bae, Jungmin; Lee, Kyung Soo; Shim, Young Mog

2016-10-11

We aimed to compare quantitative radiomic parameters from dual-energy computed tomography (DECT) of lung adenocarcinoma and pathologic complexity.A total 89 tumors with clinical stage I/II lung adenocarcinoma were prospectively included. Fifty one radiomic features were assessed both from iodine images and non-contrast images of DECT datasets. Comprehensive histologic subtyping was evaluated with all surgically resected tumors. The degree of pathologic heterogeneity was assessed using pathologic index and the number of mixture histologic subtypes in a tumor. Radiomic parameters were correlated with pathologic index. Tumors were classified as three groups according to the number of mixture histologic subtypes and radiomic parameters were compared between the three groups.Tumor density and 50th through 97.5th percentile Hounsfield units (HU) of histogram on non-contrast images showed strong correlation with the pathologic heterogeneity. Radiomic parameters including 75th and 97.5th percentile HU of histogram, entropy, and inertia on 1-, 2- and 3 voxel distance on non-contrast images showed incremental changes while homogeneity showed detrimental change according to the number of mixture histologic subtypes (all Ps < 0.05).Radiomic variables from DECT of lung adenocarcinoma reflect pathologic intratumoral heterogeneity, which may help in the prediction of intratumoral heterogeneity of the whole tumor.

Dual-energy computed tomography as a diagnostic tool for gout during intercritical periods.

PubMed

Breuer, Gabriel S; Bogot, Naama; Nesher, Gideon

2016-12-01

The aim of this study is to evaluate the diagnostic yield of dual-energy computed tomography (DECT) in detection of uric acid accumulation in joints or periarticular structures in patients suspected of having gout, in their intercritical period. Patients with a history of recurrent, short-lived mono- or oligo-arthralgia or arthritis, referred to the rheumatology clinic for diagnosis of their condition, were included in this retrospective evaluation. DECT confirmed the diagnosis of gout in 30 of 50 patients (60%). A positive DECT was present in 12 of 16 cases (75%) with serum uric acid > 8.5 mg/dL, compared to seven of 13 cases (54%) and two of five cases (40%) with levels of 6.1-8.5 mg/dL and ≤ 6 mg/dL, respectively. The diagnostic impact of screening hands and feet were highest (78% and 56%, respectively). Follow-up data were available for 24 of the 30 patients with urate deposits identified by DECT. Twenty-one were treated with urate-lowering agents, all responded with lowering of serum uric acid and cessation of flares. Follow-up data were available for 16 of the 20 patients with no urate deposits identified by DECT. Gout was diagnosed in two of them by synovial fluid examination during subsequent flares. Both positive and negative predictive values of DECT for diagnosing gout in this patient population were 87%. Following DECT, treatment regimen was modified to gout-specific therapy in 52% of the patients. The ability to make a definite diagnosis of gout by DECT imaging in a substantial number of asymptomatic patients in the intercritical period should help in treatment decision-making and improve patient adherence to long-term urate-lowering therapy. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Evaluation of Functional Marrow Irradiation Based on Skeletal Marrow Composition Obtained Using Dual-Energy Computed Tomography

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

Magome, Taiki; Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota; Department of Radiology, The University of Tokyo Hospital, Tokyo

Purpose: To develop an imaging method to characterize and map marrow composition in the entire skeletal system, and to simulate differential targeted marrow irradiation based on marrow composition. Methods and Materials: Whole-body dual energy computed tomography (DECT) images of cadavers and leukemia patients were acquired, segmented to separate bone marrow components, namely, bone, red marrow (RM), and yellow marrow (YM). DECT-derived marrow fat fraction was validated using histology of lumbar vertebrae obtained from cadavers. The fractions of RM (RMF = RM/total marrow) and YMF were calculated in each skeletal region to assess the correlation of marrow composition with sites and ages. Treatmentmore » planning was simulated to target irradiation differentially at a higher dose (18 Gy) to either RM or YM and a lower dose (12 Gy) to the rest of the skeleton. Results: A significant correlation between fat fractions obtained from DECT and cadaver histology samples was observed (r=0.861, P<.0001, Pearson). The RMF decreased in the head, neck, and chest was significantly inversely correlated with age but did not show any significant age-related changes in the abdomen and pelvis regions. Conformity of radiation to targets (RM, YM) was significantly dependent on skeletal sites. The radiation exposure was significantly reduced (P<.05, t test) to organs at risk (OARs) in RM and YM irradiation compared with standard total marrow irradiation (TMI). Conclusions: Whole-body DECT offers a new imaging technique to visualize and measure skeletal-wide marrow composition. The DECT-based treatment planning offers volumetric and site-specific precise radiation dosimetry of RM and YM, which varies with aging. Our proposed method could be used as a functional compartment of TMI for further targeted radiation to specific bone marrow environment, dose escalation, reduction of doses to OARs, or a combination of these factors.« less

The utility of dual-energy CT for metal artifact reduction from intracranial clipping and coiling.

PubMed

Mera Fernández, D; Santos Armentia, E; Bustos Fiore, A; Villanueva Campos, A M; Utrera Pérez, E; Souto Bayarri, M

2018-04-23

To assess the ability of dual-energy CT (DECT) to reduce metal-related artifacts in patients with clips and coils in head CT angiography, and to analyze the differences in this reduction between both type of devices. Thirteen patients (6 clips, 7 coils) were selected and retrospectively analized. Virtual monoenergetic images (MEI) with photon energies from 40 to 150 keV were obtained. Noise was measured at the area of maximum artifact. Subjective evaluation of streak artifact was performed by two radiologists independently. Differences between noise values in all groups were tested by using the ANOVA test. Mann-Whitney U test was used to compare the differences between clips and coils. Coheńs κ statistic was used to determine interobserver agreement. The lowest noise value was observed at high energy levels (p<0,05). Noise was higher in the coil group than in the clip group (p<0.001). Interobserver agreement was good (κ=0.72). TCED with MEI helps to minimize the artifact from clips ands coils in patients who undergo head CT angiography. The reduction of the artifact is greater in patients with surgical clipping than in patients with endovascular coiling. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Xenon-Enhanced Dual-Energy CT Imaging in Combined Pulmonary Fibrosis and Emphysema

PubMed Central

Kobayashi, Masahiro; Nakamura, Yasuhiko; Gocho, Kyoko; Ishida, Fumiaki; Isobe, Kazutoshi; Shiraga, Nobuyuki; Homma, Sakae

2017-01-01

Background Little has been reported on the feasibility of xenon-enhanced dual-energy computed tomography (Xe-DECT) in the visual and quantitative analysis of combined pulmonary fibrosis and emphysema (CPFE). Objectives We compared CPFE with idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD), as well as correlation with parameters of pulmonary function tests (PFTs). Methods Studied in 3 groups were 25 patients with CPFE, 25 with IPF without emphysema (IPF alone), 30 with COPD. Xe-DECT of the patients’ entire thorax was taken from apex to base after a patient’s single deep inspiration of 35% stable nonradioactive xenon. The differences in several parameters of PFTs and percentage of areas enhanced by xenon between 3 groups were compared and analyzed retrospectively. Results The percentage of areas enhanced by xenon in both lungs were calculated as CPFE/IPF alone/COPD = 72.2 ± 15.1% / 82.2 ± 14.7% /45.2 ± 23.2%, respectively. In the entire patients, the percentage of areas enhanced by xenon showed significantly a positive correlation with FEV1/FVC (R = 0.558, P < 0.0001) and %FEV1, (R = 0.528, P < 0.0001) and a negative correlation with %RV (R = -0.594, P < 0.0001) and RV/TLC (R = -0.579, P < 0.0001). The percentage of areas enhanced by xenon in patients with CPFE showed significantly a negative correlation with RV/TLC (R = -0.529, P = 0.007). Xenon enhancement of CPFE indicated 3 different patterns such as upper predominant, diffuse, and multifocal defect. The percentage of areas enhanced by xenon in upper predominant defect pattern was significantly higher than that in diffuse defect and multifocal defect pattern among these 3 different patterns in CPFE. Conclusion The percentage of areas enhanced by xenon demonstrated strong correlations with obstructive ventilation impairment. Therefore, we conclude that Xe-DECT may be useful for distinguishing emphysema lesion from fibrotic lesion in CPFE. PMID:28107411

Xenon-Enhanced Dual-Energy CT Imaging in Combined Pulmonary Fibrosis and Emphysema.

PubMed

Sugino, Keishi; Kobayashi, Masahiro; Nakamura, Yasuhiko; Gocho, Kyoko; Ishida, Fumiaki; Isobe, Kazutoshi; Shiraga, Nobuyuki; Homma, Sakae

2017-01-01

Little has been reported on the feasibility of xenon-enhanced dual-energy computed tomography (Xe-DECT) in the visual and quantitative analysis of combined pulmonary fibrosis and emphysema (CPFE). We compared CPFE with idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD), as well as correlation with parameters of pulmonary function tests (PFTs). Studied in 3 groups were 25 patients with CPFE, 25 with IPF without emphysema (IPF alone), 30 with COPD. Xe-DECT of the patients' entire thorax was taken from apex to base after a patient's single deep inspiration of 35% stable nonradioactive xenon. The differences in several parameters of PFTs and percentage of areas enhanced by xenon between 3 groups were compared and analyzed retrospectively. The percentage of areas enhanced by xenon in both lungs were calculated as CPFE/IPF alone/COPD = 72.2 ± 15.1% / 82.2 ± 14.7% /45.2 ± 23.2%, respectively. In the entire patients, the percentage of areas enhanced by xenon showed significantly a positive correlation with FEV1/FVC (R = 0.558, P < 0.0001) and %FEV1, (R = 0.528, P < 0.0001) and a negative correlation with %RV (R = -0.594, P < 0.0001) and RV/TLC (R = -0.579, P < 0.0001). The percentage of areas enhanced by xenon in patients with CPFE showed significantly a negative correlation with RV/TLC (R = -0.529, P = 0.007). Xenon enhancement of CPFE indicated 3 different patterns such as upper predominant, diffuse, and multifocal defect. The percentage of areas enhanced by xenon in upper predominant defect pattern was significantly higher than that in diffuse defect and multifocal defect pattern among these 3 different patterns in CPFE. The percentage of areas enhanced by xenon demonstrated strong correlations with obstructive ventilation impairment. Therefore, we conclude that Xe-DECT may be useful for distinguishing emphysema lesion from fibrotic lesion in CPFE.

Role of Dual Energy Computed Tomography Imaging in the Diagnosis of Gout

PubMed Central

Sehra, Shiv T; Anand, Suneesh; Stallings, Gary W.; Danve, Abhijeet

2017-01-01

Gout is a well-known inflammatory arthritis and affects four percent of the United States population. It results from the deposition of uric acid crystals in joints, tendons, bursae, and other surrounding tissues. Prevalence of gout has increased in the recent decade. Gout is usually seen in conjunction with other chronic comorbid conditions like cardiac disease, metabolic syndrome, and renal disease. The diagnosis of this inflammatory arthritis is confirmed by visualization of monosodium urate (MSU) crystals in the synovial fluid. Though synovial fluid aspiration is the standard of care, it is often deferred because of inaccessibility of small joints, patient assessment during intercritical period, or procedural inexperience in a primary care office. Dual energy computed tomography (DECT) is a relatively new imaging modality which shows great promise in the diagnosis of gout. It is a good noninvasive alternative to synovial fluid aspiration. DECT is increasingly useful in diagnosing cases of gout where synovial fluid fails to demonstrate monosodium urate crystals. In this article, we will review the mechanism, types, advantages, and disadvantages of DECT. PMID:28229032

Dual-energy computed tomography in patients with cutaneous malignant melanoma: Comparison of noise-optimized and traditional virtual monoenergetic imaging.

PubMed

Martin, Simon S; Wichmann, Julian L; Weyer, Hendrik; Albrecht, Moritz H; D'Angelo, Tommaso; Leithner, Doris; Lenga, Lukas; Booz, Christian; Scholtz, Jan-Erik; Bodelle, Boris; Vogl, Thomas J; Hammerstingl, Renate

2017-10-01

The aim of this study was to investigate the impact of noise-optimized virtual monoenergetic imaging (VMI+) reconstructions on quantitative and qualitative image parameters in patients with cutaneous malignant melanoma at thoracoabdominal dual-energy computed tomography (DECT). Seventy-six patients (48 men; 66.6±13.8years) with metastatic cutaneous malignant melanoma underwent DECT of the thorax and abdomen. Images were post-processed with standard linear blending (M_0.6), traditional virtual monoenergetic (VMI), and VMI+ technique. VMI and VMI+ images were reconstructed in 10-keV intervals from 40 to 100keV. Attenuation measurements were performed in cutaneous melanoma lesions, as well as in regional lymph node, subcutaneous and in-transit metastases to calculate objective signal-to-noise (SNR) and contrast-to-noise (CNR) ratios. Five-point scales were used to evaluate overall image quality and lesion delineation by three radiologists with different levels of experience. Objective indices SNR and CNR were highest at 40-keV VMI+ series (5.6±2.6 and 12.4±3.4), significantly superior to all other reconstructions (all P<0.001). Qualitative image parameters showed highest values for 50-keV and 60-keV VMI+ reconstructions (median 5, respectively; P≤0.019) regarding overall image quality. Moreover, qualitative assessment of lesion delineation peaked in 40-keV VMI+ (median 5) and 50-keV VMI+ (median 4; P=0.055), significantly superior to all other reconstructions (all P<0.001). Low-keV noise-optimized VMI+ reconstructions substantially increase quantitative and qualitative image parameters, as well as subjective lesion delineation compared to standard image reconstruction and traditional VMI in patients with cutaneous malignant melanoma at thoracoabdominal DECT. Copyright © 2017 Elsevier B.V. All rights reserved.

A stoichiometric calibration method for dual energy computed tomography

NASA Astrophysics Data System (ADS)

Bourque, Alexandra E.; Carrier, Jean-François; Bouchard, Hugo

2014-04-01

The accuracy of radiotherapy dose calculation relies crucially on patient composition data. The computed tomography (CT) calibration methods based on the stoichiometric calibration of Schneider et al (1996 Phys. Med. Biol. 41 111-24) are the most reliable to determine electron density (ED) with commercial single energy CT scanners. Along with the recent developments in dual energy CT (DECT) commercial scanners, several methods were published to determine ED and the effective atomic number (EAN) for polyenergetic beams without the need for CT calibration curves. This paper intends to show that with a rigorous definition of the EAN, the stoichiometric calibration method can be successfully adapted to DECT with significant accuracy improvements with respect to the literature without the need for spectrum measurements or empirical beam hardening corrections. Using a theoretical framework of ICRP human tissue compositions and the XCOM photon cross sections database, the revised stoichiometric calibration method yields Hounsfield unit (HU) predictions within less than ±1.3 HU of the theoretical HU calculated from XCOM data averaged over the spectra used (e.g., 80 kVp, 100 kVp, 140 kVp and 140/Sn kVp). A fit of mean excitation energy (I-value) data as a function of EAN is provided in order to determine the ion stopping power of human tissues from ED-EAN measurements. Analysis of the calibration phantom measurements with the Siemens SOMATOM Definition Flash dual source CT scanner shows that the present formalism yields mean absolute errors of (0.3 ± 0.4)% and (1.6 ± 2.0)% on ED and EAN, respectively. For ion therapy, the mean absolute errors for calibrated I-values and proton stopping powers (216 MeV) are (4.1 ± 2.7)% and (0.5 ± 0.4)%, respectively. In all clinical situations studied, the uncertainties in ion ranges in water for therapeutic energies are found to be less than 1.3 mm, 0.7 mm and 0.5 mm for protons, helium and carbon ions respectively, using a generic reconstruction algorithm (filtered back projection). With a more advanced method (sinogram affirmed iterative technique), the values become 1.0 mm, 0.5 mm and 0.4 mm for protons, helium and carbon ions, respectively. These results allow one to conclude that the present adaptation of the stoichiometric calibration yields a highly accurate method for characterizing tissue with DECT for ion beam therapy and potentially for photon beam therapy.

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

Vinke, R; Peng, H; Xing, L

Purpose: In searching for a robust, efficient and cost-effective dual energy cone beam CT (DECBCT) solution for various radiation oncology applications, in particularly for improved proton dose planning/replanning accuracy and DE-CBCT guided radiation therapy, we investigate a novel energy modulation scheme using a beam modifier placed between the source and patient and optimize its geometric configuration for routine clinical use. Methods: The study was performed using a Hitachi CBCT scanner and the tube voltage was set at 125 kVp. The higher energy beam was obtained by filtering the incident utilizing a beam modulation layer (material: copper, thickness: 1.8 mm). Tomore » avoid the need for double scans (one with and one without the energy modulator), the modulation layer was configured to cover only the half of the X-ray beam so that two sets of sinograms corresponding low and high energies were collected after a single gantry rotation of 360 deg. The average high energy and low energy HU numbers (HUhigh and HUlow) were derived for pixels in a defined region-of-interest, respectively. Results: The beam modifier increased the threshold of the energy spectrum from ∼20 keV up to ∼50 keV. Two complete sets of images were obtained with good alignment between the high energy and low-energy cases without any artifact observed (Fig. 2). The HUlow/HUhigh is ∼0/0 (water), ∼394/238 (brain), ∼1283/1085 (cortical bone) and ∼3000/1800 (titanium). Conclusion: The feasibility of the proposed DECT implementation using a beam modifier has been demonstrated. Compared to the existing DECT solutions, the proposed scheme is much more cost-effective and requires minimum hardware modification. The work lays foundation for us to study the quantification of HU values to derive material density images and atomic number (and electron density) of substances.« less

Improved visualisation of early cerebral infarctions after endovascular stroke therapy using dual-energy computed tomography oedema maps.

PubMed

Grams, Astrid Ellen; Djurdjevic, Tanja; Rehwald, Rafael; Schiestl, Thomas; Dazinger, Florian; Steiger, Ruth; Knoflach, Michael; Gizewski, Elke Ruth; Glodny, Bernhard

2018-05-04

The aim was to investigate whether dual-energy computed tomography (DECT) reconstructions optimised for oedema visualisation (oedema map; EM) facilitate an improved detection of early infarctions after endovascular stroke therapy (EST). Forty-six patients (21 women; 25 men; mean age: 63 years; range 24-89 years) were included. The brain window (BW), virtual non-contrast (VNC) and modified VNC series based on a three-material decomposition technique optimised for oedema visualisation (EM) were evaluated. Follow-up imaging was used as the standard for comparison. Contralateral side to infarction differences in density (CIDs) were determined. Infarction detectability was assessed by two blinded readers, as well as image noise and contrast using Likert scales. ROC analyses were performed and the respective Youden indices calculated for cut-off analysis. The highest CIDs were found in the EM series (73.3 ± 49.3 HU), compared with the BW (-1.72 ± 13.29 HU) and the VNC (8.30 ± 4.74 HU) series. The EM was found to have the highest infarction detection rates (area under the curve: 0.97 vs. 0.54 and 0.90, p < 0.01) with a cut-off value of < 50.7 HU, despite slightly more pronounced image noise. The location of the infarction did not affect detectability (p > 0.05 each). The EM series allows higher contrast and better early infarction detection than the VNC or BW series after EST. • Dual-energy CT EM allows better early infarction detection than standard brain window. • Dual-energy CT EM series allow better early infarction detection than VNC series. • Dual-energy CT EM are modified VNC based on water content of tissue.

Can a dual-energy computed tomography predict unsuitable stone components for extracorporeal shock wave lithotripsy?

PubMed

Ahn, Sung Hoon; Oh, Tae Hoon; Seo, Ill Young

2015-09-01

To assess the potential of dual-energy computed tomography (DECT) to identify urinary stone components, particularly uric acid and calcium oxalate monohydrate, which are unsuitable for extracorporeal shock wave lithotripsy (ESWL). This clinical study included 246 patients who underwent removal of urinary stones and an analysis of stone components between November 2009 and August 2013. All patients received preoperative DECT using two energy values (80 kVp and 140 kVp). Hounsfield units (HU) were measured and matched to the stone component. Significant differences in HU values were observed between uric acid and nonuric acid stones at the 80 and 140 kVp energy values (p<0.001). All uric acid stones were red on color-coded DECT images, whereas 96.3% of the nonuric acid stones were blue. Patients with calcium oxalate stones were divided into two groups according to the amount of monohydrate (calcium oxalate monohydrate group: monohydrate≥90%, calcium oxalate dihydrate group: monohydrate<90%). Significant differences in HU values were detected between the two groups at both energy values (p<0.001). DECT improved the characterization of urinary stone components and was a useful method for identifying uric acid and calcium oxalate monohydrate stones, which are unsuitable for ESWL.

An image-domain, contrast material extraction method for Dual-Energy CT

PubMed Central

Lambert, Jack W.; Sun, Yuxin; Gould, Robert G.; Ohliger, Michael A.; Li, Zhixi; Yeh, Benjamin M.

2016-01-01

Objectives Conventional material decomposition techniques for dual-energy CT (DECT) assume mass or volume conservation, where the CT number of each voxel is fully assigned to predefined materials. We present an image-domain contrast material extraction process (CMEP) method that preferentially extracts contrast-producing materials while leaving the remaining image intact. Materials and Methods Image processing freeware (Fiji) is used to perform consecutive arithmetic operations on a dual-energy ratio map to generate masks, which are then applied to the original images to generate material-specific images. First, a low-energy image is divided by a high-energy image to generate a ratio map. The ratio map is then split into material-specific masks. Ratio intervals known to correspond to particular materials (e.g. iodine, calcium) are assigned a multiplier of 1, while ratio values in between these intervals are assigned linear gradients from 0 to 1. The masks are then multiplied by an original CT image to produce material-specific images. The method was tested quantitatively at Dual-Source (DSCT) and Rapid kVp-Switching CT (RSCT) with phantoms using pure and mixed formulations of tungsten, calcium and iodine. Errors were evaluated by comparing the known material concentrations with those derived from the CMEP material-specific images. Further qualitative evaluation was performed in vivo at RSCT with a rabbit model using identical CMEP parameters to the phantom. Orally administered tungsten, vascularly administered iodine, and skeletal calcium were used as the three contrast materials. Results All five material combinations; tungsten, iodine and calcium, and mixtures of tungsten-calcium and iodine-calcium, showed distinct dual-energy ratios, largely independent of material concentration at both DSCT and RSCT. The CMEP was successful in both phantoms and in vivo. For pure contrast materials in the phantom, the maximum error between the known and CMEP-derived material concentrations was 0.9 mg/mL, 24.9 mg/mL and 0.4 mg/mL for iodine, calcium and tungsten respectively. Mixtures of iodine and calcium showed the highest discrepancies, which reflected the sensitivity of iodine to the image-type chosen for the extraction of the final material-specific image. The rabbit model was able to clearly show the three extracted material phases, vascular iodine, oral tungsten and skeletal calcium. Some skeletal calcium was misassigned to the extracted iodine image, however this did not impede the depiction of the vasculature. Conclusions The CMEP is a straightforward, image domain approach to extract material signal at dual-energy CT. It has particular value for separation of experimental high-Z contrast elements from conventional iodine contrast or calcium, even when the exact attenuation coefficient profiles of desired contrast materials may be unknown. The CMEP is readily implemented in the image-domain within freeware, and can be adapted for use with images from multiple vendors. PMID:27875338

Low kV versus dual-energy virtual monoenergetic CT imaging for proven liver lesions: what are the advantages and trade-offs in conspicuity and image quality? A pilot study.

PubMed

Hanson, G Jay; Michalak, Gregory J; Childs, Robert; McCollough, Brian; Kurup, Anil N; Hough, David M; Frye, Judson M; Fidler, Jeff L; Venkatesh, Sudhakar K; Leng, Shuai; Yu, Lifeng; Halaweish, Ahmed F; Harmsen, W Scott; McCollough, Cynthia H; Fletcher, J G

2018-06-01

Single-energy low tube potential (SE-LTP) and dual-energy virtual monoenergetic (DE-VM) CT images both increase the conspicuity of hepatic lesions by increasing iodine signal. Our purpose was to compare the conspicuity of proven liver lesions, artifacts, and radiologist preferences in dose-matched SE-LTP and DE-VM images. Thirty-one patients with 72 proven liver lesions (21 benign, 51 malignant) underwent full-dose contrast-enhanced dual-energy CT (DECT). Half-dose images were obtained using single tube reconstruction of the dual-source SE-LTP projection data (80 or 100 kV), and by inserting noise into dual-energy projection data, with DE-VM images reconstructed from 40 to 70 keV. Three blinded gastrointestinal radiologists evaluated half-dose SE-LTP and DE-VM images, ranking and grading liver lesion conspicuity and diagnostic confidence (4-point scale) on a per-lesion basis. Image quality (noise, artifacts, sharpness) was evaluated, and overall image preference was ranked on per-patient basis. Lesion-to-liver contrast-to-noise ratio (CNR) was compared between techniques. Mean lesion size was 1.5 ± 1.2 cm. Across the readers, the mean conspicuity ratings for 40, 45, and 50 keV half-dose DE-VM images were superior compared to other half-dose image sets (p < 0.0001). Per-lesion diagnostic confidence was similar between half-dose SE-LTP compared to half-dose DE-VM images (p ≥ 0.05; 1.19 vs. 1.24-1.32). However, SE-LTP images had less noise and artifacts and were sharper compared to DE-VM images less than 70 keV (p < 0.05). On a per-patient basis, radiologists preferred SE-LTP images the most and preferred 40-50 keV the least (p < 0.0001). Lesion CNR was also higher in SE-LTP images than DE-VM images (p < 0.01). For the same applied dose level, liver lesions were more conspicuous using DE-VM compared to SE-LTP; however, SE-LTP images were preferred more than any single DE-VM energy level, likely due to lower noise and artifacts.

DECT Ventilation Imaging

ClinicalTrials.gov

2018-03-21

For Oncologic Patients; Potentially Operable Lung Tumor; With a Recent (Less Than 1 Month) VQ Scan; For Lung Transplant Recipients; Single of Bilateral Lung Transplant; From 5 Months Onwards; With Recent (Less Than 1 Month) Respiratory Functional Explorations

Visibility of bony structures around hip prostheses in dual-energy CT: With or without metal artefact reduction software.

PubMed

Jeong, Jewon; Kim, Hyun-Joo; Oh, Eunsun; Cha, Jang Gyu; Hwang, Jiyoung; Hong, Seong Sook; Chang, Yun Woo

2018-05-23

The development of dual-energy CT and metal artefact reduction software provides a further chance of reducing metal-related artefacts. However, there have been only a few studies regarding whether MARs practically affect visibility of structures around a metallic hip prosthesis on post-operative CT evaluation. Twenty-seven patients with 42 metallic hip prostheses underwent DECT. The datasets were reconstructed with 70, 90 and 110 keV with and without MARs. The areas were classified into 10 zones according to the reference zone. All the images were reviewed in terms of the severity of the beam-hardening artefacts, differentiation of the bony cortex and trabeculae and visualization of trabecular patterns with a three-point scale. The metallic screw diameter was measured in the acetabulum with 110 keV images. The scores were the worst on 70 keV images without MARs [mean scores:1.84-4.22 (p < 0.001-1.000)]. The structures in zone II were best visualized on 110 keV (p < 0.001-0.011, mean scores: 2.86-5.22). In other zones, there is general similarity in mean scores whether applying MARs or not (p < 0.001-0.920). The mean diameter of the screw was 5.85 mm without MARs and 3.44 mm with MARs (mean reference diameter: 6.48 mm). The 110 keV images without MARs are best for evaluating acetabular zone II. The visibility of the bony structures around the hip prosthesis is similar in the other zones with or without MARs regardless of keV. MARS may not be needed for the evaluation of the metallic hip prosthesis itself at sufficient high-energy levels; however, MARS still has a role in the evaluation of other soft tissues around the prosthesis. © 2018 The Royal Australian and New Zealand College of Radiologists.

Aerial Insecticide Treatments for Management of Dectes Stem Borer, Dectes texanus, in Soybean

PubMed Central

Sloderbeck, P. E.; Buschman, L.L.

2011-01-01

The Dectes stem borer, Dectes texanus LeConte (Coleoptera: Cerambycidae), is an increasingly important pest of soybean and sunflower in central North America. Nine large-scale field trials were conducted over a 3-year period to determine if Dectes stem borer could be managed with insecticide treatments. Aerial applications of lambda on July 6, 12 and 15 were successful in significantly reducing adults, but applications on July 1, 20 and 24 were less successful. These data suggest that for central Kansas two aerial applications may be required to control Dectes stem borers in soybean. Based on our experience the first application should be made at the peak of adult flight about July 5th and the second application 10 days later. The local treatment schedule should be developed to follow the local Dectes stem borer adult emergence pattern. Treated aerial strips 59 m (195 ft) wide were not large enough to prevent reinfestation, but treated half-circles (24 ha or 60 acres) were successful in reducing in Dectes stem borer infestation of soybean. Sweep net samples of adults were not successful in identifying a treatment threshold, so treatment decisions will need to be based on field history of infestation. Further studies are needed to identify better sampling methods that can be used to establish treatment thresholds and to refine the best timing for treatments. PMID:21861653

Optimization of Dual-Energy Xenon-CT for Quantitative Assessment of Regional Pulmonary Ventilation

PubMed Central

Fuld, Matthew K.; Halaweish, Ahmed; Newell, John D.; Krauss, Bernhard; Hoffman, Eric A.

2013-01-01

Objective Dual-energy X-ray computed tomography (DECT) offers visualization of the airways and quantitation of regional pulmonary ventilation using a single breath of inhaled xenon gas. In this study we seek to optimize scanning protocols for DECT xenon gas ventilation imaging of the airways and lung parenchyma and to characterize the quantitative nature of the developed protocols through a series of test-object and animal studies. Materials and Methods The Institutional Animal Care and Use Committee approved all animal studies reported here. A range of xenon-oxygen gas mixtures (0, 20, 25, 33, 50, 66, 100%; balance oxygen) were scanned in syringes and balloon test-objects to optimize the delivered gas mixture for assessment of regional ventilation while allowing for the development of improved three-material decomposition calibration parameters. Additionally, to alleviate gravitational effects on xenon gas distribution, we replaced a portion of the oxygen in the xenon/oxygen gas mixture with helium and compared gas distributions in a rapid-prototyped human central-airway test-object. Additional syringe tests were performed to determine if the introduction of helium had any effect on xenon quantitation. Xenon gas mixtures were delivered to anesthetized swine in order to assess airway and lung parenchymal opacification while evaluating various DECT scan acquisition settings. Results Attenuation curves for xenon were obtained from the syringe test objects and were used to develop improved three-material decomposition parameters (HU enhancement per percent xenon: Within the chest phantom: 2.25 at 80kVp, 1.7 at 100 kVp, and 0.76 at 140 kVp with tin filtration; In open air: 2.5 at 80kVp, 1.95 at 100 kVp, and 0.81 at 140 kVp with tin filtration). The addition of helium improved the distribution of xenon gas to the gravitationally non-dependent portion of the airway tree test-object, while not affecting quantitation of xenon in the three-material decomposition DECT. 40%Xe/40%He/20%O2 provided good signal-to-noise, greater than the Rose Criterion (SNR > 5), while avoiding gravitational effects of similar concentrations of xenon in a 60%O2 mixture. 80/140-kVp (tin-filtered) provided improved SNR compared with 100/140-kVp in a swine with an equivalent thoracic transverse density to a human subject with body mass index of 33. Airways were brighter in the 80/140 kVp scan (80/140Sn, 31.6%; 100/140Sn, 25.1%) with considerably lower noise (80/140Sn, CV of 0.140; 100/140Sn, CV of 0.216). Conclusion In order to provide a truly quantitative measure of regional lung function with xenon-DECT, the basic protocols and parameter calibrations needed to be better understood and quantified. It is critically important to understand the fundamentals of new techniques in order to allow for proper implementation and interpretation of their results prior to wide spread usage. With the use of an in house derived xenon calibration curve for three-material decomposition rather than the scanner supplied calibration and a xenon/helium/oxygen mixture we demonstrate highly accurate quantitation of xenon gas volumes and avoid gravitational effects on gas distribution. This study provides a foundation for other researchers to use and test these methods with the goal of clinical translation. PMID:23571834

Monosodium urate crystal deposition associated with the progress of radiographic grade at the sacroiliac joint in axial SpA: a dual-energy CT study.

PubMed

Zhu, Junqing; Li, Aiwu; Jia, Ertao; Zhou, Yi; Xu, Juan; Chen, Shixian; Huang, Yinger; Xiao, Xiang; Li, Juan

2017-05-02

Previous studies have revealed that ankylosing spondylitis (AS), as the progenitor of axial spondyloarthritis (AxSpA), has been characterized by the insidiously progressive nature of sacroiliitis and spondylitis. Dual-energy computed tomography (DECT) has recently been used to analyse the deposition of monosodium urate (MSU) crystals with higher sensitivity and specificity. However, it remains unclear whether the existence of the MSU crystal deposition detected by DECT at the sacroiliac joint in patients with AxSpA also is associated with the existing structural damage. Here, we performed this study to show the DECT MSU crystal deposits in AxSpA patients without coexisting gout and to ascertain the relationship between the MSU crystal deposition and the structural joint damage of sacroiliac joints. One hundred and eighty-six AxSpA patients without coexisting gout were recruited. The plain radiographs of the sacroiliac joint were obtained, along with the DECT scans at the pelvis and the clinical variables. All statistics based on the left or right sacroiliac joint damage grading (0-4) were calculated independently. Bivariate analysis and ordinal logistic regression was performed between the clinical features and radiographic grades at the sacroiliac joint. At the pelvis, large quantities of MSU crystal deposition were found in patients with AxSpA. The average MSU crystal volume at the left sacroiliac joint, the right sacroiliac joint, and the pelvis were 0.902 ± 1.345, 1.074 ± 1.878, and 5.272 ± 9.044 cm 3 , values which were correlated with serum uric acid concentrations (r = 0.727, 0.740, 0.896; p < 0.001). In bivariate analysis, wide clinical variables were associated with the changes in sacroiliac joint damage. Further, the AxSpA duration, BASFI score, and the volume of MSU crystal at both sides of sacroiliac joint were associated with the progress of radiographic grade at the sacroiliac joints in the ordinal logistic models (left AOR = 1.180, 3.800, 1.920; right AOR = 1.190, 3.034, 1.418; p < 0.01). Large quantities of MSU crystal deposition detected by DECT were found at the pelvis in AxSpA patients without coexisting gout. In addition to AxSpA duration and BASFI score, the MSU crystal deposition at the sacroiliac joint is associated with the progress of radiographic grade at sacroiliac joints in those patients.

75 FR 33220 - Unlicensed Personal Communications Services Devices in the 1920-1930 MHz Band

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

... required minimum number of channels and transmit on the channels with the lowest power. According to DECT... interference to adjacent-band Advanced Wireless Service (AWS) and PCS services. 3. DECT claims that its... with the lowest power and an alternative approach suggested by DECT--could require affected systems to...

Image quality of mean temporal arterial and mean temporal portal venous phase images calculated from low dose dynamic volume perfusion CT datasets in patients with hepatocellular carcinoma and pancreatic cancer.

PubMed

Wang, X; Henzler, T; Gawlitza, J; Diehl, S; Wilhelm, T; Schoenberg, S O; Jin, Z Y; Xue, H D; Smakic, A

2016-11-01

Dynamic volume perfusion CT (dVPCT) provides valuable information on tissue perfusion in patients with hepatocellular carcinoma (HCC) and pancreatic cancer. However, currently dVPCT is often performed in addition to conventional CT acquisitions due to the limited morphologic image quality of dose optimized dVPCT protocols. The aim of this study was to prospectively compare objective and subjective image quality, lesion detectability and radiation dose between mean temporal arterial (mTA) and mean temporal portal venous (mTPV) images calculated from low dose dynamic volume perfusion CT (dVPCT) datasets with linearly blended 120-kVp arterial and portal venous datasets in patients with HCC and pancreatic cancer. All patients gave written informed consent for this institutional review board-approved HIPAA compliant study. 27 consecutive patients (18 men, 9 women, mean age, 69.1 years±9.4) with histologically proven HCC or suspected pancreatic cancer were prospectively enrolled. The study CT protocol included a dVPCT protocol performed with 70 or 80kVp tube voltage (18 spiral acquisitions, 71.2s total acquisition times) and standard dual-energy (90/150kVpSn) arterial and portal venous acquisition performed 25min after the dVPCT. The mTA and mTPV images were manually reconstructed from the 3 to 5 best visually selected single arterial and 3 to 5 best single portal venous phases dVPCT dataset. The linearly blended 120-kVp images were calculated from dual-energy CT (DECT) raw data. Image noise, SNR, and CNR of the liver, abdominal aorta (AA) and main portal vein (PV) were compared between the mTA/mTPV and the linearly blended 120-kVp dual-energy arterial and portal venous datasets, respectively. Subjective image quality was evaluated by two radiologists regarding subjective image noise, sharpness and overall diagnostic image quality using a 5-point Likert Scale. In addition, liver lesion detectability was performed for each liver segment by the two radiologists using the linearly blended120-kVp arterial and portal venous datasets as the reference standard. Image noise, SNR and CNR values of the mTA and mTPV were significantly higher when compared to the corresponding linearly blended arterial and portal venous 120-kVp datasets (all p<0.001) except for image noise within the PV in the portal venous phases (p=0.136). image quality of mTA and mTPV were rated significantly better when compared to the linearly blended 120-kVp arterial and portal venous datasets. Both readers were able to detect all liver lesions found on the linearly blended 120-kVp arterial and portal venous datasets using the mTA and mTPV datasets. The effective radiation dose of the dVPCT was 27.6mSv for the 80kVp protocol and 14.5mSv for the 70kVp protocol. The mean effective radiation dose for the linearly blended 120-kVp arterial and portal venous CT protocol together of the upper abdomen was 5.60mSv±1.48mSv. Our preliminary data suggest that subjective and objective image quality of mTA and mTPV datasets calculated from low-kVp dVPCT datasets is non-inferior when compared to linearly blended 120-kVp arterial and portal venous acquisitions in patients with HCC and pancreatic cancer. Thus, dVPCT could be used as a stand-alone imaging technique without additionally performed conventional arterial and portal venous CT acquisitions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Top 50 Highly Cited Articles on Dual Energy Computed Tomography (DECT) in Abdominal Radiology: A Bibliometric Analysis.

PubMed

Gong, Bo; Wu, Yuhao; O'Keeffe, Michael E; Berger, Ferco H; McLaughlin, Patrick D; Nicolaou, Savvas; Khosa, Faisal

2017-01-01

This study aims to identify the 50 most highly cited articles on dual energy computed tomography (DECT) in abdominal radiology Thomson Reuters Web of Science All Databases was queried without year or language restriction. Only original research articles with a primary focus on abdominal radiology using DECT were selected. Review articles, meta-analyses, and studies without human subjects were excluded. Fifty articles with the highest average yearly citation were identified. These articles were published between 2007 and 2017 in 12 journals, with the most in Radiology (12 articles). Articles had a median of 7 authors, with all first authors but one primarily affiliated to radiology departments. The United States of America produced the most articles (16), followed by Germany (13 articles), and China (7 articles). Most studies used Dual Source DECT technology (35 articles), followed by Rapid Kilovoltage Switching (14 articles), and Sequential Scanning (1 article). The top three scanned organs were the liver (24%), kidney (16%), and urinary tract (15%). The most commonly studied pathology was urinary calculi (28%), renal lesion/tumor (23%), and hepatic lesion/tumor (20%). Our study identifies intellectual milestones in the applications of DECT in abdominal radiology. The diversity of the articles reflects on the characteristics and quality of the most influential publications related to DECT.

Top 50 Highly Cited Articles on Dual Energy Computed Tomography (DECT) in Abdominal Radiology: A Bibliometric Analysis

PubMed Central

Gong, Bo; Wu, Yuhao; O’Keeffe, Michael E; Berger, Ferco H; McLaughlin, Patrick D; Nicolaou, Savvas

2017-01-01

Summary This study aims to identify the 50 most highly cited articles on dual energy computed tomography (DECT) in abdominal radiology Thomson Reuters Web of Science All Databases was queried without year or language restriction. Only original research articles with a primary focus on abdominal radiology using DECT were selected. Review articles, meta-analyses, and studies without human subjects were excluded. Fifty articles with the highest average yearly citation were identified. These articles were published between 2007 and 2017 in 12 journals, with the most in Radiology (12 articles). Articles had a median of 7 authors, with all first authors but one primarily affiliated to radiology departments. The United States of America produced the most articles (16), followed by Germany (13 articles), and China (7 articles). Most studies used Dual Source DECT technology (35 articles), followed by Rapid Kilovoltage Switching (14 articles), and Sequential Scanning (1 article). The top three scanned organs were the liver (24%), kidney (16%), and urinary tract (15%). The most commonly studied pathology was urinary calculi (28%), renal lesion/tumor (23%), and hepatic lesion/tumor (20%). Our study identifies intellectual milestones in the applications of DECT in abdominal radiology. The diversity of the articles reflects on the characteristics and quality of the most influential publications related to DECT. PMID:29657641

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

Sorensen, J; Duran, C; Stingo, F

Purpose: To characterize the effect of virtual monochromatic reconstructions on several commonly used texture analysis features in DECT of the chest. Further, to assess the effect of monochromatic energy levels on the ability of these textural features to identify tissue types. Methods: 20 consecutive patients underwent chest CTs for evaluation of lung nodules using Siemens Somatom Definition Flash DECT. Virtual monochromatic images were constructed at 10keV intervals from 40–190keV. For each patient, an ROI delineated the lesion under investigation, and cylindrical ROI’s were placed within 5 different healthy tissues (blood, fat, muscle, lung, and liver). Several histogram- and Grey Levelmore » Cooccurrence Matrix (GLCM)-based texture features were then evaluated in each ROI at each energy level. As a means of validation, these feature values were then used in a random forest classifier to attempt to identify the tissue types present within each ROI. Their predictive accuracy at each energy level was recorded. Results: All textural features changed considerably with virtual monochromatic energy, particularly below 70keV. Most features exhibited a global minimum or maximum around 80keV, and while feature values changed with energy above this, patient ranking was generally unaffected. As expected, blood demonstrated the lowest inter-patient variability, for all features, while lung lesions (encompassing many different pathologies) exhibited the highest. The accuracy of these features in identifying tissues (76% accuracy) was highest at 80keV, but no clear relationship between energy and classification accuracy was found. Two common misclassifications (blood vs liver and muscle vs fat) accounted for the majority (24 of the 28) errors observed. Conclusion: All textural features were highly dependent on virtual monochromatic energy level, especially below 80keV, and were more stable above this energy. However, in a random forest model, these commonly used features were able to reliably differentiate between most tissues types regardless of energy level. Dr Godoy has received a dual-energy CT research grant from Siemens Healthcare. That grant did not directly fund this research.« less

SU-G-206-07: Dual-Energy CT Inter- and Intra-Scanner Variability Within One Make and Model

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

Jacobsen, M; Wood, C; Cody, D

Purpose: It can be logistically quite difficult to scan patients on the same exact device for their repeat visits in multi-scanner facilities. The reliability between dual-energy CT scanners’ quantitative results is not known, nor is their individual repeatability. Therefore, we evaluated inter- and intra-scanner variability with respect to several key clinical quantitative metrics specific to dual-energy CT. Methods: Eleven identical GE HD-750 CT scanners in a busy clinical environment were used to perform dual-energy (DE) CT scans of a large elliptical quality control (QC) phantom (Gammex, Inc.; Middleton, WI) which contains many standard insert materials. The DE-QC phantom was scannedmore » bi-weekly during 2016; 3 to 4 scans were obtained from each scanner (a total of 35 data sets were used for analysis). Iodine accuracy for the 2mg/ml, 5mg/ml and 15mg/ml rods (from the Iodine(Water) image set) and soft tissue HU (40 HU based on NIST constants) from the 50keV data set were used to assess inter- and intra-scanner variability (standard deviation). Results: Intra-scanner variability average for 2mg/ml Iodine was 0.10 mg/ml (range 0.05–0.15 mg/ml), for 5mg/ml Iodine was 0.12 mg/ml (range 0.07–0.16 mg/ml), for 15 mg/ml Iodine was 0.25 mg/ml (range 0.16–0.37 mg/ml), and for the soft tissue inserts was 2.1 HU (range 1.8–2.6 HU). Inter-scanner variability average for 2mg/ml Iodine was 0.16 mg/ml (range 0.11–0.19 mg/ml), for 5mg/ml Iodine was 0.18 mg/ml (range 0.11–0.22 mg/ml), for 15 mg/ml Iodine was 0.35 mg/ml (range 0.23–0.44 mg/ml), and for the soft tissue inserts was 3.8 HU (range 3.1–4.5 HU). Conclusion: Intra-scanner variability for the iodine and soft tissue inserts averaged 3.1% and 5.2% respectively, and inter-scanner variability for these regions analyzed averaged 5.0% and 9.5%, respectively. Future work will include determination of smallest measurable change and acceptable limits for DE-CT scanner variability over longer time intervals. This research has been supported by funds from Dr. William Murphy, Jr., the John S. Dunn, Sr. Distinguished Chair in Diagnostic Imaging at MD Anderson Cancer Center.« less

[Clinical implications of dual-energy computed tomography in the diagnosis and treatment of urolithiasis].

PubMed

Kapanadze, L B; Ternovoy, S K; Rudenko, V I; Serova, N S

2018-03-01

Urolithiasis (urolithiasis) is one of the most common urologic diseases with an estimated prevalence of no less than 3% in the population, usually affecting active working-age patients of 30-50 years. Taking into account major public health and economic significance of this problem, there is the need for the development of effective modern diagnostic techniques. Rapid medical-technological advances of the past two decades have led to the wide spread use of minimally invasive surgery the management of urolithiasis. Nevertheless, surgical intervention only removes the result of a long pathological process and does not change its course. Thus, there is a need for a detailed understanding of the etiology, epidemiology, and pathogenesis of urolithiasis. Diagnostic imaging plays a key role in the diagnosis of urolithiasis. Multislice spiral computed tomography (MSCT) is the gold standard for the diagnosis of urolithiasis. It provides information about the size, location, and density of the calculus. Over the past decade, the use of dual-energy computed tomography (DECT) in urological practice has been widely discussed in the international and domestic literature. One of the main advantages of DECT is the ability to determine the chemical composition of urinary stones. Previous studies have reported a high diagnostic value of the method, including the ability to predict treatment outcomes. However, the shortcomings of the method and the absence of standardized examination protocols leave a wide field for further research. This article reviews major distinctive features of using DECT in the diagnosis of urolithiasis.

SU-G-IeP3-04: Effective Dose Measurements in Fast Kvp Switch Dual Energy Computed Tomography

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

Raudabaugh, J; Moore, B; Nguyen, G

2016-06-15

Purpose: The objective of this study was two-fold: (a) to test a new approach to approximating organ dose by using the effective energy of the combined 80kV/140kV beam in dual-energy (DE) computed tomography (CT), and (b) to derive the effective dose (ED) in the abdomen-pelvis protocol in DECT. Methods: A commercial dual energy CT scanner was employed using a fast-kV switch abdomen/pelvis protocol alternating between 80 kV and 140 kV. MOSFET detectors were used for organ dose measurements. First, an experimental validation of the dose equivalency between MOSFET and ion chamber (as a gold standard) was performed using a CTDImore » phantom. Second, the ED of DECT scans was measured using MOSFET detectors and an anthropomorphic phantom. For ED calculations, an abdomen/pelvis scan was used using ICRP 103 tissue weighting factors; ED was also computed using the AAPM Dose Length Product (DLP) method and compared to the MOSFET value. Results: The effective energy was determined as 42.9 kV under the combined beam from half-value layer (HVL) measurement. ED for the dual-energy scan was calculated as 16.49 ± 0.04 mSv by the MOSFET method and 14.62 mSv by the DLP method. Conclusion: Tissue dose in the center of the CTDI body phantom was 1.71 ± 0.01 cGy (ion chamber) and 1.71 ± 0.06 (MOSFET) respectively; this validated the use of effective energy method for organ dose estimation. ED from the abdomen-pelvis scan was calculated as 16.49 ± 0.04 mSv by MOSFET and 14.62 mSv by the DLP method; this suggests that the DLP method provides a reasonable approximation to the ED.« less

DECT evaluation of noncalcified coronary artery plaque

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

Ravanfar Haghighi, Rezvan; Chatterjee, S.; Tabin, Milo

2015-10-15

Purpose: Composition of the coronary artery plaque is known to have critical role in heart attack. While calcified plaque can easily be diagnosed by conventional CT, it fails to distinguish between fibrous and lipid rich plaques. In the present paper, the authors discuss the experimental techniques and obtain a numerical algorithm by which the electron density (ρ{sub e}) and the effective atomic number (Z{sub eff}) can be obtained from the dual energy computed tomography (DECT) data. The idea is to use this inversion method to characterize and distinguish between the lipid and fibrous coronary artery plaques. Methods: For the purposemore » of calibration of the CT machine, the authors prepare aqueous samples whose calculated values of (ρ{sub e}, Z{sub eff}) lie in the range of (2.65 × 10{sup 23} ≤ ρ{sub e} ≤ 3.64 × 10{sup 23}/cm{sup 3}) and (6.80 ≤ Z{sub eff} ≤ 8.90). The authors fill the phantom with these known samples and experimentally determine HU(V{sub 1}) and HU(V{sub 2}), with V{sub 1},V{sub 2} = 100 and 140 kVp, for the same pixels and thus determine the coefficients of inversion that allow us to determine (ρ{sub e}, Z{sub eff}) from the DECT data. The HU(100) and HU(140) for the coronary artery plaque are obtained by filling the channel of the coronary artery with a viscous solution of methyl cellulose in water, containing 2% contrast. These (ρ{sub e}, Z{sub eff}) values of the coronary artery plaque are used for their characterization on the basis of theoretical models of atomic compositions of the plaque materials. These results are compared with histopathological report. Results: The authors find that the calibration gives ρ{sub e} with an accuracy of ±3.5% while Z{sub eff} is found within ±1% of the actual value, the confidence being 95%. The HU(100) and HU(140) are found to be considerably different for the same plaque at the same position and there is a linear trend between these two HU values. It is noted that pure lipid type plaques are practically nonexistent, and microcalcification, as observed in histopathology, has to be taken into account to explain the nature of the observed (ρ{sub e}, Z{sub eff}) data. This also enables us to judge the composition of the plaque in terms of basic model which considers the plaque to be composed of fibres, lipids, and microcalcification. Conclusions: This simple and reliable method has the potential as an effective modality to investigate the composition of noncalcified coronary artery plaques and thus help in their characterization. In this inversion method, (ρ{sub e}, Z{sub eff}) of the scanned sample can be found by eliminating the effects of the CT machine and also by ensuring that the determination of the two unknowns (ρ{sub e}, Z{sub eff}) does not interfere with each other and the nature of the plaque can be identified in terms of a three component model.« less

Evaluation of low-dose dual energy computed tomography for in vivo assessment of renal/ureteric calculus composition.

PubMed

Mahalingam, Harshavardhan; Lal, Anupam; Mandal, Arup K; Singh, Shrawan Kumar; Bhattacharyya, Shalmoli; Khandelwal, Niranjan

2015-08-01

This study aimed to assess the accuracy of low-dose dual-energy computed tomography (DECT) in predicting the composition of urinary calculi. A total of 52 patients with urinary calculi were scanned with a 128-slice dual-source DECT scanner by use of a low-dose protocol. Dual-energy (DE) ratio, weighted average Hounsfield unit (HU) of calculi, radiation dose, and image noise levels were recorded. Two radiologists independently rated study quality. Stone composition was assessed after extraction by Fourier transform infrared spectroscopy (FTIRS). Analysis of variance was used to determine if the differences in HU values and DE ratios between the various calculus groups were significant. Threshold cutoff values to classify the calculi into separate groups were identified by receiver operating characteristic curve analysis. A total of 137 calculi were detected. FTIRS analysis differentiated the calculi into five groups: uric acid (n=17), struvite (n=3), calcium oxalate monohydrate and dihydrate (COM-COD, n=84), calcium oxalate monohydrate (COM, n=28), and carbonate apatite (n=5). The HU value could differentiate only uric acid calculi from calcified calculi (p<0.001). The DE ratio could confidently differentiate uric acid, struvite, calcium oxalate, and carbonate apatite calculi (p<0.001) with cutoff values of 1.12, 1.34, and 1.66, respectively, giving >80% sensitivity and specificity to differentiate them. The DE ratio could not differentiate COM from COM-COD calculi. No study was rated poor in quality by either of the observers. The mean radiation dose was 1.8 mSv. Low-dose DECT accurately predicts urinary calculus composition in vivo while simultaneously reducing radiation exposure without compromising study quality.

Evaluation of low-dose dual energy computed tomography for in vivo assessment of renal/ureteric calculus composition

PubMed Central

Mahalingam, Harshavardhan; Mandal, Arup K; Singh, Shrawan Kumar; Bhattacharyya, Shalmoli; Khandelwal, Niranjan

2015-01-01

Purpose This study aimed to assess the accuracy of low-dose dual-energy computed tomography (DECT) in predicting the composition of urinary calculi. Materials and Methods A total of 52 patients with urinary calculi were scanned with a 128-slice dual-source DECT scanner by use of a low-dose protocol. Dual-energy (DE) ratio, weighted average Hounsfield unit (HU) of calculi, radiation dose, and image noise levels were recorded. Two radiologists independently rated study quality. Stone composition was assessed after extraction by Fourier transform infrared spectroscopy (FTIRS). Analysis of variance was used to determine if the differences in HU values and DE ratios between the various calculus groups were significant. Threshold cutoff values to classify the calculi into separate groups were identified by receiver operating characteristic curve analysis. Results A total of 137 calculi were detected. FTIRS analysis differentiated the calculi into five groups: uric acid (n=17), struvite (n=3), calcium oxalate monohydrate and dihydrate (COM-COD, n=84), calcium oxalate monohydrate (COM, n=28), and carbonate apatite (n=5). The HU value could differentiate only uric acid calculi from calcified calculi (p<0.001). The DE ratio could confidently differentiate uric acid, struvite, calcium oxalate, and carbonate apatite calculi (p<0.001) with cutoff values of 1.12, 1.34, and 1.66, respectively, giving >80% sensitivity and specificity to differentiate them. The DE ratio could not differentiate COM from COM-COD calculi. No study was rated poor in quality by either of the observers. The mean radiation dose was 1.8 mSv. Conclusions Low-dose DECT accurately predicts urinary calculus composition in vivo while simultaneously reducing radiation exposure without compromising study quality. PMID:26279828

Texture analysis of pulmonary parenchymateous changes related to pulmonary thromboembolism in dogs - a novel approach using quantitative methods.

PubMed

Marschner, C B; Kokla, M; Amigo, J M; Rozanski, E A; Wiinberg, B; McEvoy, F J

2017-07-11

Diagnosis of pulmonary thromboembolism (PTE) in dogs relies on computed tomography pulmonary angiography (CTPA), but detailed interpretation of CTPA images is demanding for the radiologist and only large vessels may be evaluated. New approaches for better detection of smaller thrombi include dual energy computed tomography (DECT) as well as computer assisted diagnosis (CAD) techniques. The purpose of this study was to investigate the performance of quantitative texture analysis for detecting dogs with PTE using grey-level co-occurrence matrices (GLCM) and multivariate statistical classification analyses. CT images from healthy (n = 6) and diseased (n = 29) dogs with and without PTE confirmed on CTPA were segmented so that only tissue with CT numbers between -1024 and -250 Houndsfield Units (HU) was preserved. GLCM analysis and subsequent multivariate classification analyses were performed on texture parameters extracted from these images. Leave-one-dog-out cross validation and receiver operator characteristic (ROC) showed that the models generated from the texture analysis were able to predict healthy dogs with optimal levels of performance. Partial Least Square Discriminant Analysis (PLS-DA) obtained a sensitivity of 94% and a specificity of 96%, while Support Vector Machines (SVM) yielded a sensitivity of 99% and a specificity of 100%. The models, however, performed worse in classifying the type of disease in the diseased dog group: In diseased dogs with PTE sensitivities were 30% (PLS-DA) and 38% (SVM), and specificities were 80% (PLS-DA) and 89% (SVM). In diseased dogs without PTE the sensitivities of the models were 59% (PLS-DA) and 79% (SVM) and specificities were 79% (PLS-DA) and 82% (SVM). The results indicate that texture analysis of CTPA images using GLCM is an effective tool for distinguishing healthy from abnormal lung. Furthermore the texture of pulmonary parenchyma in dogs with PTE is altered, when compared to the texture of pulmonary parenchyma of healthy dogs. The models' poorer performance in classifying dogs within the diseased group, may be related to the low number of dogs compared to texture variables, a lack of balanced number of dogs within each group or a real lack of difference in the texture features among the diseased dogs.

Interference of mobile phones and digitally enhanced cordless telecommunications mobile phones in renal scintigraphy.

PubMed

Stegmayr, Armin; Fessl, Benjamin; Hörtnagl, Richard; Marcadella, Michael; Perkhofer, Susanne

2013-08-01

The aim of the study was to assess the potential negative impact of cellular phones and digitally enhanced cordless telecommunication (DECT) devices on the quality of static and dynamic scintigraphy to avoid repeated testing in infant and teenage patients to protect them from unnecessary radiation exposure. The assessment was conducted by performing phantom measurements under real conditions. A functional renal-phantom acting as a pair of kidneys in dynamic scans was created. Data were collected using the setup of cellular phones and DECT phones placed in different positions in relation to a camera head to test the potential interference of cellular phones and DECT phones with the cameras. Cellular phones reproducibly interfered with the oldest type of gamma camera, which, because of its single-head specification, is the device most often used for renal examinations. Curves indicating the renal function were considerably disrupted; cellular phones as well as DECT phones showed a disturbance concerning static acquisition. Variable electromagnetic tolerance in different types of γ-cameras could be identified. Moreover, a straightforward, low-cost method of testing the susceptibility of equipment to interference caused by cellular phones and DECT phones was generated. Even though some departments use newer models of γ-cameras, which are less susceptible to electromagnetic interference, we recommend testing examination rooms to avoid any interference caused by cellular phones. The potential electromagnetic interference should be taken into account when the purchase of new sensitive medical equipment is being considered, not least because the technology of mobile communication is developing fast, which also means that different standards of wave bands will be issued in the future.

Bayesian calibration for electrochemical thermal model of lithium-ion cells

NASA Astrophysics Data System (ADS)

Tagade, Piyush; Hariharan, Krishnan S.; Basu, Suman; Verma, Mohan Kumar Singh; Kolake, Subramanya Mayya; Song, Taewon; Oh, Dukjin; Yeo, Taejung; Doo, Seokgwang

2016-07-01

Pseudo-two dimensional electrochemical thermal (P2D-ECT) model contains many parameters that are difficult to evaluate experimentally. Estimation of these model parameters is challenging due to computational cost and the transient model. Due to lack of complete physical understanding, this issue gets aggravated at extreme conditions like low temperature (LT) operations. This paper presents a Bayesian calibration framework for estimation of the P2D-ECT model parameters. The framework uses a matrix variate Gaussian process representation to obtain a computationally tractable formulation for calibration of the transient model. Performance of the framework is investigated for calibration of the P2D-ECT model across a range of temperatures (333 Ksbnd 263 K) and operating protocols. In the absence of complete physical understanding, the framework also quantifies structural uncertainty in the calibrated model. This information is used by the framework to test validity of the new physical phenomena before incorporation in the model. This capability is demonstrated by introducing temperature dependence on Bruggeman's coefficient and lithium plating formation at LT. With the incorporation of new physics, the calibrated P2D-ECT model accurately predicts the cell voltage with high confidence. The accurate predictions are used to obtain new insights into the low temperature lithium ion cell behavior.

Stochastic spectral projection of electrochemical thermal model for lithium-ion cell state estimation

NASA Astrophysics Data System (ADS)

Tagade, Piyush; Hariharan, Krishnan S.; Kolake, Subramanya Mayya; Song, Taewon; Oh, Dukjin

2017-03-01

A novel approach for integrating a pseudo-two dimensional electrochemical thermal (P2D-ECT) model and data assimilation algorithm is presented for lithium-ion cell state estimation. This approach refrains from making any simplifications in the P2D-ECT model while making it amenable for online state estimation. Though deterministic, uncertainty in the initial states induces stochasticity in the P2D-ECT model. This stochasticity is resolved by spectrally projecting the stochastic P2D-ECT model on a set of orthogonal multivariate Hermite polynomials. Volume averaging in the stochastic dimensions is proposed for efficient numerical solution of the resultant model. A state estimation framework is developed using a transformation of the orthogonal basis to assimilate the measurables with this system of equations. Effectiveness of the proposed method is first demonstrated by assimilating the cell voltage and temperature data generated using a synthetic test bed. This validated method is used with the experimentally observed cell voltage and temperature data for state estimation at different operating conditions and drive cycle protocols. The results show increased prediction accuracy when the data is assimilated every 30s. High accuracy of the estimated states is exploited to infer temperature dependent behavior of the lithium-ion cell.

TH-CD-202-03: Enhancing Soft-Tissue CT Contrast for Radiation Therapy Using Mono-Energetic Decompositions of Dual Energy CT

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

Noid, G; Tai, A; Liu, Y

Purpose: It is desirable to increase CT soft-tissue contrast to improve delineation of tumor target and/or surrounding organs at risk (OAR) in RT planning and delivery guidance. The purpose of this work is to investigate the use of monoenergetic decompositions obtained from dual energy (DE) CT to improve soft-tissue contrast. Methods: CT data were acquired for 5 prostate and 5 pancreas patients and a phantom with a CT Scanner (Definition AS Open, Siemens) using both sequential DE protocols and standard protocols. For the DE protocols, the scanner rapidly performs two acquisitions at 80 kVp and 140 kVp. The CT numbersmore » of soft tissue inserts in the phantom (CTED/Gammex) were measured across the spectrum of available monoenergetic decompositions (40 to 140 keV) and compared to the standard protocol (120 kVp, 0.6 pitch, 18 mGy CTDIvol). Contrast, defined as the difference in the average CT number between target and OAR, was measured for all subjects and compared between the DE and standard protocols. Results: Mono-energetic decompositions of the phantom demonstrate an enhancement of soft-tissue contrast as the energy is decreased. For instance, relative to the 120 kVp scans the Liver ED insert increased in CT number by 25 HU while the adipose ED insert decreased by 50 HU. The lowest energy decompositions featured the highest contrast between target and OAR. For every patient, the contrast increased by decomposing at 40 keV. The average increase in contrast relative to a 120 kVp scan for prostate patients at 40 keV was 25.05±17.28 HU while for pancreas patients it was 19.21±17.39 HU. Conclusion: Low energy monoenergetic decompositions from dual-energy CT substantially increase soft-tissue contrast. At the lowest achievable monoenergetic decompositions the maximum soft-tissue contrast is achieved and the delineation of target and OAR is improved. Thus it is beneficial to use DECT in radiation oncology. Supported by Siemens.« less

Pulmonary Perfusion Changes as Assessed by Contrast-Enhanced Dual-Energy Computed Tomography after Endoscopic Lung Volume Reduction by Coils.

PubMed

Lador, Frédéric; Hachulla, Anne-Lise; Hohn, Olivia; Plojoux, Jérôme; Ronot, Maxime; Montet, Xavier; Soccal, Paola M

2016-01-01

Endoscopic lung volume reduction by coils (LVRC) is a recent treatment approach for severe emphysema. Furthermore, dual-energy computed tomography (DECT) now offers a combined assessment of lung morphology and pulmonary perfusion. The aim of our study was to assess the impact of LVRC on pulmonary perfusion with DECT. Seventeen patients (64.8 ± 6.7 years) underwent LVRC. DECT was performed prior to and after LVRC. For each patient, lung volumes and emphysema quantification were automatically calculated. Then, 6 regions of interest (ROIs) on the iodine perfusion map were drawn in the anterior, mid, and posterior right and left lungs at 4 defined levels. The ROI values were averaged to obtain lung perfusion as assessed by the lung's iodine concentration (CLung, μg·cm-3). The CLung values were normalized using the left atrial iodine concentration (CLA) to take into account differences between successive DECT scans. The 6-min walk distance (6MWD) improved significantly after the procedure (p = 0.0002). No lung volume changes were observed between successive DECT scans for any of the patients (p = 0.32), attesting the same suspended inspiration. After LVRC, the emphysema index was significantly reduced in the treated lung (p = 0.0014). Lung perfusion increased significantly adjacent to the treated areas (CLung/CLA from 3.4 ± 1.7 to 5.6 ± 2.2, p < 0.001) and in the ipsilateral untreated areas (from 4.1 ± 1.4 to 6.6 ± 1.7, p < 0.001), corresponding to a mean 65 and 61% increase in perfusion, respectively. No significant difference was observed in the contralateral upper and lower areas (from 4.4 ± 1.9 to 4.8 ± 2.1, p = 0.273, and from 4.9 ± 2.0 to 5.2 ± 1.7, p = 0.412, respectively). A significant correlation between increased 6MWD and increased perfusion was found (p = 0.0027, R2 = 0.3850). Quantitative analysis based on DECT acquisition revealed that LVRC results in a significant increase in perfusion in the coil-free areas adjacent to the treated ones, as well as in the ipsilateral untreated areas. This suggests a possible role for LVRC in the improvement of the ventilation/perfusion relationship. © 2016 S. Karger AG, Basel.

[Electromagnetic fields in the vicinity of DECT cordless telephones and mobile phones].

PubMed

Mamrot, Paweł; Mariańska, Magda; Aniołczyk, Halina; Politański, Piotr

2015-01-01

Mobile telephones belong to the most frequently used personal devices. In their surroundings they produce the electromagnetic field (EMF), in which exposure range there are not only users but also nearby bystanders. The aim of the investigations and EMF measurements in the vicinity of phones was to identify the electric field levels with regard to various working modes. Twelve sets of DECT (digital enhanced cordless telecommunications) cordless phones (12 base units and 15 handsets), 21 mobile telephones produced by different manufactures, and 16 smartphones in various applications, (including multimedia) in the conditions of daily use in living rooms were measured. Measurements were taken using the point method in predetermined distances of 0.05-1 m from the devices without the presence of users. In the vicinity of DECT cordless phone handsets, electric field strength ranged from 0.26 to 2.30 V/m in the distance of 0.05 m - 0.18-0.26 V/m (1 m). In surroundings of DECT cordless telephones base units the values of EMF were from 1.78-5.44 V/m (0.05 m) to 0.19- 0.41 V/m (1 m). In the vicinity of mobile phones working in GSM mode with voice transmission, the electric field strength ranged from 2.34-9.14 V/m (0.05 m) to 0.18-0.47 V/m (1 m) while in the vicinity of mobile phones working in WCDMA (Wideband Code Division Multiple Access) mode the electric field strength ranged from 0.22-1.83 V/m (0.05 m) to 0.18-0.20 V/m (1 m). The mean values of the electric field strength for each group of devices, mobile phones and DECT wireless phones sets do not exceed the reference value of 7 V/m, adopted as the limit for general public exposure. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

A full-spectral Bayesian reconstruction approach based on the material decomposition model applied in dual-energy computed tomography.

PubMed

Cai, C; Rodet, T; Legoupil, S; Mohammad-Djafari, A

2013-11-01

Dual-energy computed tomography (DECT) makes it possible to get two fractions of basis materials without segmentation. One is the soft-tissue equivalent water fraction and the other is the hard-matter equivalent bone fraction. Practical DECT measurements are usually obtained with polychromatic x-ray beams. Existing reconstruction approaches based on linear forward models without counting the beam polychromaticity fail to estimate the correct decomposition fractions and result in beam-hardening artifacts (BHA). The existing BHA correction approaches either need to refer to calibration measurements or suffer from the noise amplification caused by the negative-log preprocessing and the ill-conditioned water and bone separation problem. To overcome these problems, statistical DECT reconstruction approaches based on nonlinear forward models counting the beam polychromaticity show great potential for giving accurate fraction images. This work proposes a full-spectral Bayesian reconstruction approach which allows the reconstruction of high quality fraction images from ordinary polychromatic measurements. This approach is based on a Gaussian noise model with unknown variance assigned directly to the projections without taking negative-log. Referring to Bayesian inferences, the decomposition fractions and observation variance are estimated by using the joint maximum a posteriori (MAP) estimation method. Subject to an adaptive prior model assigned to the variance, the joint estimation problem is then simplified into a single estimation problem. It transforms the joint MAP estimation problem into a minimization problem with a nonquadratic cost function. To solve it, the use of a monotone conjugate gradient algorithm with suboptimal descent steps is proposed. The performance of the proposed approach is analyzed with both simulated and experimental data. The results show that the proposed Bayesian approach is robust to noise and materials. It is also necessary to have the accurate spectrum information about the source-detector system. When dealing with experimental data, the spectrum can be predicted by a Monte Carlo simulator. For the materials between water and bone, less than 5% separation errors are observed on the estimated decomposition fractions. The proposed approach is a statistical reconstruction approach based on a nonlinear forward model counting the full beam polychromaticity and applied directly to the projections without taking negative-log. Compared to the approaches based on linear forward models and the BHA correction approaches, it has advantages in noise robustness and reconstruction accuracy.

Bone erosions in patients with chronic gouty arthropathy are associated with tophi but not bone oedema or synovitis: new insights from a 3 T MRI study.

PubMed

McQueen, Fiona M; Doyle, Anthony; Reeves, Quentin; Gao, Angela; Tsai, Amy; Gamble, Greg D; Curteis, Barbara; Williams, Megan; Dalbeth, Nicola

2014-01-01

Bone erosion has been linked with tophus deposition in gout but the roles of osteitis (MRI bone oedema) and synovitis remain uncertain. Our aims in this prospective 3 T MRI study were to investigate the frequency of these features in gout and determine their relation to one another. 3 T MRI scans of the wrist were obtained in 40 gout patients. Scans were scored independently by two radiologists for bone oedema, erosions, tophi and synovitis. Dual-energy CT (DECT) scans were scored for tophi in a subgroup of 10 patients. Interreader reliability was high for erosions and tophi [intraclass correlation coefficients (ICCs) 0.77 (95% CI 0.71, 0.87) and 0.71 (95% CI 0.52, 0.83)] and moderate for bone oedema [ICC = 0.60 (95% CI 0.36, 0.77)]. Compared with DECT, MRI had a specificity of 0.98 (95% CI 0.93, 0.99) and sensitivity of 0.63 (95% CI 0.48, 0.76) for tophi. Erosions were detected in 63% of patients and were strongly associated with tophi [odds ratio (OR) = 13.0 (95% CI 1.5, 113)]. In contrast, no association was found between erosions and bone oedema. Using concordant data, bone oedema was scored at 6/548 (1%) sites in 5/40 patients (12.5%) and was very mild (median carpal score = 1, maximum = 45). In logistic regression analysis across all joints nested within individuals, tophus, but not synovitis, was independently associated with erosion [OR = 156.5 (21.2, >999.9), P < 0.0001]. Erosions were strongly associated with tophi but not bone oedema or synovitis. MRI bone oedema was relatively uncommon and low grade. These findings highlight the unique nature of the osteopathology of gout.

Projection decomposition algorithm for dual-energy computed tomography via deep neural network.

PubMed

Xu, Yifu; Yan, Bin; Chen, Jian; Zeng, Lei; Li, Lei

2018-03-15

Dual-energy computed tomography (DECT) has been widely used to improve identification of substances from different spectral information. Decomposition of the mixed test samples into two materials relies on a well-calibrated material decomposition function. This work aims to establish and validate a data-driven algorithm for estimation of the decomposition function. A deep neural network (DNN) consisting of two sub-nets is proposed to solve the projection decomposition problem. The compressing sub-net, substantially a stack auto-encoder (SAE), learns a compact representation of energy spectrum. The decomposing sub-net with a two-layer structure fits the nonlinear transform between energy projection and basic material thickness. The proposed DNN not only delivers image with lower standard deviation and higher quality in both simulated and real data, and also yields the best performance in cases mixed with photon noise. Moreover, DNN costs only 0.4 s to generate a decomposition solution of 360 × 512 size scale, which is about 200 times faster than the competing algorithms. The DNN model is applicable to the decomposition tasks with different dual energies. Experimental results demonstrated the strong function fitting ability of DNN. Thus, the Deep learning paradigm provides a promising approach to solve the nonlinear problem in DECT.

Usefulness of dual-energy computed tomography with and without dedicated software in identifying uric acid kidney stones.

PubMed

Salvador, R; Luque, M P; Ciudin, A; Paño, B; Buñesch, L; Sebastia, C; Nicolau, C

2016-01-01

To prospectively evaluate the usefulness of dual-energy computed tomography (DECT) with and without dedicated software in identifying uric acid kidney stones in vivo. We studied 65 kidney stones in 63 patients. All stones were analyzed in vivo by DECT and ex vivo by spectrophotometry. We evaluated the diagnostic performance in identifying uric acid stones with DECT by analyzing the radiologic densities with dedicated software and without using it (through manual measurements) as well as by analyzing the attenuation ratios of the stones in both energies with and without the dedicated software. The six uric acid stones included were correctly identified by evaluating the attenuation ratios with a cutoff of 1.21, both with the dedicated software and without it, yielding perfect diagnostic performance without false positives or false negatives. The study of the attenuations of the stones obtained the following values on the receiver operating characteristic curves in the classification of the uric acid stones: 0.92 for the measurements done with the software and 0.89 for the manual measurements; a cutoff of 538 HU yielded 84% (42/50) diagnostic accuracy for the software and 83.1% (54/65) for the manual measurements. DECT enabled the uric acid stones to be identified correctly through the calculation of the ratio of the attenuations in the two energies. The results obtained with the dedicated software were similar to those obtained manually. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Pest Status and Distribution of the Stem Borer, Dectes texanus, in Kansas

PubMed Central

Buschman, Lawrent L.; Sloderbeck, Phillip E.

2010-01-01

The Dectes stem borer, Dectes texanus LeConte (Coleoptera: Cerambycidae), is currently receiving increased attention as a pest of soybeans in the Great Plains of North America. Field surveys were conducted in 1999 and in 2008 to record the distribution of this pest in Kansas. These surveys documented an increase in the abundance of the pest and an expansion in the range of this insect westward and eastward. The percentage of fields with more than 50% of plants infested also increased from 4% in 1999 to 11% in 2008. The far eastern counties still had surprisingly few infested fields even though much of the Kansas soybean acreage is located in these counties. It is not clear if D. texanus simply haven't expanded into eastern Kansas yet or if there is an ecological barrier that keeps them from doing so. Field crop entomologists from across eastern North America were sent an email questionnaire and their responses indicate that this pest is now well established as a pest of soybeans in at least 14 states across eastern North America. PMID:21268702

The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion.

PubMed

Sun, Yajuan; Yu, Hongjuan; Ma, Jingquan; Lu, Peiou

2016-01-01

The aim of our study was to evaluate the role of 18F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion. A total of 176 patients with pleural effusion who underwent 18F-FDG PET/CT examination to differentiate malignancy from benignancy were retrospectively researched. The images of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were visually analyzed. The suspected malignant effusion was characterized by the presence of nodular or irregular pleural thickening on CT imaging. Whereas on PET imaging, pleural 18F-FDG uptake higher than mediastinal activity was interpreted as malignant effusion. Images of 18F-FDG PET/CT integrated imaging were interpreted by combining the morphologic feature of pleura on CT imaging with the degree and form of pleural 18F-FDG uptake on PET imaging. One hundred and eight patients had malignant effusion, including 86 with pleural metastasis and 22 with pleural mesothelioma, whereas 68 patients had benign effusion. The sensitivities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging in detecting malignant effusion were 75.0%, 91.7% and 93.5%, respectively, which were 69.8%, 91.9% and 93.0% in distinguishing metastatic effusion. The sensitivity of 18F-FDG PET/CT integrated imaging in detecting malignant effusion was higher than that of CT imaging (p = 0.000). For metastatic effusion, 18F-FDG PET imaging had higher sensitivity (p = 0.000) and better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with CT imaging (Kappa = 0.917 and Kappa = 0.295, respectively). The specificities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were 94.1%, 63.2% and 92.6% in detecting benign effusion. The specificities of CT imaging and 18F-FDG PET/CT integrated imaging were higher than that of 18F-FDG PET imaging (p = 0.000 and p = 0.000, respectively), and CT imaging had better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with 18F-FDG PET imaging (Kappa = 0.881 and Kappa = 0.240, respectively). 18F-FDG PET/CT integrated imaging is a more reliable modality in distinguishing malignant from benign pleural effusion than 18F-FDG PET imaging and CT imaging alone. For image interpretation of 18F-FDG PET/CT integrated imaging, the PET and CT portions play a major diagnostic role in identifying metastatic effusion and benign effusion, respectively.

Optimization of dual-energy xenon-computed tomography for quantitative assessment of regional pulmonary ventilation.

PubMed

Fuld, Matthew K; Halaweish, Ahmed F; Newell, John D; Krauss, Bernhard; Hoffman, Eric A

2013-09-01

Dual-energy x-ray computed tomography (DECT) offers visualization of the airways and quantitation of regional pulmonary ventilation using a single breath of inhaled xenon gas. In this study, we sought to optimize scanning protocols for DECT xenon gas ventilation imaging of the airways and lung parenchyma and to characterize the quantitative nature of the developed protocols through a series of test-object and animal studies. The Institutional Animal Care and Use Committee approved all animal studies reported here. A range of xenon/oxygen gas mixtures (0%, 20%, 25%, 33%, 50%, 66%, 100%; balance oxygen) were scanned in syringes and balloon test-objects to optimize the delivered gas mixture for assessment of regional ventilation while allowing for the development of improved 3-material decomposition calibration parameters. In addition, to alleviate gravitational effects on xenon gas distribution, we replaced a portion of the oxygen in the xenon/oxygen gas mixture with helium and compared gas distributions in a rapid-prototyped human central-airway test-object. Additional syringe tests were performed to determine if the introduction of helium had any effect on xenon quantitation. Xenon gas mixtures were delivered to anesthetized swine to assess airway and lung parenchymal opacification while evaluating various DECT scan acquisition settings. Attenuation curves for xenon were obtained from the syringe test-objects and were used to develop improved 3-material decomposition parameters (Hounsfield unit enhancement per percentage xenon: within the chest phantom, 2.25 at 80 kVp, 1.7 at 100 kVp, and 0.76 at 140 kVp with tin filtration; in open air, 2.5 at 80 kVp, 1.95 at 100 kVp, and 0.81 at 140 kVp with tin filtration). The addition of helium improved the distribution of xenon gas to the gravitationally nondependent portion of the airway tree test-object, while not affecting the quantitation of xenon in the 3-material decomposition DECT. The mixture 40% Xe/40% He/20% O2 provided good signal-to-noise ratio (SNR), greater than the Rose criterion (SNR > 5), while avoiding gravitational effects of similar concentrations of xenon in a 60% O2 mixture. Compared with 100/140 Sn kVp, 80/140 Sn kVp (Sn = tin filtered) provided improved SNR in a swine with an equivalent thoracic transverse density to a human subject with a body mass index of 33 kg/m. Airways were brighter in the 80/140 Sn kVp scan (80/140 Sn, 31.6%; 100/140 Sn, 25.1%) with considerably lower noise (80/140 Sn, coefficient of variation of 0.140; 100/140 Sn, coefficient of variation of 0.216). To provide a truly quantitative measure of regional lung function with xenon-DECT, the basic protocols and parameter calibrations need to be better understood and quantified. It is critically important to understand the fundamentals of new techniques to allow for proper implementation and interpretation of their results before widespread usage. With the use of an in-house derived xenon calibration curve for 3-material decomposition rather than the scanner supplied calibration and a xenon/helium/oxygen mixture, we demonstrate highly accurate quantitation of xenon gas volumes and avoid gravitational effects on gas distribution. This study provides a foundation for other researchers to use and test these methods with the goal of clinical translation.

The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion

PubMed Central

Sun, Yajuan; Yu, Hongjuan; Ma, Jingquan

2016-01-01

Objective The aim of our study was to evaluate the role of 18F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion. Methods A total of 176 patients with pleural effusion who underwent 18F-FDG PET/CT examination to differentiate malignancy from benignancy were retrospectively researched. The images of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were visually analyzed. The suspected malignant effusion was characterized by the presence of nodular or irregular pleural thickening on CT imaging. Whereas on PET imaging, pleural 18F-FDG uptake higher than mediastinal activity was interpreted as malignant effusion. Images of 18F-FDG PET/CT integrated imaging were interpreted by combining the morphologic feature of pleura on CT imaging with the degree and form of pleural 18F-FDG uptake on PET imaging. Results One hundred and eight patients had malignant effusion, including 86 with pleural metastasis and 22 with pleural mesothelioma, whereas 68 patients had benign effusion. The sensitivities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging in detecting malignant effusion were 75.0%, 91.7% and 93.5%, respectively, which were 69.8%, 91.9% and 93.0% in distinguishing metastatic effusion. The sensitivity of 18F-FDG PET/CT integrated imaging in detecting malignant effusion was higher than that of CT imaging (p = 0.000). For metastatic effusion, 18F-FDG PET imaging had higher sensitivity (p = 0.000) and better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with CT imaging (Kappa = 0.917 and Kappa = 0.295, respectively). The specificities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were 94.1%, 63.2% and 92.6% in detecting benign effusion. The specificities of CT imaging and 18F-FDG PET/CT integrated imaging were higher than that of 18F-FDG PET imaging (p = 0.000 and p = 0.000, respectively), and CT imaging had better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with 18F-FDG PET imaging (Kappa = 0.881 and Kappa = 0.240, respectively). Conclusion 18F-FDG PET/CT integrated imaging is a more reliable modality in distinguishing malignant from benign pleural effusion than 18F-FDG PET imaging and CT imaging alone. For image interpretation of 18F-FDG PET/CT integrated imaging, the PET and CT portions play a major diagnostic role in identifying metastatic effusion and benign effusion, respectively. PMID:27560933

Prediction of infarction development after endovascular stroke therapy with dual-energy computed tomography.

PubMed

Djurdjevic, Tanja; Rehwald, Rafael; Knoflach, Michael; Matosevic, Benjamin; Kiechl, Stefan; Gizewski, Elke Ruth; Glodny, Bernhard; Grams, Astrid Ellen

2017-03-01

After intraarterial recanalisation (IAR), the haemorrhage and the blood-brain barrier (BBB) disruption can be distinguished using dual-energy computed tomography (DECT). The aim of the present study was to investigate whether future infarction development can be predicted from DECT. DECT scans of 20 patients showing 45 BBB disrupted areas after IAR were assessed and compared with follow-up examinations. Receiver operator characteristic (ROC) analyses using densities from the iodine map (IM) and virtual non-contrast (VNC) were performed. Future infarction areas are denser than future non-infarction areas on IM series (23.44 ± 24.86 vs. 5.77 ± 2.77; p < 0.0001) and more hypodense on VNC series (29.71 ± 3.33 vs. 35.33 ± 3.50; p < 0.0001). ROC analyses for the IM series showed an area under the curve (AUC) of 0.99 (cut-off: <9.97 HU; p < 0.05; sensitivity 91.18 %; specificity 100.00 %; accuracy 0.93) for the prediction of future infarctions. The AUC for the prediction of haemorrhagic infarctions was 0.78 (cut-off >17.13 HU; p < 0.05; sensitivity 90.00 %; specificity 62.86 %; accuracy 0.69). The VNC series allowed prediction of infarction volume. Future infarction development after IAR can be reliably predicted with the IM series. The prediction of haemorrhages and of infarction size is less reliable. • The IM series (DECT) can predict future infarction development after IAR. • Later haemorrhages can be predicted using the IM and the BW series. • The volume of definable hypodense areas in VNC correlates with infarction volume.

Advances in Pancreatic CT Imaging.

PubMed

Almeida, Renata R; Lo, Grace C; Patino, Manuel; Bizzo, Bernardo; Canellas, Rodrigo; Sahani, Dushyant V

2018-07-01

The purpose of this article is to discuss the advances in CT acquisition and image postprocessing as they apply to imaging the pancreas and to conceptualize the role of radiogenomics and machine learning in pancreatic imaging. CT is the preferred imaging modality for assessment of pancreatic diseases. Recent advances in CT (dual-energy CT, CT perfusion, CT volumetry, and radiogenomics) and emerging computational algorithms (machine learning) have the potential to further increase the value of CT in pancreatic imaging.

Brain CT image similarity retrieval method based on uncertain location graph.

PubMed

Pan, Haiwei; Li, Pengyuan; Li, Qing; Han, Qilong; Feng, Xiaoning; Gao, Linlin

2014-03-01

A number of brain computed tomography (CT) images stored in hospitals that contain valuable information should be shared to support computer-aided diagnosis systems. Finding the similar brain CT images from the brain CT image database can effectively help doctors diagnose based on the earlier cases. However, the similarity retrieval for brain CT images requires much higher accuracy than the general images. In this paper, a new model of uncertain location graph (ULG) is presented for brain CT image modeling and similarity retrieval. According to the characteristics of brain CT image, we propose a novel method to model brain CT image to ULG based on brain CT image texture. Then, a scheme for ULG similarity retrieval is introduced. Furthermore, an effective index structure is applied to reduce the searching time. Experimental results reveal that our method functions well on brain CT images similarity retrieval with higher accuracy and efficiency.

Radiofrequency electromagnetic fields emitted from base stations of DECT cordless phones and the risk of glioma and meningioma (Interphone Study Group, Germany).

PubMed

Schüz, Joachim; Böhler, Eva; Schlehofer, Brigitte; Berg, Gabriele; Schlaefer, Klaus; Hettinger, Iris; Kunna-Grass, Katharina; Wahrendorf, Jürgen; Blettner, Maria

2006-07-01

The objective of this study was to test the hypothesis that exposure to continuous low-level radiofrequency electromagnetic fields (RF EMFs) increases the risk of glioma and meningioma. Participants in a population-based case-control study in Germany on the risk of brain tumors in relation to cellular phone use were 747 incident brain tumor cases between the ages of 30 and 69 years and 1494 matched controls. The exposure measure of this analysis was the location of a base station of a DECT (Digital Enhanced Cordless Telecommunications) cordless phone close to the bed, which was used as a proxy for continuous low-level exposure to RF EMFs during the night. Estimated odds ratios were 0.82 (95% confidence interval: 0.29-2.33) for glioma and 0.83 (0.29-2.36) for meningioma. There was also no increasing risk observed with duration of exposure to DECT cordless phone base stations. Although the study was limited due to the small number of exposed subjects, it is still a first indication that residential low-level exposure to RF EMFs may not pose a higher risk of brain tumors.

Molecular imaging of malignant tumor metabolism: whole-body image fusion of DWI/CT vs. PET/CT.

PubMed

Reiner, Caecilia S; Fischer, Michael A; Hany, Thomas; Stolzmann, Paul; Nanz, Daniel; Donati, Olivio F; Weishaupt, Dominik; von Schulthess, Gustav K; Scheffel, Hans

2011-08-01

To prospectively investigate the technical feasibility and performance of image fusion for whole-body diffusion-weighted imaging (wbDWI) and computed tomography (CT) to detect metastases using hybrid positron emission tomography/computed tomography (PET/CT) as reference standard. Fifty-two patients (60 ± 14 years; 18 women) with different malignant tumor disease examined by PET/CT for clinical reasons consented to undergo additional wbDWI at 1.5 Tesla. WbDWI was performed using a diffusion-weighted single-shot echo-planar imaging during free breathing. Images at b = 0 s/mm(2) and b = 700 s/mm(2) were acquired and apparent diffusion coefficient (ADC) maps were generated. Image fusion of wbDWI and CT (from PET/CT scan) was performed yielding for wbDWI/CT fused image data. One radiologist rated the success of image fusion and diagnostic image quality. The presence or absence of metastases on wbDWI/CT fused images was evaluated together with the separate wbDWI and CT images by two different, independent radiologists blinded to results from PET/CT. Detection rate and positive predictive values for diagnosing metastases was calculated. PET/CT examinations were used as reference standard. PET/CT identified 305 malignant lesions in 39 of 52 (75%) patients. WbDWI/CT image fusion was technically successful and yielded diagnostic image quality in 73% and 92% of patients, respectively. Interobserver agreement for the evaluation of wbDWI/CT images was κ = 0.78. WbDWI/CT identified 270 metastases in 43 of 52 (83%) patients. Overall detection rate and positive predictive value of wbDWI/CT was 89% (95% CI, 0.85-0.92) and 94% (95% CI, 0.92-0.97), respectively. WbDWI/CT image fusion is technically feasible in a clinical setting and allows the diagnostic assessment of metastatic tumor disease detecting nine of 10 lesions as compared with PET/CT. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Body-wide anatomy recognition in PET/CT images

NASA Astrophysics Data System (ADS)

Wang, Huiqian; Udupa, Jayaram K.; Odhner, Dewey; Tong, Yubing; Zhao, Liming; Torigian, Drew A.

2015-03-01

With the rapid growth of positron emission tomography/computed tomography (PET/CT)-based medical applications, body-wide anatomy recognition on whole-body PET/CT images becomes crucial for quantifying body-wide disease burden. This, however, is a challenging problem and seldom studied due to unclear anatomy reference frame and low spatial resolution of PET images as well as low contrast and spatial resolution of the associated low-dose CT images. We previously developed an automatic anatomy recognition (AAR) system [15] whose applicability was demonstrated on diagnostic computed tomography (CT) and magnetic resonance (MR) images in different body regions on 35 objects. The aim of the present work is to investigate strategies for adapting the previous AAR system to low-dose CT and PET images toward automated body-wide disease quantification. Our adaptation of the previous AAR methodology to PET/CT images in this paper focuses on 16 objects in three body regions - thorax, abdomen, and pelvis - and consists of the following steps: collecting whole-body PET/CT images from existing patient image databases, delineating all objects in these images, modifying the previous hierarchical models built from diagnostic CT images to account for differences in appearance in low-dose CT and PET images, automatically locating objects in these images following object hierarchy, and evaluating performance. Our preliminary evaluations indicate that the performance of the AAR approach on low-dose CT images achieves object localization accuracy within about 2 voxels, which is comparable to the accuracies achieved on diagnostic contrast-enhanced CT images. Object recognition on low-dose CT images from PET/CT examinations without requiring diagnostic contrast-enhanced CT seems feasible.

3D temporal subtraction on multislice CT images using nonlinear warping technique

NASA Astrophysics Data System (ADS)

Ishida, Takayuki; Katsuragawa, Shigehiko; Kawashita, Ikuo; Kim, Hyounseop; Itai, Yoshinori; Awai, Kazuo; Li, Qiang; Doi, Kunio

2007-03-01

The detection of very subtle lesions and/or lesions overlapped with vessels on CT images is a time consuming and difficult task for radiologists. In this study, we have developed a 3D temporal subtraction method to enhance interval changes between previous and current multislice CT images based on a nonlinear image warping technique. Our method provides a subtraction CT image which is obtained by subtraction of a previous CT image from a current CT image. Reduction of misregistration artifacts is important in the temporal subtraction method. Therefore, our computerized method includes global and local image matching techniques for accurate registration of current and previous CT images. For global image matching, we selected the corresponding previous section image for each current section image by using 2D cross-correlation between a blurred low-resolution current CT image and a blurred previous CT image. For local image matching, we applied the 3D template matching technique with translation and rotation of volumes of interests (VOIs) which were selected in the current and the previous CT images. The local shift vector for each VOI pair was determined when the cross-correlation value became the maximum in the 3D template matching. The local shift vectors at all voxels were determined by interpolation of shift vectors of VOIs, and then the previous CT image was nonlinearly warped according to the shift vector for each voxel. Finally, the warped previous CT image was subtracted from the current CT image. The 3D temporal subtraction method was applied to 19 clinical cases. The normal background structures such as vessels, ribs, and heart were removed without large misregistration artifacts. Thus, interval changes due to lung diseases were clearly enhanced as white shadows on subtraction CT images.

Rapid kV-switching single-source dual-energy CT ex vivo renal calculi characterization using a multiparametric approach: refining parameters on an expanded dataset.

PubMed

Kriegshauser, J Scott; Paden, Robert G; He, Miao; Humphreys, Mitchell R; Zell, Steven I; Fu, Yinlin; Wu, Teresa; Sugi, Mark D; Silva, Alvin C

2018-06-01

We aimed to determine the best algorithms for renal stone composition characterization using rapid kV-switching single-source dual-energy computed tomography (rsDECT) and a multiparametric approach after dataset expansion and refinement of variables. rsDECT scans (80 and 140 kVp) were performed on 38 ex vivo 5- to 10-mm renal stones composed of uric acid (UA; n = 21), struvite (STR; n = 5), cystine (CYS; n = 5), and calcium oxalate monohydrate (COM; n = 7). Measurements were obtained for 17 variables: mean Hounsfield units (HU) at 11 monochromatic keV levels, effective Z, 2 iodine-water material basis pairs, and 3 mean monochromatic keV ratios (40/140, 70/120, 70/140). Analysis included using 5 multiparametric algorithms: Support Vector Machine, RandomTree, Artificial Neural Network, Naïve Bayes Tree, and Decision Tree (C4.5). Separating UA from non-UA stones was 100% accurate using multiple methods. For non-UA stones, using a 70-keV mean cutoff value of 694 HU had 100% accuracy for distinguishing COM from non-COM (CYS, STR) stones. The best result for distinguishing all 3 non-UA subtypes was obtained using RandomTree (15/17, 88%). For stones 5 mm or larger, multiple methods can distinguish UA from non-UA and COM from non-COM stones with 100% accuracy. Thus, the choice for analysis is per the user's preference. The best model for separating all three non-UA subtypes was 88% accurate, although with considerable individual overlap between CYS and STR stones. Larger, more diverse datasets, including in vivo data and technical improvements in material separation, may offer more guidance in distinguishing non-UA stone subtypes in the clinical setting.

Generative Adversarial Networks for Noise Reduction in Low-Dose CT.

PubMed

Wolterink, Jelmer M; Leiner, Tim; Viergever, Max A; Isgum, Ivana

2017-12-01

Noise is inherent to low-dose CT acquisition. We propose to train a convolutional neural network (CNN) jointly with an adversarial CNN to estimate routine-dose CT images from low-dose CT images and hence reduce noise. A generator CNN was trained to transform low-dose CT images into routine-dose CT images using voxelwise loss minimization. An adversarial discriminator CNN was simultaneously trained to distinguish the output of the generator from routine-dose CT images. The performance of this discriminator was used as an adversarial loss for the generator. Experiments were performed using CT images of an anthropomorphic phantom containing calcium inserts, as well as patient non-contrast-enhanced cardiac CT images. The phantom and patients were scanned at 20% and 100% routine clinical dose. Three training strategies were compared: the first used only voxelwise loss, the second combined voxelwise loss and adversarial loss, and the third used only adversarial loss. The results showed that training with only voxelwise loss resulted in the highest peak signal-to-noise ratio with respect to reference routine-dose images. However, CNNs trained with adversarial loss captured image statistics of routine-dose images better. Noise reduction improved quantification of low-density calcified inserts in phantom CT images and allowed coronary calcium scoring in low-dose patient CT images with high noise levels. Testing took less than 10 s per CT volume. CNN-based low-dose CT noise reduction in the image domain is feasible. Training with an adversarial network improves the CNNs ability to generate images with an appearance similar to that of reference routine-dose CT images.

MO-DE-207A-09: Low-Dose CT Image Reconstruction Via Learning From Different Patient Normal-Dose Images

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

Han, H; Xing, L; Liang, Z

Purpose: To investigate a novel low-dose CT (LdCT) image reconstruction strategy for lung CT imaging in radiation therapy. Methods: The proposed approach consists of four steps: (1) use the traditional filtered back-projection (FBP) method to reconstruct the LdCT image; (2) calculate structure similarity (SSIM) index between the FBP-reconstructed LdCT image and a set of normal-dose CT (NdCT) images, and select the NdCT image with the highest SSIM as the learning source; (3) segment the NdCT source image into lung and outside tissue regions via simple thresholding, and adopt multiple linear regression to learn high-order Markov random field (MRF) pattern formore » each tissue region in the NdCT source image; (4) segment the FBP-reconstructed LdCT image into lung and outside regions as well, and apply the learnt MRF prior in each tissue region for statistical iterative reconstruction of the LdCT image following the penalized weighted least squares (PWLS) framework. Quantitative evaluation of the reconstructed images was based on the signal-to-noise ratio (SNR), local binary pattern (LBP) and histogram of oriented gradients (HOG) metrics. Results: It was observed that lung and outside tissue regions have different MRF patterns predicted from the NdCT. Visual inspection showed that our method obviously outperformed the traditional FBP method. Comparing with the region-smoothing PWLS method, our method has, in average, 13% increase in SNR, 15% decrease in LBP difference, and 12% decrease in HOG difference from reference standard for all regions of interest, which indicated the superior performance of the proposed method in terms of image resolution and texture preservation. Conclusion: We proposed a novel LdCT image reconstruction method by learning similar image characteristics from a set of NdCT images, and the to-be-learnt NdCT image does not need to be scans from the same subject. This approach is particularly important for enhancing image quality in radiation therapy.« less

Examination of the dental cone-beam CT equipped with flat-panel-detector (FPD)

NASA Astrophysics Data System (ADS)

Ito, Rieko; Fujita, Naotoshi; Kodera, Yoshie

2011-03-01

In dentistry, computed tomography (CT) is essential for diagnosis. Recently, cone-beam CT has come into use. We used an "Alphard 3030" cone-beam CT equipped with an FPD system. This system can obtain fluoroscopic and CT images. Moreover, the Alphard has 4 exposure modes for CT, and each mode has a different field of view (FOV) and voxel size. We examined the image quality of kinetic and CT images obtained using the cone-beam CT system. To evaluate kinetic image quality, we calculated the Wiener spectrum (WS) and modulation transfer function (MTF). We then analyzed the lag images and exposed a phantom. To evaluate CT image quality, we calculated WS and MTF at various places in the FOV and examined the influence of extension of the cone beam X-ray on voxel size. Furthermore, we compared the WS and MTF values of cone-beam CT to those of another CT system. Evaluation of the kinetic images showed that cone-beam CT is sufficient for clinical diagnosis and provides better image quality than the other system tested. However, during exposure of a CT image, the distance from the center influences image quality (especially MTF). Further, differences in voxel size affect image quality. It is therefore necessary to carefully position the region of interest and select an appropriate mode.

Non-rigid registration of serial dedicated breast CT, longitudinal dedicated breast CT and PET/CT images using the diffeomorphic demons method.

PubMed

Santos, Jonathan; Chaudhari, Abhijit J; Joshi, Anand A; Ferrero, Andrea; Yang, Kai; Boone, John M; Badawi, Ramsey D

2014-09-01

Dedicated breast CT and PET/CT scanners provide detailed 3D anatomical and functional imaging data sets and are currently being investigated for applications in breast cancer management such as diagnosis, monitoring response to therapy and radiation therapy planning. Our objective was to evaluate the performance of the diffeomorphic demons (DD) non-rigid image registration method to spatially align 3D serial (pre- and post-contrast) dedicated breast computed tomography (CT), and longitudinally-acquired dedicated 3D breast CT and positron emission tomography (PET)/CT images. The algorithmic parameters of the DD method were optimized for the alignment of dedicated breast CT images using training data and fixed. The performance of the method for image alignment was quantitatively evaluated using three separate data sets; (1) serial breast CT pre- and post-contrast images of 20 women, (2) breast CT images of 20 women acquired before and after repositioning the subject on the scanner, and (3) dedicated breast PET/CT images of 7 women undergoing neo-adjuvant chemotherapy acquired pre-treatment and after 1 cycle of therapy. The DD registration method outperformed no registration (p < 0.001) and conventional affine registration (p ≤ 0.002) for serial and longitudinal breast CT and PET/CT image alignment. In spite of the large size of the imaging data, the computational cost of the DD method was found to be reasonable (3-5 min). Co-registration of dedicated breast CT and PET/CT images can be performed rapidly and reliably using the DD method. This is the first study evaluating the DD registration method for the alignment of dedicated breast CT and PET/CT images. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Prior image constrained image reconstruction in emerging computed tomography applications

NASA Astrophysics Data System (ADS)

Brunner, Stephen T.

Advances have been made in computed tomography (CT), especially in the past five years, by incorporating prior images into the image reconstruction process. In this dissertation, we investigate prior image constrained image reconstruction in three emerging CT applications: dual-energy CT, multi-energy photon-counting CT, and cone-beam CT in image-guided radiation therapy. First, we investigate the application of Prior Image Constrained Compressed Sensing (PICCS) in dual-energy CT, which has been called "one of the hottest research areas in CT." Phantom and animal studies are conducted using a state-of-the-art 64-slice GE Discovery 750 HD CT scanner to investigate the extent to which PICCS can enable radiation dose reduction in material density and virtual monochromatic imaging. Second, we extend the application of PICCS from dual-energy CT to multi-energy photon-counting CT, which has been called "one of the 12 topics in CT to be critical in the next decade." Numerical simulations are conducted to generate multiple energy bin images for a photon-counting CT acquisition and to investigate the extent to which PICCS can enable radiation dose efficiency improvement. Third, we investigate the performance of a newly proposed prior image constrained scatter correction technique to correct scatter-induced shading artifacts in cone-beam CT, which, when used in image-guided radiation therapy procedures, can assist in patient localization, and potentially, dose verification and adaptive radiation therapy. Phantom studies are conducted using a Varian 2100 EX system with an on-board imager to investigate the extent to which the prior image constrained scatter correction technique can mitigate scatter-induced shading artifacts in cone-beam CT. Results show that these prior image constrained image reconstruction techniques can reduce radiation dose in dual-energy CT by 50% in phantom and animal studies in material density and virtual monochromatic imaging, can lead to radiation dose efficiency improvement in multi-energy photon-counting CT, and can mitigate scatter-induced shading artifacts in cone-beam CT in full-fan and half-fan modes.

Reduced dose CT with model-based iterative reconstruction compared to standard dose CT of the chest, abdomen, and pelvis in oncology patients: intra-individual comparison study on image quality and lesion conspicuity.

PubMed

Morimoto, Linda Nayeli; Kamaya, Aya; Boulay-Coletta, Isabelle; Fleischmann, Dominik; Molvin, Lior; Tian, Lu; Fisher, George; Wang, Jia; Willmann, Jürgen K

2017-09-01

To compare image quality and lesion conspicuity of reduced dose (RD) CT with model-based iterative reconstruction (MBIR) compared to standard dose (SD) CT in patients undergoing oncological follow-up imaging. Forty-four cancer patients who had a staging SD CT within 12 months were prospectively included to undergo a weight-based RD CT with MBIR. Radiation dose was recorded and tissue attenuation and image noise of four tissue types were measured. Reproducibility of target lesion size measurements of up to 5 target lesions per patient were analyzed. Subjective image quality was evaluated for three readers independently utilizing 4- or 5-point Likert scales. Median radiation dose reduction was 46% using RD CT (P < 0.01). Median image noise across all measured tissue types was lower (P < 0.01) in RD CT. Subjective image quality for RD CT was higher (P < 0.01) in regard to image noise and overall image quality; however, there was no statistically significant difference regarding image sharpness (P = 0.59). There were subjectively more artifacts on RD CT (P < 0.01). Lesion conspicuity was subjectively better in RD CT (P < 0.01). Repeated target lesion size measurements were highly reproducible both on SD CT (ICC = 0.987) and RD CT (ICC = 0.97). RD CT imaging with MBIR provides diagnostic imaging quality and comparable lesion conspicuity on follow-up exams while allowing dose reduction by a median of 46% compared to SD CT imaging.

Attenuation correction of emission PET images with average CT: Interpolation from breath-hold CT

NASA Astrophysics Data System (ADS)

Huang, Tzung-Chi; Zhang, Geoffrey; Chen, Chih-Hao; Yang, Bang-Hung; Wu, Nien-Yun; Wang, Shyh-Jen; Wu, Tung-Hsin

2011-05-01

Misregistration resulting from the difference of temporal resolution in PET and CT scans occur frequently in PET/CT imaging, which causes distortion in tumor quantification in PET. Respiration cine average CT (CACT) for PET attenuation correction has been reported to improve the misalignment effectively by several papers. However, the radiation dose to the patient from a four-dimensional CT scan is relatively high. In this study, we propose a method to interpolate respiratory CT images over a respiratory cycle from inhalation and exhalation breath-hold CT images, and use the average CT from the generated CT set for PET attenuation correction. The radiation dose to the patient is reduced using this method. Six cancer patients of various lesion sites underwent routine free-breath helical CT (HCT), respiration CACT, interpolated average CT (IACT), and 18F-FDG PET. Deformable image registration was used to interpolate the middle phases of a respiratory cycle based on the end-inspiration and end-expiration breath-hold CT scans. The average CT image was calculated from the eight interpolated CT image sets of middle respiratory phases and the two original inspiration and expiration CT images. Then the PET images were reconstructed by these three methods for attenuation correction using HCT, CACT, and IACT. Misalignment of PET image using either CACT or IACT for attenuation correction in PET/CT was improved. The difference in standard uptake value (SUV) from tumor in PET images was most significant between the use of HCT and CACT, while the least significant between the use of CACT and IACT. Besides the similar improvement in tumor quantification compared to the use of CACT, using IACT for PET attenuation correction reduces the radiation dose to the patient.

Computerized methodology for micro-CT and histological data inflation using an IVUS based translation map.

PubMed

Athanasiou, Lambros S; Rigas, George A; Sakellarios, Antonis I; Exarchos, Themis P; Siogkas, Panagiotis K; Naka, Katerina K; Panetta, Daniele; Pelosi, Gualtiero; Vozzi, Federico; Michalis, Lampros K; Parodi, Oberdan; Fotiadis, Dimitrios I

2015-10-01

A framework for the inflation of micro-CT and histology data using intravascular ultrasound (IVUS) images, is presented. The proposed methodology consists of three steps. In the first step the micro-CT/histological images are manually co-registered with IVUS by experts using fiducial points as landmarks. In the second step the lumen of both the micro-CT/histological images and IVUS images are automatically segmented. Finally, in the third step the micro-CT/histological images are inflated by applying a transformation method on each image. The transformation method is based on the IVUS and micro-CT/histological contour difference. In order to validate the proposed image inflation methodology, plaque areas in the inflated micro-CT and histological images are compared with the ones in the IVUS images. The proposed methodology for inflating micro-CT/histological images increases the sensitivity of plaque area matching between the inflated and the IVUS images (7% and 22% in histological and micro-CT images, respectively). Copyright © 2015 Elsevier Ltd. All rights reserved.

Iterative CT shading correction with no prior information

NASA Astrophysics Data System (ADS)

Wu, Pengwei; Sun, Xiaonan; Hu, Hongjie; Mao, Tingyu; Zhao, Wei; Sheng, Ke; Cheung, Alice A.; Niu, Tianye

2015-11-01

Shading artifacts in CT images are caused by scatter contamination, beam-hardening effect and other non-ideal imaging conditions. The purpose of this study is to propose a novel and general correction framework to eliminate low-frequency shading artifacts in CT images (e.g. cone-beam CT, low-kVp CT) without relying on prior information. The method is based on the general knowledge of the relatively uniform CT number distribution in one tissue component. The CT image is first segmented to construct a template image where each structure is filled with the same CT number of a specific tissue type. Then, by subtracting the ideal template from the CT image, the residual image from various error sources are generated. Since forward projection is an integration process, non-continuous shading artifacts in the image become continuous signals in a line integral. Thus, the residual image is forward projected and its line integral is low-pass filtered in order to estimate the error that causes shading artifacts. A compensation map is reconstructed from the filtered line integral error using a standard FDK algorithm and added back to the original image for shading correction. As the segmented image does not accurately depict a shaded CT image, the proposed scheme is iterated until the variation of the residual image is minimized. The proposed method is evaluated using cone-beam CT images of a Catphan©600 phantom and a pelvis patient, and low-kVp CT angiography images for carotid artery assessment. Compared with the CT image without correction, the proposed method reduces the overall CT number error from over 200 HU to be less than 30 HU and increases the spatial uniformity by a factor of 1.5. Low-contrast object is faithfully retained after the proposed correction. An effective iterative algorithm for shading correction in CT imaging is proposed that is only assisted by general anatomical information without relying on prior knowledge. The proposed method is thus practical and attractive as a general solution to CT shading correction.

Radiotherapy treatment planning: benefits of CT-MR image registration and fusion in tumor volume delineation.

PubMed

Djan, Igor; Petrović, Borislava; Erak, Marko; Nikolić, Ivan; Lucić, Silvija

2013-08-01

Development of imaging techniques, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), made great impact on radiotherapy treatment planning by improving the localization of target volumes. Improved localization allows better local control of tumor volumes, but also minimizes geographical misses. Mutual information is obtained by registration and fusion of images achieved manually or automatically. The aim of this study was to validate the CT-MRI image fusion method and compare delineation obtained by CT versus CT-MRI image fusion. The image fusion software (XIO CMS 4.50.0) was applied to delineate 16 patients. The patients were scanned on CT and MRI in the treatment position within an immobilization device before the initial treatment. The gross tumor volume (GTV) and clinical target volume (CTV) were delineated on CT alone and on CT+MRI images consecutively and image fusion was obtained. Image fusion showed that CTV delineated on a CT image study set is mainly inadequate for treatment planning, in comparison with CTV delineated on CT-MRI fused image study set. Fusion of different modalities enables the most accurate target volume delineation. This study shows that registration and image fusion allows precise target localization in terms of GTV and CTV and local disease control.

SU-F-T-270: A Technique for Modeling a Diode Array Into the TPS for Lung SBRT Patient Specific QA

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

Curley, C; Leventouri, T; Ouhib, Z

2016-06-15

Purpose: To accurately match the treatment planning system (TPS) with the measurement environment, where quality assurance (QA) devices are used to collect data, for lung Stereotactic Body Radiation Therapy (SBRT) patient specific QA. Incorporation of heterogeneities is also studied. Methods: Dual energy computerized tomography (DECT) and single energy computerized tomography (SECT) were used to model phantoms incorporating a 2-D diode array into the TPS. A water-equivalent and a heterogeneous phantom (simulating the thoracic region of a patient) were studied. Monte Carlo and pencil beam planar dose distributions were compared to measured distributions. Composite and individual fields were analyzed for normallymore » incident and planned gantry angle deliveries. γ- analysis was used with criteria 3% 3mm, 2% 2mm, and 1% 1mm. Results: The Monte Carlo calculations for the DECT resulted in improved agreements with the diode array for 46.4% of the fields at 3% 3mm, 85.7% at 2% 2mm, and 92.9% at 1% 1mm.For the SECT, the Monte Carlo calculations gave no agreement for the same γ-analysis criteria. Pencil beam calculations resulted in lower agreements with the diode array in the TPS. The DECT showed improvements for 14.3% of the fields at 3% 3mm and 2% 2mm, and 28.6% at 1% 1mm.In SECT comparisons, 7.1% of the fields at 3% 3mm, 10.7% at 2% 2mm, and 17.9% at 1% 1mm showed improved agreements with the diode array. Conclusion: This study demonstrates that modeling the diode array in the TPS is viable using DECT with Monte Carlo for patient specific lung SBRT QA. As recommended by task groups (e.g. TG 65, TG 101, TG 244) of the American Association of Physicists in Medicine (AAPM), pencil beam algorithms should be avoided in the presence of heterogeneous materials, including a diode array.« less

Volumetric CT-images improve testing of radiological image interpretation skills.

PubMed

Ravesloot, Cécile J; van der Schaaf, Marieke F; van Schaik, Jan P J; ten Cate, Olle Th J; van der Gijp, Anouk; Mol, Christian P; Vincken, Koen L

2015-05-01

Current radiology practice increasingly involves interpretation of volumetric data sets. In contrast, most radiology tests still contain only 2D images. We introduced a new testing tool that allows for stack viewing of volumetric images in our undergraduate radiology program. We hypothesized that tests with volumetric CT-images enhance test quality, in comparison with traditional completely 2D image-based tests, because they might better reflect required skills for clinical practice. Two groups of medical students (n=139; n=143), trained with 2D and volumetric CT-images, took a digital radiology test in two versions (A and B), each containing both 2D and volumetric CT-image questions. In a questionnaire, they were asked to comment on the representativeness for clinical practice, difficulty and user-friendliness of the test questions and testing program. Students' test scores and reliabilities, measured with Cronbach's alpha, of 2D and volumetric CT-image tests were compared. Estimated reliabilities (Cronbach's alphas) were higher for volumetric CT-image scores (version A: .51 and version B: .54), than for 2D CT-image scores (version A: .24 and version B: .37). Participants found volumetric CT-image tests more representative of clinical practice, and considered them to be less difficult than volumetric CT-image questions. However, in one version (A), volumetric CT-image scores (M 80.9, SD 14.8) were significantly lower than 2D CT-image scores (M 88.4, SD 10.4) (p<.001). The volumetric CT-image testing program was considered user-friendly. This study shows that volumetric image questions can be successfully integrated in students' radiology testing. Results suggests that the inclusion of volumetric CT-images might improve the quality of radiology tests by positively impacting perceived representativeness for clinical practice and increasing reliability of the test. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The CT image standardization based on the verified PSF

NASA Astrophysics Data System (ADS)

Wada, Shinichi; Ohkubo, Masaki; Kunii, Masayuki; Matsumoto, Toru; Murao, Kohei; Awai, Kazuo; Ikeda, Mitsuru

2007-03-01

This study discusses a method of CT image quality standardization that uses a point-spread function (PSF) in MDCT. CT image I(x,y,z) is represented by the following formula: I(x,y,z) = O(x,y,z)***PSF(x,y,z). Standardization was performed by measuring the three-dimensional (3-D) PSFs of two CT images with different image qualities. The image conversion method was constructed and tested using the 3-D PSFs and CT images of the CT scanners of three different manufacturers. The CT scanners used were Lightspeed QX/i, Somatom Volume Zoom, and Brilliance-40. To obtain the PSF(x,y) of these CT scanners, the line spread functions of the respective reconstruction kernels were measured using a phantom described by J.M. Boone. The kernels for each scanner were: soft, standard, lung, bone, and bone plus (GE); B20f, B40f, B41f, B50f, and B60f (Siemens); and B, C, D, E, and L (Philips). Slice sensitivity profile (SSP) were measured using a micro-disk phantom (50 μm* φ1 mm) with 5 mm slice thickness and beam pitch of 1.5 (GE, Siemens) and 0.626 (Philips). 3-D PSF was verified using an MDCT QA phantom. Real chest CT images were converted to images with contrasting standard image quality. Comparison between the converted CT image and the original standard image showed good agreement. The usefulness of the image conversion method is discussed using clinical CT images acquired by CT scanners produced by different manufacturers.

Development of proton CT imaging system using plastic scintillator and CCD camera

NASA Astrophysics Data System (ADS)

Tanaka, Sodai; Nishio, Teiji; Matsushita, Keiichiro; Tsuneda, Masato; Kabuki, Shigeto; Uesaka, Mitsuru

2016-06-01

A proton computed tomography (pCT) imaging system was constructed for evaluation of the error of an x-ray CT (xCT)-to-WEL (water-equivalent length) conversion in treatment planning for proton therapy. In this system, the scintillation light integrated along the beam direction is obtained by photography using the CCD camera, which enables fast and easy data acquisition. The light intensity is converted to the range of the proton beam using a light-to-range conversion table made beforehand, and a pCT image is reconstructed. An experiment for demonstration of the pCT system was performed using a 70 MeV proton beam provided by the AVF930 cyclotron at the National Institute of Radiological Sciences. Three-dimensional pCT images were reconstructed from the experimental data. A thin structure of approximately 1 mm was clearly observed, with spatial resolution of pCT images at the same level as that of xCT images. The pCT images of various substances were reconstructed to evaluate the pixel value of pCT images. The image quality was investigated with regard to deterioration including multiple Coulomb scattering.

Blind CT image quality assessment via deep learning strategy: initial study

NASA Astrophysics Data System (ADS)

Li, Sui; He, Ji; Wang, Yongbo; Liao, Yuting; Zeng, Dong; Bian, Zhaoying; Ma, Jianhua

2018-03-01

Computed Tomography (CT) is one of the most important medical imaging modality. CT images can be used to assist in the detection and diagnosis of lesions and to facilitate follow-up treatment. However, CT images are vulnerable to noise. Actually, there are two major source intrinsically causing the CT data noise, i.e., the X-ray photo statistics and the electronic noise background. Therefore, it is necessary to doing image quality assessment (IQA) in CT imaging before diagnosis and treatment. Most of existing CT images IQA methods are based on human observer study. However, these methods are impractical in clinical for their complex and time-consuming. In this paper, we presented a blind CT image quality assessment via deep learning strategy. A database of 1500 CT images is constructed, containing 300 high-quality images and 1200 corresponding noisy images. Specifically, the high-quality images were used to simulate the corresponding noisy images at four different doses. Then, the images are scored by the experienced radiologists by the following attributes: image noise, artifacts, edge and structure, overall image quality, and tumor size and boundary estimation with five-point scale. We trained a network for learning the non-liner map from CT images to subjective evaluation scores. Then, we load the pre-trained model to yield predicted score from the test image. To demonstrate the performance of the deep learning network in IQA, correlation coefficients: Pearson Linear Correlation Coefficient (PLCC) and Spearman Rank Order Correlation Coefficient (SROCC) are utilized. And the experimental result demonstrate that the presented deep learning based IQA strategy can be used in the CT image quality assessment.

Artefacts of PET/CT images

PubMed Central

Pettinato, C; Nanni, C; Farsad, M; Castellucci, P; Sarnelli, A; Civollani, S; Franchi, R; Fanti, S; Marengo, M; Bergamini, C

2006-01-01

Positron emission tomography (PET) is a non-invasive imaging modality, which is clinically widely used both for diagnosis and accessing therapy response in oncology, cardiology and neurology. Fusing PET and CT images in a single dataset would be useful for physicians who could read the functional and the anatomical aspects of a disease in a single shot. The use of fusion software has been replaced in the last few years by integrated PET/CT systems, which combine a PET and a CT scanner in the same gantry. CT images have the double function to correct PET images for attenuation and can fuse with PET for a better visualization and localization of lesions. The use of CT for attenuation correction yields several advantages in terms of accuracy and patient comfort, but can also introduce several artefacts on PET-corrected images. PET/CT image artefacts are due primarily to metallic implants, respiratory motion, use of contrast media and image truncation. This paper reviews different types artefacts and their correction methods. PET/CT improves image quality and image accuracy. However, to avoid possible pitfalls the simultaneous display of both Computed Tomography Attenuation Corrected (CTAC) and non corrected PET images, side by side with CT images is strongly recommended. PMID:21614340

SU-C-207A-03: Development of Proton CT Imaging System Using Thick Scintillator and CCD Camera

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

Tanaka, S; Uesaka, M; Nishio, T

2016-06-15

Purpose: In the treatment planning of proton therapy, Water Equivalent Length (WEL), which is the parameter for the calculation of dose and the range of proton, is derived by X-ray CT (xCT) image and xCT-WEL conversion. However, about a few percent error in the accuracy of proton range calculation through this conversion has been reported. The purpose of this study is to construct a proton CT (pCT) imaging system for an evaluation of the error. Methods: The pCT imaging system was constructed with a thick scintillator and a cooled CCD camera, which acquires the two-dimensional image of integrated value ofmore » the scintillation light toward the beam direction. The pCT image is reconstructed by FBP method using a correction between the light intensity and residual range of proton beam. An experiment for the demonstration of this system was performed with 70-MeV proton beam provided by NIRS cyclotron. The pCT image of several objects reconstructed from the experimental data was evaluated quantitatively. Results: Three-dimensional pCT images of several objects were reconstructed experimentally. A finestructure of approximately 1 mm was clearly observed. The position resolution of pCT image was almost the same as that of xCT image. And the error of proton CT pixel value was up to 4%. The deterioration of image quality was caused mainly by the effect of multiple Coulomb scattering. Conclusion: We designed and constructed the pCT imaging system using a thick scintillator and a CCD camera. And the system was evaluated with the experiment by use of 70-MeV proton beam. Three-dimensional pCT images of several objects were acquired by the system. This work was supported by JST SENTAN Grant Number 13A1101 and JSPS KAKENHI Grant Number 15H04912.« less

SU-E-J-89: Comparative Analysis of MIM and Velocity’s Image Deformation Algorithm Using Simulated KV-CBCT Images for Quality Assurance

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

Cline, K; Narayanasamy, G; Obediat, M

Purpose: Deformable image registration (DIR) is used routinely in the clinic without a formalized quality assurance (QA) process. Using simulated deformations to digitally deform images in a known way and comparing to DIR algorithm predictions is a powerful technique for DIR QA. This technique must also simulate realistic image noise and artifacts, especially between modalities. This study developed an algorithm to create simulated daily kV cone-beam computed-tomography (CBCT) images from CT images for DIR QA between these modalities. Methods: A Catphan and physical head-and-neck phantom, with known deformations, were used. CT and kV-CBCT images of the Catphan were utilized tomore » characterize the changes in Hounsfield units, noise, and image cupping that occur between these imaging modalities. The algorithm then imprinted these changes onto a CT image of the deformed head-and-neck phantom, thereby creating a simulated-CBCT image. CT and kV-CBCT images of the undeformed and deformed head-and-neck phantom were also acquired. The Velocity and MIM DIR algorithms were applied between the undeformed CT image and each of the deformed CT, CBCT, and simulated-CBCT images to obtain predicted deformations. The error between the known and predicted deformations was used as a metric to evaluate the quality of the simulated-CBCT image. Ideally, the simulated-CBCT image registration would produce the same accuracy as the deformed CBCT image registration. Results: For Velocity, the mean error was 1.4 mm for the CT-CT registration, 1.7 mm for the CT-CBCT registration, and 1.4 mm for the CT-simulated-CBCT registration. These same numbers were 1.5, 4.5, and 5.9 mm, respectively, for MIM. Conclusion: All cases produced similar accuracy for Velocity. MIM produced similar values of accuracy for CT-CT registration, but was not as accurate for CT-CBCT registrations. The MIM simulated-CBCT registration followed this same trend, but overestimated MIM DIR errors relative to the CT-CBCT registration.« less

Simulation of pseudo-CT images based on deformable image registration of ultrasound images: A proof of concept for transabdominal ultrasound imaging of the prostate during radiotherapy

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

Meer, Skadi van der; Camps, Saskia M.; Oncology Solutions Department, Philips Research, High Tech Campus 34, Eindhoven 5656 AE

Purpose: Imaging of patient anatomy during treatment is a necessity for position verification and for adaptive radiotherapy based on daily dose recalculation. Ultrasound (US) image guided radiotherapy systems are currently available to collect US images at the simulation stage (US{sub sim}), coregistered with the simulation computed tomography (CT), and during all treatment fractions. The authors hypothesize that a deformation field derived from US-based deformable image registration can be used to create a daily pseudo-CT (CT{sub ps}) image that is more representative of the patients’ geometry during treatment than the CT acquired at simulation stage (CT{sub sim}). Methods: The three prostatemore » patients, considered to evaluate this hypothesis, had coregistered CT and US scans on various days. In particular, two patients had two US–CT datasets each and the third one had five US–CT datasets. Deformation fields were computed between pairs of US images of the same patient and then applied to the corresponding US{sub sim} scan to yield a new deformed CT{sub ps} scan. The original treatment plans were used to recalculate dose distributions in the simulation, deformed and ground truth CT (CT{sub gt}) images to compare dice similarity coefficients, maximum absolute distance, and mean absolute distance on CT delineations and gamma index (γ) evaluations on both the Hounsfield units (HUs) and the dose. Results: In the majority, deformation did improve the results for all three evaluation methods. The change in gamma failure for dose (γ{sub Dose}, 3%, 3 mm) ranged from an improvement of 11.2% in the prostate volume to a deterioration of 1.3% in the prostate and bladder. The change in gamma failure for the CT images (γ{sub CT}, 50 HU, 3 mm) ranged from an improvement of 20.5% in the anus and rectum to a deterioration of 3.2% in the prostate. Conclusions: This new technique may generate CT{sub ps} images that are more representative of the actual patient anatomy than the CT{sub sim} scan.« less

Material Separation Using Dual-Energy CT: Current and Emerging Applications.

PubMed

Patino, Manuel; Prochowski, Andrea; Agrawal, Mukta D; Simeone, Frank J; Gupta, Rajiv; Hahn, Peter F; Sahani, Dushyant V

2016-01-01

Dual-energy (DE) computed tomography (CT) offers the opportunity to generate material-specific images on the basis of the atomic number Z and the unique mass attenuation coefficient of a particular material at different x-ray energies. Material-specific images provide qualitative and quantitative information about tissue composition and contrast media distribution. The most significant contribution of DE CT-based material characterization comes from the capability to assess iodine distribution through the creation of an image that exclusively shows iodine. These iodine-specific images increase tissue contrast and amplify subtle differences in attenuation between normal and abnormal tissues, improving lesion detection and characterization in the abdomen. In addition, DE CT enables computational removal of iodine influence from a CT image, generating virtual noncontrast images. Several additional materials, including calcium, fat, and uric acid, can be separated, permitting imaging assessment of metabolic imbalances, elemental deficiencies, and abnormal deposition of materials within tissues. The ability to obtain material-specific images from a single, contrast-enhanced CT acquisition can complement the anatomic knowledge with functional information, and may be used to reduce the radiation dose by decreasing the number of phases in a multiphasic CT examination. DE CT also enables generation of energy-specific and virtual monochromatic images. Clinical applications of DE CT leverage both material-specific images and virtual monochromatic images to expand the current role of CT and overcome several limitations of single-energy CT. (©)RSNA, 2016.

An approach for quantitative image quality analysis for CT

NASA Astrophysics Data System (ADS)

Rahimi, Amir; Cochran, Joe; Mooney, Doug; Regensburger, Joe

2016-03-01

An objective and standardized approach to assess image quality of Compute Tomography (CT) systems is required in a wide variety of imaging processes to identify CT systems appropriate for a given application. We present an overview of the framework we have developed to help standardize and to objectively assess CT image quality for different models of CT scanners used for security applications. Within this framework, we have developed methods to quantitatively measure metrics that should correlate with feature identification, detection accuracy and precision, and image registration capabilities of CT machines and to identify strengths and weaknesses in different CT imaging technologies in transportation security. To that end we have designed, developed and constructed phantoms that allow for systematic and repeatable measurements of roughly 88 image quality metrics, representing modulation transfer function, noise equivalent quanta, noise power spectra, slice sensitivity profiles, streak artifacts, CT number uniformity, CT number consistency, object length accuracy, CT number path length consistency, and object registration. Furthermore, we have developed a sophisticated MATLAB based image analysis tool kit to analyze CT generated images of phantoms and report these metrics in a format that is standardized across the considered models of CT scanners, allowing for comparative image quality analysis within a CT model or between different CT models. In addition, we have developed a modified sparse principal component analysis (SPCA) method to generate a modified set of PCA components as compared to the standard principal component analysis (PCA) with sparse loadings in conjunction with Hotelling T2 statistical analysis method to compare, qualify, and detect faults in the tested systems.

Evaluation of an attenuation correction method for PET/MR imaging of the head based on substitute CT images.

PubMed

Larsson, Anne; Johansson, Adam; Axelsson, Jan; Nyholm, Tufve; Asklund, Thomas; Riklund, Katrine; Karlsson, Mikael

2013-02-01

The aim of this study was to evaluate MR-based attenuation correction of PET emission data of the head, based on a previously described technique that calculates substitute CT (sCT) images from a set of MR images. Images from eight patients, examined with (18)F-FLT PET/CT and MRI, were included. sCT images were calculated and co-registered to the corresponding CT images, and transferred to the PET/CT scanner for reconstruction. The new reconstructions were then compared with the originals. The effect of replacing bone with soft tissue in the sCT-images was also evaluated. The average relative difference between the sCT-corrected PET images and the CT-corrected PET images was 1.6% for the head and 1.9% for the brain. The average standard deviations of the relative differences within the head were relatively high, at 13.2%, primarily because of large differences in the nasal septa region. For the brain, the average standard deviation was lower, 4.1%. The global average difference in the head when replacing bone with soft tissue was 11%. The method presented here has a high rate of accuracy, but high-precision quantitative imaging of the nasal septa region is not possible at the moment.

3D SPECT/CT fusion using image data projection of bone SPECT onto 3D volume-rendered CT images: feasibility and clinical impact in the diagnosis of bone metastasis.

PubMed

Ogata, Yuji; Nakahara, Tadaki; Ode, Kenichi; Matsusaka, Yohji; Katagiri, Mari; Iwabuchi, Yu; Itoh, Kazunari; Ichimura, Akira; Jinzaki, Masahiro

2017-05-01

We developed a method of image data projection of bone SPECT into 3D volume-rendered CT images for 3D SPECT/CT fusion. The aims of our study were to evaluate its feasibility and clinical usefulness. Whole-body bone scintigraphy (WB) and SPECT/CT scans were performed in 318 cancer patients using a dedicated SPECT/CT systems. Volume data of bone SPECT and CT were fused to obtain 2D SPECT/CT images. To generate our 3D SPECT/CT images, colored voxel data of bone SPECT were projected onto the corresponding location of the volume-rendered CT data after a semi-automatic bone extraction. Then, the resultant 3D images were blended with conventional volume-rendered CT images, allowing to grasp the three-dimensional relationship between bone metabolism and anatomy. WB and SPECT (WB + SPECT), 2D SPECT/CT fusion, and 3D SPECT/CT fusion were evaluated by two independent reviewers in the diagnosis of bone metastasis. The inter-observer variability and diagnostic accuracy in these three image sets were investigated using a four-point diagnostic scale. Increased bone metabolism was found in 744 metastatic sites and 1002 benign changes. On a per-lesion basis, inter-observer agreements in the diagnosis of bone metastasis were 0.72 for WB + SPECT, 0.90 for 2D SPECT/CT, and 0.89 for 3D SPECT/CT. Receiver operating characteristic analyses for the diagnostic accuracy of bone metastasis showed that WB + SPECT, 2D SPECT/CT, and 3D SPECT/CT had an area under the curve of 0.800, 0.983, and 0.983 for reader 1, 0.865, 0.992, and 0.993 for reader 2, respectively (WB + SPECT vs. 2D or 3D SPECT/CT, p < 0.001; 2D vs. 3D SPECT/CT, n.s.). The durations of interpretation of WB + SPECT, 2D SPECT/CT, and 3D SPECT/CT images were 241 ± 75, 225 ± 73, and 182 ± 71 s for reader 1 and 207 ± 72, 190 ± 73, and 179 ± 73 s for reader 2, respectively. As a result, it took shorter time to read 3D SPECT/CT images than 2D SPECT/CT (p < 0.0001) or WB + SPECT images (p < 0.0001). 3D SPECT/CT fusion offers comparable diagnostic accuracy to 2D SPECT/CT fusion. The visual effect of 3D SPECT/CT fusion facilitates reduction of reading time compared to 2D SPECT/CT fusion.

Treatment response assessment of radiofrequency ablation for hepatocellular carcinoma: usefulness of virtual CT sonography with magnetic navigation.

PubMed

Minami, Yasunori; Kitai, Satoshi; Kudo, Masatoshi

2012-03-01

Virtual CT sonography using magnetic navigation provides cross sectional images of CT volume data corresponding to the angle of the transducer in the magnetic field in real-time. The purpose of this study was to clarify the value of this virtual CT sonography for treatment response of radiofrequency ablation for hepatocellular carcinoma. Sixty-one patients with 88 HCCs measuring 0.5-1.3 cm (mean±SD, 1.0±0.3 cm) were treated by radiofrequency ablation. For early treatment response, dynamic CT was performed 1-5 days (median, 2 days). We compared early treatment response between axial CT images and multi-angle CT images using virtual CT sonography. Residual tumor stains on axial CT images and multi-angle CT images were detected in 11.4% (10/88) and 13.6% (12/88) after the first session of RFA, respectively (P=0.65). Two patients were diagnosed as showing hyperemia enhancement after the initial radiofrequency ablation on axial CT images and showed local tumor progression shortly because of unnoticed residual tumors. Only virtual CT sonography with magnetic navigation retrospectively showed the residual tumor as circular enhancement. In safety margin analysis, 10 patients were excluded because of residual tumors. The safety margin more than 5 mm by virtual CT sonographic images and transverse CT images were determined in 71.8% (56/78) and 82.1% (64/78), respectively (P=0.13). The safety margin should be overestimated on axial CT images in 8 nodules. Virtual CT sonography with magnetic navigation was useful in evaluating the treatment response of radiofrequency ablation therapy for hepatocellular carcinoma. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Intra-individual diagnostic image quality and organ-specific-radiation dose comparison between spiral cCT with iterative image reconstruction and z-axis automated tube current modulation and sequential cCT.

PubMed

Wenz, Holger; Maros, Máté E; Meyer, Mathias; Gawlitza, Joshua; Förster, Alex; Haubenreisser, Holger; Kurth, Stefan; Schoenberg, Stefan O; Groden, Christoph; Henzler, Thomas

2016-01-01

To prospectively evaluate image quality and organ-specific-radiation dose of spiral cranial CT (cCT) combined with automated tube current modulation (ATCM) and iterative image reconstruction (IR) in comparison to sequential tilted cCT reconstructed with filtered back projection (FBP) without ATCM. 31 patients with a previous performed tilted non-contrast enhanced sequential cCT aquisition on a 4-slice CT system with only FBP reconstruction and no ATCM were prospectively enrolled in this study for a clinical indicated cCT scan. All spiral cCT examinations were performed on a 3rd generation dual-source CT system using ATCM in z-axis direction. Images were reconstructed using both, FBP and IR (level 1-5). A Monte-Carlo-simulation-based analysis was used to compare organ-specific-radiation dose. Subjective image quality for various anatomic structures was evaluated using a 4-point Likert-scale and objective image quality was evaluated by comparing signal-to-noise ratios (SNR). Spiral cCT led to a significantly lower (p < 0.05) organ-specific-radiation dose in all targets including eye lense. Subjective image quality of spiral cCT datasets with an IR reconstruction level 5 was rated significantly higher compared to the sequential cCT acquisitions (p < 0.0001). Consecutive mean SNR was significantly higher in all spiral datasets (FBP, IR 1-5) when compared to sequential cCT with a mean SNR improvement of 44.77% (p < 0.0001). Spiral cCT combined with ATCM and IR allows for significant-radiation dose reduction including a reduce eye lens organ-dose when compared to a tilted sequential cCT while improving subjective and objective image quality.

Evaluation of the ablation margin of hepatocellular carcinoma using CEUS-CT/MR image fusion in a phantom model and in patients.

PubMed

Li, Kai; Su, Zhongzhen; Xu, Erjiao; Huang, Qiannan; Zeng, Qingjing; Zheng, Rongqin

2017-01-19

To assess the accuracy of contrast-enhanced ultrasound (CEUS)-CT/MR image fusion in evaluating the radiofrequency ablative margin (AM) of hepatocellular carcinoma (HCC) based on a custom-made phantom model and in HCC patients. Twenty-four phantoms were randomly divided into a complete ablation group (n = 6) and an incomplete ablation group (n = 18). After radiofrequency ablation (RFA), the AM was evaluated using ultrasound (US)-CT image fusion, and the results were compared with the AM results that were directly measured in a gross specimen. CEUS-CT/MR image fusion and CT-CT / MR-MR image fusion were used to evaluate the AM in 37 tumors from 33 HCC patients who underwent RFA. The sensitivity, specificity, and accuracy of US-CT image fusion for evaluating AM in the phantom model were 93.8, 85.7 and 91.3%, respectively. The maximal thicknesses of the residual AM were 3.5 ± 2.0 mm and 3.2 ± 2.0 mm in the US-CT image fusion and gross specimen, respectively. No significant difference was observed between the US-CT image fusion and direct measurements of the AM of HCC. In the clinical study, the success rate of the AM evaluation was 100% for both CEUS-CT/MR and CT-CT/MR-MR, and the duration was 8.5 ± 2.8 min (range: 4-12 min) and 13.5 ± 4.5 min (range: 8-16 min) for CEUS-CT/MR and CT-CT/MR-MR, respectively. The sensitivity, specificity, and accuracy of CEUS-CT/MR imaging for evaluating the AM were 100.0, 80.0, and 90.0%, respectively. A phantom model composed of carrageenan gel and additives was suitable for the evaluation of HCC AM. CEUS-CT/MR image fusion can be used to evaluate HCC AM with high accuracy.

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

Krishnan, Kalpagam; Liu, Jeff; Kohli, Kirpal

Purpose: Fusion of electrical impedance tomography (EIT) with computed tomography (CT) can be useful as a clinical tool for providing additional physiological information about tissues, but requires suitable fusion algorithms and validation procedures. This work explores the feasibility of fusing EIT and CT images using an algorithm for coregistration. The imaging performance is validated through feature space assessment on phantom contrast targets. Methods: EIT data were acquired by scanning a phantom using a circuit, configured for injecting current through 16 electrodes, placed around the phantom. A conductivity image of the phantom was obtained from the data using electrical impedance andmore » diffuse optical tomography reconstruction software (EIDORS). A CT image of the phantom was also acquired. The EIT and CT images were fused using a region of interest (ROI) coregistration fusion algorithm. Phantom imaging experiments were carried out on objects of different contrasts, sizes, and positions. The conductive medium of the phantoms was made of a tissue-mimicking bolus material that is routinely used in clinical radiation therapy settings. To validate the imaging performance in detecting different contrasts, the ROI of the phantom was filled with distilled water and normal saline. Spatially separated cylindrical objects of different sizes were used for validating the imaging performance in multiple target detection. Analyses of the CT, EIT and the EIT/CT phantom images were carried out based on the variations of contrast, correlation, energy, and homogeneity, using a gray level co-occurrence matrix (GLCM). A reference image of the phantom was simulated using EIDORS, and the performances of the CT and EIT imaging systems were evaluated and compared against the performance of the EIT/CT system using various feature metrics, detectability, and structural similarity index measures. Results: In detecting distilled and normal saline water in bolus medium, EIT as a stand-alone imaging system showed contrast discrimination of 47%, while the CT imaging system showed a discrimination of only 1.5%. The structural similarity index measure showed a drop of 24% with EIT imaging compared to CT imaging. The average detectability measure for CT imaging was found to be 2.375 ± 0.19 before fusion. After complementing with EIT information, the detectability measure increased to 11.06 ± 2.04. Based on the feature metrics, the functional imaging quality of CT and EIT were found to be 2.29% and 86%, respectively, before fusion. Structural imaging quality was found to be 66% for CT and 16% for EIT. After fusion, functional imaging quality improved in CT imaging from 2.29% to 42% and the structural imaging quality of EIT imaging changed from 16% to 66%. The improvement in image quality was also observed in detecting objects of different sizes. Conclusions: The authors found a significant improvement in the contrast detectability performance of CT imaging when complemented with functional imaging information from EIT. Along with the feature assessment metrics, the concept of complementing CT with EIT imaging can lead to an EIT/CT imaging modality which might fully utilize the functional imaging abilities of EIT imaging, thereby enhancing the quality of care in the areas of cancer diagnosis and radiotherapy treatment planning.« less

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

Leng, Shuai; Yu, Lifeng; Wang, Jia

Purpose: Our purpose was to reduce image noise in spectral CT by exploiting data redundancies in the energy domain to allow flexible selection of the number, width, and location of the energy bins. Methods: Using a variety of spectral CT imaging methods, conventional filtered backprojection (FBP) reconstructions were performed and resulting images were compared to those processed using a Local HighlY constrained backPRojection Reconstruction (HYPR-LR) algorithm. The mean and standard deviation of CT numbers were measured within regions of interest (ROIs), and results were compared between FBP and HYPR-LR. For these comparisons, the following spectral CT imaging methods were used:(i)more » numerical simulations based on a photon-counting, detector-based CT system, (ii) a photon-counting, detector-based micro CT system using rubidium and potassium chloride solutions, (iii) a commercial CT system equipped with integrating detectors utilizing tube potentials of 80, 100, 120, and 140 kV, and (iv) a clinical dual-energy CT examination. The effects of tube energy and energy bin width were evaluated appropriate to each CT system. Results: The mean CT number in each ROI was unchanged between FBP and HYPR-LR images for each of the spectral CT imaging scenarios, irrespective of bin width or tube potential. However, image noise, as represented by the standard deviation of CT numbers in each ROI, was reduced by 36%-76%. In all scenarios, image noise after HYPR-LR algorithm was similar to that of composite images, which used all available photons. No difference in spatial resolution was observed between HYPR-LR processing and FBP. Dual energy patient data processed using HYPR-LR demonstrated reduced noise in the individual, low- and high-energy images, as well as in the material-specific basis images. Conclusions: Noise reduction can be accomplished for spectral CT by exploiting data redundancies in the energy domain. HYPR-LR is a robust method for reducing image noise in a variety of spectral CT imaging systems without losing spatial resolution or CT number accuracy. This method improves the flexibility to select energy bins in the manner that optimizes material identification and separation without paying the penalty of increased image noise or its corollary, increased patient dose.« less

SU-C-9A-06: The Impact of CT Image Used for Attenuation Correction in 4D-PET

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

Cui, Y; Bowsher, J; Yan, S

2014-06-01

Purpose: To evaluate the appropriateness of using 3D non-gated CT image for attenuation correction (AC) in a 4D-PET (gated PET) imaging protocol used in radiotherapy treatment planning simulation. Methods: The 4D-PET imaging protocol in a Siemens PET/CT simulator (Biograph mCT, Siemens Medical Solutions, Hoffman Estates, IL) was evaluated. CIRS Dynamic Thorax Phantom (CIRS Inc., Norfolk, VA) with a moving glass sphere (8 mL) in the middle of its thorax portion was used in the experiments. The glass was filled with {sup 18}F-FDG and was in a longitudinal motion derived from a real patient breathing pattern. Varian RPM system (Varian Medicalmore » Systems, Palo Alto, CA) was used for respiratory gating. Both phase-gating and amplitude-gating methods were tested. The clinical imaging protocol was modified to use three different CT images for AC in 4D-PET reconstruction: first is to use a single-phase CT image to mimic actual clinical protocol (single-CT-PET); second is to use the average intensity projection CT (AveIP-CT) derived from 4D-CT scanning (AveIP-CT-PET); third is to use 4D-CT image to do the phase-matched AC (phase-matching- PET). Maximum SUV (SUVmax) and volume of the moving target (glass sphere) with threshold of 40% SUVmax were calculated for comparison between 4D-PET images derived with different AC methods. Results: The SUVmax varied 7.3%±6.9% over the breathing cycle in single-CT-PET, compared to 2.5%±2.8% in AveIP-CT-PET and 1.3%±1.2% in phasematching PET. The SUVmax in single-CT-PET differed by up to 15% from those in phase-matching-PET. The target volumes measured from single- CT-PET images also presented variations up to 10% among different phases of 4D PET in both phase-gating and amplitude-gating experiments. Conclusion: Attenuation correction using non-gated CT in 4D-PET imaging is not optimal process for quantitative analysis. Clinical 4D-PET imaging protocols should consider phase-matched 4D-CT image if available to achieve better accuracy.« less

Dual-modality brain PET-CT image segmentation based on adaptive use of functional and anatomical information.

PubMed

Xia, Yong; Eberl, Stefan; Wen, Lingfeng; Fulham, Michael; Feng, David Dagan

2012-01-01

Dual medical imaging modalities, such as PET-CT, are now a routine component of clinical practice. Medical image segmentation methods, however, have generally only been applied to single modality images. In this paper, we propose the dual-modality image segmentation model to segment brain PET-CT images into gray matter, white matter and cerebrospinal fluid. This model converts PET-CT image segmentation into an optimization process controlled simultaneously by PET and CT voxel values and spatial constraints. It is innovative in the creation and application of the modality discriminatory power (MDP) coefficient as a weighting scheme to adaptively combine the functional (PET) and anatomical (CT) information on a voxel-by-voxel basis. Our approach relies upon allowing the modality with higher discriminatory power to play a more important role in the segmentation process. We compared the proposed approach to three other image segmentation strategies, including PET-only based segmentation, combination of the results of independent PET image segmentation and CT image segmentation, and simultaneous segmentation of joint PET and CT images without an adaptive weighting scheme. Our results in 21 clinical studies showed that our approach provides the most accurate and reliable segmentation for brain PET-CT images. Copyright © 2011 Elsevier Ltd. All rights reserved.

Impact of the Adaptive Statistical Iterative Reconstruction Technique on Radiation Dose and Image Quality in Bone SPECT/CT.

PubMed

Sibille, Louis; Chambert, Benjamin; Alonso, Sandrine; Barrau, Corinne; D'Estanque, Emmanuel; Al Tabaa, Yassine; Collombier, Laurent; Demattei, Christophe; Kotzki, Pierre-Olivier; Boudousq, Vincent

2016-07-01

The purpose of this study was to compare a routine bone SPECT/CT protocol using CT reconstructed with filtered backprojection (FBP) with an optimized protocol using low-dose CT images reconstructed with adaptive statistical iterative reconstruction (ASiR). In this prospective study, enrolled patients underwent bone SPECT/CT, with 1 SPECT acquisition followed by 2 randomized CT acquisitions: FBP CT (FBP; noise index, 25) and ASiR CT (70% ASiR; noise index, 40). The image quality of both attenuation-corrected SPECT and CT images was visually (5-point Likert scale, 2 interpreters) and quantitatively (contrast ratio [CR] and signal-to-noise ratio [SNR]) estimated. The CT dose index volume, dose-length product, and effective dose were compared. Seventy-five patients were enrolled in the study. Quantitative attenuation-corrected SPECT evaluation showed no inferiority for contrast ratio and SNR issued from FBP CT or ASiR CT (respectively, 13.41 ± 7.83 vs. 13.45 ± 7.99 and 2.33 ± 0.83 vs. 2.32 ± 0.84). Qualitative image analysis showed no difference between attenuation-corrected SPECT images issued from FBP CT or ASiR CT for both interpreters (respectively, 3.5 ± 0.6 vs. 3.5 ± 0.6 and 3.6 ± 0.5 vs. 3.6 ± 0.5). Quantitative CT evaluation showed no inferiority for SNR between FBP and ASiR CT images (respectively, 0.93 ± 0.16 and 1.07 ± 0.17). Qualitative image analysis showed no quality difference between FBP and ASiR CT images for both interpreters (respectively, 3.8 ± 0.5 vs. 3.6 ± 0.5 and 4.0 ± 0.1 vs. 4.0 ± 0.2). Mean CT dose index volume, dose-length product, and effective dose for ASiR CT (3.0 ± 2.0 mGy, 148 ± 85 mGy⋅cm, and 2.2 ± 1.3 mSv) were significantly lower than for FBP CT (8.5 ± 3.7 mGy, 365 ± 160 mGy⋅cm, and 5.5 ± 2.4 mSv). The use of 70% ASiR blending in bone SPECT/CT can reduce the CT radiation dose by 60%, with no sacrifice in attenuation-corrected SPECT and CT image quality, compared with the conventional protocol using FBP CT reconstruction technique. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

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.

Noise reduction in spectral CT: reducing dose and breaking the trade-off between image noise and energy bin selection.

PubMed

Leng, Shuai; Yu, Lifeng; Wang, Jia; Fletcher, Joel G; Mistretta, Charles A; McCollough, Cynthia H

2011-09-01

Our purpose was to reduce image noise in spectral CT by exploiting data redundancies in the energy domain to allow flexible selection of the number, width, and location of the energy bins. Using a variety of spectral CT imaging methods, conventional filtered backprojection (FBP) reconstructions were performed and resulting images were compared to those processed using a Local HighlY constrained backPRojection Reconstruction (HYPR-LR) algorithm. The mean and standard deviation of CT numbers were measured within regions of interest (ROIs), and results were compared between FBP and HYPR-LR. For these comparisons, the following spectral CT imaging methods were used:(i) numerical simulations based on a photon-counting, detector-based CT system, (ii) a photon-counting, detector-based micro CT system using rubidium and potassium chloride solutions, (iii) a commercial CT system equipped with integrating detectors utilizing tube potentials of 80, 100, 120, and 140 kV, and (iv) a clinical dual-energy CT examination. The effects of tube energy and energy bin width were evaluated appropriate to each CT system. The mean CT number in each ROI was unchanged between FBP and HYPR-LR images for each of the spectral CT imaging scenarios, irrespective of bin width or tube potential. However, image noise, as represented by the standard deviation of CT numbers in each ROI, was reduced by 36%-76%. In all scenarios, image noise after HYPR-LR algorithm was similar to that of composite images, which used all available photons. No difference in spatial resolution was observed between HYPR-LR processing and FBP. Dual energy patient data processed using HYPR-LR demonstrated reduced noise in the individual, low- and high-energy images, as well as in the material-specific basis images. Noise reduction can be accomplished for spectral CT by exploiting data redundancies in the energy domain. HYPR-LR is a robust method for reducing image noise in a variety of spectral CT imaging systems without losing spatial resolution or CT number accuracy. This method improves the flexibility to select energy bins in the manner that optimizes material identification and separation without paying the penalty of increased image noise or its corollary, increased patient dose.

Physics of cardiac imaging with multiple-row detector CT.

PubMed

Mahesh, Mahadevappa; Cody, Dianna D

2007-01-01

Cardiac imaging with multiple-row detector computed tomography (CT) has become possible due to rapid advances in CT technologies. Images with high temporal and spatial resolution can be obtained with multiple-row detector CT scanners; however, the radiation dose associated with cardiac imaging is high. Understanding the physics of cardiac imaging with multiple-row detector CT scanners allows optimization of cardiac CT protocols in terms of image quality and radiation dose. Knowledge of the trade-offs between various scan parameters that affect image quality--such as temporal resolution, spatial resolution, and pitch--is the key to optimized cardiac CT protocols, which can minimize the radiation risks associated with these studies. Factors affecting temporal resolution include gantry rotation time, acquisition mode, and reconstruction method; factors affecting spatial resolution include detector size and reconstruction interval. Cardiac CT has the potential to become a reliable tool for noninvasive diagnosis and prevention of cardiac and coronary artery disease. (c) RSNA, 2007.

CT artifact recognition for the nuclear technologist.

PubMed

Popilock, Robert; Sandrasagaren, Kumar; Harris, Lowell; Kaser, Keith A

2008-06-01

The goal of this article is to make the PET/CT and SPECT/CT operator aware of common artifacts found in CT. In diagnostic imaging, the ability to render an accurate diagnosis requires the technologist to take steps to optimize image quality and recognize when image quality has been compromised-that is, when there is an image artifact. One way these artifacts occur is through the inability of the CT linear attenuation image to precisely represent the linear attenuation map of a 2-dimensional section through the body. The reasons for this inability are multifold. First, CT is subject to the laws of x-ray quantum physics resulting in noise in all CT images. Moreover, all current CT x-ray systems generate a spectrum of energies. Also, CT scanners use detectors of finite dimension, as are the x-ray focal spots; reconstruct images from a finite number of samples distributed over a finite number of views; and acquire the data for each reconstruction over a finite period.

Comparison of the Diagnostic Image Quality of the Canine Maxillary Dentoalveolar Structures Obtained by Cone Beam Computed Tomography and 64-Multidetector Row Computed Tomography

PubMed Central

Soukup, Jason W.; Drees, Randi; Koenig, Lisa J.; Snyder, Christopher J.; Hetzel, Scott; Miles, Chanda R.; Schwarz, Tobias

2016-01-01

Summary The objective of this blinded study was to validate the use of cone beam computed tomography (CT) for imaging of the canine maxillary dentoalveolar structures by comparing its diagnostic image quality with that of 64-multidetector row CT. Sagittal slices of a tooth-bearing segment of the maxilla of a commercially purchased dog skull embedded in methyl methacrylate were obtained along a line parallel with the dental arch using a commercial histology diamond saw. The slice of tooth-bearing bone that best depicted the dentoalveolar structures was chosen and photographed. The maxilla segment was imaged with cone beam CT and 64-multidetector row CT. Four blinded evaluators compared the cone beam CT and 64-multidetector row CT images and image quality was scored as it related to the anatomy of dentoalveolar structures. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, and lamina dura were scored. In addition, a score depicting the evaluators overall impression of the image was recorded. Images acquired with cone beam CT were found to be significantly superior in image quality to images acquired with 64-multidetector row CT overall, and in all scored categories. In our study setting, cone beam CT was found to be a valid and clinically superior imaging modality for the canine maxillary dentoalveolar structures when compared to 64-multidetector row CT. PMID:26415384

SU-F-J-156: The Feasibility of MR-Only IMRT Planning for Prostate Anatomy

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

Vaitheeswaran, R; Sivaramakrishnan, KR; Kumar, Prashant

Purpose: For prostate anatomy, previous investigations have shown that simulated CT (sCT) generated from MR images can be used for accurate dose computation. In this study, we demonstrate the feasibility of MR-only IMRT planning for prostate case. Methods: Regular CT (rCT) and MR images of the same patient were acquired for prostate anatomy. Regions-of-interest (ROIs) i.e. target and risk structures are delineated on the rCT. A simulated CT (sCT) is generated from the MR image using the method described by Schadewaldt N et al. Their work establishes the clinical acceptability of dose calculation results on the sCT when compared tomore » rCT. rCT and sCT are rigidly registered to ensure proper alignment between the two images. rCT and sCT are overlaid on each other and slice-wise visual inspection confirms excellent agreement between the two images. ROIs on the rCT are copied over to sCT. Philips AutoPlanning solution is used for generating treatment plans. The same treatment technique protocol (plan parameters and clinical goals) is used to generate AutoPlan-rCT and AutoPlan-sCT respectively for rCT and and sCT. DVH comparison on ROIs and slice-wise evaluation of dose is performed between AutoPlan-rCT and AutoPlan-sCT. Delivery parameters i.e. beam and corresponding segments from the AutoPlan-sCT are copied over to rCT and dose is computed to get AutoPlan-sCT-on-rCT. Results: Plan evaluation is done based on Dose Volume Histogram (DVH) of ROIs and manual slice-wise inspection of dose distribution. Both AutoPlan-rCT and AutoPlan-sCT provide a clinically acceptable plan. Also, AutoPlan-sCT-on-rCT shows excellent agreement with AutoPlan-sCT. Conclusion: The study demonstrates that it is feasible to do IMRT planning on the simulated CT image obtained from MR image for prostate anatomy. The research is supported by Philips India Ltd.« less

Synthetic Hounsfield units from spectral CT data

NASA Astrophysics Data System (ADS)

Bornefalk, Hans

2012-04-01

Beam-hardening-free synthetic images with absolute CT numbers that radiologists are used to can be constructed from spectral CT data by forming ‘dichromatic’ images after basis decomposition. The CT numbers are accurate for all tissues and the method does not require additional reconstruction. This method prevents radiologists from having to relearn new rules-of-thumb regarding absolute CT numbers for various organs and conditions as conventional CT is replaced by spectral CT. Displaying the synthetic Hounsfield unit images side-by-side with images reconstructed for optimal detectability for a certain task can ease the transition from conventional to spectral CT.

Variation in the human ribs geometrical properties and mechanical response based on X-ray computed tomography images resolution.

PubMed

Perz, Rafał; Toczyski, Jacek; Subit, Damien

2015-01-01

Computational models of the human body are commonly used for injury prediction in automobile safety research. To create these models, the geometry of the human body is typically obtained from segmentation of medical images such as computed tomography (CT) images that have a resolution between 0.2 and 1mm/pixel. While the accuracy of the geometrical and structural information obtained from these images depend greatly on their resolution, the effect of image resolution on the estimation of the ribs geometrical properties has yet to be established. To do so, each of the thirty-four sections of ribs obtained from a Post Mortem Human Surrogate (PMHS) was imaged using three different CT modalities: standard clinical CT (clinCT), high resolution clinical CT (HRclinCT), and microCT. The images were processed to estimate the rib cross-section geometry and mechanical properties, and the results were compared to those obtained from the microCT images by computing the 'deviation factor', a metric that quantifies the relative difference between results obtained from clinCT and HRclinCT to those obtained from microCT. Overall, clinCT images gave a deviation greater than 100%, and were therefore deemed inadequate for the purpose of this study. HRclinCT overestimated the rib cross-sectional area by 7.6%, the moments of inertia by about 50%, and the cortical shell area by 40.2%, while underestimating the trabecular area by 14.7%. Next, a parametric analysis was performed to quantify how the variations in the estimate of the geometrical properties affected the rib predicted mechanical response under antero-posterior loading. A variation of up to 45% for the predicted peak force and up to 50% for the predicted stiffness was observed. These results provide a quantitative estimate of the sensitivity of the response of the FE model to the resolution of the images used to generate it. They also suggest that a correction factor could be derived from the comparison between microCT and HRclinCT images to improve the response of the model developed based on HRclinCT images. Copyright © 2014 Elsevier Ltd. All rights reserved.

Application of fluence field modulation to proton computed tomography for proton therapy imaging.

PubMed

Dedes, G; De Angelis, L; Rit, S; Hansen, D; Belka, C; Bashkirov, V; Johnson, R P; Coutrakon, G; Schubert, K E; Schulte, R W; Parodi, K; Landry, G

2017-07-12

This simulation study presents the application of fluence field modulated computed tomography, initially developed for x-ray CT, to proton computed tomography (pCT). By using pencil beam (PB) scanning, fluence modulated pCT (FMpCT) may achieve variable image quality in a pCT image and imaging dose reduction. Three virtual phantoms, a uniform cylinder and two patients, were studied using Monte Carlo simulations of an ideal list-mode pCT scanner. Regions of interest (ROI) were selected for high image quality and only PBs intercepting them preserved full fluence (FF). Image quality was investigated in terms of accuracy (mean) and noise (standard deviation) of the reconstructed proton relative stopping power compared to reference values. Dose calculation accuracy on FMpCT images was evaluated in terms of dose volume histograms (DVH), range difference (RD) for beam-eye-view (BEV) dose profiles and gamma evaluation. Pseudo FMpCT scans were created from broad beam experimental data acquired with a list-mode pCT prototype. FMpCT noise in ROIs was equivalent to FF images and accuracy better than  -1.3%(-0.7%) by using 1% of FF for the cylinder (patients). Integral imaging dose reduction of 37% and 56% was achieved for the two patients for that level of modulation. Corresponding DVHs from proton dose calculation on FMpCT images agreed to those from reference images and 96% of BEV profiles had RD below 2 mm, compared to only 1% for uniform 1% of FF. Gamma pass rates (2%, 2 mm) were 98% for FMpCT while for uniform 1% of FF they were as low as 59%. Applying FMpCT to preliminary experimental data showed that low noise levels and accuracy could be preserved in a ROI, down to 30% modulation. We have shown, using both virtual and experimental pCT scans, that FMpCT is potentially feasible and may allow a means of imaging dose reduction for a pCT scanner operating in PB scanning mode. This may be of particular importance to proton therapy given the low integral dose found outside the target.

Accuracy of volume measurement using 3D ultrasound and development of CT-3D US image fusion algorithm for prostate cancer radiotherapy.

PubMed

Baek, Jihye; Huh, Jangyoung; Kim, Myungsoo; Hyun An, So; Oh, Yoonjin; Kim, DongYoung; Chung, Kwangzoo; Cho, Sungho; Lee, Rena

2013-02-01

To evaluate the accuracy of measuring volumes using three-dimensional ultrasound (3D US), and to verify the feasibility of the replacement of CT-MR fusion images with CT-3D US in radiotherapy treatment planning. Phantoms, consisting of water, contrast agent, and agarose, were manufactured. The volume was measured using 3D US, CT, and MR devices. A CT-3D US and MR-3D US image fusion software was developed using the Insight Toolkit library in order to acquire three-dimensional fusion images. The quality of the image fusion was evaluated using metric value and fusion images. Volume measurement, using 3D US, shows a 2.8 ± 1.5% error, 4.4 ± 3.0% error for CT, and 3.1 ± 2.0% error for MR. The results imply that volume measurement using the 3D US devices has a similar accuracy level to that of CT and MR. Three-dimensional image fusion of CT-3D US and MR-3D US was successfully performed using phantom images. Moreover, MR-3D US image fusion was performed using human bladder images. 3D US could be used in the volume measurement of human bladders and prostates. CT-3D US image fusion could be used in monitoring the target position in each fraction of external beam radiation therapy. Moreover, the feasibility of replacing the CT-MR image fusion to the CT-3D US in radiotherapy treatment planning was verified.

SU-E-J-97: Evaluation of Multi-Modality (CT/MR/PET) Image Registration Accuracy in Radiotherapy Planning.

PubMed

Sethi, A; Rusu, I; Surucu, M; Halama, J

2012-06-01

Evaluate accuracy of multi-modality image registration in radiotherapy planning process. A water-filled anthropomorphic head phantom containing eight 'donut-shaped' fiducial markers (3 internal + 5 external) was selected for this study. Seven image sets (3CTs, 3MRs and PET) of phantom were acquired and fused in a commercial treatment planning system. First, a narrow slice (0.75mm) baseline CT scan was acquired (CT1). Subsequently, the phantom was re-scanned with a coarse slice width = 1.5mm (CT2) and after subjecting phantom to rotation/displacement (CT3). Next, the phantom was scanned in a 1.5 Tesla MR scanner and three MR image sets (axial T1, axial T2, coronal T1) were acquired at 2mm slice width. Finally, the phantom and center of fiducials were doped with 18F and a PET scan was performed with 2mm cubic voxels. All image scans (CT/MR/PET) were fused to the baseline (CT1) data using automated mutual-information based fusion algorithm. Difference between centroids of fiducial markers in various image modalities was used to assess image registration accuracy. CT/CT image registration was superior to CT/MR and CT/PET: average CT/CT fusion error was found to be 0.64 ± 0.14 mm. Corresponding values for CT/MR and CT/PET fusion were 1.33 ± 0.71mm and 1.11 ± 0.37mm. Internal markers near the center of phantom fused better than external markers placed on the phantom surface. This was particularly true for the CT/MR and CT/PET. The inferior quality of external marker fusion indicates possible distortion effects toward the edges of MR image. Peripheral targets in the PET scan may be subject to parallax error caused by depth of interaction of photons in detectors. Current widespread use of multimodality imaging in radiotherapy planning calls for periodic quality assurance of image registration process. Such studies may help improve safety and accuracy in treatment planning. © 2012 American Association of Physicists in Medicine.

The LISS--a public database of common imaging signs of lung diseases for computer-aided detection and diagnosis research and medical education.

PubMed

Han, Guanghui; Liu, Xiabi; Han, Feifei; Santika, I Nyoman Tenaya; Zhao, Yanfeng; Zhao, Xinming; Zhou, Chunwu

2015-02-01

Lung computed tomography (CT) imaging signs play important roles in the diagnosis of lung diseases. In this paper, we review the significance of CT imaging signs in disease diagnosis and determine the inclusion criterion of CT scans and CT imaging signs of our database. We develop the software of abnormal regions annotation and design the storage scheme of CT images and annotation data. Then, we present a publicly available database of lung CT imaging signs, called LISS for short, which contains 271 CT scans and 677 abnormal regions in them. The 677 abnormal regions are divided into nine categories of common CT imaging signs of lung disease (CISLs). The ground truth of these CISLs regions and the corresponding categories are provided. Furthermore, to make the database publicly available, all private data in CT scans are eliminated or replaced with provisioned values. The main characteristic of our LISS database is that it is developed from a new perspective of CT imaging signs of lung diseases instead of commonly considered lung nodules. Thus, it is promising to apply to computer-aided detection and diagnosis research and medical education.

New and emerging patient-centered CT imaging and image-guided treatment paradigms for maxillofacial trauma.

PubMed

Dreizin, David; Nam, Arthur J; Hirsch, Jeffrey; Bernstein, Mark P

2018-06-20

This article reviews the conceptual framework, available evidence, and practical considerations pertaining to nascent and emerging advances in patient-centered CT-imaging and CT-guided surgery for maxillofacial trauma. These include cinematic rendering-a novel method for advanced 3D visualization, incorporation of quantitative CT imaging into the assessment of orbital fractures, low-dose CT imaging protocols made possible with contemporary scanners and reconstruction techniques, the rapidly growing use of cone-beam CT, virtual fracture reduction with design software for surgical pre-planning, the use of 3D printing for fabricating models and implants, and new avenues in CT-guided computer-aided surgery.

Diagnostic Performance of Ultrafast Brain MRI for Evaluation of Abusive Head Trauma.

PubMed

Kralik, S F; Yasrebi, M; Supakul, N; Lin, C; Netter, L G; Hicks, R A; Hibbard, R A; Ackerman, L L; Harris, M L; Ho, C Y

2017-04-01

MR imaging with sedation is commonly used to detect intracranial traumatic pathology in the pediatric population. Our purpose was to compare nonsedated ultrafast MR imaging, noncontrast head CT, and standard MR imaging for the detection of intracranial trauma in patients with potential abusive head trauma. A prospective study was performed in 24 pediatric patients who were evaluated for potential abusive head trauma. All patients received noncontrast head CT, ultrafast brain MR imaging without sedation, and standard MR imaging with general anesthesia or an immobilizer, sequentially. Two pediatric neuroradiologists independently reviewed each technique blinded to other modalities for intracranial trauma. We performed interreader agreement and consensus interpretation for standard MR imaging as the criterion standard. Diagnostic accuracy was calculated for ultrafast MR imaging, noncontrast head CT, and combined ultrafast MR imaging and noncontrast head CT. Interreader agreement was moderate for ultrafast MR imaging (κ = 0.42), substantial for noncontrast head CT (κ = 0.63), and nearly perfect for standard MR imaging (κ = 0.86). Forty-two percent of patients had discrepancies between ultrafast MR imaging and standard MR imaging, which included detection of subarachnoid hemorrhage and subdural hemorrhage. Sensitivity, specificity, and positive and negative predictive values were obtained for any traumatic pathology for each examination: ultrafast MR imaging (50%, 100%, 100%, 31%), noncontrast head CT (25%, 100%, 100%, 21%), and a combination of ultrafast MR imaging and noncontrast head CT (60%, 100%, 100%, 33%). Ultrafast MR imaging was more sensitive than noncontrast head CT for the detection of intraparenchymal hemorrhage ( P = .03), and the combination of ultrafast MR imaging and noncontrast head CT was more sensitive than noncontrast head CT alone for intracranial trauma ( P = .02). In abusive head trauma, ultrafast MR imaging, even combined with noncontrast head CT, demonstrated low sensitivity compared with standard MR imaging for intracranial traumatic pathology, which may limit its utility in this patient population. © 2017 by American Journal of Neuroradiology.

Texture-preserved penalized weighted least-squares reconstruction of low-dose CT image via image segmentation and high-order MRF modeling

NASA Astrophysics Data System (ADS)

Han, Hao; Zhang, Hao; Wei, Xinzhou; Moore, William; Liang, Zhengrong

2016-03-01

In this paper, we proposed a low-dose computed tomography (LdCT) image reconstruction method with the help of prior knowledge learning from previous high-quality or normal-dose CT (NdCT) scans. The well-established statistical penalized weighted least squares (PWLS) algorithm was adopted for image reconstruction, where the penalty term was formulated by a texture-based Gaussian Markov random field (gMRF) model. The NdCT scan was firstly segmented into different tissue types by a feature vector quantization (FVQ) approach. Then for each tissue type, a set of tissue-specific coefficients for the gMRF penalty was statistically learnt from the NdCT image via multiple-linear regression analysis. We also proposed a scheme to adaptively select the order of gMRF model for coefficients prediction. The tissue-specific gMRF patterns learnt from the NdCT image were finally used to form an adaptive MRF penalty for the PWLS reconstruction of LdCT image. The proposed texture-adaptive PWLS image reconstruction algorithm was shown to be more effective to preserve image textures than the conventional PWLS image reconstruction algorithm, and we further demonstrated the gain of high-order MRF modeling for texture-preserved LdCT PWLS image reconstruction.

In vivo 3D PIXE-micron-CT imaging of Drosophila melanogaster using a contrast agent

NASA Astrophysics Data System (ADS)

Matsuyama, Shigeo; Hamada, Naoki; Ishii, Keizo; Nozawa, Yuichiro; Ohkura, Satoru; Terakawa, Atsuki; Hatori, Yoshinobu; Fujiki, Kota; Fujiwara, Mitsuhiro; Toyama, Sho

2015-04-01

In this study, we developed a three-dimensional (3D) computed tomography (CT) in vivo imaging system for imaging small insects with micrometer resolution. The 3D CT imaging system, referred to as 3D PIXE-micron-CT (PIXEμCT), uses characteristic X-rays produced by ion microbeam bombardment of a metal target. PIXEμCT was used to observe the body organs and internal structure of a living Drosophila melanogaster. Although the organs of the thorax were clearly imaged, the digestive organs in the abdominal cavity could not be clearly discerned initially, with the exception of the rectum and the Malpighian tubule. To enhance the abdominal images, a barium sulfate powder radiocontrast agent was added. For the first time, 3D images of the ventriculus of a living D. melanogaster were obtained. Our results showed that PIXEμCT can provide in vivo 3D-CT images that reflect correctly the structure of individual living organs, which is expected to be very useful in biological research.

Neural network fusion: a novel CT-MR aortic aneurysm image segmentation method

NASA Astrophysics Data System (ADS)

Wang, Duo; Zhang, Rui; Zhu, Jin; Teng, Zhongzhao; Huang, Yuan; Spiga, Filippo; Du, Michael Hong-Fei; Gillard, Jonathan H.; Lu, Qingsheng; Liò, Pietro

2018-03-01

Medical imaging examination on patients usually involves more than one imaging modalities, such as Computed Tomography (CT), Magnetic Resonance (MR) and Positron Emission Tomography(PET) imaging. Multimodal imaging allows examiners to benefit from the advantage of each modalities. For example, for Abdominal Aortic Aneurysm, CT imaging shows calcium deposits in the aorta clearly while MR imaging distinguishes thrombus and soft tissues better.1 Analysing and segmenting both CT and MR images to combine the results will greatly help radiologists and doctors to treat the disease. In this work, we present methods on using deep neural network models to perform such multi-modal medical image segmentation. As CT image and MR image of the abdominal area cannot be well registered due to non-affine deformations, a naive approach is to train CT and MR segmentation network separately. However, such approach is time-consuming and resource-inefficient. We propose a new approach to fuse the high-level part of the CT and MR network together, hypothesizing that neurons recognizing the high level concepts of Aortic Aneurysm can be shared across multiple modalities. Such network is able to be trained end-to-end with non-registered CT and MR image using shorter training time. Moreover network fusion allows a shared representation of Aorta in both CT and MR images to be learnt. Through experiments we discovered that for parts of Aorta showing similar aneurysm conditions, their neural presentations in neural network has shorter distances. Such distances on the feature level is helpful for registering CT and MR image.

Application of oral contrast media in coregistered positron emission tomography-CT.

PubMed

Dizendorf, Elena V; Treyer, Valerie; Von Schulthess, Gustav K; Hany, Thomas F

2002-08-01

Coregistration of positron emission tomography (PET) and CT images results in significantly improved localization of abnormal FDG uptake compared with PET images alone. For delineation of intestinal structures, application of oral contrast media is a standard procedure in CT. The influence of oral contrast agents in PET imaging using CT data for attenuation correction was evaluated in a comparative study on an in-line PET-CT system. Sixty patients referred for PET-CT were evaluated in two groups. One group of 30 patients received oral Gastrografin 45 min before data acquisition. The second group received no contrast medium. PET images were reconstructed, using CT data for attenuation correction. Image analysis was performed by two reviewers in consensus, using a 4-point scale comparing FDG-uptake in the gastrointestinal tract in PET images of both groups. Furthermore, correlation of FDG uptake and localization of contrast media in the intestinal tract in CT images were determined. No significant difference in FDG uptake in PET images in all regions of the gastrointestinal tract except the ascending colon was seen in both groups. No correlation was found in the location of increased FDG uptake and contrast media in the CT images. An oral contrast agent can be used for coregistered PET-CT without the introduction of artifacts in PET.

Limited diagnostic value of Dual-Time-Point (18)F-FDG PET/CT imaging for classifying solitary pulmonary nodules in granuloma-endemic regions both at visual and quantitative analyses.

PubMed

Chen, Song; Li, Xuena; Chen, Meijie; Yin, Yafu; Li, Na; Li, Yaming

2016-10-01

This study is aimed to compare the diagnostic power of using quantitative analysis or visual analysis with single time point imaging (STPI) PET/CT and dual time point imaging (DTPI) PET/CT for the classification of solitary pulmonary nodules (SPN) lesions in granuloma-endemic regions. SPN patients who received early and delayed (18)F-FDG PET/CT at 60min and 180min post-injection were retrospectively reviewed. Diagnoses are confirmed by pathological results or follow-ups. Three quantitative metrics, early SUVmax, delayed SUVmax and retention index(the percentage changes between the early SUVmax and delayed SUVmax), were measured for each lesion. Three 5-point scale score was given by blinded interpretations performed by physicians based on STPI PET/CT images, DTPI PET/CT images and CT images, respectively. ROC analysis was performed on three quantitative metrics and three visual interpretation scores. One-hundred-forty-nine patients were retrospectively included. The areas under curve (AUC) of the ROC curves of early SUVmax, delayed SUVmax, RI, STPI PET/CT score, DTPI PET/CT score and CT score are 0.73, 0.74, 0.61, 0.77 0.75 and 0.76, respectively. There were no significant differences between the AUCs in visual interpretation of STPI PET/CT images and DTPI PET/CT images, nor in early SUVmax and delayed SUVmax. The differences of sensitivity, specificity and accuracy between STPI PET/CT and DTPI PET/CT were not significantly different in either quantitative analysis or visual interpretation. In granuloma-endemic regions, DTPI PET/CT did not offer significant improvement over STPI PET/CT in differentiating malignant SPNs in both quantitative analysis and visual interpretation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparison of SPECT/CT, MRI and CT in diagnosis of skull base bone invasion in nasopharyngeal carcinoma.

PubMed

Zhang, Shu-xu; Han, Peng-hui; Zhang, Guo-qian; Wang, Rui-hao; Ge, Yong-bin; Ren, Zhi-gang; Li, Jian-sheng; Fu, Wen-hai

2014-01-01

Early detection of skull base invasion in nasopharyngeal carcinoma (NPC) is crucial for correct staging, assessing treatment response and contouring the tumor target in radiotherapy planning, as well as improving the patient's prognosis. To compare the diagnostic efficacy of single photon emission computed tomography/computed tomography (SPECT/CT) imaging, magnetic resonance imaging (MRI) and computed tomography (CT) for the detection of skull base invasion in NPC. Sixty untreated patients with histologically proven NPC underwent SPECT/CT imaging, contrast-enhanced MRI and CT. Of the 60 patients, 30 had skull base invasion confirmed by the final results of contrast-enhanced MRI, CT and six-month follow-up imaging (MRI and CT). The diagnostic efficacy of the three imaging modalities in detecting skull base invasion was evaluated. The rates of positive findings of skull base invasion for SPECT/CT, MRI and CT were 53.3%, 48.3% and 33.3%, respectively. The sensitivity, specificity and accuracy were 93.3%, 86.7% and 90.0% for SPECT/CT fusion imaging, 96.7%, 100.0% and 98.3% for contrast-enhanced MRI, and 66.7%, 100.0% and 83.3% for contrast-enhanced CT. MRI showed the best performance for the diagnosis of skull base invasion in nasopharyngeal carcinoma, followed closely by SPECT/CT. SPECT/CT had poorer specificity than that of both MRI and CT, while CT had the lowest sensitivity.

TH-C-BRD-06: A Novel MRI Based CT Artifact Correction Method for Improving Proton Range Calculation in the Presence of Severe CT Artifacts

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

Park, P; Schreibmann, E; Fox, T

2014-06-15

Purpose: Severe CT artifacts can impair our ability to accurately calculate proton range thereby resulting in a clinically unacceptable treatment plan. In this work, we investigated a novel CT artifact correction method based on a coregistered MRI and investigated its ability to estimate CT HU and proton range in the presence of severe CT artifacts. Methods: The proposed method corrects corrupted CT data using a coregistered MRI to guide the mapping of CT values from a nearby artifact-free region. First patient MRI and CT images were registered using 3D deformable image registration software based on B-spline and mutual information. Themore » CT slice with severe artifacts was selected as well as a nearby slice free of artifacts (e.g. 1cm away from the artifact). The two sets of paired MRI and CT images at different slice locations were further registered by applying 2D deformable image registration. Based on the artifact free paired MRI and CT images, a comprehensive geospatial analysis was performed to predict the correct CT HU of the CT image with severe artifact. For a proof of concept, a known artifact was introduced that changed the ground truth CT HU value up to 30% and up to 5cm error in proton range. The ability of the proposed method to recover the ground truth was quantified using a selected head and neck case. Results: A significant improvement in image quality was observed visually. Our proof of concept study showed that 90% of area that had 30% errors in CT HU was corrected to 3% of its ground truth value. Furthermore, the maximum proton range error up to 5cm was reduced to 4mm error. Conclusion: MRI based CT artifact correction method can improve CT image quality and proton range calculation for patients with severe CT artifacts.« less

SU-F-J-214: Dose Reduction by Spatially Optimized Image Quality Via Fluence Modulated Proton CT (FMpCT)

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

De Angelis, L; Landry, G; Dedes, G

Purpose: Proton CT (pCT) is a promising imaging modality for reducing range uncertainty in image-guided proton therapy. Range uncertainties partially originate from X-ray CT number conversion to stopping power ratio (SPR) and are limiting the exploitation of the full potential of proton therapy. In this study we explore the concept of spatially dependent fluence modulated proton CT (FMpCT), for achieving optimal image quality in a clinical region of interest (ROI), while reducing significantly the imaging dose to the patient. Methods: The study was based on simulated ideal pCT using pencil beam (PB) scanning. A set of 250 MeV protons PBsmore » was used to create 360 projections of a cylindrical water phantom and a head and neck cancer patient. The tomographic images were reconstructed using a filtered backprojection (FBP) as well as an iterative algorithm (ITR). Different fluence modulation levels were investigated and their impact on the image was quantified in terms of SPR accuracy as well as noise within and outside selected ROIs, as a function of imaging dose. The unmodulated image served as reference. Results: Both FBP reconstruction and ITR without total variation (TV) yielded image quality in the ROIs similar to the reference images, for modulation down to 0.1 of the full proton fluence. The average dose was reduced by 75% for the water phantom and by 40% for the patient. FMpCT does not improve the noise for ITR with TV and modulation 0.1. Conclusion: This is the first work proposing and investigating FMpCT for producing optimal image quality for treatment planning and image guidance, while simultaneously reducing imaging dose. Future work will address spatial resolution effects and the impact of FMpCT on the quality of proton treatment plans for a prototype pCT scanner capable of list mode data acquisition. Acknowledgement: DFG-MAP DFG - Munich-Centre for Advanced Photonics (MAP)« less

Evaluation of a metal artifact reduction algorithm applied to post-interventional flat detector CT in comparison to pre-treatment CT in patients with acute subarachnoid haemorrhage.

PubMed

Mennecke, Angelika; Svergun, Stanislav; Scholz, Bernhard; Royalty, Kevin; Dörfler, Arnd; Struffert, Tobias

2017-01-01

Metal artefacts can impair accurate diagnosis of haemorrhage using flat detector CT (FD-CT), especially after aneurysm coiling. Within this work we evaluate a prototype metal artefact reduction algorithm by comparison of the artefact-reduced and the non-artefact-reduced FD-CT images to pre-treatment FD-CT and multi-slice CT images. Twenty-five patients with acute aneurysmal subarachnoid haemorrhage (SAH) were selected retrospectively. FD-CT and multi-slice CT before endovascular treatment as well as FD-CT data sets after treatment were available for all patients. The algorithm was applied to post-treatment FD-CT. The effect of the algorithm was evaluated utilizing the pre-post concordance of a modified Fisher score, a subjective image quality assessment, the range of the Hounsfield units within three ROIs, and the pre-post slice-wise Pearson correlation. The pre-post concordance of the modified Fisher score, the subjective image quality, and the pre-post correlation of the ranges of the Hounsfield units were significantly higher for artefact-reduced than for non-artefact-reduced images. Within the metal-affected slices, the pre-post slice-wise Pearson correlation coefficient was higher for artefact-reduced than for non-artefact-reduced images. The overall diagnostic quality of the artefact-reduced images was improved and reached the level of the pre-interventional FD-CT images. The metal-unaffected parts of the image were not modified. • After coiling subarachnoid haemorrhage, metal artefacts seriously reduce FD-CT image quality. • This new metal artefact reduction algorithm is feasible for flat-detector CT. • After coiling, MAR is necessary for diagnostic quality of affected slices. • Slice-wise Pearson correlation is introduced to evaluate improvement of MAR in future studies. • Metal-unaffected parts of image are not modified by this MAR algorithm.

Phase-contrast x-ray computed tomography for observing biological specimens and organic materials

NASA Astrophysics Data System (ADS)

Momose, Atsushi; Takeda, Tohoru; Itai, Yuji

1995-02-01

A novel three-dimensional x-ray imaging method has been developed by combining a phase-contrast x-ray imaging technique with x-ray computed tomography. This phase-contrast x-ray computed tomography (PCX-CT) provides sectional images of organic specimens that would produce absorption-contrast x-ray CT images with little contrast. Comparing PCX-CT images of rat cerebellum and cancerous rabbit liver specimens with corresponding absorption-contrast CT images shows that PCX-CT is much more sensitive to the internal structure of organic specimens.

Automated movement correction for dynamic PET/CT images: evaluation with phantom and patient data.

PubMed

Ye, Hu; Wong, Koon-Pong; Wardak, Mirwais; Dahlbom, Magnus; Kepe, Vladimir; Barrio, Jorge R; Nelson, Linda D; Small, Gary W; Huang, Sung-Cheng

2014-01-01

Head movement during a dynamic brain PET/CT imaging results in mismatch between CT and dynamic PET images. It can cause artifacts in CT-based attenuation corrected PET images, thus affecting both the qualitative and quantitative aspects of the dynamic PET images and the derived parametric images. In this study, we developed an automated retrospective image-based movement correction (MC) procedure. The MC method first registered the CT image to each dynamic PET frames, then re-reconstructed the PET frames with CT-based attenuation correction, and finally re-aligned all the PET frames to the same position. We evaluated the MC method's performance on the Hoffman phantom and dynamic FDDNP and FDG PET/CT images of patients with neurodegenerative disease or with poor compliance. Dynamic FDDNP PET/CT images (65 min) were obtained from 12 patients and dynamic FDG PET/CT images (60 min) were obtained from 6 patients. Logan analysis with cerebellum as the reference region was used to generate regional distribution volume ratio (DVR) for FDDNP scan before and after MC. For FDG studies, the image derived input function was used to generate parametric image of FDG uptake constant (Ki) before and after MC. Phantom study showed high accuracy of registration between PET and CT and improved PET images after MC. In patient study, head movement was observed in all subjects, especially in late PET frames with an average displacement of 6.92 mm. The z-direction translation (average maximum = 5.32 mm) and x-axis rotation (average maximum = 5.19 degrees) occurred most frequently. Image artifacts were significantly diminished after MC. There were significant differences (P<0.05) in the FDDNP DVR and FDG Ki values in the parietal and temporal regions after MC. In conclusion, MC applied to dynamic brain FDDNP and FDG PET/CT scans could improve the qualitative and quantitative aspects of images of both tracers.

Automated Movement Correction for Dynamic PET/CT Images: Evaluation with Phantom and Patient Data

PubMed Central

Ye, Hu; Wong, Koon-Pong; Wardak, Mirwais; Dahlbom, Magnus; Kepe, Vladimir; Barrio, Jorge R.; Nelson, Linda D.; Small, Gary W.; Huang, Sung-Cheng

2014-01-01

Head movement during a dynamic brain PET/CT imaging results in mismatch between CT and dynamic PET images. It can cause artifacts in CT-based attenuation corrected PET images, thus affecting both the qualitative and quantitative aspects of the dynamic PET images and the derived parametric images. In this study, we developed an automated retrospective image-based movement correction (MC) procedure. The MC method first registered the CT image to each dynamic PET frames, then re-reconstructed the PET frames with CT-based attenuation correction, and finally re-aligned all the PET frames to the same position. We evaluated the MC method's performance on the Hoffman phantom and dynamic FDDNP and FDG PET/CT images of patients with neurodegenerative disease or with poor compliance. Dynamic FDDNP PET/CT images (65 min) were obtained from 12 patients and dynamic FDG PET/CT images (60 min) were obtained from 6 patients. Logan analysis with cerebellum as the reference region was used to generate regional distribution volume ratio (DVR) for FDDNP scan before and after MC. For FDG studies, the image derived input function was used to generate parametric image of FDG uptake constant (Ki) before and after MC. Phantom study showed high accuracy of registration between PET and CT and improved PET images after MC. In patient study, head movement was observed in all subjects, especially in late PET frames with an average displacement of 6.92 mm. The z-direction translation (average maximum = 5.32 mm) and x-axis rotation (average maximum = 5.19 degrees) occurred most frequently. Image artifacts were significantly diminished after MC. There were significant differences (P<0.05) in the FDDNP DVR and FDG Ki values in the parietal and temporal regions after MC. In conclusion, MC applied to dynamic brain FDDNP and FDG PET/CT scans could improve the qualitative and quantitative aspects of images of both tracers. PMID:25111700

Evaluation of image registration in PET/CT of the liver and recommendations for optimized imaging.

PubMed

Vogel, Wouter V; van Dalen, Jorn A; Wiering, Bas; Huisman, Henkjan; Corstens, Frans H M; Ruers, Theo J M; Oyen, Wim J G

2007-06-01

Multimodality PET/CT of the liver can be performed with an integrated (hybrid) PET/CT scanner or with software fusion of dedicated PET and CT. Accurate anatomic correlation and good image quality of both modalities are important prerequisites, regardless of the applied method. Registration accuracy is influenced by breathing motion differences on PET and CT, which may also have impact on (attenuation correction-related) artifacts, especially in the upper abdomen. The impact of these issues was evaluated for both hybrid PET/CT and software fusion, focused on imaging of the liver. Thirty patients underwent hybrid PET/CT, 20 with CT during expiration breath-hold (EB) and 10 with CT during free breathing (FB). Ten additional patients underwent software fusion of dedicated PET and dedicated expiration breath-hold CT (SF). The image registration accuracy was evaluated at the location of liver borders on CT and uncorrected PET images and at the location of liver lesions. Attenuation-correction artifacts were evaluated by comparison of liver borders on uncorrected and attenuation-corrected PET images. CT images were evaluated for the presence of breathing artifacts. In EB, 40% of patients had an absolute registration error of the diaphragm in the craniocaudal direction of >1 cm (range, -16 to 44 mm), and 45% of lesions were mispositioned >1 cm. In 50% of cases, attenuation-correction artifacts caused a deformation of the liver dome on PET of >1 cm. Poor compliance to breath-hold instructions caused CT artifacts in 55% of cases. In FB, 30% had registration errors of >1 cm (range, -4 to 16 mm) and PET artifacts were less extensive, but all CT images had breathing artifacts. As SF allows independent alignment of PET and CT, no registration errors or artifacts of >1 cm of the diaphragm occurred. Hybrid PET/CT of the liver may have significant registration errors and artifacts related to breathing motion. The extent of these issues depends on the selected breathing protocol and the speed of the CT scanner. No protocol or scanner can guarantee perfect image fusion. On the basis of these findings, recommendations were formulated with regard to scanner requirements, breathing protocols, and reporting.

Thoracic-abdominal imaging with a novel dual-layer spectral detector CT: intra-individual comparison of image quality and radiation dose with 128-row single-energy acquisition.

PubMed

Haneder, Stefan; Siedek, Florian; Doerner, Jonas; Pahn, Gregor; Grosse Hokamp, Nils; Maintz, David; Wybranski, Christian

2018-01-01

Background A novel, multi-energy, dual-layer spectral detector computed tomography (SDCT) is commercially available now with the vendor's claim that it yields the same or better quality of polychromatic, conventional CT images like modern single-energy CT scanners without any radiation dose penalty. Purpose To intra-individually compare the quality of conventional polychromatic CT images acquired with a dual-layer spectral detector (SDCT) and the latest generation 128-row single-energy-detector (CT128) from the same manufacturer. Material and Methods Fifty patients underwent portal-venous phase, thoracic-abdominal CT scans with the SDCT and prior CT128 imaging. The SDCT scanning protocol was adapted to yield a similar estimated dose length product (DLP) as the CT128. Patient dose optimization by automatic tube current modulation and CT image reconstruction with a state-of-the-art iterative algorithm were identical on both scanners. CT image contrast-to-noise ratio (CNR) was compared between the SDCT and CT128 in different anatomic structures. Image quality and noise were assessed independently by two readers with 5-point-Likert-scales. Volume CT dose index (CTDI vol ), and DLP were recorded and normalized to 68 cm acquisition length (DLP 68 ). Results The SDCT yielded higher mean CNR values of 30.0% ± 2.0% (26.4-32.5%) in all anatomic structures ( P < 0.001) and excellent scores for qualitative parameters surpassing the CT128 (all P < 0.0001) with substantial inter-rater agreement (κ ≥ 0.801). Despite adapted scan protocols the SDCT yielded lower values for CTDI vol (-10.1 ± 12.8%), DLP (-13.1 ± 13.9%), and DLP 68 (-15.3 ± 16.9%) than the CT128 (all P < 0.0001). Conclusion The SDCT scanner yielded better CT image quality compared to the CT128 and lower radiation dose parameters.

Towards 3D printed multifunctional immobilization for proton therapy: Initial materials characterization

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

Michiels, Steven, E-mail: michiels.steven@kuleuven

Purpose: 3D printing technology is investigated for the purpose of patient immobilization during proton therapy. It potentially enables a merge of patient immobilization, bolus range shifting, and other functions into one single patient-specific structure. In this first step, a set of 3D printed materials is characterized in detail, in terms of structural and radiological properties, elemental composition, directional dependence, and structural changes induced by radiation damage. These data will serve as inputs for the design of 3D printed immobilization structure prototypes. Methods: Using four different 3D printing techniques, in total eight materials were subjected to testing. Samples with a nominalmore » dimension of 20 × 20 × 80 mm{sup 3} were 3D printed. The geometrical printing accuracy of each test sample was measured with a dial gage. To assess the mechanical response of the samples, standardized compression tests were performed to determine the Young’s modulus. To investigate the effect of radiation on the mechanical response, the mechanical tests were performed both prior and after the administration of clinically relevant dose levels (70 Gy), multiplied with a safety factor of 1.4. Dual energy computed tomography (DECT) methods were used to calculate the relative electron density to water ρ{sub e}, the effective atomic number Z{sub eff}, and the proton stopping power ratio (SPR) to water SPR. In order to validate the DECT based calculation of radiological properties, beam measurements were performed on the 3D printed samples as well. Photon irradiations were performed to measure the photon linear attenuation coefficients, while proton irradiations were performed to measure the proton range shift of the samples. The directional dependence of these properties was investigated by performing the irradiations for different orientations of the samples. Results: The printed test objects showed reduced geometric printing accuracy for 2 materials (deviation > 0.25 mm). Compression tests yielded Young’s moduli ranging from 0.6 to 2940 MPa. No deterioration in the mechanical response was observed after exposure of the samples to 100 Gy in a therapeutic MV photon beam. The DECT-based characterization yielded Z{sub eff} ranging from 5.91 to 10.43. The SPR and ρ{sub e} both ranged from 0.6 to 1.22. The measured photon attenuation coefficients at clinical energies scaled linearly with ρ{sub e}. Good agreement was seen between the DECT estimated SPR and the measured range shift, except for the higher Z{sub eff}. As opposed to the photon attenuation, the proton range shifting appeared to be printing orientation dependent for certain materials. Conclusions: In this study, the first step toward 3D printed, multifunctional immobilization was performed, by going through a candidate clinical workflow for the first time: from the material printing to DECT characterization with a verification through beam measurements. Besides a proof of concept for beam modification, the mechanical response of printed materials was also investigated to assess their capabilities for positioning functionality. For the studied set of printing techniques and materials, a wide variety of mechanical and radiological properties can be selected from for the intended purpose. Moreover the elaborated hybrid DECT methods aid in performing in-house quality assurance of 3D printed components, as these methods enable the estimation of the radiological properties relevant for use in radiation therapy.« less

High dose microCT does not contribute towards improved microPET/CT image quantitative accuracy and can limit longitudinal scanning of small animals

NASA Astrophysics Data System (ADS)

McDougald, Wendy A.; Collins, Richard; Green, Mark; Tavares, Adriana A. S.

2017-10-01

Obtaining accurate quantitative measurements in preclinical Positron Emission Tomography/Computed Tomography (PET/CT) imaging is of paramount importance in biomedical research and helps supporting efficient translation of preclinical results to the clinic. The purpose of this study was two-fold: (1) to investigate the effects of different CT acquisition protocols on PET/CT image quality and data quantification; and (2) to evaluate the absorbed dose associated with varying CT parameters. Methods: An air/water quality control CT phantom, tissue equivalent material phantom, an in-house 3D printed phantom and an image quality PET/CT phantom were imaged using a Mediso nanoPET/CT scanner. Collected data was analyzed using PMOD software, VivoQuant software and National Electric Manufactures Association (NEMA) software implemented by Mediso. Measured Hounsfield Unit (HU) in collected CT images were compared to the known HU values and image noise was quantified. PET recovery coefficients (RC), uniformity and quantitative bias were also measured. Results: Only less than 2% and 1% of CT acquisition protocols yielded water HU values < -80 and air HU values < -840, respectively. Four out of eleven CT protocols resulted in more than 100 mGy absorbed dose. Different CT protocols did not impact PET uniformity and RC, and resulted in <4% overall bias relative to expected radioactive concentration. Conclusion: Preclinical CT protocols with increased exposure times can result in high absorbed doses to the small animals. These should be avoided, as they do not contributed towards improved microPET/CT image quantitative accuracy and could limit longitudinal scanning of small animals.

Time-resolved computed tomography of the liver: retrospective, multi-phase image reconstruction derived from volumetric perfusion imaging.

PubMed

Fischer, Michael A; Leidner, Bertil; Kartalis, Nikolaos; Svensson, Anders; Aspelin, Peter; Albiin, Nils; Brismar, Torkel B

2014-01-01

To assess feasibility and image quality (IQ) of a new post-processing algorithm for retrospective extraction of an optimised multi-phase CT (time-resolved CT) of the liver from volumetric perfusion imaging. Sixteen patients underwent clinically indicated perfusion CT using 4D spiral mode of dual-source 128-slice CT. Three image sets were reconstructed: motion-corrected and noise-reduced (MCNR) images derived from 4D raw data; maximum and average intensity projections (time MIP/AVG) of the arterial/portal/portal-venous phases and all phases (total MIP/ AVG) derived from retrospective fusion of dedicated MCNR split series. Two readers assessed the IQ, detection rate and evaluation time; one reader assessed image noise and lesion-to-liver contrast. Time-resolved CT was feasible in all patients. Each post-processing step yielded a significant reduction of image noise and evaluation time, maintaining lesion-to-liver contrast. Time MIPs/AVGs showed the highest overall IQ without relevant motion artefacts and best depiction of arterial and portal/portal-venous phases respectively. Time MIPs demonstrated a significantly higher detection rate for arterialised liver lesions than total MIPs/AVGs and the raw data series. Time-resolved CT allows data from volumetric perfusion imaging to be condensed into an optimised multi-phase liver CT, yielding a superior IQ and higher detection rate for arterialised liver lesions than the raw data series. • Four-dimensional computed tomography is limited by motion artefacts and poor image quality. • Time-resolved-CT facilitates 4D-CT data visualisation, segmentation and analysis by condensing raw data. • Time-resolved CT demonstrates better image quality than raw data images. • Time-resolved CT improves detection of arterialised liver lesions in cirrhotic patients.

MR to CT registration of brains using image synthesis

NASA Astrophysics Data System (ADS)

Roy, Snehashis; Carass, Aaron; Jog, Amod; Prince, Jerry L.; Lee, Junghoon

2014-03-01

Computed tomography (CT) is the preferred imaging modality for patient dose calculation for radiation therapy. Magnetic resonance (MR) imaging (MRI) is used along with CT to identify brain structures due to its superior soft tissue contrast. Registration of MR and CT is necessary for accurate delineation of the tumor and other structures, and is critical in radiotherapy planning. Mutual information (MI) or its variants are typically used as a similarity metric to register MRI to CT. However, unlike CT, MRI intensity does not have an accepted calibrated intensity scale. Therefore, MI-based MR-CT registration may vary from scan to scan as MI depends on the joint histogram of the images. In this paper, we propose a fully automatic framework for MR-CT registration by synthesizing a synthetic CT image from MRI using a co-registered pair of MR and CT images as an atlas. Patches of the subject MRI are matched to the atlas and the synthetic CT patches are estimated in a probabilistic framework. The synthetic CT is registered to the original CT using a deformable registration and the computed deformation is applied to the MRI. In contrast to most existing methods, we do not need any manual intervention such as picking landmarks or regions of interests. The proposed method was validated on ten brain cancer patient cases, showing 25% improvement in MI and correlation between MR and CT images after registration compared to state-of-the-art registration methods.

Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma.

PubMed

Qi, Zhihua; Gates, Erica L; O'Brien, Maureen M; Trout, Andrew T

2018-02-01

Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (P<0.0001). Average dose savings with the combined approach was 24.8±17.8% (2.60±2.51 mSv [range: 0.32-4.72 mSv]) of total CT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations.

Optimization of SPECT-CT Hybrid Imaging Using Iterative Image Reconstruction for Low-Dose CT: A Phantom Study

PubMed Central

Grosser, Oliver S.; Kupitz, Dennis; Ruf, Juri; Czuczwara, Damian; Steffen, Ingo G.; Furth, Christian; Thormann, Markus; Loewenthal, David; Ricke, Jens; Amthauer, Holger

2015-01-01

Background Hybrid imaging combines nuclear medicine imaging such as single photon emission computed tomography (SPECT) or positron emission tomography (PET) with computed tomography (CT). Through this hybrid design, scanned patients accumulate radiation exposure from both applications. Imaging modalities have been the subject of long-term optimization efforts, focusing on diagnostic applications. It was the aim of this study to investigate the influence of an iterative CT image reconstruction algorithm (ASIR) on the image quality of the low-dose CT images. Methodology/Principal Findings Examinations were performed with a SPECT-CT scanner with standardized CT and SPECT-phantom geometries and CT protocols with systematically reduced X-ray tube currents. Analyses included image quality with respect to photon flux. Results were compared to the standard FBP reconstructed images. The general impact of the CT-based attenuation maps used during SPECT reconstruction was examined for two SPECT phantoms. Using ASIR for image reconstructions, image noise was reduced compared to FBP reconstructions for the same X-ray tube current. The Hounsfield unit (HU) values reconstructed by ASIR were correlated to the FBP HU values(R2 ≥ 0.88) and the contrast-to-noise ratio (CNR) was improved by ASIR. However, for a phantom with increased attenuation, the HU values shifted for low X-ray tube currents I ≤ 60 mA (p ≤ 0.04). In addition, the shift of the HU values was observed within the attenuation corrected SPECT images for very low X-ray tube currents (I ≤ 20 mA, p ≤ 0.001). Conclusion/Significance In general, the decrease in X-ray tube current up to 30 mA in combination with ASIR led to a reduction of CT-related radiation exposure without a significant decrease in image quality. PMID:26390216

Comparison of the Diagnostic Image Quality of the Canine Maxillary Dentoalveolar Structures Obtained by Cone Beam Computed Tomography and 64-Multidetector Row Computed Tomography.

PubMed

Soukup, Jason W; Drees, Randi; Koenig, Lisa J; Snyder, Christopher J; Hetzel, Scott; Miles, Chanda R; Schwarz, Tobias

2015-01-01

The objective of this blinded study was to validate the use of cone beam computed tomography (C) for imaging of the canine maxillary dentoalveolar structures by comparing its diagnostic image quality with that of 64-multidetector row CT Sagittal slices of a tooth-bearing segment of the maxilla of a commercially purchased dog skull embedded in methylmethacrylate were obtained along a line parallel with the dental arch using a commercial histology diamond saw. The slice of tooth-bearing bone that best depicted the dentoalveolar structures was chosen and photographed. The maxillary segment was imaged with cone beam CT and 64-multidetector row CT. Four blinded evaluators compared the cone beam CT and 64-multidetector row CT images and image quality was scored as it related to the anatomy of dentoalveolar structures. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, and lamina dura were scored In addition, a score depicting the evaluators overall impression of the image was recorded. Images acquired with cone beam CT were found to be significantly superior in image quality to images acquired with 64-multidetector row CT overall, and in all scored categories. In our study setting cone beam CT was found to be a valid and clinically superior imaging modality for the canine maxillary dentoalveolar structures when compared to 64-multidetector row CT.

Can CT imaging of the chest, abdomen, and pelvis identify all vertebral injuries of the thoracolumbar spine without dedicated reformatting?

PubMed

Imran, Jonathan B; Madni, Tarik D; Pruitt, Jeffrey H; Cornelius, Canon; Subramanian, Madhu; Clark, Audra T; Mokdad, Ali A; Rizk, Paul; Minei, Joseph P; Cripps, Michael W; Eastman, Alexander L

2018-07-01

The main objective of this study was to compare detection rates of clinically significant thoracolumbar spine (TLS) fracture between computed tomography (CT) imaging of the chest, abdomen, and spine (CT CAP) and CT for the thoracolumbar spine (CT TL). We retrospectively identified patients at our institution with a TLS fracture over a two-year period that had both CT CAP and reformatted CT TL imaging. The sensitivity of CT CAP to identify fracture was calculated for each fracture type. A total of 516 TLS fractures were identified in 125 patients using reformatted CT TL spine imaging. Overall, 69 of 512 fractures (13%) were missed on CT CAP that were identified on CT TL. Of those, there were no clinically significant missed fractures. CT CAP could potentially be used as a screening tool for clinically significant TLS injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of the impact of metal artifacts in CT-based attenuation correction of positron emission tomography scans

NASA Astrophysics Data System (ADS)

Wu, Jay; Shih, Cheng-Ting; Chang, Shu-Jun; Huang, Tzung-Chi; Chen, Chuan-Lin; Wu, Tung Hsin

2011-08-01

The quantitative ability of PET/CT allows the widespread use in clinical research and cancer staging. However, metal artifacts induced by high-density metal objects degrade the quality of CT images. These artifacts also propagate to the corresponding PET image and cause a false increase of 18F-FDG uptake near the metal implants when the CT-based attenuation correction (AC) is performed. In this study, we applied a model-based metal artifact reduction (MAR) algorithm to reduce the dark and bright streaks in the CT image and compared the differences between PET images with the general CT-based AC (G-AC) and the MAR-corrected-CT AC (MAR-AC). Results showed that the MAR algorithm effectively reduced the metal artifacts in the CT images of the ACR flangeless phantom and two clinical cases. The MAR-AC also removed the false-positive hot spot near the metal implants of the PET images. We conclude that the MAR-AC could be applied in clinical practice to improve the quantitative accuracy of PET images. Additionally, further use of PET/CT fusion images with metal artifact correction could be more valuable for diagnosis.

Globally optimal tumor segmentation in PET-CT images: a graph-based co-segmentation method.

PubMed

Han, Dongfeng; Bayouth, John; Song, Qi; Taurani, Aakant; Sonka, Milan; Buatti, John; Wu, Xiaodong

2011-01-01

Tumor segmentation in PET and CT images is notoriously challenging due to the low spatial resolution in PET and low contrast in CT images. In this paper, we have proposed a general framework to use both PET and CT images simultaneously for tumor segmentation. Our method utilizes the strength of each imaging modality: the superior contrast of PET and the superior spatial resolution of CT. We formulate this problem as a Markov Random Field (MRF) based segmentation of the image pair with a regularized term that penalizes the segmentation difference between PET and CT. Our method simulates the clinical practice of delineating tumor simultaneously using both PET and CT, and is able to concurrently segment tumor from both modalities, achieving globally optimal solutions in low-order polynomial time by a single maximum flow computation. The method was evaluated on clinically relevant tumor segmentation problems. The results showed that our method can effectively make use of both PET and CT image information, yielding segmentation accuracy of 0.85 in Dice similarity coefficient and the average median hausdorff distance (HD) of 6.4 mm, which is 10% (resp., 16%) improvement compared to the graph cuts method solely using the PET (resp., CT) images.

Dual-Energy CT: New Horizon in Medical Imaging

PubMed Central

Goo, Jin Mo

2017-01-01

Dual-energy CT has remained underutilized over the past decade probably due to a cumbersome workflow issue and current technical limitations. Clinical radiologists should be made aware of the potential clinical benefits of dual-energy CT over single-energy CT. To accomplish this aim, the basic principle, current acquisition methods with advantages and disadvantages, and various material-specific imaging methods as clinical applications of dual-energy CT should be addressed in detail. Current dual-energy CT acquisition methods include dual tubes with or without beam filtration, rapid voltage switching, dual-layer detector, split filter technique, and sequential scanning. Dual-energy material-specific imaging methods include virtual monoenergetic or monochromatic imaging, effective atomic number map, virtual non-contrast or unenhanced imaging, virtual non-calcium imaging, iodine map, inhaled xenon map, uric acid imaging, automatic bone removal, and lung vessels analysis. In this review, we focus on dual-energy CT imaging including related issues of radiation exposure to patients, scanning and post-processing options, and potential clinical benefits mainly to improve the understanding of clinical radiologists and thus, expand the clinical use of dual-energy CT; in addition, we briefly describe the current technical limitations of dual-energy CT and the current developments of photon-counting detector. PMID:28670151

Automatic anatomy recognition in whole-body PET/CT images

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

Wang, Huiqian; Udupa, Jayaram K., E-mail: jay@mail.med.upenn.edu; Odhner, Dewey

Purpose: Whole-body positron emission tomography/computed tomography (PET/CT) has become a standard method of imaging patients with various disease conditions, especially cancer. Body-wide accurate quantification of disease burden in PET/CT images is important for characterizing lesions, staging disease, prognosticating patient outcome, planning treatment, and evaluating disease response to therapeutic interventions. However, body-wide anatomy recognition in PET/CT is a critical first step for accurately and automatically quantifying disease body-wide, body-region-wise, and organwise. This latter process, however, has remained a challenge due to the lower quality of the anatomic information portrayed in the CT component of this imaging modality and the paucity ofmore » anatomic details in the PET component. In this paper, the authors demonstrate the adaptation of a recently developed automatic anatomy recognition (AAR) methodology [Udupa et al., “Body-wide hierarchical fuzzy modeling, recognition, and delineation of anatomy in medical images,” Med. Image Anal. 18, 752–771 (2014)] to PET/CT images. Their goal was to test what level of object localization accuracy can be achieved on PET/CT compared to that achieved on diagnostic CT images. Methods: The authors advance the AAR approach in this work in three fronts: (i) from body-region-wise treatment in the work of Udupa et al. to whole body; (ii) from the use of image intensity in optimal object recognition in the work of Udupa et al. to intensity plus object-specific texture properties, and (iii) from the intramodality model-building-recognition strategy to the intermodality approach. The whole-body approach allows consideration of relationships among objects in different body regions, which was previously not possible. Consideration of object texture allows generalizing the previous optimal threshold-based fuzzy model recognition method from intensity images to any derived fuzzy membership image, and in the process, to bring performance to the level achieved on diagnostic CT and MR images in body-region-wise approaches. The intermodality approach fosters the use of already existing fuzzy models, previously created from diagnostic CT images, on PET/CT and other derived images, thus truly separating the modality-independent object assembly anatomy from modality-specific tissue property portrayal in the image. Results: Key ways of combining the above three basic ideas lead them to 15 different strategies for recognizing objects in PET/CT images. Utilizing 50 diagnostic CT image data sets from the thoracic and abdominal body regions and 16 whole-body PET/CT image data sets, the authors compare the recognition performance among these 15 strategies on 18 objects from the thorax, abdomen, and pelvis in object localization error and size estimation error. Particularly on texture membership images, object localization is within three voxels on whole-body low-dose CT images and 2 voxels on body-region-wise low-dose images of known true locations. Surprisingly, even on direct body-region-wise PET images, localization error within 3 voxels seems possible. Conclusions: The previous body-region-wise approach can be extended to whole-body torso with similar object localization performance. Combined use of image texture and intensity property yields the best object localization accuracy. In both body-region-wise and whole-body approaches, recognition performance on low-dose CT images reaches levels previously achieved on diagnostic CT images. The best object recognition strategy varies among objects; the proposed framework however allows employing a strategy that is optimal for each object.« less

Optimising μCT imaging of the middle and inner cat ear.

PubMed

Seifert, H; Röher, U; Staszyk, C; Angrisani, N; Dziuba, D; Meyer-Lindenberg, A

2012-04-01

This study's aim was to determine the optimal scan parameters for imaging the middle and inner ear of the cat with micro-computertomography (μCT). Besides, the study set out to assess whether adequate image quality can be obtained to use μCT in diagnostics and research on cat ears. For optimisation, μCT imaging of two cat skull preparations was performed using 36 different scanning protocols. The μCT-scans were evaluated by four experienced experts with regard to the image quality and detail detectability. By compiling a ranking of the results, the best possible scan parameters could be determined. From a third cat's skull, a μCT-scan, using these optimised scan parameters, and a comparative clinical CT-scan were acquired. Afterwards, histological specimens of the ears were produced which were compared to the μCT-images. The comparison shows that the osseous structures are depicted in detail. Although soft tissues cannot be differentiated, the osseous structures serve as valuable spatial orientation of relevant nerves and muscles. Clinical CT can depict many anatomical structures which can also be seen on μCT-images, but these appear a lot less sharp and also less detailed than with μCT. © 2011 Blackwell Verlag GmbH.

Optimization of CT image reconstruction algorithms for the lung tissue research consortium (LTRC)

NASA Astrophysics Data System (ADS)

McCollough, Cynthia; Zhang, Jie; Bruesewitz, Michael; Bartholmai, Brian

2006-03-01

To create a repository of clinical data, CT images and tissue samples and to more clearly understand the pathogenetic features of pulmonary fibrosis and emphysema, the National Heart, Lung, and Blood Institute (NHLBI) launched a cooperative effort known as the Lung Tissue Resource Consortium (LTRC). The CT images for the LTRC effort must contain accurate CT numbers in order to characterize tissues, and must have high-spatial resolution to show fine anatomic structures. This study was performed to optimize the CT image reconstruction algorithms to achieve these criteria. Quantitative analyses of phantom and clinical images were conducted. The ACR CT accreditation phantom containing five regions of distinct CT attenuations (CT numbers of approximately -1000 HU, -80 HU, 0 HU, 130 HU and 900 HU), and a high-contrast spatial resolution test pattern, was scanned using CT systems from two manufacturers (General Electric (GE) Healthcare and Siemens Medical Solutions). Phantom images were reconstructed using all relevant reconstruction algorithms. Mean CT numbers and image noise (standard deviation) were measured and compared for the five materials. Clinical high-resolution chest CT images acquired on a GE CT system for a patient with diffuse lung disease were reconstructed using BONE and STANDARD algorithms and evaluated by a thoracic radiologist in terms of image quality and disease extent. The clinical BONE images were processed with a 3 x 3 x 3 median filter to simulate a thicker slice reconstructed in smoother algorithms, which have traditionally been proven to provide an accurate estimation of emphysema extent in the lungs. Using a threshold technique, the volume of emphysema (defined as the percentage of lung voxels having a CT number lower than -950 HU) was computed for the STANDARD, BONE, and BONE filtered. The CT numbers measured in the ACR CT Phantom images were accurate for all reconstruction kernels for both manufacturers. As expected, visual evaluation of the spatial resolution bar patterns demonstrated that the BONE (GE) and B46f (Siemens) showed higher spatial resolution compared to the STANDARD (GE) or B30f (Siemens) reconstruction algorithms typically used for routine body CT imaging. Only the sharper images were deemed clinically acceptable for the evaluation of diffuse lung disease (e.g. emphysema). Quantitative analyses of the extent of emphysema in patient data showed the percent volumes above the -950 HU threshold as 9.4% for the BONE reconstruction, 5.9% for the STANDARD reconstruction, and 4.7% for the BONE filtered images. Contrary to the practice of using standard resolution CT images for the quantitation of diffuse lung disease, these data demonstrate that a single sharp reconstruction (BONE/B46f) should be used for both the qualitative and quantitative evaluation of diffuse lung disease. The sharper reconstruction images, which are required for diagnostic interpretation, provide accurate CT numbers over the range of -1000 to +900 HU and preserve the fidelity of small structures in the reconstructed images. A filtered version of the sharper images can be accurately substituted for images reconstructed with smoother kernels for comparison to previously published results.

Modeling respiratory motion for reducing motion artifacts in 4D CT images.

PubMed

Zhang, Yongbin; Yang, Jinzhong; Zhang, Lifei; Court, Laurence E; Balter, Peter A; Dong, Lei

2013-04-01

Four-dimensional computed tomography (4D CT) images have been recently adopted in radiation treatment planning for thoracic and abdominal cancers to explicitly define respiratory motion and anatomy deformation. However, significant image distortions (artifacts) exist in 4D CT images that may affect accurate tumor delineation and the shape representation of normal anatomy. In this study, the authors present a patient-specific respiratory motion model, based on principal component analysis (PCA) of motion vectors obtained from deformable image registration, with the main goal of reducing image artifacts caused by irregular motion during 4D CT acquisition. For a 4D CT image set of a specific patient, the authors calculated displacement vector fields relative to a reference phase, using an in-house deformable image registration method. The authors then used PCA to decompose each of the displacement vector fields into linear combinations of principal motion bases. The authors have demonstrated that the regular respiratory motion of a patient can be accurately represented by a subspace spanned by three principal motion bases and their projections. These projections were parameterized using a spline model to allow the reconstruction of the displacement vector fields at any given phase in a respiratory cycle. Finally, the displacement vector fields were used to deform the reference CT image to synthesize CT images at the selected phase with much reduced image artifacts. The authors evaluated the performance of the in-house deformable image registration method using benchmark datasets consisting of ten 4D CT sets annotated with 300 landmark pairs that were approved by physicians. The initial large discrepancies across the landmark pairs were significantly reduced after deformable registration, and the accuracy was similar to or better than that reported by state-of-the-art methods. The proposed motion model was quantitatively validated on 4D CT images of a phantom and a lung cancer patient by comparing the synthesized images and the original images at different phases. The synthesized images matched well with the original images. The motion model was used to reduce irregular motion artifacts in the 4D CT images of three lung cancer patients. Visual assessment indicated that the proposed approach could reduce severe image artifacts. The shape distortions around the diaphragm and tumor regions were mitigated in the synthesized 4D CT images. The authors have derived a mathematical model to represent the regular respiratory motion from a patient-specific 4D CT set and have demonstrated its application in reducing irregular motion artifacts in 4D CT images. The authors' approach can mitigate shape distortions of anatomy caused by irregular breathing motion during 4D CT acquisition.

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

The impact of the CartoSound® image directly acquired from the left atrium for integration in atrial fibrillation ablation.

PubMed

Kaseno, Kenichi; Hisazaki, Kaori; Nakamura, Kohki; Ikeda, Etsuko; Hasegawa, Kanae; Aoyama, Daisetsu; Shiomi, Yuichiro; Ikeda, Hiroyuki; Morishita, Tetsuji; Ishida, Kentaro; Amaya, Naoki; Uzui, Hiroyasu; Tada, Hiroshi

2018-04-14

Intracardiac echocardiographic (ICE) imaging might be useful for integrating three-dimensional computed tomographic (CT) images for left atrial (LA) catheter navigation during atrial fibrillation (AF) ablation. However, the optimal CT image integration method using ICE has not been established. This study included 52 AF patients who underwent successful circumferential pulmonary vein isolation (CPVI). In all patients, CT image integration was performed after the CPVI with the following two methods: (1) using ICE images of the LA derived from the right atrium and right ventricular outflow tract (RA-merge) and (2) using ICE images of the LA directly derived from the LA added to the image for the RA-merge (LA-merge). The accuracy of these two methods was assessed by the distances between the integrated CT image and ICE image (ICE-to-CT distance), and between the CT image and actual ablated sites for the CPVI (CT-to-ABL distance). The mean ICE-to-CT distance was comparable between the two methods (RA-merge = 1.6 ± 0.5 mm, LA-merge = 1.7 ± 0.4 mm; p = 0.33). However, the mean CT-to-ABL distance was shorter for the LA-merge (2.1 ± 0.6 mm) than RA-merge (2.5 ± 0.8 mm; p < 0.01). The LA, especially the left-sided PVs and LA roof, was more sharply delineated by direct LA imaging, and whereas the greatest CT-to-ABL distance was observed at the roof portion of the left superior PV (3.7 ± 2.8 mm) after the RA-merge, it improved to 2.6 ± 1.9 mm after the LA-merge (p < 0.01). Additional ICE images of the LA directly acquired from the LA might lead to a greater accuracy of the CT image integration for the CVPI.

Application of Super-Resolution Convolutional Neural Network for Enhancing Image Resolution in Chest CT.

PubMed

Umehara, Kensuke; Ota, Junko; Ishida, Takayuki

2017-10-18

In this study, the super-resolution convolutional neural network (SRCNN) scheme, which is the emerging deep-learning-based super-resolution method for enhancing image resolution in chest CT images, was applied and evaluated using the post-processing approach. For evaluation, 89 chest CT cases were sampled from The Cancer Imaging Archive. The 89 CT cases were divided randomly into 45 training cases and 44 external test cases. The SRCNN was trained using the training dataset. With the trained SRCNN, a high-resolution image was reconstructed from a low-resolution image, which was down-sampled from an original test image. For quantitative evaluation, two image quality metrics were measured and compared to those of the conventional linear interpolation methods. The image restoration quality of the SRCNN scheme was significantly higher than that of the linear interpolation methods (p < 0.001 or p < 0.05). The high-resolution image reconstructed by the SRCNN scheme was highly restored and comparable to the original reference image, in particular, for a ×2 magnification. These results indicate that the SRCNN scheme significantly outperforms the linear interpolation methods for enhancing image resolution in chest CT images. The results also suggest that SRCNN may become a potential solution for generating high-resolution CT images from standard CT images.

Dental flat panel conebeam CT in the evaluation of patients with inflammatory sinonasal disease: Diagnostic efficacy and radiation dose savings.

PubMed

Leiva-Salinas, C; Flors, L; Gras, P; Más-Estellés, F; Lemercier, P; Patrie, J T; Wintermark, M; Martí-Bonmatí, L

2014-01-01

CT is the imaging modality of choice to study the paranasal sinuses; unfortunately, it involves significant radiation dose. Our aim was to assess the diagnostic validity, image quality, and radiation-dose savings of dental conebeam CT in the evaluation of patients with suspected inflammatory disorders of the paranasal sinuses. We prospectively studied 40 patients with suspected inflammatory disorders of the sinuses with dental conebeam CT and standard CT. Two radiologists analyzed the images independently, blinded to clinical information. The image quality of both techniques and the diagnostic validity of dental conebeam CT compared with the reference standard CT were assessed by using 3 different scoring systems. Image noise, signal-to-noise ratio, and contrast-to-noise ratio were calculated for both techniques. The absorbed radiation dose to the lenses and thyroid and parotid glands was measured by using a phantom and dosimeter chips. The effective radiation dose for CT was calculated. All dental conebeam CT scans were judged of diagnostic quality. Compared with CT, the conebeam CT image noise was 37.3% higher (P < .001) and the SNR of the bone was 75% lower (P < .001). The effective dose of our conebeam CT protocol was 23 μSv. Compared with CT, the absorbed radiation dose to the lenses and parotid and thyroid glands with conebeam CT was 4%, 7.8%, and 7.3% of the dose delivered to the same organs by conventional CT (P < .001). Dental conebeam CT is a valid imaging procedure for the evaluation of patients with inflammatory sinonasal disorders. © 2014 by American Journal of Neuroradiology.

Cine Computed Tomography Without Respiratory Surrogate in Planning Stereotactic Radiotherapy for Non-Small-Cell Lung Cancer

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

Riegel, Adam C. B.A.; Chang, Joe Y.; Vedam, Sastry S.

2009-02-01

Purpose: To determine whether cine computed tomography (CT) can serve as an alternative to four-dimensional (4D)-CT by providing tumor motion information and producing equivalent target volumes when used to contour in radiotherapy planning without a respiratory surrogate. Methods and Materials: Cine CT images from a commercial CT scanner were used to form maximum intensity projection and respiratory-averaged CT image sets. These image sets then were used together to define the targets for radiotherapy. Phantoms oscillating under irregular motion were used to assess the differences between contouring using cine CT and 4D-CT. We also retrospectively reviewed the image sets for 26more » patients (27 lesions) at our institution who had undergone stereotactic radiotherapy for Stage I non-small-cell lung cancer. The patients were included if the tumor motion was >1 cm. The lesions were first contoured using maximum intensity projection and respiratory-averaged CT image sets processed from cine CT and then with 4D-CT maximum intensity projection and 10-phase image sets. The mean ratios of the volume magnitude were compared with intraobserver variation, the mean centroid shifts were calculated, and the volume overlap was assessed with the normalized Dice similarity coefficient index. Results: The phantom studies demonstrated that cine CT captured a greater extent of irregular tumor motion than did 4D-CT, producing a larger tumor volume. The patient studies demonstrated that the gross tumor defined using cine CT imaging was similar to, or slightly larger than, that defined using 4D-CT. Conclusion: The results of our study have shown that cine CT is a promising alternative to 4D-CT for stereotactic radiotherapy planning.« less

CT image electron density quantification in regions with metal implants: implications for radiotherapy treatment planning

NASA Astrophysics Data System (ADS)

Jechel, Christopher Alexander

In radiotherapy planning, computed tomography (CT) images are used to quantify the electron density of tissues and provide spatial anatomical information. Treatment planning systems use these data to calculate the expected spatial distribution of absorbed dose in a patient. CT imaging is complicated by the presence of metal implants which cause increased image noise, produce artifacts throughout the image and can exceed the available range of CT number values within the implant, perturbing electron density estimates in the image. Furthermore, current dose calculation algorithms do not accurately model radiation transport at metal-tissue interfaces. Combined, these issues adversely affect the accuracy of dose calculations in the vicinity of metal implants. As the number of patients with orthopedic and dental implants grows, so does the need to deliver safe and effective radiotherapy treatments in the presence of implants. The Medical Physics group at the Cancer Centre of Southeastern Ontario and Queen's University has developed a Cobalt-60 CT system that is relatively insensitive to metal artifacts due to the high energy, nearly monoenergetic Cobalt-60 photon beam. Kilovoltage CT (kVCT) images, including images corrected using a commercial metal artifact reduction tool, were compared to Cobalt-60 CT images throughout the treatment planning process, from initial imaging through to dose calculation. An effective metal artifact reduction algorithm was also implemented for the Cobalt-60 CT system. Electron density maps derived from the same kVCT and Cobalt-60 CT images indicated the impact of image artifacts on estimates of photon attenuation for treatment planning applications. Measurements showed that truncation of CT number data in kVCT images produced significant mischaracterization of the electron density of metals. Dose measurements downstream of metal inserts in a water phantom were compared to dose data calculated using CT images from kVCT and Cobalt-60 systems with and without artifact correction. The superior accuracy of electron density data derived from Cobalt-60 images compared to kVCT images produced calculated dose with far better agreement with measured results. These results indicated that dose calculation errors from metal image artifacts are primarily due to misrepresentation of electron density within metals rather than artifacts surrounding the implants.

Neural network and its application to CT imaging

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

Nikravesh, M.; Kovscek, A.R.; Patzek, T.W.

We present an integrated approach to imaging the progress of air displacement by spontaneous imbibition of oil into sandstone. We combine Computerized Tomography (CT) scanning and neural network image processing. The main aspects of our approach are (I) visualization of the distribution of oil and air saturation by CT, (II) interpretation of CT scans using neural networks, and (III) reconstruction of 3-D images of oil saturation from the CT scans with a neural network model. Excellent agreement between the actual images and the neural network predictions is found.

Calibration free beam hardening correction for cardiac CT perfusion imaging

NASA Astrophysics Data System (ADS)

Levi, Jacob; Fahmi, Rachid; Eck, Brendan L.; Fares, Anas; Wu, Hao; Vembar, Mani; Dhanantwari, Amar; Bezerra, Hiram G.; Wilson, David L.

2016-03-01

Myocardial perfusion imaging using CT (MPI-CT) and coronary CTA have the potential to make CT an ideal noninvasive gate-keeper for invasive coronary angiography. However, beam hardening artifacts (BHA) prevent accurate blood flow calculation in MPI-CT. BH Correction (BHC) methods require either energy-sensitive CT, not widely available, or typically a calibration-based method. We developed a calibration-free, automatic BHC (ABHC) method suitable for MPI-CT. The algorithm works with any BHC method and iteratively determines model parameters using proposed BHA-specific cost function. In this work, we use the polynomial BHC extended to three materials. The image is segmented into soft tissue, bone, and iodine images, based on mean HU and temporal enhancement. Forward projections of bone and iodine images are obtained, and in each iteration polynomial correction is applied. Corrections are then back projected and combined to obtain the current iteration's BHC image. This process is iterated until cost is minimized. We evaluate the algorithm on simulated and physical phantom images and on preclinical MPI-CT data. The scans were obtained on a prototype spectral detector CT (SDCT) scanner (Philips Healthcare). Mono-energetic reconstructed images were used as the reference. In the simulated phantom, BH streak artifacts were reduced from 12+/-2HU to 1+/-1HU and cupping was reduced by 81%. Similarly, in physical phantom, BH streak artifacts were reduced from 48+/-6HU to 1+/-5HU and cupping was reduced by 86%. In preclinical MPI-CT images, BHA was reduced from 28+/-6 HU to less than 4+/-4HU at peak enhancement. Results suggest that the algorithm can be used to reduce BHA in conventional CT and improve MPI-CT accuracy.

CT Image Sequence Restoration Based on Sparse and Low-Rank Decomposition

PubMed Central

Gou, Shuiping; Wang, Yueyue; Wang, Zhilong; Peng, Yong; Zhang, Xiaopeng; Jiao, Licheng; Wu, Jianshe

2013-01-01

Blurry organ boundaries and soft tissue structures present a major challenge in biomedical image restoration. In this paper, we propose a low-rank decomposition-based method for computed tomography (CT) image sequence restoration, where the CT image sequence is decomposed into a sparse component and a low-rank component. A new point spread function of Weiner filter is employed to efficiently remove blur in the sparse component; a wiener filtering with the Gaussian PSF is used to recover the average image of the low-rank component. And then we get the recovered CT image sequence by combining the recovery low-rank image with all recovery sparse image sequence. Our method achieves restoration results with higher contrast, sharper organ boundaries and richer soft tissue structure information, compared with existing CT image restoration methods. The robustness of our method was assessed with numerical experiments using three different low-rank models: Robust Principle Component Analysis (RPCA), Linearized Alternating Direction Method with Adaptive Penalty (LADMAP) and Go Decomposition (GoDec). Experimental results demonstrated that the RPCA model was the most suitable for the small noise CT images whereas the GoDec model was the best for the large noisy CT images. PMID:24023764

Metal artifact reduction through MVCBCT and kVCT in radiotherapy

NASA Astrophysics Data System (ADS)

Liugang, Gao; Hongfei, Sun; Xinye, Ni; Mingming, Fang; Zheng, Cao; Tao, Lin

2016-11-01

This study proposes a new method for removal of metal artifacts from megavoltage cone beam computed tomography (MVCBCT) and kilovoltage CT (kVCT) images. Both images were combined to obtain prior image, which was forward projected to obtain surrogate data and replace metal trace in the uncorrected kVCT image. The corrected image was then reconstructed through filtered back projection. A similar radiotherapy plan was designed using the theoretical CT image, the uncorrected kVCT image, and the corrected image. The corrected images removed most metal artifacts, and the CT values were accurate. The corrected image also distinguished the hollow circular hole at the center of the metal. The uncorrected kVCT image did not display the internal structure of the metal, and the hole was misclassified as metal portion. Dose distribution calculated based on the corrected image was similar to that based on the theoretical CT image. The calculated dose distribution also evidently differed between the uncorrected kVCT image and the theoretical CT image. The use of the combined kVCT and MVCBCT to obtain the prior image can distinctly improve the quality of CT images containing large metal implants.

Registration of parametric dynamic F-18-FDG PET/CT breast images with parametric dynamic Gd-DTPA breast images

NASA Astrophysics Data System (ADS)

Magri, Alphonso; Krol, Andrzej; Lipson, Edward; Mandel, James; McGraw, Wendy; Lee, Wei; Tillapaugh-Fay, Gwen; Feiglin, David

2009-02-01

This study was undertaken to register 3D parametric breast images derived from Gd-DTPA MR and F-18-FDG PET/CT dynamic image series. Nonlinear curve fitting (Levenburg-Marquardt algorithm) based on realistic two-compartment models was performed voxel-by-voxel separately for MR (Brix) and PET (Patlak). PET dynamic series consists of 50 frames of 1-minute duration. Each consecutive PET image was nonrigidly registered to the first frame using a finite element method and fiducial skin markers. The 12 post-contrast MR images were nonrigidly registered to the precontrast frame using a free-form deformation (FFD) method. Parametric MR images were registered to parametric PET images via CT using FFD because the first PET time frame was acquired immediately after the CT image on a PET/CT scanner and is considered registered to the CT image. We conclude that nonrigid registration of PET and MR parametric images using CT data acquired during PET/CT scan and the FFD method resulted in their improved spatial coregistration. The success of this procedure was limited due to relatively large target registration error, TRE = 15.1+/-7.7 mm, as compared to spatial resolution of PET (6-7 mm), and swirling image artifacts created in MR parametric images by the FFD. Further refinement of nonrigid registration of PET and MR parametric images is necessary to enhance visualization and integration of complex diagnostic information provided by both modalities that will lead to improved diagnostic performance.

Hybrid SPECT-CT and PET-CT imaging of differentiated thyroid carcinoma.

PubMed

Wong, K K; Zarzhevsky, N; Cahill, J M; Frey, K A; Avram, A M

2009-10-01

Hybrid imaging modalities such as radioiodine single photon emission CT with integrated CT ((131)I SPECT-CT) and 2-(fluorine-18)-fluoro-2-deoxy-D-glucose positron emission tomography with integrated CT (FDG PET-CT) allow the rapid and efficient fusion of functional and anatomic images, and provide diagnostic information that may influence management decisions in patients with differentiated thyroid carcinoma (DTC). Diagnostic localisation and therapy of these tumours are dependent upon their capacity to concentrate radioiodine ((131)I) via uptake through the sodium-iodide symporter and retention within the tumour. The prognosis for most patients with DTC is favourable, although controversy exists regarding the role of post-operative (131)I therapy in patients at low-risk for disease. Accurate identification of functional thyroid tissue (benign or malignant) using diagnostic (131)I planar scintigraphy complemented by SPECT-CT imaging enables the completion of post-operative staging and patient risk stratification prior to (131)I therapy administration. In patients with non-iodine-avid tumours (negative (131)I scan but elevated thyroglobulin indicative of persistent or recurrent disease), FDG PET-CT is used to identify tumours with enhanced glucose metabolism and to localise the source of thyroglobulin production. The CT component of this hybrid technology provides anatomic localisation of activity and allows CT-based attenuation correction of PET images. Images from 15 patients illustrate the applications of (131)I SPECT-CT and FDG PET-CT.

Combining transrectal ultrasound and CT for image-guided adaptive brachytherapy of cervical cancer: Proof of concept.

PubMed

Nesvacil, Nicole; Schmid, Maximilian P; Pötter, Richard; Kronreif, Gernot; Kirisits, Christian

To investigate the feasibility of a treatment planning workflow for three-dimensional image-guided cervix cancer brachytherapy, combining volumetric transrectal ultrasound (TRUS) for target definition with CT for dose optimization to organs at risk (OARs), for settings with no access to MRI. A workflow for TRUS/CT-based volumetric treatment planning was developed, based on a customized system including ultrasound probe, stepper unit, and software for image volume acquisition. A full TRUS/CT-based workflow was simulated in a clinical case and compared with MR- or CT-only delineation. High-risk clinical target volume was delineated on TRUS, and OARs were delineated on CT. Manually defined tandem/ring applicator positions on TRUS and CT were used as a reference for rigid registration of the image volumes. Treatment plan optimization for TRUS target and CT organ volumes was performed and compared to MRI and CT target contours. TRUS/CT-based contouring, applicator reconstruction, image fusion, and treatment planning were feasible, and the full workflow could be successfully demonstrated. The TRUS/CT plan fulfilled all clinical planning aims. Dose-volume histogram evaluation of the TRUS/CT-optimized plan (high-risk clinical target volume D 90 , OARs D 2cm³ for) on different image modalities showed good agreement between dose values reported for TRUS/CT and MRI-only reference contours and large deviations for CT-only target parameters. A TRUS/CT-based workflow for full three-dimensional image-guided cervix brachytherapy treatment planning seems feasible and may be clinically comparable to MRI-based treatment planning. Further development to solve challenges with applicator definition in the TRUS volume is required before systematic applicability of this workflow. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

CT of the chest with model-based, fully iterative reconstruction: comparison with adaptive statistical iterative reconstruction.

PubMed

Ichikawa, Yasutaka; Kitagawa, Kakuya; Nagasawa, Naoki; Murashima, Shuichi; Sakuma, Hajime

2013-08-09

The recently developed model-based iterative reconstruction (MBIR) enables significant reduction of image noise and artifacts, compared with adaptive statistical iterative reconstruction (ASIR) and filtered back projection (FBP). The purpose of this study was to evaluate lesion detectability of low-dose chest computed tomography (CT) with MBIR in comparison with ASIR and FBP. Chest CT was acquired with 64-slice CT (Discovery CT750HD) with standard-dose (5.7 ± 2.3 mSv) and low-dose (1.6 ± 0.8 mSv) conditions in 55 patients (aged 72 ± 7 years) who were suspected of lung disease on chest radiograms. Low-dose CT images were reconstructed with MBIR, ASIR 50% and FBP, and standard-dose CT images were reconstructed with FBP, using a reconstructed slice thickness of 0.625 mm. Two observers evaluated the image quality of abnormal lung and mediastinal structures on a 5-point scale (Score 5 = excellent and score 1 = non-diagnostic). The objective image noise was also measured as the standard deviation of CT intensity in the descending aorta. The image quality score of enlarged mediastinal lymph nodes on low-dose MBIR CT (4.7 ± 0.5) was significantly improved in comparison with low-dose FBP and ASIR CT (3.0 ± 0.5, p = 0.004; 4.0 ± 0.5, p = 0.02, respectively), and was nearly identical to the score of standard-dose FBP image (4.8 ± 0.4, p = 0.66). Concerning decreased lung attenuation (bulla, emphysema, or cyst), the image quality score on low-dose MBIR CT (4.9 ± 0.2) was slightly better compared to low-dose FBP and ASIR CT (4.5 ± 0.6, p = 0.01; 4.6 ± 0.5, p = 0.01, respectively). There were no significant differences in image quality scores of visualization of consolidation or mass, ground-glass attenuation, or reticular opacity among low- and standard-dose CT series. Image noise with low-dose MBIR CT (11.6 ± 1.0 Hounsfield units (HU)) were significantly lower than with low-dose ASIR (21.1 ± 2.6 HU, p < 0.0005), low-dose FBP CT (30.9 ± 3.9 HU, p < 0.0005), and standard-dose FBP CT (16.6 ± 2.3 HU, p < 0.0005). MBIR shows greater potential than ASIR for providing diagnostically acceptable low-dose CT without compromising image quality. With radiation dose reduction of >70%, MBIR can provide equivalent lesion detectability of standard-dose FBP CT.

SU-E-J-252: A Motion Algorithm to Extract Physical and Motion Parameters of a Mobile Target in Cone-Beam Computed Tomographic Imaging Retrospective to Image Reconstruction

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

Ali, I; Ahmad, S; Alsbou, N

Purpose: A motion algorithm was developed to extract actual length, CT-numbers and motion amplitude of a mobile target imaged with cone-beam-CT (CBCT) retrospective to image-reconstruction. Methods: The motion model considered a mobile target moving with a sinusoidal motion and employed three measurable parameters: apparent length, CT number level and gradient of a mobile target obtained from CBCT images to extract information about the actual length and CT number value of the stationary target and motion amplitude. The algorithm was verified experimentally with a mobile phantom setup that has three targets with different sizes manufactured from homogenous tissue-equivalent gel material embeddedmore » into a thorax phantom. The phantom moved sinusoidal in one-direction using eight amplitudes (0–20mm) and a frequency of 15-cycles-per-minute. The model required imaging parameters such as slice thickness, imaging time. Results: This motion algorithm extracted three unknown parameters: length of the target, CT-number-level, motion amplitude for a mobile target retrospective to CBCT image reconstruction. The algorithm relates three unknown parameters to measurable apparent length, CT-number-level and gradient for well-defined mobile targets obtained from CBCT images. The motion model agreed with measured apparent lengths which were dependent on actual length of the target and motion amplitude. The cumulative CT-number for a mobile target was dependent on CT-number-level of the stationary target and motion amplitude. The gradient of the CT-distribution of mobile target is dependent on the stationary CT-number-level, actual target length along the direction of motion, and motion amplitude. Motion frequency and phase did not affect the elongation and CT-number distributions of mobile targets when imaging time included several motion cycles. Conclusion: The motion algorithm developed in this study has potential applications in diagnostic CT imaging and radiotherapy to extract actual length, size and CT-numbers distorted by motion in CBCT imaging. The model provides further information about motion of the target.« less

WE-G-207-07: Iterative CT Shading Correction Method with No Prior Information

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

Wu, P; Mao, T; Niu, T

2015-06-15

Purpose: Shading artifacts are caused by scatter contamination, beam hardening effects and other non-ideal imaging condition. Our Purpose is to propose a novel and general correction framework to eliminate low-frequency shading artifacts in CT imaging (e.g., cone-beam CT, low-kVp CT) without relying on prior information. Methods: Our method applies general knowledge of the relatively uniform CT number distribution in one tissue component. Image segmentation is applied to construct template image where each structure is filled with the same CT number of that specific tissue. By subtracting the ideal template from CT image, the residual from various error sources are generated.more » Since the forward projection is an integration process, the non-continuous low-frequency shading artifacts in the image become continuous and low-frequency signals in the line integral. Residual image is thus forward projected and its line integral is filtered using Savitzky-Golay filter to estimate the error. A compensation map is reconstructed on the error using standard FDK algorithm and added to the original image to obtain the shading corrected one. Since the segmentation is not accurate on shaded CT image, the proposed scheme is iterated until the variation of residual image is minimized. Results: The proposed method is evaluated on a Catphan600 phantom, a pelvic patient and a CT angiography scan for carotid artery assessment. Compared to the one without correction, our method reduces the overall CT number error from >200 HU to be <35 HU and increases the spatial uniformity by a factor of 1.4. Conclusion: We propose an effective iterative algorithm for shading correction in CT imaging. Being different from existing algorithms, our method is only assisted by general anatomical and physical information in CT imaging without relying on prior knowledge. Our method is thus practical and attractive as a general solution to CT shading correction. This work is supported by the National Science Foundation of China (NSFC Grant No. 81201091), National High Technology Research and Development Program of China (863 program, Grant No. 2015AA020917), and Fund Project for Excellent Abroad Scholar Personnel in Science and Technology.« less

Study of Image Quality From CT Scanner Multi-Detector by using Americans College of Radiology (ACR) Phantom

NASA Astrophysics Data System (ADS)

Mulyadin; Dewang, Syamsir; Abdullah, Bualkar; Tahir, Dahlang

2018-03-01

In this study, the image quality of CT scan using phantom American College of Radiology (ACR) was determined. Scanning multidetector CT is used to know the image quality parameters by using a solid phantom containing four modules and primarily from materials that are equivalent to water. Each module is 4 cm in diameter and 20 cm in diameter. There is white alignment marks painted white to reflect the alignment laser and there are also “HEAD”, “FOOT”, and “TOP” marks on the phantom to help align. This test obtains CT images of each module according to the routine inspection protocol of the head. Acceptance of image quality obtained for determination: CT Number Accuracy (CTN), CT Number Uniformity and Noise, Linearity CT Number, Slice Technique, Low Contrast Resolution and High Contrast Resolution represent image quality parameters. In testing CT Number Accuracy (CTN), CT Uniform number and Noise are in the range of tolerable values allowed. In the test, Linearity CT Number obtained correlation value above 0.99 is the relationship between electron density and CT Number. In a low contrast resolution test, the smallest contrast groups are visible. In contrast, the high resolution is seen up to 7 lp/cm. The quality of GE CT Scan is very high, as all the image quality tests obtained are within the tolerance brackets of values permitted by the Nuclear Power Control Agency (BAPETEN). Image quality test is a way to get very important information about the accuracy of snoring result by using phantom ACR.

Prediction of CT Substitutes from MR Images Based on Local Diffeomorphic Mapping for Brain PET Attenuation Correction.

PubMed

Wu, Yao; Yang, Wei; Lu, Lijun; Lu, Zhentai; Zhong, Liming; Huang, Meiyan; Feng, Yanqiu; Feng, Qianjin; Chen, Wufan

2016-10-01

Attenuation correction is important for PET reconstruction. In PET/MR, MR intensities are not directly related to attenuation coefficients that are needed in PET imaging. The attenuation coefficient map can be derived from CT images. Therefore, prediction of CT substitutes from MR images is desired for attenuation correction in PET/MR. This study presents a patch-based method for CT prediction from MR images, generating attenuation maps for PET reconstruction. Because no global relation exists between MR and CT intensities, we propose local diffeomorphic mapping (LDM) for CT prediction. In LDM, we assume that MR and CT patches are located on 2 nonlinear manifolds, and the mapping from the MR manifold to the CT manifold approximates a diffeomorphism under a local constraint. Locality is important in LDM and is constrained by the following techniques. The first is local dictionary construction, wherein, for each patch in the testing MR image, a local search window is used to extract patches from training MR/CT pairs to construct MR and CT dictionaries. The k-nearest neighbors and an outlier detection strategy are then used to constrain the locality in MR and CT dictionaries. Second is local linear representation, wherein, local anchor embedding is used to solve MR dictionary coefficients when representing the MR testing sample. Under these local constraints, dictionary coefficients are linearly transferred from the MR manifold to the CT manifold and used to combine CT training samples to generate CT predictions. Our dataset contains 13 healthy subjects, each with T1- and T2-weighted MR and CT brain images. This method provides CT predictions with a mean absolute error of 110.1 Hounsfield units, Pearson linear correlation of 0.82, peak signal-to-noise ratio of 24.81 dB, and Dice in bone regions of 0.84 as compared with real CTs. CT substitute-based PET reconstruction has a regression slope of 1.0084 and R 2 of 0.9903 compared with real CT-based PET. In this method, no image segmentation or accurate registration is required. Our method demonstrates superior performance in CT prediction and PET reconstruction compared with competing methods. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Imaging the Parasinus Region with a Third-Generation Dual-Source CT and the Effect of Tin Filtration on Image Quality and Radiation Dose.

PubMed

Lell, M M; May, M S; Brand, M; Eller, A; Buder, T; Hofmann, E; Uder, M; Wuest, W

2015-07-01

CT is the imaging technique of choice in the evaluation of midface trauma or inflammatory disease. We performed a systematic evaluation of scan protocols to optimize image quality and radiation exposure on third-generation dual-source CT. CT protocols with different tube voltage (70-150 kV), current (25-300 reference mAs), prefiltration, pitch value, and rotation time were systematically evaluated. All images were reconstructed with iterative reconstruction (Advanced Modeled Iterative Reconstruction, level 2). To individually compare results with otherwise identical factors, we obtained all scans on a frozen human head. Conebeam CT was performed for image quality and dose comparison with multidetector row CT. Delineation of important anatomic structures and incidental pathologic conditions in the cadaver head was evaluated. One hundred kilovolts with tin prefiltration demonstrated the best compromise between dose and image quality. The most dose-effective combination for trauma imaging was Sn100 kV/250 mAs (volume CT dose index, 2.02 mGy), and for preoperative sinus surgery planning, Sn100 kV/150 mAs (volume CT dose index, 1.22 mGy). "Sn" indicates an additional prefiltration of the x-ray beam with a tin filter to constrict the energy spectrum. Exclusion of sinonasal disease was possible with even a lower dose by using Sn100 kV/25 mAs (volume CT dose index, 0.2 mGy). High image quality at very low dose levels can be achieved by using a Sn100-kV protocol with iterative reconstruction. The effective dose is comparable with that of conventional radiography, and the high image quality at even lower radiation exposure favors multidetector row CT over conebeam CT. © 2015 by American Journal of Neuroradiology.

Pseudo CT estimation from MRI using patch-based random forest

NASA Astrophysics Data System (ADS)

Yang, Xiaofeng; Lei, Yang; Shu, Hui-Kuo; Rossi, Peter; Mao, Hui; Shim, Hyunsuk; Curran, Walter J.; Liu, Tian

2017-02-01

Recently, MR simulators gain popularity because of unnecessary radiation exposure of CT simulators being used in radiation therapy planning. We propose a method for pseudo CT estimation from MR images based on a patch-based random forest. Patient-specific anatomical features are extracted from the aligned training images and adopted as signatures for each voxel. The most robust and informative features are identified using feature selection to train the random forest. The well-trained random forest is used to predict the pseudo CT of a new patient. This prediction technique was tested with human brain images and the prediction accuracy was assessed using the original CT images. Peak signal-to-noise ratio (PSNR) and feature similarity (FSIM) indexes were used to quantify the differences between the pseudo and original CT images. The experimental results showed the proposed method could accurately generate pseudo CT images from MR images. In summary, we have developed a new pseudo CT prediction method based on patch-based random forest, demonstrated its clinical feasibility, and validated its prediction accuracy. This pseudo CT prediction technique could be a useful tool for MRI-based radiation treatment planning and attenuation correction in a PET/MRI scanner.

The role of FDG PET/CT in patients with locoregional breast cancer recurrence: a comparison to conventional imaging techniques.

PubMed

Aukema, T S; Rutgers, E J Th; Vogel, W V; Teertstra, H J; Oldenburg, H S; Vrancken Peeters, M T F D; Wesseling, J; Russell, N S; Valdés Olmos, R A

2010-04-01

The aim of this study was to evaluate the impact of (18)F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) on clinical management in patients with locoregional breast cancer recurrence amenable for locoregional treatment and to compare the PET/CT results with the conventional imaging data. From January 2006 to August 2008, all patients with locoregional breast cancer recurrence underwent whole-body PET/CT. PET/CT findings were compared with results of the conventional imaging techniques and final pathology. The impact of PET/CT results on clinical management was evaluated based on clinical decisions obtained from patient files. 56 patients were included. In 32 patients (57%) PET/CT revealed additional tumour localisations. Distant metastases were detected in 11 patients on conventional imaging and in 23 patients on PET/CT images (p < 0.01). In 25 patients (45%), PET/CT detected additional lesions not visible on conventional imaging. PET/CT had an impact on clinical management in 27 patients (48%) by detecting more extensive locoregional disease or distant metastases. In 20 patients (36%) extensive surgery was prevented and treatment was changed to palliative treatment. The sensitivity, specificity, accuracy, positive and negative predictive values of FDG PET/CT were respectively 97%, 92%, 95%, 94% and 96%. PET/CT, in addition to conventional imaging techniques, plays an important role in staging patients with locoregional breast cancer recurrence since its result changed the clinical management in almost half of the patients. PET/CT could potentially replace conventional staging imaging in patients with a locoregional breast cancer recurrence. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Patient-specific lean body mass can be estimated from limited-coverage computed tomography images.

PubMed

Devriese, Joke; Beels, Laurence; Maes, Alex; van de Wiele, Christophe; Pottel, Hans

2018-06-01

In PET/CT, quantitative evaluation of tumour metabolic activity is possible through standardized uptake values, usually normalized for body weight (BW) or lean body mass (LBM). Patient-specific LBM can be estimated from whole-body (WB) CT images. As most clinical indications only warrant PET/CT examinations covering head to midthigh, the aim of this study was to develop a simple and reliable method to estimate LBM from limited-coverage (LC) CT images and test its validity. Head-to-toe PET/CT examinations were retrospectively retrieved and semiautomatically segmented into tissue types based on thresholding of CT Hounsfield units. LC was obtained by omitting image slices. Image segmentation was validated on the WB CT examinations by comparing CT-estimated BW with actual BW, and LBM estimated from LC images were compared with LBM estimated from WB images. A direct method and an indirect method were developed and validated on an independent data set. Comparing LBM estimated from LC examinations with estimates from WB examinations (LBMWB) showed a significant but limited bias of 1.2 kg (direct method) and nonsignificant bias of 0.05 kg (indirect method). This study demonstrates that LBM can be estimated from LC CT images with no significant difference from LBMWB.

SU-E-T-428: Feasibility Study of 4D Image Reconstruction by Organ Motion Vector Extension Based On Portal Images

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

Yoon, J; Jung, J; Yeo, I

2015-06-15

Purpose: To develop and to test a method to generate a new 4D CT images of the treatment day from the old 4D CT and the portal images of the day when the motion extent exceeded from that represented by plan CTs. Methods: A motion vector of a moving tumor in a patient may be extended to reconstruct the tumor position when the motion extent exceeded from that represented by plan CTs. To test this, 1. a phantom that consists of a polystyrene cylinder (tumor) embedded in cork (lung) was placed on a moving platform with 4 sec/cycle and amplitudesmore » of 1 cm and 2 cm, and was 4D-scanned. 2. A 6MV photon beam was irradiated on the moving phantoms and cineEPID images were obtained. 3. A motion vector of the tumor was acquired from 4D CT images of the phantom with 1 cm amplitude. 4. From cine EPID images of the phantom with the 2 cm amplitude, various motion extents (0.3 cm, 0.5 cm, etc) were acquired and programmed into the motion vector, producing CT images at each position. 5. The reconstructed CT images were then compared with pre-acquired “reference” 4D CT images at each position (i.e. phase). Results: The CT image was reconstructed and compared with the reference image, showing a slight mismatch in the transition direction limited by voxel size (slice thickness) in CT image. Due to the rigid nature of the phantom studied, the modeling the displacement of the center of object was sufficient. When deformable tumors are to be modeled, more complex scheme is necessary, which utilize cine EPID and 4D CT images. Conclusion: The new idea of CT image reconstruction was demonstrated. Deformable tumor movements need to be considered in the future.« less

Algorithm for lung cancer detection based on PET/CT images

NASA Astrophysics Data System (ADS)

Saita, Shinsuke; Ishimatsu, Keita; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Ohtsuka, Hideki; Nishitani, Hiromu; Ohmatsu, Hironobu; Eguchi, Kenji; Kaneko, Masahiro; Moriyama, Noriyuki

2009-02-01

The five year survival rate of the lung cancer is low with about twenty-five percent. In addition it is an obstinate lung cancer wherein three out of four people die within five years. Then, the early stage detection and treatment of the lung cancer are important. Recently, we can obtain CT and PET image at the same time because PET/CT device has been developed. PET/CT is possible for a highly accurate cancer diagnosis because it analyzes quantitative shape information from CT image and FDG distribution from PET image. However, neither benign-malignant classification nor staging intended for lung cancer have been established still enough by using PET/CT images. In this study, we detect lung nodules based on internal organs extracted from CT image, and we also develop algorithm which classifies benignmalignant and metastatic or non metastatic lung cancer using lung structure and FDG distribution(one and two hour after administering FDG). We apply the algorithm to 59 PET/CT images (malignant 43 cases [Ad:31, Sq:9, sm:3], benign 16 cases) and show the effectiveness of this algorithm.

Development of CT and 3D-CT Using Flat Panel Detector Based Real-Time Digital Radiography System

NASA Astrophysics Data System (ADS)

Ravindran, V. R.; Sreelakshmi, C.; Vibin, Vibin

2008-09-01

The application of Digital Radiography in the Nondestructive Evaluation (NDE) of space vehicle components is a recent development in India. A Real-time DR system based on amorphous silicon Flat Panel Detector has been developed for the NDE of solid rocket motors at Rocket Propellant Plant of VSSC in a few years back. The technique has been successfully established for the nondestructive evaluation of solid rocket motors. The DR images recorded for a few solid rocket specimens are presented in the paper. The Real-time DR system is capable of generating sufficient digital X-ray image data with object rotation for the CT image reconstruction. In this paper the indigenous development of CT imaging based on the Realtime DR system for solid rocket motor is presented. Studies are also carried out to generate 3D-CT image from a set of adjacent CT images of the rocket motor. The capability of revealing the spatial location and characterisation of defect is demonstrated by the CT and 3D-CT images generated.

Nondestructive Evaluation of Hardwood Logs Using Automated Interpretation of CT Images

Treesearch

Daniel L. Schmoldt; Dongping Zhu; Richard W. Conners

1993-01-01

Computed tomography (CT) imaging is being used to examine the internal structure of hardwood logs. The following steps are used to automatically interpret CT images: (1) preprocessing to remove unwanted portions of the image, e.g., annual ring structure, (2) image-by-image segmentation to produce relatively homogeneous image areas, (3) volume growing to create volumes...

Automated extraction method for the center line of spinal canal and its application to the spinal curvature quantification in torso X-ray CT images

NASA Astrophysics Data System (ADS)

Hayashi, Tatsuro; Zhou, Xiangrong; Chen, Huayue; Hara, Takeshi; Miyamoto, Kei; Kobayashi, Tatsunori; Yokoyama, Ryujiro; Kanematsu, Masayuki; Hoshi, Hiroaki; Fujita, Hiroshi

2010-03-01

X-ray CT images have been widely used in clinical routine in recent years. CT images scanned by a modern CT scanner can show the details of various organs and tissues. This means various organs and tissues can be simultaneously interpreted on CT images. However, CT image interpretation requires a lot of time and energy. Therefore, support for interpreting CT images based on image-processing techniques is expected. The interpretation of the spinal curvature is important for clinicians because spinal curvature is associated with various spinal disorders. We propose a quantification scheme of the spinal curvature based on the center line of spinal canal on CT images. The proposed scheme consists of four steps: (1) Automated extraction of the skeletal region based on CT number thresholding. (2) Automated extraction of the center line of spinal canal. (3) Generation of the median plane image of spine, which is reformatted based on the spinal canal. (4) Quantification of the spinal curvature. The proposed scheme was applied to 10 cases, and compared with the Cobb angle that is commonly used by clinicians. We found that a high-correlation (for the 95% confidence interval, lumbar lordosis: 0.81-0.99) between values obtained by the proposed (vector) method and Cobb angle. Also, the proposed method can provide the reproducible result (inter- and intra-observer variability: within 2°). These experimental results suggested a possibility that the proposed method was efficient for quantifying the spinal curvature on CT images.

Optimization of dose and image quality in adult and pediatric computed tomography scans

NASA Astrophysics Data System (ADS)

Chang, Kwo-Ping; Hsu, Tzu-Kun; Lin, Wei-Ting; Hsu, Wen-Lin

2017-11-01

Exploration to maximize CT image and reduce radiation dose was conducted while controlling for multiple factors. The kVp, mAs, and iteration reconstruction (IR), affect the CT image quality and radiation dose absorbed. The optimal protocols (kVp, mAs, IR) are derived by figure of merit (FOM) based on CT image quality (CNR) and CT dose index (CTDIvol). CT image quality metrics such as CT number accuracy, SNR, low contrast materials' CNR and line pair resolution were also analyzed as auxiliary assessments. CT protocols were carried out with an ACR accreditation phantom and a five-year-old pediatric head phantom. The threshold values of the adult CT scan parameters, 100 kVp and 150 mAs, were determined from the CT number test and line pairs in ACR phantom module 1and module 4 respectively. The findings of this study suggest that the optimal scanning parameters for adults be set at 100 kVp and 150-250 mAs. However, for improved low- contrast resolution, 120 kVp and 150-250 mAs are optimal. Optimal settings for pediatric head CT scan were 80 kVp/50 mAs, for maxillary sinus and brain stem, while 80 kVp /300 mAs for temporal bone. SNR is not reliable as the independent image parameter nor the metric for determining optimal CT scan parameters. The iteration reconstruction (IR) approach is strongly recommended for both adult and pediatric CT scanning as it markedly improves image quality without affecting radiation dose.

In vivo small animal micro-CT using nanoparticle contrast agents

PubMed Central

Ashton, Jeffrey R.; West, Jennifer L.; Badea, Cristian T.

2015-01-01

Computed tomography (CT) is one of the most valuable modalities for in vivo imaging because it is fast, high-resolution, cost-effective, and non-invasive. Moreover, CT is heavily used not only in the clinic (for both diagnostics and treatment planning) but also in preclinical research as micro-CT. Although CT is inherently effective for lung and bone imaging, soft tissue imaging requires the use of contrast agents. For small animal micro-CT, nanoparticle contrast agents are used in order to avoid rapid renal clearance. A variety of nanoparticles have been used for micro-CT imaging, but the majority of research has focused on the use of iodine-containing nanoparticles and gold nanoparticles. Both nanoparticle types can act as highly effective blood pool contrast agents or can be targeted using a wide variety of targeting mechanisms. CT imaging can be further enhanced by adding spectral capabilities to separate multiple co-injected nanoparticles in vivo. Spectral CT, using both energy-integrating and energy-resolving detectors, has been used with multiple contrast agents to enable functional and molecular imaging. This review focuses on new developments for in vivo small animal micro-CT using novel nanoparticle probes applied in preclinical research. PMID:26581654

Image quality of conventional images of dual-layer SPECTRAL CT: A phantom study.

PubMed

van Ommen, Fasco; Bennink, Edwin; Vlassenbroek, Alain; Dankbaar, Jan Willem; Schilham, Arnold M R; Viergever, Max A; de Jong, Hugo W A M

2018-05-10

Spectral CT using a dual layer detector offers the possibility of retrospectively introducing spectral information to conventional CT images. In theory, the dual-layer technology should not come with a dose or image quality penalty for conventional images. In this study, we evaluate the influence of a dual-layer detector (IQon Spectral CT, Philips Healthcare) on the image quality of conventional CT images, by comparing these images with those of a conventional but otherwise technically comparable single-layer CT scanner (Brilliance iCT, Philips Healthcare), by means of phantom experiments. For both CT scanners, conventional CT images were acquired using four adult scanning protocols: (a) body helical, (b) body axial, (c) head helical, and (d) head axial. A CATPHAN 600 phantom was scanned to conduct an assessment of image quality metrics at equivalent (CTDI) dose levels. Noise was characterized by means of noise power spectra (NPS) and standard deviation (SD) of a uniform region, and spatial resolution was evaluated with modulation transfer functions (MTF) of a tungsten wire. In addition, contrast-to-noise ratio (CNR), image uniformity, CT number linearity, slice thickness, slice spacing, and spatial linearity were measured and evaluated. Additional measurements of CNR, resolution and noise were performed in two larger phantoms. The resolution levels at 50%, 10%, and 5% MTF of the iCT and IQon showed small, but significant differences up to 0.25 lp/cm for body scans, and up to 0.2 lp/cm for head scans in favor of the IQon. The iCT and IQon showed perfect CT linearity for body scans, but for head scans both scanners showed an underestimation of the CT numbers of materials with a high opacity. Slice thickness was slightly overestimated for both scanners. Slice spacing was comparable and reconstructed correctly. In addition, spatial linearity was excellent for both scanners, with a maximum error of 0.11 mm. CNR was higher on the IQon compared to the iCT for both normal and larger phantoms with differences up to 0.51. Spatial resolution did not change with phantom size, but noise levels increased significantly. For head scans, IQon had a noise level that was significantly lower than the iCT, on the other hand IQon showed noise levels significantly higher than the iCT for body scans. Still, these differences were well within the specified range of performance of iCT scanners. At equivalent dose levels, this study showed similar quality of conventional images acquired on iCT and IQon for medium-sized phantoms and slightly degraded image quality for (very) large phantoms at lower tube voltages on the IQon. Accordingly, it may be concluded that the introduction of a dual-layer detector neither compromises image quality of conventional images nor increases radiation dose for normal-sized patients, and slightly degrades dose efficiency for large patients at 120 kVp and lower tube voltages. © 2018 The Authors. Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

TH-E-202-02: The Use of Hypoxia PET Imaging for Radiotherapy

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

Humm, J.

2016-06-15

PET/CT is a very important imaging tool in the management of oncology patients. PET/CT has been applied for treatment planning and response evaluation in radiation therapy. This educational session will discuss: Pitfalls and remedies in PET/CT imaging for RT planning The use of hypoxia PET imaging for radiotherapy PET for tumor response evaluation The first presentation will address the issue of mis-registration between the CT and PET images in the thorax and the abdomen. We will discuss the challenges of respiratory gating and introduce an average CT technique to improve the registration for dose calculation and image-guidance in radiation therapy.more » The second presentation will discuss the use of hypoxia PET Imaging for radiation therapy. We will discuss various hypoxia radiotracers, the choice of clinical acquisition protocol (in particular a single late static acquisition versus a dynamic acquisition), and the compartmental modeling with different transfer rate constants explained. We will demonstrate applications of hypoxia imaging for dose escalation/de-escalation in clinical trials. The last presentation will discuss the use of PET/CT for tumor response evaluation. We will discuss anatomic response assessment vs. metabolic response assessment, visual evaluation and semi-quantitative evaluation, and limitations of current PET/CT assessment. We will summarize clinical trials using PET response in guiding adaptive radiotherapy. Finally, we will summarize recent advancements in PET/CT radiomics and non-FDG PET tracers for response assessment. Learning Objectives: Identify the causes of mis-registration of CT and PET images in PET/CT, and review the strategies to remedy the issue. Understand the basics of PET imaging of tumor hypoxia (radiotracers, how PET measures the hypoxia selective uptake, imaging protocols, applications in chemo-radiation therapy). Understand the basics of dynamic PET imaging, compartmental modeling and parametric images. Understand the basics of using FDG PET/CT for tumor response evaluation. Learn about recent advancement in PET/CT radiomics and non-FDG PET tracers for response assessment. This work was supported in part by the National Cancer Institute Grants R01CA172638.; W. Lu, This work was supported in part by the National Cancer Institute Grants R01CA172638.« less

Denoising of polychromatic CT images based on their own noise properties

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

Kim, Ji Hye; Chang, Yongjin; Ra, Jong Beom, E-mail: jbra@kaist.ac.kr

Purpose: Because of high diagnostic accuracy and fast scan time, computed tomography (CT) has been widely used in various clinical applications. Since the CT scan introduces radiation exposure to patients, however, dose reduction has recently been recognized as an important issue in CT imaging. However, low-dose CT causes an increase of noise in the image and thereby deteriorates the accuracy of diagnosis. In this paper, the authors develop an efficient denoising algorithm for low-dose CT images obtained using a polychromatic x-ray source. The algorithm is based on two steps: (i) estimation of space variant noise statistics, which are uniquely determinedmore » according to the system geometry and scanned object, and (ii) subsequent novel conversion of the estimated noise to Gaussian noise so that an existing high performance Gaussian noise filtering algorithm can be directly applied to CT images with non-Gaussian noise. Methods: For efficient polychromatic CT image denoising, the authors first reconstruct an image with the iterative maximum-likelihood polychromatic algorithm for CT to alleviate the beam-hardening problem. We then estimate the space-variant noise variance distribution on the image domain. Since there are many high performance denoising algorithms available for the Gaussian noise, image denoising can become much more efficient if they can be used. Hence, the authors propose a novel conversion scheme to transform the estimated space-variant noise to near Gaussian noise. In the suggested scheme, the authors first convert the image so that its mean and variance can have a linear relationship, and then produce a Gaussian image via variance stabilizing transform. The authors then apply a block matching 4D algorithm that is optimized for noise reduction of the Gaussian image, and reconvert the result to obtain a final denoised image. To examine the performance of the proposed method, an XCAT phantom simulation and a physical phantom experiment were conducted. Results: Both simulation and experimental results show that, unlike the existing denoising algorithms, the proposed algorithm can effectively reduce the noise over the whole region of CT images while preventing degradation of image resolution. Conclusions: To effectively denoise polychromatic low-dose CT images, a novel denoising algorithm is proposed. Because this algorithm is based on the noise statistics of a reconstructed polychromatic CT image, the spatially varying noise on the image is effectively reduced so that the denoised image will have homogeneous quality over the image domain. Through a simulation and a real experiment, it is verified that the proposed algorithm can deliver considerably better performance compared to the existing denoising algorithms.« less

Utility of CT-compatible EEG electrodes in critically ill children.

PubMed

Abend, Nicholas S; Dlugos, Dennis J; Zhu, Xiaowei; Schwartz, Erin S

2015-04-01

Electroencephalographic monitoring is being used with increasing frequency in critically ill children who may require frequent and sometimes urgent brain CT scans. Standard metallic disk EEG electrodes commonly produce substantial imaging artifact, and they must be removed and later reapplied when CT scans are indicated. To determine whether conductive plastic electrodes caused artifact that limited CT interpretation. We describe a retrospective cohort of 13 consecutive critically ill children who underwent 17 CT scans with conductive plastic electrodes during 1 year. CT images were evaluated by a pediatric neuroradiologist for artifact presence, type and severity. All CT scans had excellent quality images without artifact that impaired CT interpretation except for one scan in which improper wire placement resulted in artifact. Conductive plastic electrodes do not cause artifact limiting CT scan interpretation and may be used in critically ill children to permit concurrent electroencephalographic monitoring and CT imaging.

TH-E-BRF-02: 4D-CT Ventilation Image-Based IMRT Plans Are Dosimetrically Comparable to SPECT Ventilation Image-Based Plans

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

Kida, S; University of Tokyo Hospital, Bunkyo, Tokyo; Bal, M

Purpose: An emerging lung ventilation imaging method based on 4D-CT can be used in radiotherapy to selectively avoid irradiating highly-functional lung regions, which may reduce pulmonary toxicity. Efforts to validate 4DCT ventilation imaging have been focused on comparison with other imaging modalities including SPECT and xenon CT. The purpose of this study was to compare 4D-CT ventilation image-based functional IMRT plans with SPECT ventilation image-based plans as reference. Methods: 4D-CT and SPECT ventilation scans were acquired for five thoracic cancer patients in an IRB-approved prospective clinical trial. The ventilation images were created by quantitative analysis of regional volume changes (amore » surrogate for ventilation) using deformable image registration of the 4D-CT images. A pair of 4D-CT ventilation and SPECT ventilation image-based IMRT plans was created for each patient. Regional ventilation information was incorporated into lung dose-volume objectives for IMRT optimization by assigning different weights on a voxel-by-voxel basis. The objectives and constraints of the other structures in the plan were kept identical. The differences in the dose-volume metrics have been evaluated and tested by a paired t-test. SPECT ventilation was used to calculate the lung functional dose-volume metrics (i.e., mean dose, V20 and effective dose) for both 4D-CT ventilation image-based and SPECT ventilation image-based plans. Results: Overall there were no statistically significant differences in any dose-volume metrics between the 4D-CT and SPECT ventilation imagebased plans. For example, the average functional mean lung dose of the 4D-CT plans was 26.1±9.15 (Gy), which was comparable to 25.2±8.60 (Gy) of the SPECT plans (p = 0.89). For other critical organs and PTV, nonsignificant differences were found as well. Conclusion: This study has demonstrated that 4D-CT ventilation image-based functional IMRT plans are dosimetrically comparable to SPECT ventilation image-based plans, providing evidence to use 4D-CT ventilation imaging for clinical applications. Supported in part by Free to Breathe Young Investigator Research Grant and NIH/NCI R01 CA 093626. The authors thank Philips Radiation Oncology Systems for the Pinnacle3 treatment planning systems.« less

Hepatic CT image query using Gabor features

NASA Astrophysics Data System (ADS)

Zhao, Chenguang; Cheng, Hongyan; Zhuang, Tiange

2004-07-01

A retrieval scheme for liver computerize tomography (CT) images based on Gabor texture is presented. For each hepatic CT image, we manually delineate abnormal regions within liver area. Then, a continuous Gabor transform is utilized to analyze the texture of the pathology bearing region and extract the corresponding feature vectors. For a given sample image, we compare its feature vector with those of other images. Similar images with the highest rank are retrieved. In experiments, 45 liver CT images are collected, and the effectiveness of Gabor texture for content based retrieval is verified.

Reducing image noise in computed tomography (CT) colonography: effect of an integrated circuit CT detector.

PubMed

Liu, Yu; Leng, Shuai; Michalak, Gregory J; Vrieze, Thomas J; Duan, Xinhui; Qu, Mingliang; Shiung, Maria M; McCollough, Cynthia H; Fletcher, Joel G

2014-01-01

To investigate whether the integrated circuit (IC) detector results in reduced noise in computed tomography (CT) colonography (CTC). Three hundred sixty-six consecutive patients underwent clinically indicated CTC using the same CT scanner system, except for a difference in CT detectors (IC or conventional). Image noise, patient size, and scanner radiation output (volume CT dose index) were quantitatively compared between patient cohorts using each detector system, with separate comparisons for the abdomen and pelvis. For the abdomen and pelvis, despite significantly larger patient sizes in the IC detector cohort (both P < 0.001), image noise was significantly lower (both P < 0.001), whereas volume CT dose index was unchanged (both P > 0.18). Based on the observed image noise reduction, radiation dose could alternatively be reduced by approximately 20% to result in similar levels of image noise. Computed tomography colonography images acquired using the IC detector had significantly lower noise than images acquired using the conventional detector. This noise reduction can permit further radiation dose reduction in CTC.

A Method for Application of Classification Tree Models to Map Aquatic Vegetation Using Remotely Sensed Images from Different Sensors and Dates

PubMed Central

Jiang, Hao; Zhao, Dehua; Cai, Ying; An, Shuqing

2012-01-01

In previous attempts to identify aquatic vegetation from remotely-sensed images using classification trees (CT), the images used to apply CT models to different times or locations necessarily originated from the same satellite sensor as that from which the original images used in model development came, greatly limiting the application of CT. We have developed an effective normalization method to improve the robustness of CT models when applied to images originating from different sensors and dates. A total of 965 ground-truth samples of aquatic vegetation types were obtained in 2009 and 2010 in Taihu Lake, China. Using relevant spectral indices (SI) as classifiers, we manually developed a stable CT model structure and then applied a standard CT algorithm to obtain quantitative (optimal) thresholds from 2009 ground-truth data and images from Landsat7-ETM+, HJ-1B-CCD, Landsat5-TM and ALOS-AVNIR-2 sensors. Optimal CT thresholds produced average classification accuracies of 78.1%, 84.7% and 74.0% for emergent vegetation, floating-leaf vegetation and submerged vegetation, respectively. However, the optimal CT thresholds for different sensor images differed from each other, with an average relative variation (RV) of 6.40%. We developed and evaluated three new approaches to normalizing the images. The best-performing method (Method of 0.1% index scaling) normalized the SI images using tailored percentages of extreme pixel values. Using the images normalized by Method of 0.1% index scaling, CT models for a particular sensor in which thresholds were replaced by those from the models developed for images originating from other sensors provided average classification accuracies of 76.0%, 82.8% and 68.9% for emergent vegetation, floating-leaf vegetation and submerged vegetation, respectively. Applying the CT models developed for normalized 2009 images to 2010 images resulted in high classification (78.0%–93.3%) and overall (92.0%–93.1%) accuracies. Our results suggest that Method of 0.1% index scaling provides a feasible way to apply CT models directly to images from sensors or time periods that differ from those of the images used to develop the original models.

Noise correlation in PET, CT, SPECT and PET/CT data evaluated using autocorrelation function: a phantom study on data, reconstructed using FBP and OSEM.

PubMed

Razifar, Pasha; Sandström, Mattias; Schnieder, Harald; Långström, Bengt; Maripuu, Enn; Bengtsson, Ewert; Bergström, Mats

2005-08-25

Positron Emission Tomography (PET), Computed Tomography (CT), PET/CT and Single Photon Emission Tomography (SPECT) are non-invasive imaging tools used for creating two dimensional (2D) cross section images of three dimensional (3D) objects. PET and SPECT have the potential of providing functional or biochemical information by measuring distribution and kinetics of radiolabelled molecules, whereas CT visualizes X-ray density in tissues in the body. PET/CT provides fused images representing both functional and anatomical information with better precision in localization than PET alone. Images generated by these types of techniques are generally noisy, thereby impairing the imaging potential and affecting the precision in quantitative values derived from the images. It is crucial to explore and understand the properties of noise in these imaging techniques. Here we used autocorrelation function (ACF) specifically to describe noise correlation and its non-isotropic behaviour in experimentally generated images of PET, CT, PET/CT and SPECT. Experiments were performed using phantoms with different shapes. In PET and PET/CT studies, data were acquired in 2D acquisition mode and reconstructed by both analytical filter back projection (FBP) and iterative, ordered subsets expectation maximisation (OSEM) methods. In the PET/CT studies, different magnitudes of X-ray dose in the transmission were employed by using different mA settings for the X-ray tube. In the CT studies, data were acquired using different slice thickness with and without applied dose reduction function and the images were reconstructed by FBP. SPECT studies were performed in 2D, reconstructed using FBP and OSEM, using post 3D filtering. ACF images were generated from the primary images, and profiles across the ACF images were used to describe the noise correlation in different directions. The variance of noise across the images was visualised as images and with profiles across these images. The most important finding was that the pattern of noise correlation is rotation symmetric or isotropic, independent of object shape in PET and PET/CT images reconstructed using the iterative method. This is, however, not the case in FBP images when the shape of phantom is not circular. Also CT images reconstructed using FBP show the same non-isotropic pattern independent of slice thickness and utilization of care dose function. SPECT images show an isotropic correlation of the noise independent of object shape or applied reconstruction algorithm. Noise in PET/CT images was identical independent of the applied X-ray dose in the transmission part (CT), indicating that the noise from transmission with the applied doses does not propagate into the PET images showing that the noise from the emission part is dominant. The results indicate that in human studies it is possible to utilize a low dose in transmission part while maintaining the noise behaviour and the quality of the images. The combined effect of noise correlation for asymmetric objects and a varying noise variance across the image field significantly complicates the interpretation of the images when statistical methods are used, such as with statistical estimates of precision in average values, use of statistical parametric mapping methods and principal component analysis. Hence it is recommended that iterative reconstruction methods are used for such applications. However, it is possible to calculate the noise analytically in images reconstructed by FBP, while it is not possible to do the same calculation in images reconstructed by iterative methods. Therefore for performing statistical methods of analysis which depend on knowing the noise, FBP would be preferred.

Simultaneous CT-MRI Reconstruction for Constrained Imaging Geometries using Structural Coupling and Compressive Sensing

PubMed Central

Xi, Yan; Zhao, Jun; Bennett, James R.; Stacy, Mitchel R.; Sinusas, Albert J.; Wang, Ge

2016-01-01

Objective A unified reconstruction framework is presented for simultaneous CT-MRI reconstruction. Significance Combined CT-MRI imaging has the potential for improved results in existing preclinical and clinical applications, as well as opening novel research directions for future applications. Methods In an ideal CT-MRI scanner, CT and MRI acquisitions would occur simultaneously, and hence would be inherently registered in space and time. Alternatively, separately acquired CT and MRI scans can be fused to simulate an instantaneous acquisition. In this study, structural coupling and compressive sensing techniques are combined to unify CT and MRI reconstructions. A bidirectional image estimation method was proposed to connect images from different modalities. Hence, CT and MRI data serve as prior knowledge to each other for better CT and MRI image reconstruction than what could be achieved with separate reconstruction. Results Our integrated reconstruction methodology is demonstrated with numerical phantom and real-dataset based experiments, and has yielded promising results. PMID:26672028

Evaluation of radiographic, computed tomographic, and cadaveric anatomy of the head of boa constrictors.

PubMed

Banzato, Tommaso; Russo, Elisa; Di Toma, Anna; Palmisano, Giuseppe; Zotti, Alessandro

2011-12-01

To evaluate the radiographic, computed tomographic (CT), and cadaveric anatomy of the head of boa constrictors. 4 Boa constrictor imperator cadavers. Cadavers weighed 3.4 to 5.6 kg and had a body length ranging from 189 to 221 cm. Radiographic and CT images were obtained with a high-detail screen-film combination, and conventional CT was performed with a slice thickness of 1.5 mm. Radiographic images were obtained in ventrodorsal, dorsoventral, and left and right laterolateral recumbency; CT images were obtained with the animals positioned in ventral recumbency directly laying on a plastic support. At the end of the radiographic and CT imaging session, 2 heads were sectioned following a stratigraphic approach; the other 2, carefully maintained in the same position on the plastic support, were moved into a freezer (-20°C) until completely frozen and then sectioned into 3-mm slices, respecting the imaging protocol. The frozen sections were cleaned and then photographed on each side. Anatomic structures were identified and labeled on gross anatomic images and on the corresponding CT or radiographic image with the aid of available literature. Radiographic and CT images provided high detail for visualization of bony structures; soft tissues were not easily identified on radiographic and CT images. Results provide an atlas of stratigraphic and cross-sectional gross anatomy and radiographic and CT anatomy of the heads of boa constrictors that might be useful in the interpretation of any imaging modality in this species.

An evaluation on CT image acquisition method for medical VR applications

NASA Astrophysics Data System (ADS)

Jang, Seong-wook; Ko, Junho; Yoo, Yon-sik; Kim, Yoonsang

2017-02-01

Recent medical virtual reality (VR) applications to minimize re-operations are being studied for improvements in surgical efficiency and reduction of operation error. The CT image acquisition method considering three-dimensional (3D) modeling for medical VR applications is important, because the realistic model is required for the actual human organ. However, the research for medical VR applications has focused on 3D modeling techniques and utilized 3D models. In addition, research on a CT image acquisition method considering 3D modeling has never been reported. The conventional CT image acquisition method involves scanning a limited area of the lesion for the diagnosis of doctors once or twice. However, the medical VR application is required to acquire the CT image considering patients' various postures and a wider area than the lesion. A wider area than the lesion is required because of the necessary process of comparing bilateral sides for dyskinesia diagnosis of the shoulder, pelvis, and leg. Moreover, patients' various postures are required due to the different effects on the musculoskeletal system. Therefore, in this paper, we perform a comparative experiment on the acquired CT images considering image area (unilateral/bilateral) and patients' postures (neutral/abducted). CT images are acquired from 10 patients for the experiments, and the acquired CT images are evaluated based on the length per pixel and the morphological deviation. Finally, by comparing the experiment results, we evaluate the CT image acquisition method for medical VR applications.

Radionuclide bone scan SPECT-CT: lowering the dose of CT significantly reduces radiation dose without impacting CT image quality

PubMed Central

Gupta, Sandeep Kumar; Trethewey, Scott; Brooker, Bree; Rutherford, Natalie; Diffey, Jenny; Viswanathan, Suresh; Attia, John

2017-01-01

The CT component of SPECT-CT is required for attenuation correction and anatomical localization of the uptake on SPECT but there is no guideline about the optimal CT acquisition parameters. In our department, a standard CT acquisition protocol was changed in 2013 to give lower radiation dose to the patient. In this study, we retrospectively compared the effects on patient dose as well as the CT image quality with current versus older CT protocols. Ninety nine consecutive patients [n=51 Standard dose ‘old’ protocol (SDP); n=48 lower dose ‘new’ protocol (LDP)] with lumbar spine SPECT-CT for bone scan were examined. The main differences between the two protocols were that SDP used 130 kVp tube voltage and reference current-time product of 70 mAs whereas the LDP used 110 kVp and 40 mAs respectively. Various quantitative parameters from the CT images were obtained and the images were also rated blindly by two experienced nuclear medicine physicians for bony definition and noise. The mean calculated dose length product of the LDP group (121.5±39.6 mGy.cm) was significantly lower compared to the SDP group patients (266.9±96.9 mGy.cm; P<0.0001). This translated into a significant reduction in the mean effective dose to 1.8 mSv from 4.0 mSv. The physicians reported better CT image quality for the bony structures in LDP group although for soft tissue structures, the SDP group had better image quality. The optimized new CT acquisition protocol significantly reduced the radiation dose to the patient and in-fact improved CT image quality for the assessment of bony structures. PMID:28533938

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

Johnston, H; UT Southwestern Medical Center, Dallas, TX; Hilts, M

Purpose: To commission a multislice computed tomography (CT) scanner for fast and reliable readout of radiation therapy (RT) dose distributions using CT polymer gel dosimetry (PGD). Methods: Commissioning was performed for a 16-slice CT scanner using images acquired through a 1L cylinder filled with water. Additional images were collected using a single slice machine for comparison purposes. The variability in CT number associated with the anode heel effect was evaluated and used to define a new slice-by-slice background image subtraction technique. Image quality was assessed for the multislice system by comparing image noise and uniformity to that of the singlemore » slice machine. The consistency in CT number across slices acquired simultaneously using the multislice detector array was also evaluated. Finally, the variability in CT number due to increasing x-ray tube load was measured for the multislice scanner and compared to the tube load effects observed on the single slice machine. Results: Slice-by-slice background subtraction effectively removes the variability in CT number across images acquired simultaneously using the multislice scanner and is the recommended background subtraction method when using a multislice CT system. Image quality for the multislice machine was found to be comparable to that of the single slice scanner. Further study showed CT number was consistent across image slices acquired simultaneously using the multislice detector array for each detector configuration of the slice thickness examined. In addition, the multislice system was found to eliminate variations in CT number due to increasing x-ray tube load and reduce scanning time by a factor of 4 when compared to imaging a large volume using a single slice scanner. Conclusion: A multislice CT scanner has been commissioning for CT PGD, allowing images of an entire dose distribution to be acquired in a matter of minutes. Funding support provided by the Natural Sciences and Engineering Research Council of Canada (NSERC)« less

Statistical distributions of ultra-low dose CT sinograms and their fundamental limits

NASA Astrophysics Data System (ADS)

Lee, Tzu-Cheng; Zhang, Ruoqiao; Alessio, Adam M.; Fu, Lin; De Man, Bruno; Kinahan, Paul E.

2017-03-01

Low dose CT imaging is typically constrained to be diagnostic. However, there are applications for even lowerdose CT imaging, including image registration across multi-frame CT images and attenuation correction for PET/CT imaging. We define this as the ultra-low-dose (ULD) CT regime where the exposure level is a factor of 10 lower than current low-dose CT technique levels. In the ULD regime it is possible to use statistically-principled image reconstruction methods that make full use of the raw data information. Since most statistical based iterative reconstruction methods are based on the assumption of that post-log noise distribution is close to Poisson or Gaussian, our goal is to understand the statistical distribution of ULD CT data with different non-positivity correction methods, and to understand when iterative reconstruction methods may be effective in producing images that are useful for image registration or attenuation correction in PET/CT imaging. We first used phantom measurement and calibrated simulation to reveal how the noise distribution deviate from normal assumption under the ULD CT flux environment. In summary, our results indicate that there are three general regimes: (1) Diagnostic CT, where post-log data are well modeled by normal distribution. (2) Lowdose CT, where normal distribution remains a reasonable approximation and statistically-principled (post-log) methods that assume a normal distribution have an advantage. (3) An ULD regime that is photon-starved and the quadratic approximation is no longer effective. For instance, a total integral density of 4.8 (ideal pi for 24 cm of water) for 120kVp, 0.5mAs of radiation source is the maximum pi value where a definitive maximum likelihood value could be found. This leads to fundamental limits in the estimation of ULD CT data when using a standard data processing stream

CT imaging, then and now: a 30-year review of the economics of computed tomography.

PubMed

Stockburger, Wayne T

2004-01-01

The first computed tomography (CT) scanner in the US was installed in June 1973 at the Mayo Clinic in Rochester, MN. By the end of 1974, 44 similar systems had been installed at medical facilities around the country. Less than 4 years after the introduction of CT imaging in the US, at least 400 CT systems had been installed. The practice of pneumoencephalography was eliminated. The use of nuclear medicine brain scans significantly diminished. At the time, CT imaging was limited to head studies, but with the introduction of contrast agents and full body CT systems the changes in the practice of medicine became even more significant. CT imaging was hailed by the US medical community as the greatest advance in radiology since the discovery of x-rays. But the rapid spread of CT systems, their frequency of use, and the associated increase in healthcare costs combined to draw the attention of decision-makers within the federal and state governments, specifically to establish policies regarding the acquisition and use of diagnostic technologies. Initially, CT imaging was limited to neurological applications, but in the 30 years since its inception, capabilities and applications have been expanded as a result of the advancements in technology and software development. While neurological disorders are still a common reason for CT imaging, many other medical disciplines (oncology, emergency medicine, orthopedics, etc.) have found CT imaging to be the definitive tool for diagnostic information. As such, the clinical demand for CT imaging has steadily increased. Economically, the development of CT imaging has been one of success, even in the face of governmental action to restrict its acquisition and utilization by healthcare facilities. CTimaging has increased the cost of healthcare, but in turn has added unquantifiable value to the practice of medicine in the US.

SU-F-J-114: On-Treatment Imagereconstruction Using Transit Images of Treatment Beams Through Patient and Thosethrough Planning CT Images

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

Lee, H; Cho, S; Cheong, K

Purpose: To reconstruct patient images at the time of radiation delivery using measured transit images of treatment beams through patient and calculated transit images through planning CT images. Methods: We hypothesize that the ratio of the measured transit images to the calculated images may provide changed amounts of the patient image between times of planning CT and treatment. To test, we have devised lung phantoms with a tumor object (3-cm diameter) placed at iso-center (simulating planning CT) and off-center by 1 cm (simulating treatment). CT images of the two phantoms were acquired; the image of the off-centered phantom, unavailable clinically,more » represents the reference on-treatment image in the image quality of planning CT. Cine-transit images through the two phantoms were also acquired in EPID from a non-modulated 6 MV beam when the gantry was rotated 360 degrees; the image through the centered phantom simulates calculated image. While the current study is a feasibility study, in reality our computational EPID model can be applicable in providing accurate transit image from MC simulation. Changed MV HU values were reconstructed from the ratio between two EPID projection data, converted to KV HU values, and added to the planning CT, thereby reconstructing the on-treatment image of the patient limited to the irradiated region of the phantom. Results: The reconstructed image was compared with the reference image. Except for local HU differences>200 as a maximum, excellent agreement was found. The average difference across the entire image was 16.2 HU. Conclusion: We have demonstrated the feasibility of a method of reconstructing on-treatment images of a patient using EPID image and planning CT images. Further studies will include resolving the local HU differences and investigation on the dosimetry impact of the reconstructed image.« less

Comparison Between CT and MR Images as More Favorable Reference Data Sets for Fusion Imaging-Guided Radiofrequency Ablation or Biopsy of Hepatic Lesions: A Prospective Study with Focus on Patient's Respiration.

PubMed

Cha, Dong Ik; Lee, Min Woo; Kang, Tae Wook; Oh, Young-Taek; Jeong, Ja-Yeon; Chang, Jung-Woo; Ryu, Jiwon; Lee, Kyong Joon; Kim, Jaeil; Bang, Won-Chul; Shin, Dong Kuk; Choi, Sung Jin; Koh, Dalkwon; Kim, Kyunga

2017-10-01

To identify the more accurate reference data sets for fusion imaging-guided radiofrequency ablation or biopsy of hepatic lesions between computed tomography (CT) and magnetic resonance (MR) images. This study was approved by the institutional review board, and written informed consent was received from all patients. Twelve consecutive patients who were referred to assess the feasibility of radiofrequency ablation or biopsy were enrolled. Automatic registration using CT and MR images was performed in each patient. Registration errors during optimal and opposite respiratory phases, time required for image fusion and number of point locks used were compared using the Wilcoxon signed-rank test. The registration errors during optimal respiratory phase were not significantly different between image fusion using CT and MR images as reference data sets (p = 0.969). During opposite respiratory phase, the registration error was smaller with MR images than CT (p = 0.028). The time and the number of points locks needed for complete image fusion were not significantly different between CT and MR images (p = 0.328 and p = 0.317, respectively). MR images would be more suitable as the reference data set for fusion imaging-guided procedures of focal hepatic lesions than CT images.

SU-F-T-427: Utilization and Evaluation of Diagnostic CT Imaging with MAR Technique for Radiation Therapy Treatment Planning

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

Xu, M; Foster, R; Parks, H

Purpose: The objective was to utilize and evaluate diagnostic CT-MAR technique for radiation therapy treatment planning. Methods: A Toshiba-diagnostic-CT acquisition with SEMAR(Single-energy-MAR)-algorism was performed to make the metal-artifact-reduction (MAR) for patient treatment planning. CT-imaging datasets with and without SEMAR were taken on a Catphan-phantom. Two sets of CT-numbers were calibrated with the relative electron densities (RED). A tissue characterization phantom with Gammex various simulating material rods was used to establish the relationship between known REDs and corresponding CT-numbers. A GE-CT-sim acquisition was taken on the Catphan for comparison. A patient with bilateral hip arthroplasty was scanned in the radiotherapy CT-simmore » and the diagnostic SEMAR-CT on a flat panel. The derived SEMAR images were used as a primary CT dataset to create contours for the target, critical-structures, and for planning. A deformable registration was performed with VelocityAI to track voxel changes between SEMAR and CT-sim images. The SEMAR-CT images with minimal artifacts and high quality of geometrical and spatial integrity were employed for a treatment plan. Treatment-plans were evaluated based on deformable registration of SEMAR-CT and CT-sim dataset with assigned CT-numbers in the metal artifact regions in Eclipse v11 TPS. Results: The RED and CT-number relationships were consistent for the datasets in CT-sim and CT’s with and without SEMAR. SEMAR datasets with high image quality were used for PTV and organ delineation in the treatment planning process. For dose distribution to the PTV through the DVH analysis, the plan using CT-sim with the assigned CT-number showed a good agreement to those on deformable CT-SEMAR. Conclusion: A diagnostic-CT with MAR-algorithm can be utilized for radiotherapy treatment planning with CT-number calibrated to the RED. Treatment planning comparison and DVH shows a good agreement in the PTV and critical organs between the plans on CT-sim with assigned CT-number and the deformable SEMAR CT datasets.« less

TH-E-202-01: Pitfalls and Remedies in PET/CT Imaging for RT Planning

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

Pan, T.

2016-06-15

PET/CT is a very important imaging tool in the management of oncology patients. PET/CT has been applied for treatment planning and response evaluation in radiation therapy. This educational session will discuss: Pitfalls and remedies in PET/CT imaging for RT planning The use of hypoxia PET imaging for radiotherapy PET for tumor response evaluation The first presentation will address the issue of mis-registration between the CT and PET images in the thorax and the abdomen. We will discuss the challenges of respiratory gating and introduce an average CT technique to improve the registration for dose calculation and image-guidance in radiation therapy.more » The second presentation will discuss the use of hypoxia PET Imaging for radiation therapy. We will discuss various hypoxia radiotracers, the choice of clinical acquisition protocol (in particular a single late static acquisition versus a dynamic acquisition), and the compartmental modeling with different transfer rate constants explained. We will demonstrate applications of hypoxia imaging for dose escalation/de-escalation in clinical trials. The last presentation will discuss the use of PET/CT for tumor response evaluation. We will discuss anatomic response assessment vs. metabolic response assessment, visual evaluation and semi-quantitative evaluation, and limitations of current PET/CT assessment. We will summarize clinical trials using PET response in guiding adaptive radiotherapy. Finally, we will summarize recent advancements in PET/CT radiomics and non-FDG PET tracers for response assessment. Learning Objectives: Identify the causes of mis-registration of CT and PET images in PET/CT, and review the strategies to remedy the issue. Understand the basics of PET imaging of tumor hypoxia (radiotracers, how PET measures the hypoxia selective uptake, imaging protocols, applications in chemo-radiation therapy). Understand the basics of dynamic PET imaging, compartmental modeling and parametric images. Understand the basics of using FDG PET/CT for tumor response evaluation. Learn about recent advancement in PET/CT radiomics and non-FDG PET tracers for response assessment. This work was supported in part by the National Cancer Institute Grants R01CA172638.; W. Lu, This work was supported in part by the National Cancer Institute Grants R01CA172638.« less

Acceptance test of a commercially available software for automatic image registration of computed tomography (CT), magnetic resonance imaging (MRI) and 99mTc-methoxyisobutylisonitrile (MIBI) single-photon emission computed tomography (SPECT) brain images.

PubMed

Loi, Gianfranco; Dominietto, Marco; Manfredda, Irene; Mones, Eleonora; Carriero, Alessandro; Inglese, Eugenio; Krengli, Marco; Brambilla, Marco

2008-09-01

This note describes a method to characterize the performances of image fusion software (Syntegra) with respect to accuracy and robustness. Computed tomography (CT), magnetic resonance imaging (MRI), and single-photon emission computed tomography (SPECT) studies were acquired from two phantoms and 10 patients. Image registration was performed independently by two couples composed of one radiotherapist and one physicist by means of superposition of anatomic landmarks. Each couple performed jointly and saved the registration. The two solutions were averaged to obtain the gold standard registration. A new set of estimators was defined to identify translation and rotation errors in the coordinate axes, independently from point position in image field of view (FOV). Algorithms evaluated were local correlation (LC) for CT-MRI, normalized mutual information (MI) for CT-MRI, and CT-SPECT registrations. To evaluate accuracy, estimator values were compared to limiting values for the algorithms employed, both in phantoms and in patients. To evaluate robustness, different alignments between images taken from a sample patient were produced and registration errors determined. LC algorithm resulted accurate in CT-MRI registrations in phantoms, but exceeded limiting values in 3 of 10 patients. MI algorithm resulted accurate in CT-MRI and CT-SPECT registrations in phantoms; limiting values were exceeded in one case in CT-MRI and never reached in CT-SPECT registrations. Thus, the evaluation of robustness was restricted to the algorithm of MI both for CT-MRI and CT-SPECT registrations. The algorithm of MI proved to be robust: limiting values were not exceeded with translation perturbations up to 2.5 cm, rotation perturbations up to 10 degrees and roto-translational perturbation up to 3 cm and 5 degrees.

SU-E-I-09: The Impact of X-Ray Scattering On Image Noise for Dedicated Breast CT

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

Yang, K; Gazi, P; Boone, J

2015-06-15

Purpose: To quantify the impact of detected x-ray scatter on image noise in flat panel based dedicated breast CT systems and to determine the optimal scanning geometry given practical trade-offs between radiation dose and scatter reduction. Methods: Four different uniform polyethylene cylinders (104, 131, 156, and 184 mm in diameter) were scanned as the phantoms on a dedicated breast CT scanner developed in our laboratory. Both stationary projection imaging and rotational cone-beam CT imaging was performed. For each acquisition type, three different x-ray beam collimations were used (12, 24, and 109 mm measured at isocenter). The aim was to quantifymore » image noise properties (pixel variance, SNR, and image NPS) under different levels of x-ray scatter, in order to optimize the scanning geometry. For both projection images and reconstructed CT images, individual pixel variance and NPS were determined and compared. Noise measurement from the CT images were also performed with different detector binning modes and reconstruction matrix sizes. Noise propagation was also tracked throughout the intermediate steps of cone-beam CT reconstruction, including the inverse-logarithmic process, Fourier-filtering before backprojection. Results: Image noise was lower in the presence of higher scatter levels. For the 184 mm polyethylene phantom, the image noise (measured in pixel variance) was ∼30% lower with full cone-beam acquisition compared to a narrow (12 mm) fan-beam acquisition. This trend is consistent across all phantom sizes and throughout all steps of CT image reconstruction. Conclusion: From purely a noise perspective, the cone-beam geometry (i.e. the full cone-angle acquisition) produces lower image noise compared to the lower-scatter fan-beam acquisition for breast CT. While these results are relevant in homogeneous phantoms, the full impact of scatter on noise in bCT should involve contrast-to-noise-ratio measurements in heterogeneous phantoms if the goal is to optimize the scanning geometry for dedicated breast CT. This work was supported by a grant from the National Institute for Biomedical Imaging and Bioengineering (R01 EB002138)« less

TH-E-202-00: PET for Radiation Therapy

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

NONE

PET/CT is a very important imaging tool in the management of oncology patients. PET/CT has been applied for treatment planning and response evaluation in radiation therapy. This educational session will discuss: Pitfalls and remedies in PET/CT imaging for RT planning The use of hypoxia PET imaging for radiotherapy PET for tumor response evaluation The first presentation will address the issue of mis-registration between the CT and PET images in the thorax and the abdomen. We will discuss the challenges of respiratory gating and introduce an average CT technique to improve the registration for dose calculation and image-guidance in radiation therapy.more » The second presentation will discuss the use of hypoxia PET Imaging for radiation therapy. We will discuss various hypoxia radiotracers, the choice of clinical acquisition protocol (in particular a single late static acquisition versus a dynamic acquisition), and the compartmental modeling with different transfer rate constants explained. We will demonstrate applications of hypoxia imaging for dose escalation/de-escalation in clinical trials. The last presentation will discuss the use of PET/CT for tumor response evaluation. We will discuss anatomic response assessment vs. metabolic response assessment, visual evaluation and semi-quantitative evaluation, and limitations of current PET/CT assessment. We will summarize clinical trials using PET response in guiding adaptive radiotherapy. Finally, we will summarize recent advancements in PET/CT radiomics and non-FDG PET tracers for response assessment. Learning Objectives: Identify the causes of mis-registration of CT and PET images in PET/CT, and review the strategies to remedy the issue. Understand the basics of PET imaging of tumor hypoxia (radiotracers, how PET measures the hypoxia selective uptake, imaging protocols, applications in chemo-radiation therapy). Understand the basics of dynamic PET imaging, compartmental modeling and parametric images. Understand the basics of using FDG PET/CT for tumor response evaluation. Learn about recent advancement in PET/CT radiomics and non-FDG PET tracers for response assessment. This work was supported in part by the National Cancer Institute Grants R01CA172638.; W. Lu, This work was supported in part by the National Cancer Institute Grants R01CA172638.« less

TH-E-202-03: PET for Tumor Response Evaluation

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

Lu, W.

PET/CT is a very important imaging tool in the management of oncology patients. PET/CT has been applied for treatment planning and response evaluation in radiation therapy. This educational session will discuss: Pitfalls and remedies in PET/CT imaging for RT planning The use of hypoxia PET imaging for radiotherapy PET for tumor response evaluation The first presentation will address the issue of mis-registration between the CT and PET images in the thorax and the abdomen. We will discuss the challenges of respiratory gating and introduce an average CT technique to improve the registration for dose calculation and image-guidance in radiation therapy.more » The second presentation will discuss the use of hypoxia PET Imaging for radiation therapy. We will discuss various hypoxia radiotracers, the choice of clinical acquisition protocol (in particular a single late static acquisition versus a dynamic acquisition), and the compartmental modeling with different transfer rate constants explained. We will demonstrate applications of hypoxia imaging for dose escalation/de-escalation in clinical trials. The last presentation will discuss the use of PET/CT for tumor response evaluation. We will discuss anatomic response assessment vs. metabolic response assessment, visual evaluation and semi-quantitative evaluation, and limitations of current PET/CT assessment. We will summarize clinical trials using PET response in guiding adaptive radiotherapy. Finally, we will summarize recent advancements in PET/CT radiomics and non-FDG PET tracers for response assessment. Learning Objectives: Identify the causes of mis-registration of CT and PET images in PET/CT, and review the strategies to remedy the issue. Understand the basics of PET imaging of tumor hypoxia (radiotracers, how PET measures the hypoxia selective uptake, imaging protocols, applications in chemo-radiation therapy). Understand the basics of dynamic PET imaging, compartmental modeling and parametric images. Understand the basics of using FDG PET/CT for tumor response evaluation. Learn about recent advancement in PET/CT radiomics and non-FDG PET tracers for response assessment. This work was supported in part by the National Cancer Institute Grants R01CA172638.; W. Lu, This work was supported in part by the National Cancer Institute Grants R01CA172638.« less

TH-CD-202-01: BEST IN PHYSICS (JOINT IMAGING-THERAPY): Evaluation of the Use of Direct Electron Density CT Images in Radiation Therapy

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

Zhao, T; Sun, B; Li, H

Purpose: The current standard for calculation of photon and electron dose requires conversion of Hounsfield Units (HU) to Electron Density (ED) by applying a calibration curve specifically constructed for the corresponding CT tube voltage. This practice limits the use of the CT scanner to a single tube voltage and hinders the freedom in the selection of optimal tube voltage for better image quality. The objective of this study is to report a prototype CT reconstruction algorithm that provides direct ED images from the raw CT data independently of tube voltages used during acquisition. Methods: A tissue substitute phantom was scannedmore » for Stoichiometric CT calibrations at tube voltages of 70kV, 80kV, 100kV, 120kV and 140kV respectively. HU images and direct ED images were acquired sequentially on a thoracic anthropomorphic phantom at the same tube voltages. Electron densities converted from the HU images were compared to ED obtained from the direct ED images. A 7-field treatment plan was made on all HU and ED images. Gamma analysis was performed to demonstrate quantitatively dosimetric change from the two schemes in acquiring ED. Results: The average deviation of EDs obtained from the direct ED images was −1.5%±2.1% from the EDs from HU images with the corresponding CT calibration curves applied. Gamma analysis on dose calculated on the direct ED images and the HU images acquired at the same tube voltage indicated negligible difference with lowest passing rate at 99.9%. Conclusion: Direct ED images require no CT calibration while demonstrate equivalent dosimetry compared to that obtained from standard HU images. The ability of acquiring direct ED images simplifies the current practice at a safer level by eliminating CT calibration and HU conversion from commissioning and treatment planning respectively. Furthermore, it unlocks a wider range of tube voltages in CT scanner for better imaging quality while maintaining similar dosimetric accuracy.« less

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

Gong, G; Liu, C; Liu, C

Purpose: To analyze the error in contouring the brainstem for patients with head and neck cancer who underwent radiotherapy based on computed tomography (CT) and magnetic resonance (MR) images. Methods: 20 brain tumor and 17 nasopharyngeal cancer patients were randomly selected. Each patient underwent MR and CT scanning. For each patient, one observer contoured the brainstem on CT and MR images for 10 times, and 10 observers from five centers delineated the brainstem on CT and MR images only one time. The inter- and intra-observers volume and outline variations were compared. Results: The volumes of brainstem contoured by inter- andmore » intra-observers on CT and MR images were similar (p>0.05). The reproducibility of contouring brainstem on MR images was better than that on CT images (p<0.05) for both inter- and intra-observer variability. The inter- and intra-observer for contouring on CT images reached mean values of 0.81±0.05 (p>0.05) and of 0.85±0.05 (p>0.05), respectively, while on MR images these respective values were 0.90±0.05 (p>0.05) and 0.92±0.04 (p>0.05). Conclusion: Contouring the brainstem on MR images was more accurate and reproducible than that on CT images. Precise information might be more helpful for protecting the brainstem radiation injury the patients whose lesion were closed to brainstem.« less

Multi-modality PET-CT imaging of breast cancer in an animal model using nanoparticle x-ray contrast agent and 18F-FDG

NASA Astrophysics Data System (ADS)

Badea, C. T.; Ghaghada, K.; Espinosa, G.; Strong, L.; Annapragada, A.

2011-03-01

Multi-modality PET-CT imaging is playing an important role in the field of oncology. While PET imaging facilitates functional interrogation of tumor status, the use of CT imaging is primarily limited to anatomical reference. In an attempt to extract comprehensive information about tumor cells and its microenvironment, we used a nanoparticle xray contrast agent to image tumor vasculature and vessel 'leakiness' and 18F-FDG to investigate the metabolic status of tumor cells. In vivo PET/CT studies were performed in mice implanted with 4T1 mammary breast cancer cells.Early-phase micro-CT imaging enabled visualization 3D vascular architecture of the tumors whereas delayedphase micro-CT demonstrated highly permeable vessels as evident by nanoparticle accumulation within the tumor. Both imaging modalities demonstrated the presence of a necrotic core as indicated by a hypo-enhanced region in the center of the tumor. At early time-points, the CT-derived fractional blood volume did not correlate with 18F-FDG uptake. At delayed time-points, the tumor enhancement in 18F-FDG micro-PET images correlated with the delayed signal enhanced due to nanoparticle extravasation seen in CT images. The proposed hybrid imaging approach could be used to better understand tumor angiogenesis and to be the basis for monitoring and evaluating anti-angiogenic and nano-chemotherapies.

Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT

PubMed Central

Kraft, Otakar; Havel, Martin

2012-01-01

Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) detection in patients with gynecologic tumours. Material and Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 64 consecutive women with gynecologic tumours (mean age 53.6 with range 30-77 years): 36 pts with cervical cancer (Group A), 21 pts with endometrial cancer (Group B), 7 pts with vulvar carcinoma (Group C). Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared. Results: Planar scintigraphy did not image SLN in 7 patients (10.9%), SPECT/CT was negative in 4 patients (6.3%). In 35 (54.7%) patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. Differences in detection of SLN between planar and SPECT/CT imaging in the group of all 64 patients are statistically significant (p<0.05). Three foci of uptake (1.7% from totally visible 177 foci on planar images) in 2 patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes. Conclusion: In some patients with gynecologic cancers SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localise pelvic and paraaortal SLNs. It improves anatomic localization of SLNs. Conflict of interest:None declared. PMID:23486989

Diagnostic role of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for early and atypical bone metastases.

PubMed

Chen, Xiao-Liang; Li, Qian; Cao, Lin; Jiang, Shi-Xi

2014-01-01

The bone metastasis appeared early before the bone imaging for most of the above patients. (99)Tc(m)-MDP ((99)Tc(m) marked methylene diphosphonate) bone imaging could diagnosis the bone metastasis with highly sensitivity, but with lower specificity. The aim of this study is to explore the diagnostic value of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for the early period atypical bone metastases. 15 to 30 mCi (99)Tc(m)-MDP was intravenously injected to the 34 malignant patients diagnosed as doubtful early bone metastases. SPECT, CT and SPECT/CT images were captured and analyzed consequently. For the patients diagnosed as early period atypical bone metastases by SPECT/CT, combining the SPECT/CT and MRI together as the SPECT/MRI integrated image. The obtained SPECT/MRI image was analyzed and compared with the pathogenic results of patients. The results indicated that 34 early period doubtful metastatic focus, including 34 SPECT positive focus, 17 focus without special changes by using CT method, 11 bone metastases focus by using SPECT/CT method, 23 doubtful bone metastases focus, 8 doubtful bone metastases focus, 14 doubtful bone metastases focus and 2 focus without clear image. Totally, SPECT/CT combined with SPECT/MRI method diagnosed 30 bone metastatic focus and 4 doubtfully metastatic focus. In conclusion, (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging shows a higher diagnostic value for the early period bone metastases, which also enhances the diagnostic accuracy rate.

An audit of imaging test utilization for the management of lymphoma in an oncology hospital: implications for resource planning?

PubMed

Schwartz, A; Gospodarowicz, M K; Khalili, K; Pintilie, M; Goddard, S; Keller, A; Tsang, R W

2006-02-01

The purpose of this study was to assist with resource planning by examining the pattern of physician utilization of imaging procedures for lymphoma patients in a dedicated oncology hospital. The proportion of imaging tests ordered for routine follow up with no specific clinical indication was quantified, with specific attention to CT scans. A 3-month audit was performed. The reasons for ordering all imaging procedures (X-rays, CT scans, ultrasound, nuclear scan and MRI) were determined through a retrospective chart review. 411 lymphoma patients had 686 assessments (sets of imaging tests) and 981 procedures (individual imaging tests). Most procedures were CT scans (52%) and chest radiographs (30%). The most common reasons for ordering imaging were assessing response (23%), and investigating new symptoms (19%). Routine follow up constituted 21% of the assessments (142/686), and of these, 82% were chest radiographs (116/142), while 24% (34/142) were CT scans. With analysis restricted to CT scans (296 assessments in 248 patients), the most common reason for ordering CT scans were response evaluation (40%), and suspicion of recurrence and/or new symptom (23%). Follow-up CT scans done with no clinical indication comprised 8% (25/296) of all CT assessments. Staging CT scans were under-represented at 6% of all assessments. Imaging with CT scans for follow up of asymptomatic patients is infrequent. However, scans done for staging new lymphoma patients were unexpectedly low in frequency, due to scans done elsewhere prior to referral. This analysis uncovered utilization patterns, helped resource planning and provided data to reduce unnecessary imaging procedures.

18F-FDG PET/MRI fusion in characterizing pancreatic tumors: comparison to PET/CT.

PubMed

Tatsumi, Mitsuaki; Isohashi, Kayako; Onishi, Hiromitsu; Hori, Masatoshi; Kim, Tonsok; Higuchi, Ichiro; Inoue, Atsuo; Shimosegawa, Eku; Takeda, Yutaka; Hatazawa, Jun

2011-08-01

To demonstrate that positron emission tomography (PET)/magnetic resonance imaging (MRI) fusion was feasible in characterizing pancreatic tumors (PTs), comparing MRI and computed tomography (CT) as mapping images for fusion with PET as well as fused PET/MRI and PET/CT. We retrospectively reviewed 47 sets of (18)F-fluorodeoxyglucose ((18)F -FDG) PET/CT and MRI examinations to evaluate suspected or known pancreatic cancer. To assess the ability of mapping images for fusion with PET, CT (of PET/CT), T1- and T2-weighted (w) MR images (all non-contrast) were graded regarding the visibility of PT (5-point confidence scale). Fused PET/CT, PET/T1-w or T2-w MR images of the upper abdomen were evaluated to determine whether mapping images provided additional diagnostic information to PET alone (3-point scale). The overall quality of PET/CT or PET/MRI sets in diagnosis was also assessed (3-point scale). These PET/MRI-related scores were compared to PET/CT-related scores and the accuracy in characterizing PTs was compared. Forty-three PTs were visualized on CT or MRI, including 30 with abnormal FDG uptake and 13 without. The confidence score for the visibility of PT was significantly higher on T1-w MRI than CT. The scores for additional diagnostic information to PET and overall quality of each image set in diagnosis were significantly higher on the PET/T1-w MRI set than the PET/CT set. The diagnostic accuracy was higher on PET/T1-w or PET/T2-w MRI (93.0 and 90.7%, respectively) than PET/CT (88.4%), but statistical significance was not obtained. PET/MRI fusion, especially PET with T1-w MRI, was demonstrated to be superior to PET/CT in characterizing PTs, offering better mapping and fusion image quality.

Validity of multislice computerized tomography for diagnosis of maxillofacial fractures using an independent workstation.

PubMed

Dos Santos, Denise Takehana; Costa e Silva, Adriana Paula Andrade; Vannier, Michael Walter; Cavalcanti, Marcelo Gusmão Paraiso

2004-12-01

The purpose of this study was to demonstrate the sensitivity and specificity of multislice computerized tomography (CT) for diagnosis of maxillofacial fractures following specific protocols using an independent workstation. The study population consisted of 56 patients with maxillofacial fractures who were submitted to a multislice CT. The original data were transferred to an independent workstation using volumetric imaging software to generate axial images and simultaneous multiplanar (MPR) and 3-dimensional (3D-CT) volume rendering reconstructed images. The images were then processed and interpreted by 2 examiners using the following protocols independently of each other: axial, MPR/axial, 3D-CT images, and the association of axial/MPR/3D images. The clinical/surgical findings were considered the gold standard corroborating the diagnosis of the fractures and their anatomic localization. The statistical analysis was carried out using validity and chi-squared tests. The association of axial/MPR/3D images indicated a higher sensitivity (range 95.8%) and specificity (range 99%) than the other methods regarding the analysis of all regions. CT imaging demonstrated high specificity and sensitivity for maxillofacial fractures. The association of axial/MPR/3D-CT images added important information in relationship to other CT protocols.

Image Quality of 3rd Generation Spiral Cranial Dual-Source CT in Combination with an Advanced Model Iterative Reconstruction Technique: A Prospective Intra-Individual Comparison Study to Standard Sequential Cranial CT Using Identical Radiation Dose

PubMed Central

Wenz, Holger; Maros, Máté E.; Meyer, Mathias; Förster, Alex; Haubenreisser, Holger; Kurth, Stefan; Schoenberg, Stefan O.; Flohr, Thomas; Leidecker, Christianne; Groden, Christoph; Scharf, Johann; Henzler, Thomas

2015-01-01

Objectives To prospectively intra-individually compare image quality of a 3rd generation Dual-Source-CT (DSCT) spiral cranial CT (cCT) to a sequential 4-slice Multi-Slice-CT (MSCT) while maintaining identical intra-individual radiation dose levels. Methods 35 patients, who had a non-contrast enhanced sequential cCT examination on a 4-slice MDCT within the past 12 months, underwent a spiral cCT scan on a 3rd generation DSCT. CTDIvol identical to initial 4-slice MDCT was applied. Data was reconstructed using filtered backward projection (FBP) and 3rd-generation iterative reconstruction (IR) algorithm at 5 different IR strength levels. Two neuroradiologists independently evaluated subjective image quality using a 4-point Likert-scale and objective image quality was assessed in white matter and nucleus caudatus with signal-to-noise ratios (SNR) being subsequently calculated. Results Subjective image quality of all spiral cCT datasets was rated significantly higher compared to the 4-slice MDCT sequential acquisitions (p<0.05). Mean SNR was significantly higher in all spiral compared to sequential cCT datasets with mean SNR improvement of 61.65% (p*Bonferroni0.05<0.0024). Subjective image quality improved with increasing IR levels. Conclusion Combination of 3rd-generation DSCT spiral cCT with an advanced model IR technique significantly improves subjective and objective image quality compared to a standard sequential cCT acquisition acquired at identical dose levels. PMID:26288186

Image Quality of 3rd Generation Spiral Cranial Dual-Source CT in Combination with an Advanced Model Iterative Reconstruction Technique: A Prospective Intra-Individual Comparison Study to Standard Sequential Cranial CT Using Identical Radiation Dose.

PubMed

Wenz, Holger; Maros, Máté E; Meyer, Mathias; Förster, Alex; Haubenreisser, Holger; Kurth, Stefan; Schoenberg, Stefan O; Flohr, Thomas; Leidecker, Christianne; Groden, Christoph; Scharf, Johann; Henzler, Thomas

2015-01-01

To prospectively intra-individually compare image quality of a 3rd generation Dual-Source-CT (DSCT) spiral cranial CT (cCT) to a sequential 4-slice Multi-Slice-CT (MSCT) while maintaining identical intra-individual radiation dose levels. 35 patients, who had a non-contrast enhanced sequential cCT examination on a 4-slice MDCT within the past 12 months, underwent a spiral cCT scan on a 3rd generation DSCT. CTDIvol identical to initial 4-slice MDCT was applied. Data was reconstructed using filtered backward projection (FBP) and 3rd-generation iterative reconstruction (IR) algorithm at 5 different IR strength levels. Two neuroradiologists independently evaluated subjective image quality using a 4-point Likert-scale and objective image quality was assessed in white matter and nucleus caudatus with signal-to-noise ratios (SNR) being subsequently calculated. Subjective image quality of all spiral cCT datasets was rated significantly higher compared to the 4-slice MDCT sequential acquisitions (p<0.05). Mean SNR was significantly higher in all spiral compared to sequential cCT datasets with mean SNR improvement of 61.65% (p*Bonferroni0.05<0.0024). Subjective image quality improved with increasing IR levels. Combination of 3rd-generation DSCT spiral cCT with an advanced model IR technique significantly improves subjective and objective image quality compared to a standard sequential cCT acquisition acquired at identical dose levels.

Automated segmentation and recognition of the bone structure in non-contrast torso CT images using implicit anatomical knowledge

NASA Astrophysics Data System (ADS)

Zhou, X.; Hayashi, T.; Han, M.; Chen, H.; Hara, T.; Fujita, H.; Yokoyama, R.; Kanematsu, M.; Hoshi, H.

2009-02-01

X-ray CT images have been widely used in clinical diagnosis in recent years. A modern CT scanner can generate about 1000 CT slices to show the details of all the human organs within 30 seconds. However, CT image interpretations (viewing 500-1000 slices of CT images manually in front of a screen or films for each patient) require a lot of time and energy. Therefore, computer-aided diagnosis (CAD) systems that can support CT image interpretations are strongly anticipated. Automated recognition of the anatomical structures in CT images is a basic pre-processing of the CAD system. The bone structure is a part of anatomical structures and very useful to act as the landmarks for predictions of the other different organ positions. However, the automated recognition of the bone structure is still a challenging issue. This research proposes an automated scheme for segmenting the bone regions and recognizing the bone structure in noncontrast torso CT images. The proposed scheme was applied to 48 torso CT cases and a subjective evaluation for the experimental results was carried out by an anatomical expert following the anatomical definition. The experimental results showed that the bone structure in 90% CT cases have been recognized correctly. For quantitative evaluation, automated recognition results were compared to manual inputs of bones of lower limb created by an anatomical expert on 10 randomly selected CT cases. The error (maximum distance in 3D) between the recognition results and manual inputs distributed from 3-8 mm in different parts of the bone regions.

High-resolution three-dimensional visualization of the rat spinal cord microvasculature by synchrotron radiation micro-CT

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

Hu, Jianzhong; Cao, Yong; Wu, Tianding

2014-10-15

Purpose: Understanding the three-dimensional (3D) morphology of the spinal cord microvasculature has been limited by the lack of an effective high-resolution imaging technique. In this study, synchrotron radiation microcomputed tomography (SRµCT), a novel imaging technique based on absorption imaging, was evaluated with regard to the detection of the 3D morphology of the rat spinal cord microvasculature. Methods: Ten Sprague-Dawley rats were used in this ex vivo study. After contrast agent perfusion, their spinal cords were isolated and scanned using conventional x-rays, conventional micro-CT (CµCT), and SRµCT. Results: Based on contrast agent perfusion, the microvasculature of the rat spinal cord wasmore » clearly visualized for the first time ex vivo in 3D by means of SRµCT scanning. Compared to conventional imaging techniques, SRµCT achieved higher resolution 3D vascular imaging, with the smallest vessel that could be distinguished approximately 7.4 μm in diameter. Additionally, a 3D pseudocolored image of the spinal cord microvasculature was generated in a single session of SRµCT imaging, which was conducive to detailed observation of the vessel morphology. Conclusions: The results of this study indicated that SRµCT scanning could provide higher resolution images of the vascular network of the spinal cord. This modality also has the potential to serve as a powerful imaging tool for the investigation of morphology changes in the 3D angioarchitecture of the neurovasculature in preclinical research.« less

Quantifying the impact of respiratory-gated 4D CT acquisition on thoracic image quality: a digital phantom study.

PubMed

Bernatowicz, K; Keall, P; Mishra, P; Knopf, A; Lomax, A; Kipritidis, J

2015-01-01

Prospective respiratory-gated 4D CT has been shown to reduce tumor image artifacts by up to 50% compared to conventional 4D CT. However, to date no studies have quantified the impact of gated 4D CT on normal lung tissue imaging, which is important in performing dose calculations based on accurate estimates of lung volume and structure. To determine the impact of gated 4D CT on thoracic image quality, the authors developed a novel simulation framework incorporating a realistic deformable digital phantom driven by patient tumor motion patterns. Based on this framework, the authors test the hypothesis that respiratory-gated 4D CT can significantly reduce lung imaging artifacts. Our simulation framework synchronizes the 4D extended cardiac torso (XCAT) phantom with tumor motion data in a quasi real-time fashion, allowing simulation of three 4D CT acquisition modes featuring different levels of respiratory feedback: (i) "conventional" 4D CT that uses a constant imaging and couch-shift frequency, (ii) "beam paused" 4D CT that interrupts imaging to avoid oversampling at a given couch position and respiratory phase, and (iii) "respiratory-gated" 4D CT that triggers acquisition only when the respiratory motion fulfills phase-specific displacement gating windows based on prescan breathing data. Our framework generates a set of ground truth comparators, representing the average XCAT anatomy during beam-on for each of ten respiratory phase bins. Based on this framework, the authors simulated conventional, beam-paused, and respiratory-gated 4D CT images using tumor motion patterns from seven lung cancer patients across 13 treatment fractions, with a simulated 5.5 cm(3) spherical lesion. Normal lung tissue image quality was quantified by comparing simulated and ground truth images in terms of overall mean square error (MSE) intensity difference, threshold-based lung volume error, and fractional false positive/false negative rates. Averaged across all simulations and phase bins, respiratory-gating reduced overall thoracic MSE by 46% compared to conventional 4D CT (p ∼ 10(-19)). Gating leads to small but significant (p < 0.02) reductions in lung volume errors (1.8%-1.4%), false positives (4.0%-2.6%), and false negatives (2.7%-1.3%). These percentage reductions correspond to gating reducing image artifacts by 24-90 cm(3) of lung tissue. Similar to earlier studies, gating reduced patient image dose by up to 22%, but with scan time increased by up to 135%. Beam paused 4D CT did not significantly impact normal lung tissue image quality, but did yield similar dose reductions as for respiratory-gating, without the added cost in scanning time. For a typical 6 L lung, respiratory-gated 4D CT can reduce image artifacts affecting up to 90 cm(3) of normal lung tissue compared to conventional acquisition. This image improvement could have important implications for dose calculations based on 4D CT. Where image quality is less critical, beam paused 4D CT is a simple strategy to reduce imaging dose without sacrificing acquisition time.

Experimental Evaluation of a Deformable Registration Algorithm for Motion Correction in PET-CT Guided Biopsy.

PubMed

Khare, Rahul; Sala, Guillaume; Kinahan, Paul; Esposito, Giuseppe; Banovac, Filip; Cleary, Kevin; Enquobahrie, Andinet

2013-01-01

Positron emission tomography computed tomography (PET-CT) images are increasingly being used for guidance during percutaneous biopsy. However, due to the physics of image acquisition, PET-CT images are susceptible to problems due to respiratory and cardiac motion, leading to inaccurate tumor localization, shape distortion, and attenuation correction. To address these problems, we present a method for motion correction that relies on respiratory gated CT images aligned using a deformable registration algorithm. In this work, we use two deformable registration algorithms and two optimization approaches for registering the CT images obtained over the respiratory cycle. The two algorithms are the BSpline and the symmetric forces Demons registration. In the first optmization approach, CT images at each time point are registered to a single reference time point. In the second approach, deformation maps are obtained to align each CT time point with its adjacent time point. These deformations are then composed to find the deformation with respect to a reference time point. We evaluate these two algorithms and optimization approaches using respiratory gated CT images obtained from 7 patients. Our results show that overall the BSpline registration algorithm with the reference optimization approach gives the best results.

TU-AB-207A-03: Image Quality, Dose, and Clinical Applications

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

Dong, F.

Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality. This course will not focus on the rapid-changing advanced technologies given the two-hour time limit, but the fundamental principles discussed in this course may facilitatemore » better understanding of those more complicated technologies. The course will begin with an overview of CT acquisition physics and geometry. X-ray tube and CT detector are important acquisition hardware critical to the overall image quality. Each of these two subsystems consists of several major components. An in-depth description of the function and failure modes of these components will be provided. Examples of artifacts related to these failure modes will be presented: off-focal radiation, tube arcing, heel effect, oil bubble, offset drift effect, cross-talk effect, and bad pixels. The fundamentals of CT image reconstruction will first be discussed on an intuitive level. Approaches that do not require rigorous derivation of mathematical formulations will be presented. This is followed by a detailed derivation of the Fourier slice theorem: the foundation of the FBP algorithm. FBP for parallel-beam, fan-beam, and cone-beam geometries will be discussed. To address the issue of radiation dose related to x-ray CT, recent advances in iterative reconstruction, their advantages, and clinical applications will also be described. Because of the nature of fundamental physics and mathematics, limitations in data acquisition, and non-ideal conditions of major system components, image artifact often arise in the reconstructed images. Because of the limited scope of this course, only major imaging artifacts, their appearance, and possible mitigation and corrections will be discussed. Assessment of the performance of a CT scanner is a complicated subject. Procedures to measure common image quality metrics such as high contrast spatial resolution, low contrast detectability, and slice profile will be described. The reason why these metrics used for FBP may not be sufficient for statistical iterative reconstruction will be explained. Optimizing radiation dose requires comprehension of CT dose metrics. This course will briefly describe various dose metrics, and interaction with acquisition parameters and patient habitus. CT is among the most frequently used imaging tools due to its superior image quality, easy to operate, and a broad range of applications. This course will present several interesting CT applications such as a mobile CT unit on an ambulance for stroke patients, low dose lung cancer screening, and single heartbeat cardiac CT. Learning Objectives: Understand the function and impact of major components of X-ray tube on the image quality. Understand the function and impact of major components of CT detector on the image quality. Be familiar with the basic procedure of CT image reconstruction. Understand the effect of image reconstruction on CT image quality and artifacts. Understand the root causes of common CT image artifacts. Be familiar with image quality metrics especially high and low contrast resolution, noise power spectrum, slice sensitivity profile, etc. Understand why basic image quality metrics used for FBP may not be sufficient to characterize the performance of advanced iterative reconstruction. Be familiar with various CT dose metrics and their interaction with acquisition parameters. New development in advanced CT clinical applications. JH: Employee of GE Healthcare. FD: No disclosure.; J. Hsieh, Jiang Hsieh is an employee of GE Healthcare.« less

Three-dimensional imaging modalities in endodontics

PubMed Central

Mao, Teresa

2014-01-01

Recent research in endodontics has highlighted the need for three-dimensional imaging in the clinical arena as well as in research. Three-dimensional imaging using computed tomography (CT) has been used in endodontics over the past decade. Three types of CT scans have been studied in endodontics, namely cone-beam CT, spiral CT, and peripheral quantitative CT. Contemporary endodontics places an emphasis on the use of cone-beam CT for an accurate diagnosis of parameters that cannot be visualized on a two-dimensional image. This review discusses the role of CT in endodontics, pertaining to its importance in the diagnosis of root canal anatomy, detection of peri-radicular lesions, diagnosis of trauma and resorption, presurgical assessment, and evaluation of the treatment outcome. PMID:25279337

Lesion detection performance: comparative analysis of low-dose CT data of the chest on two hybrid imaging systems.

PubMed

Jessop, Maryam; Thompson, John D; Coward, Joanne; Sanderud, Audun; Jorge, José; de Groot, Martijn; Lança, Luís; Hogg, Peter

2015-03-01

Incidental findings on low-dose CT images obtained during hybrid imaging are an increasing phenomenon as CT technology advances. Understanding the diagnostic value of incidental findings along with the technical limitations is important when reporting image results and recommending follow-up, which may result in an additional radiation dose from further diagnostic imaging and an increase in patient anxiety. This study assessed lesions incidentally detected on CT images acquired for attenuation correction on two SPECT/CT systems. An anthropomorphic chest phantom containing simulated lesions of varying size and density was imaged on an Infinia Hawkeye 4 and a Symbia T6 using the low-dose CT settings applied for attenuation correction acquisitions in myocardial perfusion imaging. Twenty-two interpreters assessed 46 images from each SPECT/CT system (15 normal images and 31 abnormal images; 41 lesions). Data were evaluated using a jackknife alternative free-response receiver-operating-characteristic analysis (JAFROC). JAFROC analysis showed a significant difference (P < 0.0001) in lesion detection, with the figures of merit being 0.599 (95% confidence interval, 0.568, 0.631) and 0.810 (95% confidence interval, 0.781, 0.839) for the Infinia Hawkeye 4 and Symbia T6, respectively. Lesion detection on the Infinia Hawkeye 4 was generally limited to larger, higher-density lesions. The Symbia T6 allowed improved detection rates for midsized lesions and some lower-density lesions. However, interpreters struggled to detect small (5 mm) lesions on both image sets, irrespective of density. Lesion detection is more reliable on low-dose CT images from the Symbia T6 than from the Infinia Hawkeye 4. This phantom-based study gives an indication of potential lesion detection in the clinical context as shown by two commonly used SPECT/CT systems, which may assist the clinician in determining whether further diagnostic imaging is justified. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

SU-E-J-218: Evaluation of CT Images Created Using a New Metal Artifact Reduction Reconstruction Algorithm for Radiation Therapy Treatment Planning

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

Niemkiewicz, J; Palmiotti, A; Miner, M

2014-06-01

Purpose: Metal in patients creates streak artifacts in CT images. When used for radiation treatment planning, these artifacts make it difficult to identify internal structures and affects radiation dose calculations, which depend on HU numbers for inhomogeneity correction. This work quantitatively evaluates a new metal artifact reduction (MAR) CT image reconstruction algorithm (GE Healthcare CT-0521-04.13-EN-US DOC1381483) when metal is present. Methods: A Gammex Model 467 Tissue Characterization phantom was used. CT images were taken of this phantom on a GE Optima580RT CT scanner with and without steel and titanium plugs using both the standard and MAR reconstruction algorithms. HU valuesmore » were compared pixel by pixel to determine if the MAR algorithm altered the HUs of normal tissues when no metal is present, and to evaluate the effect of using the MAR algorithm when metal is present. Also, CT images of patients with internal metal objects using standard and MAR reconstruction algorithms were compared. Results: Comparing the standard and MAR reconstructed images of the phantom without metal, 95.0% of pixels were within ±35 HU and 98.0% of pixels were within ±85 HU. Also, the MAR reconstruction algorithm showed significant improvement in maintaining HUs of non-metallic regions in the images taken of the phantom with metal. HU Gamma analysis (2%, 2mm) of metal vs. non-metal phantom imaging using standard reconstruction resulted in an 84.8% pass rate compared to 96.6% for the MAR reconstructed images. CT images of patients with metal show significant artifact reduction when reconstructed with the MAR algorithm. Conclusion: CT imaging using the MAR reconstruction algorithm provides improved visualization of internal anatomy and more accurate HUs when metal is present compared to the standard reconstruction algorithm. MAR reconstructed CT images provide qualitative and quantitative improvements over current reconstruction algorithms, thus improving radiation treatment planning accuracy.« less

SU-F-I-08: CT Image Ring Artifact Reduction Based On Prior Image

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

Yuan, C; Qi, H; Chen, Z

Purpose: In computed tomography (CT) system, CT images with ring artifacts will be reconstructed when some adjacent bins of detector don’t work. The ring artifacts severely degrade CT image quality. We present a useful CT ring artifacts reduction based on projection data correction, aiming at estimating the missing data of projection data accurately, thus removing the ring artifacts of CT images. Methods: The method consists of ten steps: 1) Identification of abnormal pixel line in projection sinogram; 2) Linear interpolation within the pixel line of projection sinogram; 3) FBP reconstruction using interpolated projection data; 4) Filtering FBP image using meanmore » filter; 5) Forwarding projection of filtered FBP image; 6) Subtraction forwarded projection from original projection; 7) Linear interpolation of abnormal pixel line area in the subtraction projection; 8) Adding the interpolated subtraction projection on the forwarded projection; 9) FBP reconstruction using corrected projection data; 10) Return to step 4 until the pre-set iteration number is reached. The method is validated on simulated and real data to restore missing projection data and reconstruct ring artifact-free CT images. Results: We have studied impact of amount of dead bins of CT detector on the accuracy of missing data estimation in projection sinogram. For the simulated case with a resolution of 256 by 256 Shepp-Logan phantom, three iterations are sufficient to restore projection data and reconstruct ring artifact-free images when the dead bins rating is under 30%. The dead-bin-induced artifacts are substantially reduced. More iteration number is needed to reconstruct satisfactory images while the rating of dead bins increases. Similar results were found for a real head phantom case. Conclusion: A practical CT image ring artifact correction scheme based on projection data is developed. This method can produce ring artifact-free CT images feasibly and effectively.« less

Non-contrast CT at comparable dose to an abdominal radiograph in patients with acute renal colic; impact of iterative reconstruction on image quality and diagnostic performance.

PubMed

McLaughlin, P D; Murphy, K P; Hayes, S A; Carey, K; Sammon, J; Crush, L; O'Neill, F; Normoyle, B; McGarrigle, A M; Barry, J E; Maher, M M

2014-04-01

The aim was to assess the performance of low-dose non-contrast CT of the urinary tract (LD-CT) acquired at radiation exposures close to that of abdominal radiography using adaptive statistical iterative reconstruction (ASiR). Thirty-three patients with clinically suspected renal colic were prospectively included. Conventional dose (CD-CT) and LD-CT data sets were contemporaneously acquired. LD-CT images were reconstructed with 40 %, 70 % and 90 % ASiR. Image quality was subjectively and objectively measured. Images were also clinically interpreted. Mean ED was 0.48 ± 0.07 mSv for LD-CT compared with 4.43 ± 3.14 mSv for CD-CT. Increasing the percentage ASiR resulted in a step-wise reduction in mean objective noise (p < 0.001 for all comparisons). Seventy % ASiR LD-CT images had higher diagnostic acceptability and spatial resolution than 90 % ASiR LD-CT images (p < 0.001). Twenty-seven calculi (diameter = 5.5 ± 1.7 mm), including all ureteric stones, were correctly identified using 70 % ASiR LD-CT with two false positives and 16 false negatives (diameter = 2.3 ± 0.7 mm) equating to a sensitivity and specificity of 72 % and 94 %. Seventy % ASiR LD-CT had a sensitivity and specificity of 87 % and 100 % for detection of calculi >3 mm. Reconstruction of LD-CT images with 70 % ASiR resulted in superior image quality than FBP, 40 % ASIR and 90 % ASIR. LD-CT with ASIR demonstrates high sensitivity and specificity for detection of calculi >3 mm. • Low-dose CT studies for urinary calculus detection were performed with a mean dose of 0.48 ± 0.07 mSv • Low-dose CT with 70 % ASiR detected calculi >3 mm with a sensitivity and specificity of 87 % and 100 % • Reconstruction with 70 % ASiR was superior to filtered back projection, 40 % ASiR and 90 % ASiR images.

Development of CT and 3D-CT Using Flat Panel Detector Based Real-Time Digital Radiography System

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

Ravindran, V. R.; Sreelakshmi, C.; Vibin

2008-09-26

The application of Digital Radiography in the Nondestructive Evaluation (NDE) of space vehicle components is a recent development in India. A Real-time DR system based on amorphous silicon Flat Panel Detector has been developed for the NDE of solid rocket motors at Rocket Propellant Plant of VSSC in a few years back. The technique has been successfully established for the nondestructive evaluation of solid rocket motors. The DR images recorded for a few solid rocket specimens are presented in the paper. The Real-time DR system is capable of generating sufficient digital X-ray image data with object rotation for the CTmore » image reconstruction. In this paper the indigenous development of CT imaging based on the Realtime DR system for solid rocket motor is presented. Studies are also carried out to generate 3D-CT image from a set of adjacent CT images of the rocket motor. The capability of revealing the spatial location and characterisation of defect is demonstrated by the CT and 3D-CT images generated.« less

SU-E-J-86: Lobar Lung Function Quantification by PET Galligas and CT Ventilation Imaging in Lung Cancer Patients

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

Eslick, E; Kipritidis, J; Keall, P

2014-06-01

Purpose: The purpose of this study was to quantify the lobar lung function using the novel PET Galligas ([68Ga]-carbon nanoparticle) ventilation imaging and the investigational CT ventilation imaging in lung cancer patients pre-treatment. Methods: We present results on our first three lung cancer patients (2 male, mean age 78 years) as part of an ongoing ethics approved study. For each patient a PET Galligas ventilation (PET-V) image and a pair of breath hold CT images (end-exhale and end-inhale tidal volumes) were acquired using a Siemens Biograph PET CT. CT-ventilation (CT-V) images were created from the pair of CT images usingmore » deformable image registration (DIR) algorithms and the Hounsfield Unit (HU) ventilation metric. A comparison of ventilation quantification from each modality was done on the lobar level and the voxel level. A Bland-Altman plot was used to assess the difference in mean percentage contribution of each lobe to the total lung function between the two modalities. For each patient, a voxel-wise Spearmans correlation was calculated for the whole lungs between the two modalities. Results: The Bland-Altman plot demonstrated strong agreement between PET-V and CT-V for assessment of lobar function (r=0.99, p<0.001; range mean difference: −5.5 to 3.0). The correlation between PET-V and CT-V at the voxel level was moderate(r=0.60, p<0.001). Conclusion: This preliminary study on the three patients data sets demonstrated strong agreement between PET and CT ventilation imaging for the assessment of pre-treatment lung function at the lobar level. Agreement was only moderate at the level of voxel correlations. These results indicate that CT ventilation imaging has potential for assessing pre-treatment lobar lung function in lung cancer patients.« less

Implementation of an image sharing system significantly reduced repeat computed tomographic imaging in a regional trauma system.

PubMed

Banerjee, Aman; Zosa, Brenda M; Allen, Debra; Wilczewski, Patricia A; Ferguson, Robert; Claridge, Jeffrey A

2016-01-01

The practice of repeating computed tomography (re-CT) is common among trauma patients transferred between hospitals incurring additional cost and radiation exposure. This study sought to evaluate the effectiveness of implementing modern cloud-based technology (lifeIMAGE) across a regional trauma system to reduce the incidence of re-CT imaging. This is a prospective interventional study to evaluate outcomes after implementation of lifeIMAGE in January 2012. Key outcomes were rates of CT imaging, including the rates and costs of re-CT from January 2009 through December 2012. There were 1,081 trauma patients transferred from participating hospitals during the study period (657 patients before and 425 patients after implementation), with the overall re-CT rate of 20.5%. Rates of any CT imaging at referring hospitals decreased (62% vs. 55%, p < 0.05) and also decreased at the accepting regional Level I center (58% vs. 52%, p < 0.05) following system implementation. There were 639 patients (59%) who had CT imaging performed before transfer (404 patients before and 235 patients after implementation). Of these patients, the overall re-CT rate decreased from 38.4% to 28.1% (p = 0.01). Rates of re-CT of the head (21% vs. 11%, p = 0.002), chest (7% vs. 3%, p = 0.05), as well as abdomen and pelvis (12% vs. 5%, p = 0.007) were significantly reduced following system implementation. The cost of repeat imaging per patient was significantly lower following system implementation (mean charges, $1,046 vs. $589; p < 0.001). These results were more pronounced in a subgroup of patients with an Injury Severity Score (ISS) of greater than 14, with a reduction in overall re-CT rate from 51% to 30% (p = 0.03). The implementation of modern cloud-based technology across the regional trauma system resulted in significant reductions in re-CT imaging and cost. Therapeutic/care management study, level IV; economic analysis, level IV.

Thoracic staging in lung cancer: prospective comparison of 18F-FDG PET/MR imaging and 18F-FDG PET/CT.

PubMed

Heusch, Philipp; Buchbender, Christian; Köhler, Jens; Nensa, Felix; Gauler, Thomas; Gomez, Benedikt; Reis, Henning; Stamatis, Georgios; Kühl, Hilmar; Hartung, Verena; Heusner, Till A

2014-03-01

Therapeutic decisions in non-small cell lung cancer (NSCLC) patients depend on the tumor stage. PET/CT with (18)F-FDG is widely accepted as the diagnostic standard of care. The purpose of this study was to compare a dedicated pulmonary (18)F-FDG PET/MR imaging protocol with (18)F-FDG PET/CT for primary and locoregional lymph node staging in NSCLC patients using histopathology as the reference. Twenty-two patients (12 men, 10 women; mean age ± SD, 65.1 ± 9.1 y) with histopathologically confirmed NSCLC underwent (18)F-FDG PET/CT, followed by (18)F-FDG PET/MR imaging, including a dedicated pulmonary MR imaging protocol. T and N staging according to the seventh edition of the American Joint Committee on Cancer staging manual was performed by 2 readers in separate sessions for (18)F-FDG PET/CT and PET/MR imaging, respectively. Results from histopathology were used as the standard of reference. The mean and maximum standardized uptake value (SUV(mean) and SUV(max), respectively) and maximum diameter of the primary tumor was measured and compared in (18)F-FDG PET/CT and PET/MR imaging. PET/MR imaging and (18)F-FDG PET/CT agreed on T stages in 16 of 16 of patients (100%). All patients were correctly staged by (18)F-FDG PET/CT and PET/MR (100%), compared with histopathology. There was no statistically significant difference between (18)F-FDG PET/CT and (18)F-FDG PET/MR imaging for lymph node metastases detection (P = 0.48). For definition of thoracic N stages, PET/MR imaging and (18)F-FDG PET/CT were concordant in 20 of 22 patients (91%). PET/MR imaging determined the N stage correctly in 20 of 22 patients (91%). (18)F-FDG PET/CT determined the N stage correctly in 18 of 22 patients (82%). The mean differences for SUV(mean) and SUV(max) of NSCLC in (18)F-FDG PET/MR imaging and (18)F-FDG PET/CT were 0.21 and -5.06. These differences were not statistically significant (P > 0.05). The SUV(mean) and SUV(max) measurements derived from (18)F-FDG PET/CT and (18)F-FDG PET/MR imaging exhibited a high correlation (R = 0.74 and 0.86, respectively; P < 0.0001). Size measurements showed an excellent correlation between (18)F-FDG PET/MR imaging and (18)F-FDG PET/CT (R = 0.99; P < 0.0001). The lower and upper limits of agreement between (18)F-FDG PET/CT and (18)F-FDG PET/MR imaging using Bland-Altman analysis were -2.34 to 3.89 for SUV(mean), -7.42 to 4.40 for SUV(max), and -0.59 to 0.83 for the tumor size, respectively. (18)F-FDG PET/MR imaging using a dedicated pulmonary MR imaging protocol, compared with (18)F-FDG PET/CT, does not provide advantages in thoracic staging in NSCLC patients.

Convolutional auto-encoder for image denoising of ultra-low-dose CT.

PubMed

Nishio, Mizuho; Nagashima, Chihiro; Hirabayashi, Saori; Ohnishi, Akinori; Sasaki, Kaori; Sagawa, Tomoyuki; Hamada, Masayuki; Yamashita, Tatsuo

2017-08-01

The purpose of this study was to validate a patch-based image denoising method for ultra-low-dose CT images. Neural network with convolutional auto-encoder and pairs of standard-dose CT and ultra-low-dose CT image patches were used for image denoising. The performance of the proposed method was measured by using a chest phantom. Standard-dose and ultra-low-dose CT images of the chest phantom were acquired. The tube currents for standard-dose and ultra-low-dose CT were 300 and 10 mA, respectively. Ultra-low-dose CT images were denoised with our proposed method using neural network, large-scale nonlocal mean, and block-matching and 3D filtering. Five radiologists and three technologists assessed the denoised ultra-low-dose CT images visually and recorded their subjective impressions of streak artifacts, noise other than streak artifacts, visualization of pulmonary vessels, and overall image quality. For the streak artifacts, noise other than streak artifacts, and visualization of pulmonary vessels, the results of our proposed method were statistically better than those of block-matching and 3D filtering (p-values < 0.05). On the other hand, the difference in the overall image quality between our proposed method and block-matching and 3D filtering was not statistically significant (p-value = 0.07272). The p-values obtained between our proposed method and large-scale nonlocal mean were all less than 0.05. Neural network with convolutional auto-encoder could be trained using pairs of standard-dose and ultra-low-dose CT image patches. According to the visual assessment by radiologists and technologists, the performance of our proposed method was superior to that of large-scale nonlocal mean and block-matching and 3D filtering.

Adjunctive role of preoperative liver magnetic resonance imaging for potentially resectable pancreatic cancer.

PubMed

Kim, Hyoung Woo; Lee, Jong-Chan; Paik, Kyu-Hyun; Kang, Jingu; Kim, Young Hoon; Yoon, Yoo-Seok; Han, Ho-Seong; Kim, Jaihwan; Hwang, Jin-Hyeok

2017-06-01

The adjunctive role of magnetic resonance imaging of the liver before pancreatic ductal adenocarcinoma has been unclear. We evaluated whether the combination of hepatic magnetic resonance imaging with multidetector computed tomography using a pancreatic protocol (pCT) could help surgeons select appropriate candidates and decrease the risk of early recurrence. We retrospectively enrolled 167 patients in whom complete resection was achieved without grossly visible residual tumor; 102 patients underwent pCT alone (CT group) and 65 underwent both hepatic magnetic resonance imaging and pCT (magnetic resonance imaging group). By adding hepatic magnetic resonance imaging during preoperative evaluation, hepatic metastases were newly discovered in 3 of 58 patients (5%) without hepatic lesions on pCT and 17 of 53 patients (32%) with indeterminate hepatic lesions on pCT. Patients with borderline resectability, a tumor size >3 cm, or preoperative carbohydrate antigen 19-9 level >1,000 U/mL had a greater rate of hepatic metastasis on subsequent hepatic magnetic resonance imaging. Among 167 patients in whom R0/R1 resection was achieved, the median overall survival was 18.2 vs 24.7 months (P = .020) and the disease-free survival was 8.5 vs 10.0 months (P = .016) in the CT and magnetic resonance imaging groups, respectively (median follow-up, 18.3 months). Recurrence developed in 82 (80%) and 43 (66%) patients in the CT and magnetic resonance imaging groups, respectively. The cumulative hepatic recurrence rate was greater in the CT group than in the magnetic resonance imaging group (P < .001). Preoperative hepatic magnetic resonance imaging should be considered in patients with potentially resectable pancreatic ductal adenocarcinoma, especially those with high tumor burden. Copyright © 2017 Elsevier Inc. All rights reserved.

Carbon nanotube based respiratory gated micro-CT imaging of a murine model of lung tumors with optical imaging correlation

NASA Astrophysics Data System (ADS)

Burk, Laurel M.; Lee, Yueh Z.; Heathcote, Samuel; Wang, Ko-han; Kim, William Y.; Lu, Jianping; Zhou, Otto

2011-03-01

Current optical imaging techniques can successfully measure tumor load in murine models of lung carcinoma but lack structural detail. We demonstrate that respiratory gated micro-CT imaging of such models gives information about structure and correlates with tumor load measurements by optical methods. Four mice with multifocal, Kras-induced tumors expressing firefly luciferase were imaged against four controls using both optical imaging and respiratory gated micro-CT. CT images of anesthetized animals were acquired with a custom CNT-based system using 30 ms x-ray pulses during peak inspiration; respiration motion was tracked with a pressure sensor beneath each animal's abdomen. Optical imaging based on the Luc+ signal correlating with tumor load was performed on a Xenogen IVIS Kinetix. Micro-CT images were post-processed using Osirix, measuring lung volume with region growing. Diameters of the largest three tumors were measured. Relationships between tumor size, lung volumes, and optical signal were compared. CT images and optical signals were obtained for all animals at two time points. In all lobes of the Kras+ mice in all images, tumors were visible; the smallest to be readily identified measured approximately 300 microns diameter. CT-derived tumor volumes and optical signals related linearly, with r=0.94 for all animals. When derived for only tumor bearing animals, r=0.3. The trend of each individual animal's optical signal tracked correctly based on the CT volumes. Interestingly, lung volumes also correlated positively with optical imaging data and tumor volume burden, suggesting active remodeling.

Hounsfield unit recovery in clinical cone beam CT images of the thorax acquired for image guided radiation therapy

NASA Astrophysics Data System (ADS)

Slot Thing, Rune; Bernchou, Uffe; Mainegra-Hing, Ernesto; Hansen, Olfred; Brink, Carsten

2016-08-01

A comprehensive artefact correction method for clinical cone beam CT (CBCT) images acquired for image guided radiation therapy (IGRT) on a commercial system is presented. The method is demonstrated to reduce artefacts and recover CT-like Hounsfield units (HU) in reconstructed CBCT images of five lung cancer patients. Projection image based artefact corrections of image lag, detector scatter, body scatter and beam hardening are described and applied to CBCT images of five lung cancer patients. Image quality is evaluated through visual appearance of the reconstructed images, HU-correspondence with the planning CT images, and total volume HU error. Artefacts are reduced and CT-like HUs are recovered in the artefact corrected CBCT images. Visual inspection confirms that artefacts are indeed suppressed by the proposed method, and the HU root mean square difference between reconstructed CBCTs and the reference CT images are reduced by 31% when using the artefact corrections compared to the standard clinical CBCT reconstruction. A versatile artefact correction method for clinical CBCT images acquired for IGRT has been developed. HU values are recovered in the corrected CBCT images. The proposed method relies on post processing of clinical projection images, and does not require patient specific optimisation. It is thus a powerful tool for image quality improvement of large numbers of CBCT images.

Evaluation of treatment response after chemoembolisation (TACE) in hepatocellular carcinoma using real time image fusion of contrast-enhanced ultrasound (CEUS) and computed tomography (CT)--preliminary results.

PubMed

Wobser, Hella; Wiest, Reiner; Salzberger, Bernd; Wohlgemuth, Walter Alexander; Stroszczynski, Christian; Jung, Ernst-Michael

2014-01-01

To evaluate treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with a new real-time imaging fusion technique of contrast-enhanced ultrasound (CEUS) with multi-slice detection computed tomography (CT) in comparison to conventional post-interventional follow-up. 40 patients with HCC (26 male, ages 46-81 years) were evaluated 24 hours after TACE using CEUS with ultrasound volume navigation and image fusion with CT compared to non-enhanced CT and follow-up contrast-enhanced CT after 6-8 weeks. Reduction of tumor vascularization to less than 25% was regarded as "successful" treatment, whereas reduction to levels >25% was considered as "partial" treatment response. Homogenous lipiodol retention was regarded as successful treatment in non-enhanced CT. Post-interventional image fusion of CEUS with CT was feasible in all 40 patients. In 24 patients (24/40), post-interventional image fusion with CEUS revealed residual tumor vascularity, that was confirmed by contrast-enhanced CT 6-8 weeks later in 24/24 patients. In 16 patients (16/40), post-interventional image fusion with CEUS demonstrated successful treatment, but follow-up CT detected residual viable tumor (6/16). Non-enhanced CT did not identify any case of treatment failure. Image fusion with CEUS assessed treatment efficacy with a specificity of 100%, sensitivity of 80% and a positive predictive value of 1 (negative predictive value 0.63). Image fusion of CEUS with CT allows a reliable, highly specific post-interventional evaluation of embolization response with good sensitivity without any further radiation exposure. It can detect residual viable tumor at early state, resulting in a close patient monitoring or re-therapy.

Combined multi-kernel head computed tomography images optimized for depicting both brain parenchyma and bone.

PubMed

Takagi, Satoshi; Nagase, Hiroyuki; Hayashi, Tatsuya; Kita, Tamotsu; Hayashi, Katsumi; Sanada, Shigeru; Koike, Masayuki

2014-01-01

The hybrid convolution kernel technique for computed tomography (CT) is known to enable the depiction of an image set using different window settings. Our purpose was to decrease the number of artifacts in the hybrid convolution kernel technique for head CT and to determine whether our improved combined multi-kernel head CT images enabled diagnosis as a substitute for both brain (low-pass kernel-reconstructed) and bone (high-pass kernel-reconstructed) images. Forty-four patients with nondisplaced skull fractures were included. Our improved multi-kernel images were generated so that pixels of >100 Hounsfield unit in both brain and bone images were composed of CT values of bone images and other pixels were composed of CT values of brain images. Three radiologists compared the improved multi-kernel images with bone images. The improved multi-kernel images and brain images were identically displayed on the brain window settings. All three radiologists agreed that the improved multi-kernel images on the bone window settings were sufficient for diagnosing skull fractures in all patients. This improved multi-kernel technique has a simple algorithm and is practical for clinical use. Thus, simplified head CT examinations and fewer images that need to be stored can be expected.

Prostate seed implant quality assessment using MR and CT image fusion.

PubMed

Amdur, R J; Gladstone, D; Leopold, K A; Harris, R D

1999-01-01

After a seed implant of the prostate, computerized tomography (CT) is ideal for determining seed distribution but soft tissue anatomy is frequently not well visualized. Magnetic resonance (MR) images soft tissue anatomy well but seed visualization is problematic. We describe a method of fusing CT and MR images to exploit the advantages of both of these modalities when assessing the quality of a prostate seed implant. Eleven consecutive prostate seed implant patients were imaged with axial MR and CT scans. MR and CT images were fused in three dimensions using the Pinnacle 3.0 version of the ADAC treatment planning system. The urethra and bladder base were used to "line up" MR and CT image sets during image fusion. Alignment was accomplished using translation and rotation in the three ortho-normal planes. Accuracy of image fusion was evaluated by calculating the maximum deviation in millimeters between the center of the urethra on axial MR versus CT images. Implant quality was determined by comparing dosimetric results to previously set parameters. Image fusion was performed with a high degree of accuracy. When lining up the urethra and base of bladder, the maximum difference in axial position of the urethra between MR and CT averaged 2.5 mm (range 1.3-4.0 mm, SD 0.9 mm). By projecting CT-derived dose distributions over MR images of soft tissue structures, qualitative and quantitative evaluation of implant quality is straightforward. The image-fusion process we describe provides a sophisticated way of assessing the quality of a prostate seed implant. Commercial software makes the process time-efficient and available to any clinical practice with a high-quality treatment planning system. While we use MR to image soft tissue structures, the process could be used with any imaging modality that is able to visualize the prostatic urethra (e.g., ultrasound).

A framework for optimizing micro-CT in dual-modality micro-CT/XFCT small-animal imaging system

NASA Astrophysics Data System (ADS)

Vedantham, Srinivasan; Shrestha, Suman; Karellas, Andrew; Cho, Sang Hyun

2017-09-01

Dual-modality Computed Tomography (CT)/X-ray Fluorescence Computed Tomography (XFCT) can be a valuable tool for imaging and quantifying the organ and tissue distribution of small concentrations of high atomic number materials in small-animal system. In this work, the framework for optimizing the micro-CT imaging system component of the dual-modality system is described, either when the micro-CT images are concurrently acquired with XFCT and using the x-ray spectral conditions for XFCT, or when the micro-CT images are acquired sequentially and independently of XFCT. This framework utilizes the cascaded systems analysis for task-specific determination of the detectability index using numerical observer models at a given radiation dose, where the radiation dose is determined using Monte Carlo simulations.

Integrated image presentation of transmission and fluorescent X-ray CT using synchrotron radiation

NASA Astrophysics Data System (ADS)

Zeniya, T.; Takeda, T.; Yu, Q.; Hasegawa, Y.; Hyodo, K.; Yuasa, T.; Hiranaka, Y.; Itai, Y.; Akatsuka, T.

2001-07-01

We have developed a computed tomography (CT) system with synchrotron radiation (SR) to detect fluorescent X-rays and transmitted X-rays simultaneously. Both SR transmission X-ray CT (SR-TXCT) and SR fluorescent X-ray CT (SR-FXCT) can describe cross-sectional images with high spatial and contrast resolutions as compared to conventional CT. TXCT gives morphological information and FXCT gives functional information of organs. So, superposed display system for SR-FXCT and SR-TXCT images has been developed for clinical diagnosis with higher reliability. Preliminary experiment with brain phantom was carried out and the superposition of both images was performed. The superposed SR-CT image gave us both functional and morphological information easily with high reliability, thus demonstrating the usefulness of this system.

Comparison of CT enterography and MR enterography imaging features of active Crohn disease in children and adolescents.

PubMed

Gale, Heather I; Sharatz, Steven M; Taphey, Mayureewan; Bradley, William F; Nimkin, Katherine; Gee, Michael S

2017-09-01

Assessment for active Crohn disease by CT enterography and MR enterography relies on identifying mural and perienteric imaging features. To evaluate the performance of established imaging features of active Crohn disease in children and adolescents on CT and MR enterography compared with histological reference. We included patients ages 18 years and younger who underwent either CT or MR enterography from 2007 to 2014 and had endoscopic biopsy within 28 days of imaging. Two pediatric radiologists blinded to the histological results reviewed imaging studies and scored the bowel for the presence or absence of mural features (wall thickening >3 mm, mural hyperenhancement) and perienteric features (mesenteric hypervascularity, edema, fibrofatty proliferation and lymphadenopathy) of active disease. We performed univariate analysis and multivariate logistic regression to compare imaging features with histological reference. We evaluated 452 bowel segments (135 from CT enterography, 317 from MR enterography) from 84 patients. Mural imaging features had the highest association with active inflammation both for MR enterography (wall thickening had 80% accuracy, 69% sensitivity and 91% specificity; mural hyperenhancement had 78%, 53% and 96%, respectively) and CT enterography (wall thickening had 84% accuracy, 72% sensitivity and 91% specificity; mural hyperenhancement had 76%, 51% and 91%, respectively), with perienteric imaging features performing significantly worse on MR enterography relative to CT enterography (P < 0.001). Mural features are predictors of active inflammation for both CT and MR enterography, while perienteric features can be distinguished better on CT enterography compared with MR enterography. This likely reflects the increased conspicuity of the mesentery on CT enterography and suggests that mural features are the most reliable imaging features of active Crohn disease in children and adolescents.

Integration of prior CT into CBCT reconstruction for improved image quality via reconstruction of difference: first patient studies

NASA Astrophysics Data System (ADS)

Zhang, Hao; Gang, Grace J.; Lee, Junghoon; Wong, John; Stayman, J. Webster

2017-03-01

Purpose: There are many clinical situations where diagnostic CT is used for an initial diagnosis or treatment planning, followed by one or more CBCT scans that are part of an image-guided intervention. Because the high-quality diagnostic CT scan is a rich source of patient-specific anatomical knowledge, this provides an opportunity to incorporate the prior CT image into subsequent CBCT reconstruction for improved image quality. We propose a penalized-likelihood method called reconstruction of difference (RoD), to directly reconstruct differences between the CBCT scan and the CT prior. In this work, we demonstrate the efficacy of RoD with clinical patient datasets. Methods: We introduce a data processing workflow using the RoD framework to reconstruct anatomical changes between the prior CT and current CBCT. This workflow includes processing steps to account for non-anatomical differences between the two scans including 1) scatter correction for CBCT datasets due to increased scatter fractions in CBCT data; 2) histogram matching for attenuation variations between CT and CBCT; and 3) registration for different patient positioning. CBCT projection data and CT planning volumes for two radiotherapy patients - one abdominal study and one head-and-neck study - were investigated. Results: In comparisons between the proposed RoD framework and more traditional FDK and penalized-likelihood reconstructions, we find a significant improvement in image quality when prior CT information is incorporated into the reconstruction. RoD is able to provide additional low-contrast details while correctly incorporating actual physical changes in patient anatomy. Conclusions: The proposed framework provides an opportunity to either improve image quality or relax data fidelity constraints for CBCT imaging when prior CT studies of the same patient are available. Possible clinical targets include CBCT image-guided radiotherapy and CBCT image-guided surgeries.

Single-energy pediatric chest computed tomography with spectral filtration at 100 kVp: effects on radiation parameters and image quality.

PubMed

Bodelle, Boris; Fischbach, Constanze; Booz, Christian; Yel, Ibrahim; Frellesen, Claudia; Kaup, Moritz; Beeres, Martin; Vogl, Thomas J; Scholtz, Jan-Erik

2017-06-01

Most of the applied radiation dose at CT is in the lower photon energy range, which is of limited diagnostic importance. To investigate image quality and effects on radiation parameters of 100-kVp spectral filtration single-energy chest CT using a tin-filter at third-generation dual-source CT in comparison to standard 100-kVp chest CT. Thirty-three children referred for a non-contrast chest CT performed on a third-generation dual-source CT scanner were examined at 100 kVp with a dedicated tin filter with a tube current-time product resulting in standard protocol dose. We compared resulting images with images from children examined using standard single-source chest CT at 100 kVp. We assessed objective and subjective image quality and compared radiation dose parameters. Radiation dose was comparable for children 5 years old and younger, and it was moderately decreased for older children when using spectral filtration (P=0.006). Effective tube current increased significantly (P=0.0001) with spectral filtration, up to a factor of 10. Signal-to-noise ratio and image noise were similar for both examination techniques (P≥0.06). Subjective image quality showed no significant differences (P≥0.2). Using 100-kVp spectral filtration chest CT in children by means of a tube-based tin-filter on a third-generation dual-source CT scanner increases effective tube current up to a factor of 10 to provide similar image quality at equivalent dose compared to standard single-source CT without spectral filtration.

Image fusion in craniofacial virtual reality modeling based on CT and 3dMD photogrammetry.

PubMed

Xin, Pengfei; Yu, Hongbo; Cheng, Huanchong; Shen, Shunyao; Shen, Steve G F

2013-09-01

The aim of this study was to demonstrate the feasibility of building a craniofacial virtual reality model by image fusion of 3-dimensional (3D) CT models and 3 dMD stereophotogrammetric facial surface. A CT scan and stereophotography were performed. The 3D CT models were reconstructed by Materialise Mimics software, and the stereophotogrammetric facial surface was reconstructed by 3 dMD patient software. All 3D CT models were exported as Stereo Lithography file format, and the 3 dMD model was exported as Virtual Reality Modeling Language file format. Image registration and fusion were performed in Mimics software. Genetic algorithm was used for precise image fusion alignment with minimum error. The 3D CT models and the 3 dMD stereophotogrammetric facial surface were finally merged into a single file and displayed using Deep Exploration software. Errors between the CT soft tissue model and 3 dMD facial surface were also analyzed. Virtual model based on CT-3 dMD image fusion clearly showed the photorealistic face and bone structures. Image registration errors in virtual face are mainly located in bilateral cheeks and eyeballs, and the errors are more than 1.5 mm. However, the image fusion of whole point cloud sets of CT and 3 dMD is acceptable with a minimum error that is less than 1 mm. The ease of use and high reliability of CT-3 dMD image fusion allows the 3D virtual head to be an accurate, realistic, and widespread tool, and has a great benefit to virtual face model.

Radiomic biomarkers from PET/CT multi-modality fusion images for the prediction of immunotherapy response in advanced non-small cell lung cancer patients

NASA Astrophysics Data System (ADS)

Mu, Wei; Qi, Jin; Lu, Hong; Schabath, Matthew; Balagurunathan, Yoganand; Tunali, Ilke; Gillies, Robert James

2018-02-01

Purpose: Investigate the ability of using complementary information provided by the fusion of PET/CT images to predict immunotherapy response in non-small cell lung cancer (NSCLC) patients. Materials and methods: We collected 64 patients diagnosed with primary NSCLC treated with anti PD-1 checkpoint blockade. Using PET/CT images, fused images were created following multiple methodologies, resulting in up to 7 different images for the tumor region. Quantitative image features were extracted from the primary image (PET/CT) and the fused images, which included 195 from primary images and 1235 features from the fusion images. Three clinical characteristics were also analyzed. We then used support vector machine (SVM) classification models to identify discriminant features that predict immunotherapy response at baseline. Results: A SVM built with 87 fusion features and 13 primary PET/CT features on validation dataset had an accuracy and area under the ROC curve (AUROC) of 87.5% and 0.82, respectively, compared to a model built with 113 original PET/CT features on validation dataset 78.12% and 0.68. Conclusion: The fusion features shows better ability to predict immunotherapy response prediction compared to individual image features.

MRI for the detection of calcific features of vertebral haemangioma.

PubMed

Bender, Y Y; Böker, S M; Diederichs, G; Walter, T; Wagner, M; Fallenberg, E; Liebig, T; Rickert, M; Hamm, B; Makowski, M R

2017-08-01

To evaluate the diagnostic performance of susceptibility-weighted-magnetic-resonance imaging (SW-MRI) for the detection of vertebral haemangiomas (VHs) compared to T1/T2-weighted MRI sequences, radiographs, and computed tomography (CT). The study was approved by the local ethics review board. An SW-MRI sequence was added to the clinical spine imaging protocol. The image-based diagnosis of 56 VHs in 46 patients was established using T1/T2 MRI in combination with radiography/CT as the reference standard. VHs were assessed based on T1/T2-weighted MRI images alone and in combination with SW-MRI, while radiographs/CT images were excluded from the analysis. Fifty-one of 56 VHs could be identified on T1/T2 MRI images alone, if radiographs/CT images were excluded from analysis. In five cases (9.1%), additional radiographs/CT images were required for the imaging-based diagnosis. If T1/T2 and SW-MRI images were used in combination, all VHs could be diagnosed, without the need for radiography/CT. Size measurements revealed a close correlation between CT and SW-MRI (R 2 =0.94; p<0.05). This study demonstrates that SW-MRI enables reliable detection of the typical calcified features of VHs. This is of importance for routine MRI of the spine, as the use of additional CT/radiography can be minimized. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Deep embedding convolutional neural network for synthesizing CT image from T1-Weighted MR image.

PubMed

Xiang, Lei; Wang, Qian; Nie, Dong; Zhang, Lichi; Jin, Xiyao; Qiao, Yu; Shen, Dinggang

2018-07-01

Recently, more and more attention is drawn to the field of medical image synthesis across modalities. Among them, the synthesis of computed tomography (CT) image from T1-weighted magnetic resonance (MR) image is of great importance, although the mapping between them is highly complex due to large gaps of appearances of the two modalities. In this work, we aim to tackle this MR-to-CT synthesis task by a novel deep embedding convolutional neural network (DECNN). Specifically, we generate the feature maps from MR images, and then transform these feature maps forward through convolutional layers in the network. We can further compute a tentative CT synthesis from the midway of the flow of feature maps, and then embed this tentative CT synthesis result back to the feature maps. This embedding operation results in better feature maps, which are further transformed forward in DECNN. After repeating this embedding procedure for several times in the network, we can eventually synthesize a final CT image in the end of the DECNN. We have validated our proposed method on both brain and prostate imaging datasets, by also comparing with the state-of-the-art methods. Experimental results suggest that our DECNN (with repeated embedding operations) demonstrates its superior performances, in terms of both the perceptive quality of the synthesized CT image and the run-time cost for synthesizing a CT image. Copyright © 2018. Published by Elsevier B.V.

Enhancing 18F-FDG-PET/CT analysis in lung cancer patients. Is CT-CT image fusion helpful in predicting pleural involvement? A pilot study.

PubMed

Kapfhammer, A; Winkens, T; Lesser, T; Reissig, A; Steinert, M; Freesmeyer, M

2015-01-01

To retrospectively evaluate the feasibility and value of CT-CT image fusion to assess the shift of peripheral lung cancers with/-out chest wall infiltration, comparing computed tomography acquisitions in shallow-breathing (SB-CT) and deep-inspiration breath-hold (DIBH-CT) in patients undergoing FDG-PET/CT for lung cancer staging. Image fusion of SB-CT and DIBH-CT was performed with a multimodal workstation used for nuclear medicine fusion imaging. The distance of intrathoracic landmarks and the positional shift of tumours were measured using semi-transparent overlay of both CT series. Statistical analyses were adjusted for confounders of tumour infiltration. Cutoff levels were calculated for prediction of no-/infiltration. Lateral pleural recessus and diaphragm showed the largest respiratory excursions. Infiltrating lung cancers showed more limited respiratory shifts than non-infiltrating tumours. A large respiratory tumour-motility accurately predicted non-infiltration. However, the tumour shifts were limited and variable, limiting the accuracy of prediction. This pilot fusion study proved feasible and allowed a simple analysis of the respiratory shifts of peripheral lung tumours using CT-CT image fusion in a PET/CT setting. The calculated cutoffs were useful in predicting the exclusion of chest wall infiltration but did not accurately predict tumour infiltration. This method can provide additional qualitative information in patients with lung cancers with contact to the chest wall but unclear CT evidence of infiltration undergoing PET/CT without the need of additional investigations. Considering the small sample size investigated, further studies are necessary to verify the obtained results.

Subjective and objective comparisons of image quality between ultra-high-resolution CT and conventional area detector CT in phantoms and cadaveric human lungs.

PubMed

Yanagawa, Masahiro; Hata, Akinori; Honda, Osamu; Kikuchi, Noriko; Miyata, Tomo; Uranishi, Ayumi; Tsukagoshi, Shinsuke; Tomiyama, Noriyuki

2018-05-29

To compare the image quality of the lungs between ultra-high-resolution CT (U-HRCT) and conventional area detector CT (AD-CT) images. Image data of slit phantoms (0.35, 0.30, and 0.15 mm) and 11 cadaveric human lungs were acquired by both U-HRCT and AD-CT devices. U-HRCT images were obtained with three acquisition modes: normal mode (U-HRCT N : 896 channels, 0.5 mm × 80 rows; 512 matrix), super-high-resolution mode (U-HRCT SHR : 1792 channels, 0.25 mm × 160 rows; 1024 matrix), and volume mode (U-HRCT SHR-VOL : non-helical acquisition with U-HRCT SHR ). AD-CT images were obtained with the same conditions as U-HRCT N . Three independent observers scored normal anatomical structures (vessels and bronchi), abnormal CT findings (faint nodules, solid nodules, ground-glass opacity, consolidation, emphysema, interlobular septal thickening, intralobular reticular opacities, bronchovascular bundle thickening, bronchiectasis, and honeycombing), noise, artifacts, and overall image quality on a 3-point scale (1 = worst, 2 = equal, 3 = best) compared with U-HRCT N . Noise values were calculated quantitatively. U-HRCT could depict a 0.15-mm slit. Both U-HRCT SHR and U-HRCT SHR-VOL significantly improved visualization of normal anatomical structures and abnormal CT findings, except for intralobular reticular opacities and reduced artifacts, compared with AD-CT (p < 0.014). Visually, U-HRCT SHR-VOL has less noise than U-HRCT SHR and AD-CT (p < 0.00001). Quantitative noise values were significantly higher in the following order: U-HRCT SHR (mean, 30.41), U-HRCT SHR-VOL (26.84), AD-CT (16.03), and U-HRCT N (15.14) (p < 0.0001). U-HRCT SHR and U-HRCT SHR-VOL resulted in significantly higher overall image quality than AD-CT and were almost equal to U-HRCT N (p < 0.0001). Both U-HRCT SHR and U-HRCT SHR-VOL can provide higher image quality than AD-CT, while U-HRCT SHR-VOL was less noisy than U-HRCT SHR . • Ultra-high-resolution CT (U-HRCT) can improve spatial resolution. • U-HRCT can reduce streak and dark band artifacts. • U-HRCT can provide higher image quality than conventional area detector CT. • In U-HRCT, the volume mode is less noisy than the super-high-resolution mode. • U-HRCT may provide more detailed information about the lung anatomy and pathology.

Evaluation of Effective Parameters on Quality of Magnetic Resonance Imaging-computed Tomography Image Fusion in Head and Neck Tumors for Application in Treatment Planning.

PubMed

Shirvani, Atefeh; Jabbari, Keyvan; Amouheidari, Alireza

2017-01-01

In radiation therapy, computed tomography (CT) simulation is used for treatment planning to define the location of tumor. Magnetic resonance imaging (MRI)-CT image fusion leads to more efficient tumor contouring. This work tried to identify the practical issues for the combination of CT and MRI images in real clinical cases. The effect of various factors is evaluated on image fusion quality. In this study, the data of thirty patients with brain tumors were used for image fusion. The effect of several parameters on possibility and quality of image fusion was evaluated. These parameters include angles of the patient's head on the bed, slices thickness, slice gap, and height of the patient's head. According to the results, the first dominating factor on quality of image fusion was the difference slice gap between CT and MRI images (cor = 0.86, P < 0.005) and second factor was the angle between CT and MRI slice in the sagittal plane (cor = 0.75, P < 0.005). In 20% of patients, this angle was more than 28° and image fusion was not efficient. In 17% of patients, difference slice gap in CT and MRI was >4 cm and image fusion quality was <25%. The most important problem in image fusion is that MRI images are taken without regard to their use in treatment planning. In general, parameters related to the patient position during MRI imaging should be chosen to be consistent with CT images of the patient in terms of location and angle.

Attenuation-based estimation of patient size for the purpose of size specific dose estimation in CT. Part II. Implementation on abdomen and thorax phantoms using cross sectional CT images and scanned projection radiograph images

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

Wang Jia; Christner, Jodie A.; Duan Xinhui

2012-11-15

Purpose: To estimate attenuation using cross sectional CT images and scanned projection radiograph (SPR) images in a series of thorax and abdomen phantoms. Methods: Attenuation was quantified in terms of a water cylinder with cross sectional area of A{sub w} from both the CT and SPR images of abdomen and thorax phantoms, where A{sub w} is the area of a water cylinder that would absorb the same dose as the specified phantom. SPR and axial CT images were acquired using a dual-source CT scanner operated at 120 kV in single-source mode. To use the SPR image for estimating A{sub w},more » the pixel values of a SPR image were calibrated to physical water attenuation using a series of water phantoms. A{sub w} and the corresponding diameter D{sub w} were calculated using the derived attenuation-based methods (from either CT or SPR image). A{sub w} was also calculated using only geometrical dimensions of the phantoms (anterior-posterior and lateral dimensions or cross sectional area). Results: For abdomen phantoms, the geometry-based and attenuation-based methods gave similar results for D{sub w}. Using only geometric parameters, an overestimation of D{sub w} ranging from 4.3% to 21.5% was found for thorax phantoms. Results for D{sub w} using the CT image and SPR based methods agreed with each other within 4% on average in both thorax and abdomen phantoms. Conclusions: Either the cross sectional CT or SPR images can be used to estimate patient attenuation in CT. Both are more accurate than use of only geometrical information for the task of quantifying patient attenuation. The SPR based method requires calibration of SPR pixel values to physical water attenuation and this calibration would be best performed by the scanner manufacturer.« less

Adaptive iterative dose reduction (AIDR) 3D in low dose CT abdomen-pelvis: Effects on image quality and radiation exposure

NASA Astrophysics Data System (ADS)

Ang, W. C.; Hashim, S.; Karim, M. K. A.; Bahruddin, N. A.; Salehhon, N.; Musa, Y.

2017-05-01

The widespread use of computed tomography (CT) has increased the medical radiation exposure and cancer risk. We aimed to evaluate the impact of AIDR 3D in CT abdomen-pelvic examinations based on image quality and radiation dose in low dose (LD) setting compared to standard dose (STD) with filtered back projection (FBP) reconstruction. We retrospectively reviewed the images of 40 patients who underwent CT abdomen-pelvic using a 80 slice CT scanner. Group 1 patients (n=20, mean age 41 ± 17 years) were performed at LD with AIDR 3D reconstruction and Group 2 patients (n=20, mean age 52 ± 21 years) were scanned with STD using FBP reconstruction. Objective image noise was assessed by region of interest (ROI) measurements in the liver and aorta as standard deviation (SD) of the attenuation value (Hounsfield Unit, HU) while subjective image quality was evaluated by two radiologists. Statistical analysis was used to compare the scan length, CT dose index volume (CTDIvol) and image quality of both patient groups. Although both groups have similar mean scan length, the CTDIvol significantly decreased by 38% in LD CT compared to STD CT (p<0.05). Objective and subjective image quality were statistically improved with AIDR 3D (p<0.05). In conclusion, AIDR 3D enables significant dose reduction of 38% with superior image quality in LD CT abdomen-pelvis.

Evaluation of the low dose cardiac CT imaging using ASIR technique

NASA Astrophysics Data System (ADS)

Fan, Jiahua; Hsieh, Jiang; Deubig, Amy; Sainath, Paavana; Crandall, Peter

2010-04-01

Today Cardiac imaging is one of the key driving forces for the research and development activities of Computed Tomography (CT) imaging. It requires high spatial and temporal resolution and is often associated with high radiation dose. The newly introduced ASIR technique presents an efficient method that offers the dose reduction benefits while maintaining image quality and providing fast reconstruction speed. This paper discusses the study of image quality of the ASIR technique for Cardiac CT imaging. Phantoms as well as clinical data have been evaluated to demonstrate the effectiveness of ASIR technique for Cardiac CT applications.

Metal artifact reduction in CT, a phantom study: subjective and objective evaluation of four commercial metal artifact reduction algorithms when used on three different orthopedic metal implants.

PubMed

Bolstad, Kirsten; Flatabø, Silje; Aadnevik, Daniel; Dalehaug, Ingvild; Vetti, Nils

2018-01-01

Background Metal implants may introduce severe artifacts in computed tomography (CT) images. Over the last few years dedicated algorithms have been developed in order to reduce metal artifacts in CT images. Purpose To investigate and compare metal artifact reduction algorithms (MARs) from four different CT vendors when imaging three different orthopedic metal implants. Material and Methods Three clinical metal implants were attached to the leg of an anthropomorphic phantom: cobalt-chrome; stainless steel; and titanium. Four commercial MARs were investigated: SmartMAR (GE); O-MAR (Philips); iMAR (Siemens); and SEMAR (Toshiba). The images were evaluated subjectively by three observers and analyzed objectively by calculating the fraction of pixels with CT number above 500 HU in a region of interest around the metal. The average CT number and image noise were also measured. Results Both subjective evaluation and objective analysis showed that MARs reduced metal artifacts and improved the image quality for CT images containing metal implants of steel and cobalt-chrome. When using MARs on titanium, all MARs introduced new visible artifacts. Conclusion The effect of MARs varied between CT vendors and different metal implants used in orthopedic surgery. Both in subjective evaluation and objective analysis the effect of applying MARs was most obvious on steel and cobalt-chrome implants when using SEMAR from Toshiba followed by SmartMAR from GE. However, MARs may also introduce new image artifacts especially when used on titanium implants. Therefore, it is important to reconstruct all CT images containing metal with and without MARs.

Automatic co-segmentation of lung tumor based on random forest in PET-CT images

NASA Astrophysics Data System (ADS)

Jiang, Xueqing; Xiang, Dehui; Zhang, Bin; Zhu, Weifang; Shi, Fei; Chen, Xinjian

2016-03-01

In this paper, a fully automatic method is proposed to segment the lung tumor in clinical 3D PET-CT images. The proposed method effectively combines PET and CT information to make full use of the high contrast of PET images and superior spatial resolution of CT images. Our approach consists of three main parts: (1) initial segmentation, in which spines are removed in CT images and initial connected regions achieved by thresholding based segmentation in PET images; (2) coarse segmentation, in which monotonic downhill function is applied to rule out structures which have similar standardized uptake values (SUV) to the lung tumor but do not satisfy a monotonic property in PET images; (3) fine segmentation, random forests method is applied to accurately segment the lung tumor by extracting effective features from PET and CT images simultaneously. We validated our algorithm on a dataset which consists of 24 3D PET-CT images from different patients with non-small cell lung cancer (NSCLC). The average TPVF, FPVF and accuracy rate (ACC) were 83.65%, 0.05% and 99.93%, respectively. The correlation analysis shows our segmented lung tumor volumes has strong correlation ( average 0.985) with the ground truth 1 and ground truth 2 labeled by a clinical expert.

Comparison of conventional ultrasonography and ultrasonography-computed tomography fusion imaging for target identification using digital/real hybrid phantoms: a preliminary study.

PubMed

Soyama, Takeshi; Sakuhara, Yusuke; Kudo, Kohsuke; Abo, Daisuke; Wang, Jeff; Ito, Yoichi M; Hasegawa, Yu; Shirato, Hiroki

2016-07-01

This preliminary study compared ultrasonography-computed tomography (US-CT) fusion imaging and conventional ultrasonography (US) for accuracy and time required for target identification using a combination of real phantoms and sets of digitally modified computed tomography (CT) images (digital/real hybrid phantoms). In this randomized prospective study, 27 spheres visible on B-mode US were placed at depths of 3.5, 8.5, and 13.5 cm (nine spheres each). All 27 spheres were digitally erased from the CT images, and a radiopaque sphere was digitally placed at each of the 27 locations to create 27 different sets of CT images. Twenty clinicians were instructed to identify the sphere target using US alone and fusion imaging. The accuracy of target identification of the two methods was compared using McNemar's test. The mean time required for target identification and error distances were compared using paired t tests. At all three depths, target identification was more accurate and the mean time required for target identification was significantly less with US-CT fusion imaging than with US alone, and the mean error distances were also shorter with US-CT fusion imaging. US-CT fusion imaging was superior to US alone in terms of accurate and rapid identification of target lesions.

WE-G-209-02: CT

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

Kofler, J.

2016-06-15

Digital radiography, CT, PET, and MR are complicated imaging modalities which are composed of many hardware and software components. These components work together in a highly coordinated chain of events with the intent to produce high quality images. Acquisition, processing and reconstruction of data must occur in a precise way for optimum image quality to be achieved. Any error or unexpected event in the entire process can produce unwanted pixel intensities in the final images which may contribute to visible image artifacts. The diagnostic imaging physicist is uniquely qualified to investigate and contribute to resolution of image artifacts. This coursemore » will teach the participant to identify common artifacts found clinically in digital radiography, CT, PET, and MR, to determine the causes of artifacts, and to make recommendations for how to resolve artifacts. Learning Objectives: Identify common artifacts found clinically in digital radiography, CT, PET and MR. Determine causes of various clinical artifacts from digital radiography, CT, PET and MR. Describe how to resolve various clinical artifacts from digital radiography, CT, PET and MR.« less

Adaptive statistical iterative reconstruction use for radiation dose reduction in pediatric lower-extremity CT: impact on diagnostic image quality.

PubMed

Shah, Amisha; Rees, Mitchell; Kar, Erica; Bolton, Kimberly; Lee, Vincent; Panigrahy, Ashok

2018-06-01

For the past several years, increased levels of imaging radiation and cumulative radiation to children has been a significant concern. Although several measures have been taken to reduce radiation dose during computed tomography (CT) scan, the newer dose reduction software adaptive statistical iterative reconstruction (ASIR) has been an effective technique in reducing radiation dose. To our knowledge, no studies are published that assess the effect of ASIR on extremity CT scans in children. To compare radiation dose, image noise, and subjective image quality in pediatric lower extremity CT scans acquired with and without ASIR. The study group consisted of 53 patients imaged on a CT scanner equipped with ASIR software. The control group consisted of 37 patients whose CT images were acquired without ASIR. Image noise, Computed Tomography Dose Index (CTDI) and dose length product (DLP) were measured. Two pediatric radiologists rated the studies in subjective categories: image sharpness, noise, diagnostic acceptability, and artifacts. The CTDI (p value = 0.0184) and DLP (p value <0.0002) were significantly decreased with the use of ASIR compared with non-ASIR studies. However, the subjective ratings for sharpness (p < 0.0001) and diagnostic acceptability of the ASIR images (p < 0.0128) were decreased compared with standard, non-ASIR CT studies. Adaptive statistical iterative reconstruction reduces radiation dose for lower extremity CTs in children, but at the expense of diagnostic imaging quality. Further studies are warranted to determine the specific utility of ASIR for pediatric musculoskeletal CT imaging.

Automated segmentation of 3D anatomical structures on CT images by using a deep convolutional network based on end-to-end learning approach

NASA Astrophysics Data System (ADS)

Zhou, Xiangrong; Takayama, Ryosuke; Wang, Song; Zhou, Xinxin; Hara, Takeshi; Fujita, Hiroshi

2017-02-01

We have proposed an end-to-end learning approach that trained a deep convolutional neural network (CNN) for automatic CT image segmentation, which accomplished a voxel-wised multiple classification to directly map each voxel on 3D CT images to an anatomical label automatically. The novelties of our proposed method were (1) transforming the anatomical structures segmentation on 3D CT images into a majority voting of the results of 2D semantic image segmentation on a number of 2D-slices from different image orientations, and (2) using "convolution" and "deconvolution" networks to achieve the conventional "coarse recognition" and "fine extraction" functions which were integrated into a compact all-in-one deep CNN for CT image segmentation. The advantage comparing to previous works was its capability to accomplish real-time image segmentations on 2D slices of arbitrary CT-scan-range (e.g. body, chest, abdomen) and produced correspondingly-sized output. In this paper, we propose an improvement of our proposed approach by adding an organ localization module to limit CT image range for training and testing deep CNNs. A database consisting of 240 3D CT scans and a human annotated ground truth was used for training (228 cases) and testing (the remaining 12 cases). We applied the improved method to segment pancreas and left kidney regions, respectively. The preliminary results showed that the accuracies of the segmentation results were improved significantly (pancreas was 34% and kidney was 8% increased in Jaccard index from our previous results). The effectiveness and usefulness of proposed improvement for CT image segmentations were confirmed.

Ceftriaxone-associated pancreatitis captured on serial computed tomography scans.

PubMed

Nakagawa, Nozomu; Ochi, Nobuaki; Yamane, Hiromichi; Honda, Yoshihiro; Nagasaki, Yasunari; Urata, Noriyo; Nakanishi, Hidekazu; Kawamoto, Hirofumi; Takigawa, Nagio

2018-02-01

A 74-year-old man was treated with ceftriaxone for 5 days and subsequently experienced epigastric pain. Computed tomography (CT) was performed 7 and 3 days before epigastralgia. Although the first CT image revealed no radiographic signs in his biliary system, the second CT image revealed dense radiopaque material in the gallbladder lumen. The third CT image, taken at symptom onset, showed high density in the common bile duct and enlargement of the pancreatic head. This is a very rare case of pseudolithiasis involving the common bile duct, as captured on a series of CT images.

Quantitative Image Quality and Histogram-Based Evaluations of an Iterative Reconstruction Algorithm at Low-to-Ultralow Radiation Dose Levels: A Phantom Study in Chest CT

PubMed Central

Lee, Ki Baek

2018-01-01

Objective To describe the quantitative image quality and histogram-based evaluation of an iterative reconstruction (IR) algorithm in chest computed tomography (CT) scans at low-to-ultralow CT radiation dose levels. Materials and Methods In an adult anthropomorphic phantom, chest CT scans were performed with 128-section dual-source CT at 70, 80, 100, 120, and 140 kVp, and the reference (3.4 mGy in volume CT Dose Index [CTDIvol]), 30%-, 60%-, and 90%-reduced radiation dose levels (2.4, 1.4, and 0.3 mGy). The CT images were reconstructed by using filtered back projection (FBP) algorithms and IR algorithm with strengths 1, 3, and 5. Image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were statistically compared between different dose levels, tube voltages, and reconstruction algorithms. Moreover, histograms of subtraction images before and after standardization in x- and y-axes were visually compared. Results Compared with FBP images, IR images with strengths 1, 3, and 5 demonstrated image noise reduction up to 49.1%, SNR increase up to 100.7%, and CNR increase up to 67.3%. Noteworthy image quality degradations on IR images including a 184.9% increase in image noise, 63.0% decrease in SNR, and 51.3% decrease in CNR, and were shown between 60% and 90% reduced levels of radiation dose (p < 0.0001). Subtraction histograms between FBP and IR images showed progressively increased dispersion with increased IR strength and increased dose reduction. After standardization, the histograms appeared deviated and ragged between FBP images and IR images with strength 3 or 5, but almost normally-distributed between FBP images and IR images with strength 1. Conclusion The IR algorithm may be used to save radiation doses without substantial image quality degradation in chest CT scanning of the adult anthropomorphic phantom, down to approximately 1.4 mGy in CTDIvol (60% reduced dose). PMID:29354008

Three-dimensional CT enterography using oral gastrografin in patients with small bowel obstruction: comparison with axial CT images or fluoroscopic findings.

PubMed

Hong, Seong Sook; Kim, Ah Young; Kwon, Seok Beom; Kim, Pyo Nyun; Lee, Moon-Gyu; Ha, Hyun Kwon

2010-10-01

To evaluate the feasibility of 3D CT enterography using oral gastrografin in patients with small bowel obstruction (SBO), focusing on improving diagnostic performance as compared with the use of axial CT imagings and fluoroscopic findings. For a 10-month period, 18 patients with known SBO detected clinically and radiologically were enrolled. In all patients, gastrografin was ingested prior to CT enterography. Twelve patients underwent a fluoroscopic examination. Images were randomly assessed for confidence for the level, for the cause of SBO, and for the assessment of the interpretability of each image by two gastrointestinal radiologists. The results were considered statistically significant using the Wilcoxon rank sum test. All patients (100%) well tolerated the administration of oral gastrografin. The use of 3D CT enterography significantly improved diagnostic confidence for the interpretation of the level, cause of SBO, and the assessment of the interpretability of each image as compared with the use of axial CT images (P < 0.05). 3D CT enterography was superior as compared to fluoroscopic examination (P < 0.05). The use of gastrografin for 3D CT enterography is a safe and feasible technique for precise evaluation of known or suspected SBO.

Calibration of CT Hounsfield units for proton therapy treatment planning: use of kilovoltage and megavoltage images and comparison of parameterized methods

NASA Astrophysics Data System (ADS)

De Marzi, L.; Lesven, C.; Ferrand, R.; Sage, J.; Boulé, T.; Mazal, A.

2013-06-01

Proton beam range is of major concern, in particular, when images used for dose computations are artifacted (for example in patients with surgically treated bone tumors). We investigated several conditions and methods for determination of computed tomography Hounsfield unit (CT-HU) calibration curves, using two different conversion schemes. A stoichiometric methodology was used on either kilovoltage (kV) or megavoltage (MV) CT images and the accuracy of the calibration methods was evaluated. We then studied the effects of metal artifacts on proton dose distributions using metallic implants in rigid phantom mimicking clinical conditions. MV-CT images were used to evaluate relative proton stopping power in certain high density implants, and a methodology is proposed for accurate delineation and dose calculation, using a combined set of kV- and MV-CT images. Our results show good agreement between measurements and dose calculations or relative proton stopping power determination (<5%). The results also show that range uncertainty increases when only kV-CT images are used or when no correction is made on artifacted images. However, differences between treatment plans calculated on corrected kV-CT data and MV-CT data remained insignificant in the investigated patient case, even with streak artifacts and volume effects that reduce the accuracy of manual corrections.

Acquiring 4D Thoracic CT Scans Using Ciné CT Acquisition

NASA Astrophysics Data System (ADS)

Low, Daniel

One method for acquiring 4D thoracic CT scans is to use ciné acquisition. Ciné acquisition is conducted by rotating the gantry and acquiring x-ray projections while keeping the couch stationary. After a complete rotation, a single set of CT slices, the number corresponding to the number of CT detector rows, is produced. The rotation period is typically sub second so each image set corresponds to a single point in time. The ciné image acquisition is repeated for at least one breathing cycle to acquire images throughout the breathing cycle. Once the images are acquired at a single couch position, the couch is moved to the abutting position and the acquisition is repeated. Post-processing of the images sets typically resorts the sets into breathing phases, stacking images from a specific phase to produce a thoracic CT scan at that phase. Benefits of the ciné acquisition protocol include, the ability to precisely identify the phase with respect to the acquired image, the ability to resort images after reconstruction, and the ability to acquire images over arbitrarily long times and for arbitrarily many images (within dose constraints).

Investigating existing medical CT segmentation techniques within automated baggage and package inspection

NASA Astrophysics Data System (ADS)

Megherbi, Najla; Breckon, Toby P.; Flitton, Greg T.

2013-10-01

3D Computed Tomography (CT) image segmentation is already well established tool in medical research and in routine daily clinical practice. However, such techniques have not been used in the context of 3D CT image segmentation for baggage and package security screening using CT imagery. CT systems are increasingly used in airports for security baggage examination. We propose in this contribution an investigation of the current 3D CT medical image segmentation methods for use in this new domain. Experimental results of 3D segmentation on real CT baggage security imagery using a range of techniques are presented and discussed.

Model-based iterative reconstruction for reduction of radiation dose in abdominopelvic CT: comparison to adaptive statistical iterative reconstruction.

PubMed

Yasaka, Koichiro; Katsura, Masaki; Akahane, Masaaki; Sato, Jiro; Matsuda, Izuru; Ohtomo, Kuni

2013-12-01

To evaluate dose reduction and image quality of abdominopelvic computed tomography (CT) reconstructed with model-based iterative reconstruction (MBIR) compared to adaptive statistical iterative reconstruction (ASIR). In this prospective study, 85 patients underwent referential-, low-, and ultralow-dose unenhanced abdominopelvic CT. Images were reconstructed with ASIR for low-dose (L-ASIR) and ultralow-dose CT (UL-ASIR), and with MBIR for ultralow-dose CT (UL-MBIR). Image noise was measured in the abdominal aorta and iliopsoas muscle. Subjective image analyses and a lesion detection study (adrenal nodules) were conducted by two blinded radiologists. A reference standard was established by a consensus panel of two different radiologists using referential-dose CT reconstructed with filtered back projection. Compared to low-dose CT, there was a 63% decrease in dose-length product with ultralow-dose CT. UL-MBIR had significantly lower image noise than L-ASIR and UL-ASIR (all p<0.01). UL-MBIR was significantly better for subjective image noise and streak artifacts than L-ASIR and UL-ASIR (all p<0.01). There were no significant differences between UL-MBIR and L-ASIR in diagnostic acceptability (p>0.65), or diagnostic performance for adrenal nodules (p>0.87). MBIR significantly improves image noise and streak artifacts compared to ASIR, and can achieve radiation dose reduction without severely compromising image quality.

Evaluation of GMI and PMI diffeomorphic‐based demons algorithms for aligning PET and CT Images

PubMed Central

Yang, Juan; Zhang, You; Yin, Yong

2015-01-01

Fusion of anatomic information in computed tomography (CT) and functional information in F18‐FDG positron emission tomography (PET) is crucial for accurate differentiation of tumor from benign masses, designing radiotherapy treatment plan and staging of cancer. Although current PET and CT images can be acquired from combined F18‐FDG PET/CT scanner, the two acquisitions are scanned separately and take a long time, which may induce potential positional errors in global and local caused by respiratory motion or organ peristalsis. So registration (alignment) of whole‐body PET and CT images is a prerequisite for their meaningful fusion. The purpose of this study was to assess the performance of two multimodal registration algorithms for aligning PET and CT images. The proposed gradient of mutual information (GMI)‐based demons algorithm, which incorporated the GMI between two images as an external force to facilitate the alignment, was compared with the point‐wise mutual information (PMI) diffeomorphic‐based demons algorithm whose external force was modified by replacing the image intensity difference in diffeomorphic demons algorithm with the PMI to make it appropriate for multimodal image registration. Eight patients with esophageal cancer(s) were enrolled in this IRB‐approved study. Whole‐body PET and CT images were acquired from a combined F18‐FDG PET/CT scanner for each patient. The modified Hausdorff distance (dMH) was used to evaluate the registration accuracy of the two algorithms. Of all patients, the mean values and standard deviations (SDs) of dMH were 6.65 (± 1.90) voxels and 6.01 (± 1.90) after the GMI‐based demons and the PMI diffeomorphic‐based demons registration algorithms respectively. Preliminary results on oncological patients showed that the respiratory motion and organ peristalsis in PET/CT esophageal images could not be neglected, although a combined F18‐FDG PET/CT scanner was used for image acquisition. The PMI diffeomorphic‐based demons algorithm was more accurate than the GMI‐based demons algorithm in registering PET/CT esophageal images. PACS numbers: 87.57.nj, 87.57. Q‐, 87.57.uk PMID:26218993

Evaluation of GMI and PMI diffeomorphic-based demons algorithms for aligning PET and CT Images.

PubMed

Yang, Juan; Wang, Hongjun; Zhang, You; Yin, Yong

2015-07-08

Fusion of anatomic information in computed tomography (CT) and functional information in 18F-FDG positron emission tomography (PET) is crucial for accurate differentiation of tumor from benign masses, designing radiotherapy treatment plan and staging of cancer. Although current PET and CT images can be acquired from combined 18F-FDG PET/CT scanner, the two acquisitions are scanned separately and take a long time, which may induce potential positional errors in global and local caused by respiratory motion or organ peristalsis. So registration (alignment) of whole-body PET and CT images is a prerequisite for their meaningful fusion. The purpose of this study was to assess the performance of two multimodal registration algorithms for aligning PET and CT images. The proposed gradient of mutual information (GMI)-based demons algorithm, which incorporated the GMI between two images as an external force to facilitate the alignment, was compared with the point-wise mutual information (PMI) diffeomorphic-based demons algorithm whose external force was modified by replacing the image intensity difference in diffeomorphic demons algorithm with the PMI to make it appropriate for multimodal image registration. Eight patients with esophageal cancer(s) were enrolled in this IRB-approved study. Whole-body PET and CT images were acquired from a combined 18F-FDG PET/CT scanner for each patient. The modified Hausdorff distance (d(MH)) was used to evaluate the registration accuracy of the two algorithms. Of all patients, the mean values and standard deviations (SDs) of d(MH) were 6.65 (± 1.90) voxels and 6.01 (± 1.90) after the GMI-based demons and the PMI diffeomorphic-based demons registration algorithms respectively. Preliminary results on oncological patients showed that the respiratory motion and organ peristalsis in PET/CT esophageal images could not be neglected, although a combined 18F-FDG PET/CT scanner was used for image acquisition. The PMI diffeomorphic-based demons algorithm was more accurate than the GMI-based demons algorithm in registering PET/CT esophageal images.

Contrast-enhanced cardiac C-arm CT evaluation of radiofrequency ablation lesions in the left ventricle

PubMed Central

Girard, Erin E; Al-Ahmad, Amin A; Rosenberg, Jarrett; Luong, Richard; Moore, Teri; Lauritsch, Günter; Boese, Jan; Fahrig, Rebecca

2011-01-01

Objectives The purpose of this study was to evaluate use of cardiac C-arm computed tomography (CT) in the assessment of the dimensions and temporal characteristics of radiofrequency ablation (RFA) lesions. This imaging modality uses a standard C-arm fluoroscopy system rotating around the patient, providing CT-like images during the RFA procedure. Background Both magnetic resonance imaging (MRI) and CT can be used to assess myocardial necrotic tissue. Several studies have reported visualizing cardiac RF ablation lesions with MRI, however obtaining MR images during interventional procedures is not common practice. Direct visualization of RFA lesions using C-arm CT during the procedure may improve outcomes and circumvent complications associated with cardiac ablation procedures. Methods RFA lesions were created on the endocardial surface of the left ventricle of 9 swine using a 7-F RF ablation catheter. An ECG-gated C-arm CT imaging protocol was used to acquire projection images during iodine contrast injection and following the injection every 5 min for up to 30 min, with no additional contrast. Reconstructed images were analyzed offline. The mean and standard deviation of the signal intensity of the lesion and normal myocardium were measured in all images in each time series. Lesion dimensions and area were measured and compared in pathologic specimens and C-arm CT images. Results All ablation lesions (n=29) were visualized and lesion dimensions, as measured on C-arm CT, correlated well with postmortem tissue measurements (1D dimensions : concordance correlation = 0.87; area : concordance correlation = 0.90). Lesions were visualized as a perfusion defect on first-pass C-arm CT images with a signal intensity 95 HU lower than normal myocardium (95% confidence interval: -111 to -79 HU). Images acquired at 1 and 5 minutes exhibited an enhancing ring surrounding the perfusion defect in 24 (83%) lesions. Conclusions RFA lesion size, including transmurality, can be assessed using ECG-gated cardiac C-arm CT in the interventional suite. Visualization of RFA lesions using cardiac C-arm CT may facilitate the assessment of adequate lesion delivery and provide valuable feedback during cardiac ablation procedures. PMID:21414574

A combined learning algorithm for prostate segmentation on 3D CT images.

PubMed

Ma, Ling; Guo, Rongrong; Zhang, Guoyi; Schuster, David M; Fei, Baowei

2017-11-01

Segmentation of the prostate on CT images has many applications in the diagnosis and treatment of prostate cancer. Because of the low soft-tissue contrast on CT images, prostate segmentation is a challenging task. A learning-based segmentation method is proposed for the prostate on three-dimensional (3D) CT images. We combine population-based and patient-based learning methods for segmenting the prostate on CT images. Population data can provide useful information to guide the segmentation processing. Because of inter-patient variations, patient-specific information is particularly useful to improve the segmentation accuracy for an individual patient. In this study, we combine a population learning method and a patient-specific learning method to improve the robustness of prostate segmentation on CT images. We train a population model based on the data from a group of prostate patients. We also train a patient-specific model based on the data of the individual patient and incorporate the information as marked by the user interaction into the segmentation processing. We calculate the similarity between the two models to obtain applicable population and patient-specific knowledge to compute the likelihood of a pixel belonging to the prostate tissue. A new adaptive threshold method is developed to convert the likelihood image into a binary image of the prostate, and thus complete the segmentation of the gland on CT images. The proposed learning-based segmentation algorithm was validated using 3D CT volumes of 92 patients. All of the CT image volumes were manually segmented independently three times by two, clinically experienced radiologists and the manual segmentation results served as the gold standard for evaluation. The experimental results show that the segmentation method achieved a Dice similarity coefficient of 87.18 ± 2.99%, compared to the manual segmentation. By combining the population learning and patient-specific learning methods, the proposed method is effective for segmenting the prostate on 3D CT images. The prostate CT segmentation method can be used in various applications including volume measurement and treatment planning of the prostate. © 2017 American Association of Physicists in Medicine.

Generation of synthetic CT data using patient specific daily MR image data and image registration

NASA Astrophysics Data System (ADS)

Melanie Kraus, Kim; Jäkel, Oliver; Niebuhr, Nina I.; Pfaffenberger, Asja

2017-02-01

To fully exploit the advantages of magnetic resonance imaging (MRI) for radiotherapy (RT) treatment planning, a method is required to overcome the problem of lacking electron density information. We aim to establish and evaluate a new method for computed tomography (CT) data generation based on MRI and image registration. The thereby generated CT data is used for dose accumulation. We developed a process flow based on an initial pair of rigidly co-registered CT and T2-weighted MR image representing the same anatomical situation. Deformable image registration using anatomical landmarks is performed between the initial MRI data and daily MR images. The resulting transformation is applied to the initial CT, thus fractional CT data is generated. Furthermore, the dose for a photon intensity modulated RT (IMRT) or intensity modulated proton therapy (IMPT) plan is calculated on the generated fractional CT and accumulated on the initial CT via inverse transformation. The method is evaluated by the use of phantom CT and MRI data. Quantitative validation is performed by evaluation of the mean absolute error (MAE) between the measured and the generated CT. The effect on dose accumulation is examined by means of dose-volume parameters. One patient case is presented to demonstrate the applicability of the method introduced here. Overall, CT data derivation lead to MAEs with a median of 37.0 HU ranging from 29.9 to 66.6 HU for all investigated tissues. The accuracy of image registration showed to be limited in the case of unexpected air cavities and at tissue boundaries. The comparisons of dose distributions based on measured and generated CT data agree well with the published literature. Differences in dose volume parameters kept within 1.6% and 3.2% for photon and proton RT, respectively. The method presented here is particularly suited for application in adaptive RT in current clinical routine, since only minor additional technical equipment is required.

68Ga-PSMA-PET/CT in Patients With Biochemical Prostate Cancer Recurrence and Negative 18F-Choline-PET/CT.

PubMed

Bluemel, Christina; Krebs, Markus; Polat, Bülent; Linke, Fränze; Eiber, Matthias; Samnick, Samuel; Lapa, Constantin; Lassmann, Michael; Riedmiller, Hubertus; Czernin, Johannes; Rubello, Domenico; Bley, Thorsten; Kropf, Saskia; Wester, Hans-Juergen; Buck, Andreas K; Herrmann, Ken

2016-07-01

Investigating the value of Ga-PSMA-PET/CT in biochemically recurring prostate cancer patients with negative F-choline-PET/CT. One hundred thirty-nine consecutive patients with biochemical recurrence after curative (surgery and/or radiotherapy) therapy were offered participation in this sequential clinical imaging approach. Patients first underwent an F-choline-PET/CT. If negative, an additional Ga-PSMA-PET/CT was offered. One hundred twenty-five of 139 eligible patients were included in the study; 32 patients underwent additional Ga-PSMA-PET/CT. Patients with equivocal findings (n = 5) on F-choline-PET/CT and those who declined the additional Ga-PSMA-PET/CT (n = 9) were excluded. Images were analyzed visually for the presence of suspicious lesions. Findings on PET/CT were correlated with PSA level, PSA doubling time (dt), and PSA velocity (vel). The overall detection rates were 85.6% (107/125) for the sequential imaging approach and 74.4% (93/125) for F-choline-PET/CT alone. Ga-PSMA-PET/CT detected sites of recurrence in 43.8% (14/32) of the choline-negative patients. Detection rates of the sequential imaging approach and F-choline-PET/CT alone increased with higher serum PSA levels and PSA vel. Subgroup analysis of Ga-PSMA-PET/CT in F-choline negative patients revealed detection rates of 28.6%, 45.5%, and 71.4% for PSA levels of 0.2 or greater to less than 1 ng/mL, 1 to 2 ng/mL, and greater than 2 ng/mL, respectively. The sequential imaging approach designed to limit Ga-PSMA imaging to patients with negative choline scans resulted in high detection rates. Ga-PSMA-PET/CT identified sites of recurrent disease in 43.8% of the patients with negative F-choline PET/CT scans.

Test of 3D CT reconstructions by EM + TV algorithm from undersampled data

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

Evseev, Ivan; Ahmann, Francielle; Silva, Hamilton P. da

2013-05-06

Computerized tomography (CT) plays an important role in medical imaging for diagnosis and therapy. However, CT imaging is connected with ionization radiation exposure of patients. Therefore, the dose reduction is an essential issue in CT. In 2011, the Expectation Maximization and Total Variation Based Model for CT Reconstruction (EM+TV) was proposed. This method can reconstruct a better image using less CT projections in comparison with the usual filtered back projection (FBP) technique. Thus, it could significantly reduce the overall dose of radiation in CT. This work reports the results of an independent numerical simulation for cone beam CT geometry withmore » alternative virtual phantoms. As in the original report, the 3D CT images of 128 Multiplication-Sign 128 Multiplication-Sign 128 virtual phantoms were reconstructed. It was not possible to implement phantoms with lager dimensions because of the slowness of code execution even by the CORE i7 CPU.« less

An evaluation of the use of oral contrast media in abdominopelvic CT.

PubMed

Buttigieg, Erica Lauren; Grima, Karen Borg; Cortis, Kelvin; Soler, Sandro Galea; Zarb, Francis

2014-11-01

To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department. Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n = 46) were recruited and prospectively placed into either the water (n = 25) or no OCM (n = 21) group. Three radiologists performed absolute visual grading analysis (VGA) to assess image quality by grading the fulfilment of 24 anatomical image quality criteria. Visual grading characteristics (VGC) analysis of the data showed comparable image quality with regards to reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three OCM protocols. All three OCM protocols provided similar image quality for follow-up abdominopelvic CT for general oncological indications. • Positive oral contrast media are routinely used for abdominopelvic multidetector computed tomography • Experimental study comparing image quality using three different oral contrast materials • Three different oral contrast materials result in comparable CT image quality • Benefits for patients and medical imaging department.

Design of CT reconstruction kernel specifically for clinical lung imaging

NASA Astrophysics Data System (ADS)

Cody, Dianna D.; Hsieh, Jiang; Gladish, Gregory W.

2005-04-01

In this study we developed a new reconstruction kernel specifically for chest CT imaging. An experimental flat-panel CT scanner was used on large dogs to produce 'ground-truth" reference chest CT images. These dogs were also examined using a clinical 16-slice CT scanner. We concluded from the dog images acquired on the clinical scanner that the loss of subtle lung structures was due mostly to the presence of the background noise texture when using currently available reconstruction kernels. This qualitative evaluation of the dog CT images prompted the design of a new recon kernel. This new kernel consisted of the combination of a low-pass and a high-pass kernel to produce a new reconstruction kernel, called the 'Hybrid" kernel. The performance of this Hybrid kernel fell between the two kernels on which it was based, as expected. This Hybrid kernel was also applied to a set of 50 patient data sets; the analysis of these clinical images is underway. We are hopeful that this Hybrid kernel will produce clinical images with an acceptable tradeoff of lung detail, reliable HU, and image noise.

Early clinical applications for imaging at microscopic detail: microfocus computed tomography (micro-CT).

PubMed

Hutchinson, J Ciaran; Shelmerdine, Susan C; Simcock, Ian C; Sebire, Neil J; Arthurs, Owen J

2017-07-01

Microfocus CT (micro-CT) has traditionally been used in industry and preclinical studies, although it may find new applicability in the routine clinical setting. It can provide high-resolution three-dimensional digital imaging data sets to the same level of detail as microscopic examination without the need for tissue dissection. Micro-CT is already enabling non-invasive detailed internal assessment of various tissue specimens, particularly in breast imaging and early gestational fetal autopsy, not previously possible from more conventional modalities such as MRI or CT. In this review, we discuss the technical aspects behind micro-CT image acquisition, how early work with small animal studies have informed our knowledge of human disease and the imaging performed so far on human tissue specimens. We conclude with potential future clinical applications of this novel and emerging technique.

Multi-layer cube sampling for liver boundary detection in PET-CT images.

PubMed

Liu, Xinxin; Yang, Jian; Song, Shuang; Song, Hong; Ai, Danni; Zhu, Jianjun; Jiang, Yurong; Wang, Yongtian

2018-06-01

Liver metabolic information is considered as a crucial diagnostic marker for the diagnosis of fever of unknown origin, and liver recognition is the basis of automatic diagnosis of metabolic information extraction. However, the poor quality of PET and CT images is a challenge for information extraction and target recognition in PET-CT images. The existing detection method cannot meet the requirement of liver recognition in PET-CT images, which is the key problem in the big data analysis of PET-CT images. A novel texture feature descriptor called multi-layer cube sampling (MLCS) is developed for liver boundary detection in low-dose CT and PET images. The cube sampling feature is proposed for extracting more texture information, which uses a bi-centric voxel strategy. Neighbour voxels are divided into three regions by the centre voxel and the reference voxel in the histogram, and the voxel distribution information is statistically classified as texture feature. Multi-layer texture features are also used to improve the ability and adaptability of target recognition in volume data. The proposed feature is tested on the PET and CT images for liver boundary detection. For the liver in the volume data, mean detection rate (DR) and mean error rate (ER) reached 95.15 and 7.81% in low-quality PET images, and 83.10 and 21.08% in low-contrast CT images. The experimental results demonstrated that the proposed method is effective and robust for liver boundary detection.

Dual-energy CT and ceramic or titanium prostheses material reduce CT artifacts and provide superior image quality of total knee arthroplasty.

PubMed

Kasparek, Maximilian F; Töpker, Michael; Lazar, Mathias; Weber, Michael; Kasparek, Michael; Mang, Thomas; Apfaltrer, Paul; Kubista, Bernd; Windhager, Reinhard; Ringl, Helmut

2018-06-07

To evaluate the influence of different scan parameters for single-energy CT and dual-energy CT, as well as the impact of different material used in a TKA prosthesis on image quality and the extent of metal artifacts. Eight pairs of TKA prostheses from different vendors were examined in a phantom set-up. Each pair consisted of a conventional CoCr prosthesis and the corresponding anti-allergic prosthesis (full titanium, ceramic, or ceramic-coated) from the same vendor. Nine different (seven dual-energy CT and two single-energy CT) scan protocols with different characteristics were used to determine the most suitable CT protocol for TKA imaging. Quantitative image analysis included assessment of blooming artifacts (metal implants appear thicker on CT than they are, given as virtual growth in mm in this paper) and streak artifacts (thick dark lines around metal). Qualitative image analysis was used to investigate the bone-prosthesis interface. The full titanium prosthesis and full ceramic knee showed significantly fewer blooming artifacts compared to the standard CoCr prosthesis (mean virtual growth 0.6-2.2 mm compared to 2.9-4.6 mm, p < 0.001). Dual-energy CT protocols showed less blooming (range 3.3-3.8 mm) compared to single-energy protocols (4.6-5.5 mm). The full titanium and full ceramic prostheses showed significantly fewer streak artifacts (mean standard deviation 77-86 Hounsfield unit (HU)) compared to the standard CoCr prosthesis (277-334 HU, p < 0.001). All dual-energy CT protocols had fewer metal streak artifacts (215-296 HU compared to single-energy CT protocols (392-497 HU)). Full titanium and ceramic prostheses were ranked superior with regard to the image quality at the bone/prosthesis interface compared to a standard CoCr prosthesis, and all dual-energy CT protocols were ranked better than single-energy protocols. Dual-energy CT and ceramic or titanium prostheses reduce CT artifacts and provide superior image quality of total knee arthroplasty at the bone/prosthesis interface. These findings support the use of dual-energy CT as a solid imaging base for clinical decision-making and the use of full-titanium or ceramic prostheses to allow for better CT visualization of the bone-prosthesis interface.

Chest CT in children: anesthesia and atelectasis.

PubMed

Newman, Beverley; Krane, Elliot J; Gawande, Rakhee; Holmes, Tyson H; Robinson, Terry E

2014-02-01

There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain reliable and reproducible high-quality, motion-free chest CT images in children.

Ultralow dose computed tomography attenuation correction for pediatric PET CT using adaptive statistical iterative reconstruction

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

Brady, Samuel L., E-mail: samuel.brady@stjude.org; Shulkin, Barry L.

2015-02-15

Purpose: To develop ultralow dose computed tomography (CT) attenuation correction (CTAC) acquisition protocols for pediatric positron emission tomography CT (PET CT). Methods: A GE Discovery 690 PET CT hybrid scanner was used to investigate the change to quantitative PET and CT measurements when operated at ultralow doses (10–35 mA s). CT quantitation: noise, low-contrast resolution, and CT numbers for 11 tissue substitutes were analyzed in-phantom. CT quantitation was analyzed to a reduction of 90% volume computed tomography dose index (0.39/3.64; mGy) from baseline. To minimize noise infiltration, 100% adaptive statistical iterative reconstruction (ASiR) was used for CT reconstruction. PET imagesmore » were reconstructed with the lower-dose CTAC iterations and analyzed for: maximum body weight standardized uptake value (SUV{sub bw}) of various diameter targets (range 8–37 mm), background uniformity, and spatial resolution. Radiation dose and CTAC noise magnitude were compared for 140 patient examinations (76 post-ASiR implementation) to determine relative dose reduction and noise control. Results: CT numbers were constant to within 10% from the nondose reduced CTAC image for 90% dose reduction. No change in SUV{sub bw}, background percent uniformity, or spatial resolution for PET images reconstructed with CTAC protocols was found down to 90% dose reduction. Patient population effective dose analysis demonstrated relative CTAC dose reductions between 62% and 86% (3.2/8.3–0.9/6.2). Noise magnitude in dose-reduced patient images increased but was not statistically different from predose-reduced patient images. Conclusions: Using ASiR allowed for aggressive reduction in CT dose with no change in PET reconstructed images while maintaining sufficient image quality for colocalization of hybrid CT anatomy and PET radioisotope uptake.« less

Prevalence of monosodium urate deposits in a population of rheumatoid arthritis patients with hyperuricemia.

PubMed

Petsch, Christina; Araujo, Elizabeth G; Englbrecht, Matthias; Bayat, Sara; Cavallaro, Alexander; Hueber, Axel J; Lell, Michael; Schett, Georg; Manger, Bernhard; Rech, Juergen

2016-06-01

To investigate the prevalence of monosodium urate (MSU) crystal deposits, indicative for gout, in a population of rheumatoid arthritis (RA) patients with concomitant hyperuricemia and to analyze the clinical and disease-specific characteristics of RA patients who exhibit MSU crystal deposits. Overall, 100 consecutive patients with the diagnosis of RA and a serum urate level above 6mg/dl underwent dual energy computed tomography (DECT) of both feet and hands to search for MSU crystals in a prospective study between October 2011 and July 2013. Presence and extent of MSU crystal deposits on DECT was assessed by automated volume measurement. Demographic and disease-specific characteristics were recorded and included into two logistic regression models to test for the factors associated with MSU crystal deposits in RA. Hyperuricemic RA patients were mostly male (55%), over 60 years of age (63 ± 11 years), had established disease (8.7 ± 10.5 years) and a mean disease activity score 28 (DAS 28) of 3.2. In total, 20 out of 100 patients displayed MSU crystal deposits in DECT. Interestingly, the majority (70%) of the RA patients positive for MSU crystal deposits were seronegative RA patients. Hence, every third seronegative RA patient had MSU crystal deposits. According to logistic regression model analysis, seronegative status correlated positively with presence of urate deposits (p = 0.019). These data show that a considerable number of RA patients display periarticular MSU crystal deposits. Seronegative patients were shown to be predominantly affected with every third patient being positive for urate deposits. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of optimized segmentation map in dual energy computed tomography

NASA Astrophysics Data System (ADS)

Yamakawa, Keisuke; Ueki, Hironori

2012-03-01

Dual energy computed tomography (DECT) has been widely used in clinical practice and has been particularly effective for tissue diagnosis. In DECT the difference of two attenuation coefficients acquired by two kinds of X-ray energy enables tissue segmentation. One problem in conventional DECT is that the segmentation deteriorates in some cases, such as bone removal. This is due to two reasons. Firstly, the segmentation map is optimized without considering the Xray condition (tube voltage and current). If we consider the tube voltage, it is possible to create an optimized map, but unfortunately we cannot consider the tube current. Secondly, the X-ray condition is not optimized. The condition can be set empirically, but this means that the optimized condition is not used correctly. To solve these problems, we have developed methods for optimizing the map (Method-1) and the condition (Method-2). In Method-1, the map is optimized to minimize segmentation errors. The distribution of the attenuation coefficient is modeled by considering the tube current. In Method-2, the optimized condition is decided to minimize segmentation errors depending on tube voltagecurrent combinations while keeping the total exposure constant. We evaluated the effectiveness of Method-1 by performing a phantom experiment under the fixed condition and of Method-2 by performing a phantom experiment under different combinations calculated from the total exposure constant. When Method-1 was followed with Method-2, the segmentation error was reduced from 37.8 to 13.5 %. These results demonstrate that our developed methods can achieve highly accurate segmentation while keeping the total exposure constant.

Three modality image registration of brain SPECT/CT and MR images for quantitative analysis of dopamine transporter imaging

NASA Astrophysics Data System (ADS)

Yamaguchi, Yuzuho; Takeda, Yuta; Hara, Takeshi; Zhou, Xiangrong; Matsusako, Masaki; Tanaka, Yuki; Hosoya, Kazuhiko; Nihei, Tsutomu; Katafuchi, Tetsuro; Fujita, Hiroshi

2016-03-01

Important features in Parkinson's disease (PD) are degenerations and losses of dopamine neurons in corpus striatum. 123I-FP-CIT can visualize activities of the dopamine neurons. The activity radio of background to corpus striatum is used for diagnosis of PD and Dementia with Lewy Bodies (DLB). The specific activity can be observed in the corpus striatum on SPECT images, but the location and the shape of the corpus striatum on SPECT images only are often lost because of the low uptake. In contrast, MR images can visualize the locations of the corpus striatum. The purpose of this study was to realize a quantitative image analysis for the SPECT images by using image registration technique with brain MR images that can determine the region of corpus striatum. In this study, the image fusion technique was used to fuse SPECT and MR images by intervening CT image taken by SPECT/CT. The mutual information (MI) for image registration between CT and MR images was used for the registration. Six SPECT/CT and four MR scans of phantom materials are taken by changing the direction. As the results of the image registrations, 16 of 24 combinations were registered within 1.3mm. By applying the approach to 32 clinical SPECT/CT and MR cases, all of the cases were registered within 0.86mm. In conclusions, our registration method has a potential in superimposing MR images on SPECT images.

SU-F-J-76: Evaluation of the Performance of Different Deformable Image Registration Algorithms in Helical, Axial and Cone-Beam CT Images of a Mobile Phantom

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

Jaskowiak, J; Ahmad, S; Ali, I

Purpose: To investigate quantitatively the performance of different deformable-image-registration algorithms (DIR) with helical (HCT), axial (ACT) and cone-beam CT (CBCT) by evaluating the variations in the CT-numbers and lengths of targets moving with controlled motion-patterns. Methods: Four DIR-algorithms including demons, fast-demons, Horn-Schunk and Locas-Kanade from the DIRART-software are used to register CT-images of a mobile-phantom. A mobile-phantom is scanned with different imaging techniques that include helical, axial and cone-beam CT. The phantom includes three targets with different lengths that are made from water-equivalent material and inserted in low-density-foam which is moved with adjustable motion-amplitudes and frequencies. Results: Most of themore » DIR-algorithms are able to produce the lengths of the stationary-targets, however, they do not produce the CT-number values in CBCT. The image-artifacts induced by motion are more regular in CBCT imaging where the mobile-target elongation increases linearly with motion-amplitude. In ACT and HCT, the motion-artifacts are irregular where some mobile -targets are elongated or shrunk depending on the motion-phase during imaging. The DIR-algorithms are successful in deforming the images of the mobile-targets to the images of the stationary-targets producing the CT-number values and length of the target for motion-amplitudes < 20 mm. Similarly in ACT, all DIR-algorithms produced the actual CT-number and length of the stationary-targets for motion-amplitudes < 15 mm. As stronger motion-artifacts are induced in HCT and ACT, DIR-algorithms fail to produce CT-values and shape of the stationary-targets and fast-demons-algorithm has worst performance. Conclusion: Most of DIR-algorithms produce the CT-number values and lengths of the stationary-targets in HCT and ACT images that has motion-artifacts induced by small motion-amplitudes. As motion-amplitudes increase, the DIR-algorithms fail to deform mobile-target images to the stationary-images in HCT and ACT. In CBCT, DIR-algorithms are successful in producing length and shape of the stationary-targets, however, they fail to produce the accurate CT-number level.« less

4D-CT motion estimation using deformable image registration and 5D respiratory motion modeling.

PubMed

Yang, Deshan; Lu, Wei; Low, Daniel A; Deasy, Joseph O; Hope, Andrew J; El Naqa, Issam

2008-10-01

Four-dimensional computed tomography (4D-CT) imaging technology has been developed for radiation therapy to provide tumor and organ images at the different breathing phases. In this work, a procedure is proposed for estimating and modeling the respiratory motion field from acquired 4D-CT imaging data and predicting tissue motion at the different breathing phases. The 4D-CT image data consist of series of multislice CT volume segments acquired in ciné mode. A modified optical flow deformable image registration algorithm is used to compute the image motion from the CT segments to a common full volume 3D-CT reference. This reference volume is reconstructed using the acquired 4D-CT data at the end-of-exhalation phase. The segments are optimally aligned to the reference volume according to a proposed a priori alignment procedure. The registration is applied using a multigrid approach and a feature-preserving image downsampling maxfilter to achieve better computational speed and higher registration accuracy. The registration accuracy is about 1.1 +/- 0.8 mm for the lung region according to our verification using manually selected landmarks and artificially deformed CT volumes. The estimated motion fields are fitted to two 5D (spatial 3D+tidal volume+airflow rate) motion models: forward model and inverse model. The forward model predicts tissue movements and the inverse model predicts CT density changes as a function of tidal volume and airflow rate. A leave-one-out procedure is used to validate these motion models. The estimated modeling prediction errors are about 0.3 mm for the forward model and 0.4 mm for the inverse model.

Recommendations on nuclear and multimodality imaging in IE and CIED infections.

PubMed

Erba, Paola Anna; Lancellotti, Patrizio; Vilacosta, Isidre; Gaemperli, Oliver; Rouzet, Francois; Hacker, Marcus; Signore, Alberto; Slart, Riemer H J A; Habib, Gilbert

2018-05-24

In the latest update of the European Society of Cardiology (ESC) guidelines for the management of infective endocarditis (IE), imaging is positioned at the centre of the diagnostic work-up so that an early and accurate diagnosis can be reached. Besides echocardiography, contrast-enhanced CT (ce-CT), radiolabelled leucocyte (white blood cell, WBC) SPECT/CT and [ 18 F]FDG PET/CT are included as diagnostic tools in the diagnostic flow chart for IE. Following the clinical guidelines that provided a straightforward message on the role of multimodality imaging, we believe that it is highly relevant to produce specific recommendations on nuclear multimodality imaging in IE and cardiac implantable electronic device infections. In these procedural recommendations we therefore describe in detail the technical and practical aspects of WBC SPECT/CT and [ 18 F]FDG PET/CT, including ce-CT acquisition protocols. We also discuss the advantages and limitations of each procedure, specific pitfalls when interpreting images, and the most important results from the literature, and also provide recommendations on the appropriate use of multimodality imaging.

Hybrid ECG-gated versus non-gated 512-slice CT angiography of the aorta and coronary artery: image quality and effect of a motion correction algorithm.

PubMed

Lee, Ji Won; Kim, Chang Won; Lee, Geewon; Lee, Han Cheol; Kim, Sang-Pil; Choi, Bum Sung; Jeong, Yeon Joo

2018-02-01

Background Using the hybrid electrocardiogram (ECG)-gated computed tomography (CT) technique, assessment of entire aorta, coronary arteries, and aortic valve can be possible using single-bolus contrast administration within a single acquisition. Purpose To compare the image quality of hybrid ECG-gated and non-gated CT angiography of the aorta and evaluate the effect of a motion correction algorithm (MCA) on coronary artery image quality in a hybrid ECG-gated aorta CT group. Material and Methods In total, 104 patients (76 men; mean age = 65.8 years) prospectively randomized into two groups (Group 1 = hybrid ECG-gated CT; Group 2 = non-gated CT) underwent wide-detector array aorta CT. Image quality, assessed using a four-point scale, was compared between the groups. Coronary artery image quality was compared between the conventional reconstruction and motion correction reconstruction subgroups in Group 1. Results Group 1 showed significant advantages over Group 2 in aortic wall, cardiac chamber, aortic valve, coronary ostia, and main coronary arteries image quality (all P < 0.001). All Group 1 patients had diagnostic image quality of the aortic wall and left ostium. The MCA significantly improved the image quality of the three main coronary arteries ( P < 0.05). Moreover, per-vessel interpretability improved from 92.3% to 97.1% with the MCA ( P = 0.013). Conclusion Hybrid ECG-gated CT significantly improved the heart and aortic wall image quality and the MCA can further improve the image quality and interpretability of coronary arteries.

Technical Note: Quantitative accuracy evaluation for spectral images from a detector-based spectral CT scanner using an iodine phantom.

PubMed

Duan, Xinhui; Arbique, Gary; Guild, Jeffrey; Xi, Yin; Anderson, Jon

2018-05-01

The purpose of this study was to evaluate the quantitative accuracy of spectral images from a detector-based spectral CT scanner using a phantom with iodine-loaded inserts. A 40-cm long-body phantom with seven iodine inserts (2-20 mg/ml of iodine) was used in the study. The inserts could be placed at 5.5 or 10.5 cm from the phantom axis. The phantom was scanned five times for each insert configuration using 120 kVp tube voltage. A set of iodine, virtual noncontrast, effective atomic number, and virtual monoenergetic spectral CT images were generated and measurements were made for all the iodine rods. Measured values were compared with reference values calculated from the chemical composition information provided by the phantom manufacturer. Radiation dose from the spectral CT was compared to a conventional CT using a CTDI (32 cm) phantom. Good agreement between measurements and reference values was achieved for all types of spectral images. The differences ranged from -0.46 to 0.1 mg/ml for iodine concentration, -9.95 to 6.41 HU for virtual noncontrast images, 0.12 to 0.35 for effective Z images, and -17.7 to 55.7 HU for virtual monoenergetic images. For a similar CTDIvol, image noise from the conventional CT was 10% lower than the spectral CT. The detector-based spectral CT can achieve accurate spectral measurements on iodine concentration, virtual non-contrast images, effective atomic numbers, and virtual monoenergetic images. © 2018 American Association of Physicists in Medicine.

Evaluation of Effective Parameters on Quality of Magnetic Resonance Imaging-computed Tomography Image Fusion in Head and Neck Tumors for Application in Treatment Planning

PubMed Central

Shirvani, Atefeh; Jabbari, Keyvan; Amouheidari, Alireza

2017-01-01

Background: In radiation therapy, computed tomography (CT) simulation is used for treatment planning to define the location of tumor. Magnetic resonance imaging (MRI)-CT image fusion leads to more efficient tumor contouring. This work tried to identify the practical issues for the combination of CT and MRI images in real clinical cases. The effect of various factors is evaluated on image fusion quality. Materials and Methods: In this study, the data of thirty patients with brain tumors were used for image fusion. The effect of several parameters on possibility and quality of image fusion was evaluated. These parameters include angles of the patient's head on the bed, slices thickness, slice gap, and height of the patient's head. Results: According to the results, the first dominating factor on quality of image fusion was the difference slice gap between CT and MRI images (cor = 0.86, P < 0.005) and second factor was the angle between CT and MRI slice in the sagittal plane (cor = 0.75, P < 0.005). In 20% of patients, this angle was more than 28° and image fusion was not efficient. In 17% of patients, difference slice gap in CT and MRI was >4 cm and image fusion quality was <25%. Conclusion: The most important problem in image fusion is that MRI images are taken without regard to their use in treatment planning. In general, parameters related to the patient position during MRI imaging should be chosen to be consistent with CT images of the patient in terms of location and angle. PMID:29387672

A computed tomography-based spatial normalization for the analysis of [18F] fluorodeoxyglucose positron emission tomography of the brain.

PubMed

Cho, Hanna; Kim, Jin Su; Choi, Jae Yong; Ryu, Young Hoon; Lyoo, Chul Hyoung

2014-01-01

We developed a new computed tomography (CT)-based spatial normalization method and CT template to demonstrate its usefulness in spatial normalization of positron emission tomography (PET) images with [(18)F] fluorodeoxyglucose (FDG) PET studies in healthy controls. Seventy healthy controls underwent brain CT scan (120 KeV, 180 mAs, and 3 mm of thickness) and [(18)F] FDG PET scans using a PET/CT scanner. T1-weighted magnetic resonance (MR) images were acquired for all subjects. By averaging skull-stripped and spatially-normalized MR and CT images, we created skull-stripped MR and CT templates for spatial normalization. The skull-stripped MR and CT images were spatially normalized to each structural template. PET images were spatially normalized by applying spatial transformation parameters to normalize skull-stripped MR and CT images. A conventional perfusion PET template was used for PET-based spatial normalization. Regional standardized uptake values (SUV) measured by overlaying the template volume of interest (VOI) were compared to those measured with FreeSurfer-generated VOI (FSVOI). All three spatial normalization methods underestimated regional SUV values by 0.3-20% compared to those measured with FSVOI. The CT-based method showed slightly greater underestimation bias. Regional SUV values derived from all three spatial normalization methods were correlated significantly (p < 0.0001) with those measured with FSVOI. CT-based spatial normalization may be an alternative method for structure-based spatial normalization of [(18)F] FDG PET when MR imaging is unavailable. Therefore, it is useful for PET/CT studies with various radiotracers whose uptake is expected to be limited to specific brain regions or highly variable within study population.

Diagnostic accuracy of sequential co-registered PET+MR in comparison to PET/CT in local thoracic staging of malignant pleural mesothelioma.

PubMed

Martini, Katharina; Meier, Andreas; Opitz, Isabelle; Weder, Walter; Veit-Haibach, Patrick; Stahel, Rolf A; Frauenfelder, Thomas

2016-04-01

To investigate the diagnostic accuracy of sequential co-registered PET+MR (PET+MR) for local staging of malignant pleural mesothelioma (MPM) compared to PET/CT. In a prospective clinical trial 34 consecutive patients (median age 66 years; range 40-79 years; 1 female, 33 male) with known MPM, who underwent PET/CT and PET+MR exams for either staging or re-staging/follow-up were evaluated. Imaging was conducted using a tri-modality PET/CT-MR set-up (Discovery PET/CT 690, 3T Discovery MR 750w, both GE Healthcare, Waukesha, WI, USA). In 26 cases histopathology served as standard of reference. Two independent readers evaluated images for T and N stage, confidence level (sure to unsure; 1-3) and subjective overall image quality (very good to non-diagnostic; 1-4). Inter-observer agreement of T and N stages (Cohen's kappa) and interclass correlation coefficient (ICC) between PET/CT vs. PET+MR was calculated. Inter observer agreement for evaluation of T and N Stage in PET/CT images was excellent (k=0.844 and k=0.824, respectively), whereas PET+MR imaging showed substantial agreement in T and N stage (k=0.729 and k=0.691, respectively). The ICC of PET/CT vs. PET+MR for evaluation of both, T and N Stage, was excellent (ICC=0.951 and ICC=0.93, respectively). Diagnostic confidence was scored significantly higher in PET+MR compared to PET/CT (mean score=1.66 and 1.93, respectively; p=0.004). Image quality was diagnostic for all image series. Comparing pT and pN stage vs cT and cN stage (n=26 cases), both imaging modalities showed excellent agreement for T stage (ICCPET+MR=0.888 vs. ICCPET/CT=0.853, respectively) and substantial to moderate agreement for N stage (ICCPET+MR=0.683 vs. ICC=0.595PET/CT, respectively). Our findings suggest that diagnostic accuracy of PET+MR is comparable to PET/CT for local staging of MPM, whereas radiologists felt significantly more confident staging PET+MR compared to PET/CT images (p=0003), using dedicated sequences. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stereotactic ultrasound for target volume definition in a patient with prostate cancer and bilateral total hip replacement.

PubMed

Boda-Heggemann, Judit; Haneder, Stefan; Ehmann, Michael; Sihono, Dwi Seno Kuncoro; Wertz, Hansjörg; Mai, Sabine; Kegel, Stefan; Heitmann, Sigrun; von Swietochowski, Sandra; Lohr, Frank; Wenz, Frederik

2015-01-01

Target-volume definition for prostate cancer in patients with bilateral metal total hip replacements (THRs) is a challenge because of metal artifacts in the planning computed tomography (CT) scans. Magnetic resonance imaging (MRI) can be used for matching and prostate delineation; however, at a spatial and temporal distance from the planning CT, identical rectal and vesical filling is difficult to achieve. In addition, MRI may also be impaired by metal artifacts, even resulting in spatial image distortion. Here, we present a method to define prostate target volumes based on ultrasound images acquired during CT simulation and online-matched to the CT data set directly at the planning CT. A 78-year-old patient with cT2cNxM0 prostate cancer with bilateral metal THRs was referred to external beam radiation therapy. T2-weighted MRI was performed on the day of the planning CT with preparation according to a protocol for reproducible bladder and rectal filling. The planning CT was obtained with the immediate acquisition of a 3-dimensional ultrasound data set with a dedicated stereotactic ultrasound system for online intermodality image matching referenced to the isocenter by ceiling-mounted infrared cameras. MRI (offline) and ultrasound images (online) were thus both matched to the CT images for planning. Daily image guided radiation therapy (IGRT) was performed with transabdominal ultrasound and compared with cone beam CT. Because of variations in bladder and rectal filling and metal-induced image distortion in MRI, soft-tissue-based matching of the MRI to CT was not sufficient for unequivocal prostate target definition. Ultrasound-based images could be matched, and prostate, seminal vesicles, and target volumes were reliably defined. Daily IGRT could be successfully completed with transabdominal ultrasound with good accordance between cone beam CT and ultrasound. For prostate cancer patients with bilateral THRs causing artifacts in planning CTs, ultrasound referenced to the isocenter of the CT simulator and acquired with intermodal online coregistration directly at the planning CT is a fast and easy method to reliably delineate the prostate and target volumes and for daily IGRT. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Dose assessment of digital tomosynthesis in pediatric imaging

NASA Astrophysics Data System (ADS)

Gislason, Amber; Elbakri, Idris A.; Reed, Martin

2009-02-01

We investigated the potential for digital tomosynthesis (DT) to reduce pediatric x-ray dose while maintaining image quality. We utilized the DT feature (VolumeRadTM) on the GE DefiniumTM 8000 flat panel system installed in the Winnipeg Children's Hospital. Facial bones, cervical spine, thoracic spine, and knee of children aged 5, 10, and 15 years were represented by acrylic phantoms for DT dose measurements. Effective dose was estimated for DT and for corresponding digital radiography (DR) and computed tomography (CT) patient image sets. Anthropomorphic phantoms of selected body parts were imaged by DR, DT, and CT. Pediatric radiologists rated visualization of selected anatomic features in these images. Dose and image quality comparisons between DR, DT, and CT determined the usefulness of tomosynthesis for pediatric imaging. CT effective dose was highest; total DR effective dose was not always lowest - depending how many projections were in the DR image set. For the cervical spine, DT dose was close to and occasionally lower than DR dose. Expert radiologists rated visibility of the central facial complex in a skull phantom as better than DR and comparable to CT. Digital tomosynthesis has a significantly lower dose than CT. This study has demonstrated DT shows promise to replace CT for some facial bones and spinal diagnoses. Other clinical applications will be evaluated in the future.

Synchrotron μCT imaging of bone, titanium implants and bone substitutes - a systematic review of the literature.

PubMed

Neldam, Camilla Albeck; Pinholt, Else Marie

2014-09-01

Today X-ray micro computer tomography (μCT) imaging is used to investigate bone microarchitecture. μCT imaging is obtained by polychromatic X-ray beams, resulting in images with beam hardening artifacts, resolution levels at 10 μm, geometrical blurring, and lack of contrasts. When μCT is coupled to synchrotron sources (SRμCT) a spatial resolution up to one tenth of a μm may be achieved. A review of the literature concerning SRμCT was performed to investigate its usability and its strength in visualizing fine bone structures, vessels, and microarchitecture of bone. Although mainly limited to in vitro examinations, SRμCT is considered as a gold standard to image trabecular bone microarchitecture since it is possible in a 3D manner to visualize fine structural elements within mineralized tissue such as osteon boundaries, rods and plates structures, cement lines, and differences in mineralization. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Emerging Techniques for Dose Optimization in Abdominal CT

PubMed Central

Platt, Joel F.; Goodsitt, Mitchell M.; Al-Hawary, Mahmoud M.; Maturen, Katherine E.; Wasnik, Ashish P.; Pandya, Amit

2014-01-01

Recent advances in computed tomographic (CT) scanning technique such as automated tube current modulation (ATCM), optimized x-ray tube voltage, and better use of iterative image reconstruction have allowed maintenance of good CT image quality with reduced radiation dose. ATCM varies the tube current during scanning to account for differences in patient attenuation, ensuring a more homogeneous image quality, although selection of the appropriate image quality parameter is essential for achieving optimal dose reduction. Reducing the x-ray tube voltage is best suited for evaluating iodinated structures, since the effective energy of the x-ray beam will be closer to the k-edge of iodine, resulting in a higher attenuation for the iodine. The optimal kilovoltage for a CT study should be chosen on the basis of imaging task and patient habitus. The aim of iterative image reconstruction is to identify factors that contribute to noise on CT images with use of statistical models of noise (statistical iterative reconstruction) and selective removal of noise to improve image quality. The degree of noise suppression achieved with statistical iterative reconstruction can be customized to minimize the effect of altered image quality on CT images. Unlike with statistical iterative reconstruction, model-based iterative reconstruction algorithms model both the statistical noise and the physical acquisition process, allowing CT to be performed with further reduction in radiation dose without an increase in image noise or loss of spatial resolution. Understanding these recently developed scanning techniques is essential for optimization of imaging protocols designed to achieve the desired image quality with a reduced dose. © RSNA, 2014 PMID:24428277

SU-E-J-240: The Impact On Clinical Dose-Distributions When Using MR-Images Registered with Stereotactic CT-Images in Gamma Knife Radiosurgery

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

Benmakhlouf, H; Kraepelien, T; Forander, P

2014-06-01

Purpose: Most Gamma knife treatments are based solely on MR-images. However, for fractionated treatments and to implement TPS dose calculations that require electron densities, CT image data is essential. The purpose of this work is to assess the dosimetric effects of using MR-images registered with stereotactic CT-images in Gamma knife treatments. Methods: Twelve patients treated for vestibular schwannoma with Gamma Knife Perfexion (Elekta Instruments, Sweden) were selected for this study. The prescribed doses (12 Gy to periphery) were delivered based on the conventional approach of using stereotactic MR-images only. These plans were imported into stereotactic CT-images (by registering MR-images withmore » stereotactic CT-images using the Leksell gamma plan registration software). The dose plans, for each patient, are identical in both cases except for potential rotations and translations resulting from the registration. The impact of the registrations was assessed by an algorithm written in Matlab. The algorithm compares the dose-distributions voxel-by-voxel between the two plans, calculates the full dose coverage of the target (treated in the conventional approach) achieved by the CT-based plan, and calculates the minimum dose delivered to the target (treated in the conventional approach) achieved by the CT-based plan. Results: The mean dose difference between the plans was 0.2 Gy to 0.4 Gy (max 4.5 Gy) whereas between 89% and 97% of the target (treated in the conventional approach) received the prescribed dose, by the CT-plan. The minimum dose to the target (treated in the conventional approach) given by the CT-based plan was between 7.9 Gy and 10.7 Gy (compared to 12 Gy in the conventional treatment). Conclusion: The impact of using MR-images registered with stereotactic CT-images has successfully been compared to conventionally delivered dose plans showing significant differences between the two. Although CTimages have been implemented clinically; the effect of the registration has not been fully investigated.« less

Low-cost printing of computerised tomography (CT) images where there is no dedicated CT camera.

PubMed

Tabari, Abdulkadir M

2007-01-01

Many developing countries still rely on conventional hard copy images to transfer information among physicians. We have developed a low-cost alternative method of printing computerised tomography (CT) scan images where there is no dedicated camera. A digital camera is used to photograph images from the CT scan screen monitor. The images are then transferred to a PC via a USB port, before being printed on glossy paper using an inkjet printer. The method can be applied to other imaging modalities like ultrasound and MRI and appears worthy of emulation elsewhere in the developing world where resources and technical expertise are scarce.

Quality of routine diagnostic abdominal images generated from a novel detector-based spectral CT scanner: a technical report on a phantom and clinical study.

PubMed

Hojjati, Mojgan; Van Hedent, Steven; Rassouli, Negin; Tatsuoka, Curtis; Jordan, David; Dhanantwari, Amar; Rajiah, Prabhakar

2017-11-01

To evaluate the image quality of routine diagnostic images generated from a novel detector-based spectral detector CT (SDCT) and compare it with CT images obtained from a conventional scanner with an energy-integrating detector (Brilliance iCT), Routine diagnostic (conventional/polyenergetic) images are non-material-specific images that resemble single-energy images obtained at the same radiation, METHODS: ACR guideline-based phantom evaluations were performed on both SDCT and iCT for CT adult body protocol. Retrospective analysis was performed on 50 abdominal CT scans from each scanner. Identical ROIs were placed at multiple locations in the abdomen and attenuation, noise, SNR, and CNR were measured. Subjective image quality analysis on a 5-point Likert scale was performed by 2 readers for enhancement, noise, and image quality. On phantom studies, SDCT images met the ACR requirements for CT number and deviation, CNR and effective radiation dose. In patients, the qualitative scores were significantly higher for the SDCT than the iCT, including enhancement (4.79 ± 0.38 vs. 4.60 ± 0.51, p = 0.005), noise (4.63 ± 0.42 vs. 4.29 ± 0.50, p = 0.000), and quality (4.85 ± 0.32, vs. 4.57 ± 0.50, p = 0.000). The SNR was higher in SDCT than iCT for liver (7.4 ± 4.2 vs. 7.2 ± 5.3, p = 0.662), spleen (8.6 ± 4.1 vs. 7.4 ± 3.5, p = 0.152), kidney (11.1 ± 6.3 vs. 8.7 ± 5.0, p = 0.033), pancreas (6.90 ± 3.45 vs 6.11 ± 2.64, p = 0.303), aorta (14.2 ± 6.2 vs. 11.0 ± 4.9, p = 0.007), but was slightly lower in lumbar-vertebra (7.7 ± 4.2 vs. 7.8 ± 4.5, p = 0.937). The CNR of the SDCT was also higher than iCT for all abdominal organs. Image quality of routine diagnostic images from the SDCT is comparable to images of a conventional CT scanner with energy-integrating detectors, making it suitable for diagnostic purposes.

Image-based metal artifact reduction in x-ray computed tomography utilizing local anatomical similarity

NASA Astrophysics Data System (ADS)

Dong, Xue; Yang, Xiaofeng; Rosenfield, Jonathan; Elder, Eric; Dhabaan, Anees

2017-03-01

X-ray computed tomography (CT) is widely used in radiation therapy treatment planning in recent years. However, metal implants such as dental fillings and hip prostheses can cause severe bright and dark streaking artifacts in reconstructed CT images. These artifacts decrease image contrast and degrade HU accuracy, leading to inaccuracies in target delineation and dose calculation. In this work, a metal artifact reduction method is proposed based on the intrinsic anatomical similarity between neighboring CT slices. Neighboring CT slices from the same patient exhibit similar anatomical features. Exploiting this anatomical similarity, a gamma map is calculated as a weighted summation of relative HU error and distance error for each pixel in an artifact-corrupted CT image relative to a neighboring, artifactfree image. The minimum value in the gamma map for each pixel is used to identify an appropriate pixel from the artifact-free CT slice to replace the corresponding artifact-corrupted pixel. With the proposed method, the mean CT HU error was reduced from 360 HU and 460 HU to 24 HU and 34 HU on head and pelvis CT images, respectively. Dose calculation accuracy also improved, as the dose difference was reduced from greater than 20% to less than 4%. Using 3%/3mm criteria, the gamma analysis failure rate was reduced from 23.25% to 0.02%. An image-based metal artifact reduction method is proposed that replaces corrupted image pixels with pixels from neighboring CT slices free of metal artifacts. This method is shown to be capable of suppressing streaking artifacts, thereby improving HU and dose calculation accuracy.

Use of a Diagnostic Score to Prioritize Computed Tomographic (CT) Imaging for Patients Suspected of Ischemic Stroke Who May Benefit from Thrombolytic Therapy

PubMed Central

Bots, Michiel L.; Selvarajah, Sharmini; Kappelle, L. Jaap; Abdul Aziz, Zariah; Sidek, Norsima Nazifah; Vaartjes, Ilonca

2016-01-01

Background A shortage of computed tomographic (CT) machines in low and middle income countries often results in delayed CT imaging for patients suspected of a stroke. Yet, time constraint is one of the most important aspects for patients with an ischemic stroke to benefit from thrombolytic therapy. We set out to assess whether application of the Siriraj Stroke Score is able to assist physicians in prioritizing patients with a high probability of having an ischemic stroke for urgent CT imaging. Methods From the Malaysian National Neurology Registry, we selected patients aged 18 years and over with clinical features suggesting of a stroke, who arrived in the hospital 4.5 hours or less from ictus. The prioritization of receiving CT imaging was left to the discretion of the treating physician. We applied the Siriraj Stroke Score to all patients, refitted the score and defined a cut-off value to best distinguish an ischemic stroke from a hemorrhagic stroke. Results Of the 2176 patients included, 73% had an ischemic stroke. Only 33% of the ischemic stroke patients had CT imaging within 4.5 hours. The median door-to-scan time for these patients was 4 hours (IQR: 1;16). With the recalibrated score, it would have been possible to prioritize 95% (95% CI: 94%–96%) of patients with an ischemic stroke for urgent CT imaging. Conclusions In settings where CT imaging capacity is limited, we propose the use of the Siriraj Stroke Score to prioritize patients with a probable ischemic stroke for urgent CT imaging. PMID:27768752

Quantifying the impact of respiratory-gated 4D CT acquisition on thoracic image quality: A digital phantom study

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

Bernatowicz, K., E-mail: kingab@student.ethz.ch; Knopf, A.; Lomax, A.

Purpose: Prospective respiratory-gated 4D CT has been shown to reduce tumor image artifacts by up to 50% compared to conventional 4D CT. However, to date no studies have quantified the impact of gated 4D CT on normal lung tissue imaging, which is important in performing dose calculations based on accurate estimates of lung volume and structure. To determine the impact of gated 4D CT on thoracic image quality, the authors developed a novel simulation framework incorporating a realistic deformable digital phantom driven by patient tumor motion patterns. Based on this framework, the authors test the hypothesis that respiratory-gated 4D CTmore » can significantly reduce lung imaging artifacts. Methods: Our simulation framework synchronizes the 4D extended cardiac torso (XCAT) phantom with tumor motion data in a quasi real-time fashion, allowing simulation of three 4D CT acquisition modes featuring different levels of respiratory feedback: (i) “conventional” 4D CT that uses a constant imaging and couch-shift frequency, (ii) “beam paused” 4D CT that interrupts imaging to avoid oversampling at a given couch position and respiratory phase, and (iii) “respiratory-gated” 4D CT that triggers acquisition only when the respiratory motion fulfills phase-specific displacement gating windows based on prescan breathing data. Our framework generates a set of ground truth comparators, representing the average XCAT anatomy during beam-on for each of ten respiratory phase bins. Based on this framework, the authors simulated conventional, beam-paused, and respiratory-gated 4D CT images using tumor motion patterns from seven lung cancer patients across 13 treatment fractions, with a simulated 5.5 cm{sup 3} spherical lesion. Normal lung tissue image quality was quantified by comparing simulated and ground truth images in terms of overall mean square error (MSE) intensity difference, threshold-based lung volume error, and fractional false positive/false negative rates. Results: Averaged across all simulations and phase bins, respiratory-gating reduced overall thoracic MSE by 46% compared to conventional 4D CT (p ∼ 10{sup −19}). Gating leads to small but significant (p < 0.02) reductions in lung volume errors (1.8%–1.4%), false positives (4.0%–2.6%), and false negatives (2.7%–1.3%). These percentage reductions correspond to gating reducing image artifacts by 24–90 cm{sup 3} of lung tissue. Similar to earlier studies, gating reduced patient image dose by up to 22%, but with scan time increased by up to 135%. Beam paused 4D CT did not significantly impact normal lung tissue image quality, but did yield similar dose reductions as for respiratory-gating, without the added cost in scanning time. Conclusions: For a typical 6 L lung, respiratory-gated 4D CT can reduce image artifacts affecting up to 90 cm{sup 3} of normal lung tissue compared to conventional acquisition. This image improvement could have important implications for dose calculations based on 4D CT. Where image quality is less critical, beam paused 4D CT is a simple strategy to reduce imaging dose without sacrificing acquisition time.« less

Simultaneous (68)Ga-DOTA-TOC PET/MRI with gadoxetate disodium in patients with neuroendocrine tumor.

PubMed

Hope, Thomas A; Pampaloni, Miguel Hernandez; Nakakura, Eric; VanBrocklin, Henry; Slater, James; Jivan, Salma; Aparici, Carina Mari; Yee, Judy; Bergsland, Emily

2015-08-01

To evaluate a simultaneous PET/MRI approach to imaging patients with neuroendocrine tumor using a combination of (68)Ga-DOTA-TOC as a PET contrast agent and gadoxetate disodium as a hepatobiliary MRI contrast agent. Ten patients with neuroendocrine tumor with known or suspected hepatic disease were imaged using a (68)Ga-DOTA-TOC PET/CT immediately followed by a 3.0T time-of-flight PET/MRI, using a combined whole body and liver specific imaging. The presence of lesions and DOTA-TOC avidity were assessed on CT, PET from PET/CT, diffusion weighted imaging, hepatobiliary phase imaging (HBP), and PET from PET/MRI. Maximum standardized uptake values (SUVmax) in hepatic lesions and nodal metastases were compared between PET/CT and PET/MRI, as were detection rates using each imaging approach. A total of 101 hepatic lesions were identified, 47 of which were DOTA-TOC avid and able to be individually measured on both PET/CT and PET/MRI. HBP imaging had a higher sensitivity for detection of hepatic lesions compared to CT or PET (99% vs. 46% and 64%, respectively; p values <0.001). There was a strong correlation between SUVmax of liver lesions obtained with PET/CT compared to PET/MR imaging (Pearson's correlation = 0.91). For nodal disease, CT had a higher sensitivity compared to whole body MRI (p = 0.015), although PET acquired from PET/MRI detected slightly more lesions compared to PET from PET/CT. A simultaneous PET/MRI using both (68)Ga-DOTA-TOC and gadoxetate disodium was successful in whole body staging of patients with neuroendocrine tumor. HBP imaging had an increased detection rate for hepatic metastases.

PET/CT scanners: a hardware approach to image fusion.

PubMed

Townsend, David W; Beyer, Thomas; Blodgett, Todd M

2003-07-01

New technology that combines positron tomography with x-ray computed tomography (PET/CT) is available from all major vendors of PET imaging equipment: CTI, Siemens, GE, Philips. Although not all vendors have made the same design choices as those described in this review all have in common that their high performance design places a commercial CT scanner in tandem with a commercial PET scanner. The level of physical integration is actually less than that of the original prototype design where the CT and PET components were mounted on the same rotating support. There will undoubtedly be a demand for PET/CT technology with a greater level of integration, and at a reduced cost. This may be achieved through the design of a scanner specifically for combined anatomical and functional imaging, rather than a design combining separate CT and PET scanners, as in the current approaches. By avoiding the duplication of data acquisition and image reconstruction functions, for example, a more integrated design should also allow cost savings over current commercial PET/CT scanners. The goal is then to design and build a device specifically for imaging the function and anatomy of cancer in the most optimal and effective way, without conceptualizing it as combined PET and CT. The development of devices specifically for imaging a particular disease (eg, cancer) differs from the conventional approach of, for example, an all-purpose anatomical imaging device such as a CT scanner. This new concept targets more of a disease management approach rather than the usual division into the medical specialties of radiology (anatomical imaging) and nuclear medicine (functional imaging). Copyright 2003 Elsevier Inc. All rights reserved.

68Ga-PSMA-PET/CT in Patients With Biochemical Prostate Cancer Recurrence and Negative 18F-Choline-PET/CT

PubMed Central

Bluemel, Christina; Krebs, Markus; Polat, Bülent; Linke, Fränze; Eiber, Matthias; Samnick, Samuel; Lapa, Constantin; Lassmann, Michael; Riedmiller, Hubertus; Czernin, Johannes; Rubello, Domenico; Bley, Thorsten; Kropf, Saskia; Wester, Hans-Juergen; Buck, Andreas K.; Herrmann, Ken

2016-01-01

Purpose Investigating the value of 68Ga-PSMA-PET/CT in biochemically recurring prostate cancer patients with negative 18F-choline-PET/CT. Patients and Methods One hundred thirty-nine consecutive patients with biochemical recurrence after curative (surgery and/or radiotherapy) therapy were offered participation in this sequential clinical imaging approach. Patients first underwent an 18F-choline-PET/CT. If negative, an additional 68Ga-PSMA-PET/CTwas offered. One hundred twenty-five of 139 eligible patients were included in the study; 32 patients underwent additional 68Ga-PSMA-PET/CT. Patients with equivocal findings (n = 5) on 18F-choline-PET/CT and those who declined the additional 68Ga-PSMA-PET/CT (n = 9) were excluded. Images were analyzed visually for the presence of suspicious lesions. Findings on PET/CT were correlated with PSA level, PSA doubling time (dt), and PSA velocity (vel). Results The overall detection rates were 85.6% (107/125) for the sequential imaging approach and 74.4% (93/125) for 18F-choline-PET/CT alone. 68Ga-PSMA-PET/CT detected sites of recurrence in 43.8% (14/32) of the choline-negative patients. Detection rates of the sequential imaging approach and 18F-choline-PET/CT alone increased with higher serum PSA levels and PSA vel. Subgroup analysis of 68Ga-PSMA-PET/CT in 18F-choline negative patients revealed detection rates of 28.6%, 45.5%, and 71.4% for PSA levels of 0.2 or greater to less than 1 ng/mL, 1 to 2 ng/mL, and greater than 2 ng/mL, respectively. Conclusions The sequential imaging approach designed to limit 68Ga-PSMA imaging to patients with negative choline scans resulted in high detection rates. 68Ga-PSMA-PET/CT identified sites of recurrent disease in 43.8% of the patients with negative 18F-choline PET/CT scans. PMID:26975008

Low-dose computed tomography scans with automatic exposure control for patients of different ages undergoing cardiac PET/CT and SPECT/CT.

PubMed

Yang, Ching-Ching; Yang, Bang-Hung; Tu, Chun-Yuan; Wu, Tung-Hsin; Liu, Shu-Hsin

2017-06-01

This study aimed to evaluate the efficacy of automatic exposure control (AEC) in order to optimize low-dose computed tomography (CT) protocols for patients of different ages undergoing cardiac PET/CT and single-photon emission computed tomography/computed tomography (SPECT/CT). One PET/CT and one SPECT/CT were used to acquire CT images for four anthropomorphic phantoms representative of 1-year-old, 5-year-old and 10-year-old children and an adult. For the hybrid systems investigated in this study, the radiation dose and image quality of cardiac CT scans performed with AEC activated depend mainly on the selection of a predefined image quality index. Multiple linear regression methods were used to analyse image data from anthropomorphic phantom studies to investigate the effects of body size and predefined image quality index on CT radiation dose in cardiac PET/CT and SPECT/CT scans. The regression relationships have a coefficient of determination larger than 0.9, indicating a good fit to the data. According to the regression models, low-dose protocols using the AEC technique were optimized for patients of different ages. In comparison with the standard protocol with AEC activated for adult cardiac examinations used in our clinical routine practice, the optimized paediatric protocols in PET/CT allow 32.2, 63.7 and 79.2% CT dose reductions for anthropomorphic phantoms simulating 10-year-old, 5-year-old and 1-year-old children, respectively. The corresponding results for cardiac SPECT/CT are 8.4, 51.5 and 72.7%. AEC is a practical way to reduce CT radiation dose in cardiac PET/CT and SPECT/CT, but the AEC settings should be determined properly for optimal effect. Our results show that AEC does not eliminate the need for paediatric protocols and CT examinations using the AEC technique should be optimized for paediatric patients to reduce the radiation dose as low as reasonably achievable.

Cardiac CT for myocardial ischaemia detection and characterization--comparative analysis.

PubMed

Bucher, A M; De Cecco, C N; Schoepf, U J; Wang, R; Meinel, F G; Binukrishnan, S R; Spearman, J V; Vogl, T J; Ruzsics, B

2014-11-01

The assessment of patients presenting with symptoms of myocardial ischaemia remains one of the most common and challenging clinical scenarios faced by physicians. Current imaging modalities are capable of three-dimensional, functional and anatomical views of the heart and as such offer a unique contribution to understanding and managing the pathology involved. Evidence has accumulated that visual anatomical coronary evaluation does not adequately predict haemodynamic relevance and should be complemented by physiological evaluation, highlighting the importance of functional assessment. Technical advances in CT technology over the past decade have progressively moved cardiac CT imaging into the clinical workflow. In addition to anatomical evaluation, cardiac CT is capable of providing myocardial perfusion parameters. A variety of CT techniques can be used to assess the myocardial perfusion. The single energy first-pass CT and dual energy first-pass CT allow static assessment of myocardial blood pool. Dynamic cardiac CT imaging allows quantification of myocardial perfusion through time-resolved attenuation data. CT-based myocardial perfusion imaging (MPI) is showing promising diagnostic accuracy compared with the current reference modalities. The aim of this review is to present currently available myocardial perfusion techniques with a focus on CT imaging in light of recent clinical investigations. This article provides a comprehensive overview of currently available CT approaches of static and dynamic MPI and presents the results of corresponding clinical trials.

Region-of-interest image reconstruction in circular cone-beam microCT

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

Cho, Seungryong; Bian, Junguo; Pelizzari, Charles A.

2007-12-15

Cone-beam microcomputed tomography (microCT) is one of the most popular choices for small animal imaging which is becoming an important tool for studying animal models with transplanted diseases. Region-of-interest (ROI) imaging techniques in CT, which can reconstruct an ROI image from the projection data set of the ROI, can be used not only for reducing imaging-radiation exposure to the subject and scatters to the detector but also for potentially increasing spatial resolution of the reconstructed images. Increasing spatial resolution in microCT images can facilitate improved accuracy in many assessment tasks. A method proposed previously for increasing CT image spatial resolutionmore » entails the exploitation of the geometric magnification in cone-beam CT. Due to finite detector size, however, this method can lead to data truncation for a large geometric magnification. The Feldkamp-Davis-Kress (FDK) algorithm yields images with artifacts when truncated data are used, whereas the recently developed backprojection filtration (BPF) algorithm is capable of reconstructing ROI images without truncation artifacts from truncated cone-beam data. We apply the BPF algorithm to reconstructing ROI images from truncated data of three different objects acquired by our circular cone-beam microCT system. Reconstructed images by use of the FDK and BPF algorithms from both truncated and nontruncated cone-beam data are compared. The results of the experimental studies demonstrate that, from certain truncated data, the BPF algorithm can reconstruct ROI images with quality comparable to that reconstructed from nontruncated data. In contrast, the FDK algorithm yields ROI images with truncation artifacts. Therefore, an implication of the studies is that, when truncated data are acquired with a configuration of a large geometric magnification, the BPF algorithm can be used for effective enhancement of the spatial resolution of a ROI image.« less

Standard-, Reduced-, and No-Dose Thin-Section Radiologic Examinations: Comparison of Capability for Nodule Detection and Nodule Type Assessment in Patients Suspected of Having Pulmonary Nodules.

PubMed

Ohno, Yoshiharu; Koyama, Hisanobu; Yoshikawa, Takeshi; Kishida, Yuji; Seki, Shinichiro; Takenaka, Daisuke; Yui, Masao; Miyazaki, Mitsue; Sugimura, Kazuro

2017-08-01

Purpose To compare the capability of pulmonary thin-section magnetic resonance (MR) imaging with ultrashort echo time (UTE) with that of standard- and reduced-dose thin-section computed tomography (CT) in nodule detection and evaluation of nodule type. Materials and Methods The institutional review board approved this study, and written informed consent was obtained from each patient. Standard- and reduced-dose chest CT (60 and 250 mA) and MR imaging with UTE were used to examine 52 patients; 29 were men (mean age, 66.4 years ± 7.3 [standard deviation]; age range, 48-79 years) and 23 were women (mean age, 64.8 years ± 10.1; age range, 42-83 years). Probability of nodule presence was assessed for all methods with a five-point visual scoring system. All nodules were then classified as missed, ground-glass, part-solid, or solid nodules. To compare nodule detection capability of the three methods, consensus for performances was rated by using jackknife free-response receiver operating characteristic analysis, and κ analysis was used to compare intermethod agreement for nodule type classification. Results There was no significant difference (F = 0.70, P = .59) in figure of merit between methods (standard-dose CT, 0.86; reduced-dose CT, 0.84; MR imaging with UTE, 0.86). There was no significant difference in sensitivity between methods (standard-dose CT vs reduced-dose CT, P = .50; standard-dose CT vs MR imaging with UTE, P = .50; reduced-dose CT vs MR imaging with UTE, P >.99). Intermethod agreement was excellent (standard-dose CT vs reduced-dose CT, κ = 0.98, P < .001; standard-dose CT vs MR imaging with UTE, κ = 0.98, P < .001; reduced-dose CT vs MR imaging with UTE, κ = 0.99, P < .001). Conclusion Pulmonary thin-section MR imaging with UTE was useful in nodule detection and evaluation of nodule type, and it is considered at least as efficacious as standard- or reduced-dose thin-section CT. © RSNA, 2017 Online supplemental material is available for this article.

FDG-PET/CT imaging for tumor staging and definition of tumor volumes in radiation treatment planning in non-small cell lung cancer.

PubMed

Zheng, Yuanda; Sun, Xiaojiang; Wang, Jian; Zhang, Lingnan; DI, Xiaoyun; Xu, Yaping

2014-04-01

18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) has the potential to improve the staging and radiation treatment (RT) planning of various tumor sites. However, from a clinical standpoint, questions remain with regard to what extent PET/CT changes the target volume and whether PET/CT reduces interobserver variability in target volume delineation. The present study analyzed the use of FDG-PET/CT images for staging and evaluated the impact of FDG-PET/CT on the radiotherapy volume delineation compared with CT in patients with non-small cell lung cancer (NSCLC) who were candidates for radiotherapy. Intraobserver variation in delineating tumor volumes was also observed. In total, 23 patients with stage I-III NSCLC were enrolled and treated with fractionated RT-based therapy with or without chemotherapy. FDG-PET/CT scans were acquired within two weeks prior to RT. PET and CT data sets were sent to the treatment planning system, Pinnacle, through compact discs. The CT and PET images were subsequently fused by means of a dedicated RT planning system. Gross tumor volume (GTV) was contoured by four radiation oncologists on CT (GTV-CT) and PET/CT images (GTV-PET/CT). The resulting volumes were analyzed and compared. For the first phase, two radiation oncologists outlined the contours together, achieving a final consensus. Based on PET/CT, changes in tumor-node-metastasis categories occurred in 8/23 cases (35%). Radiation targeting with fused FDG-PET and CT images resulted in alterations in radiation therapy planning in 12/20 patients (60%) in comparison with CT targeting. The most prominent changes in GTV were observed in cases with atelectasis. For the second phase, the variation in delineating tumor volumes was assessed by four observers. The mean ratio of largest to smallest CT-based GTV was 2.31 (range, 1.01-5.96). The addition of the PET results reduced the mean ratio to 1.46 (range, 1.02-2.27). PET/CT fusion images may have a potential impact on tumor staging and treatment planning. Implementing matched PET/CT results reduced observer variation in delineating tumor volumes significantly with respect to CT only.

Technical Note: MRI only prostate radiotherapy planning using the statistical decomposition algorithm

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

Siversson, Carl, E-mail: carl.siversson@med.lu.se; Nordström, Fredrik; Department of Radiation Physics, Skåne University Hospital, Lund 214 28

2015-10-15

Purpose: In order to enable a magnetic resonance imaging (MRI) only workflow in radiotherapy treatment planning, methods are required for generating Hounsfield unit (HU) maps (i.e., synthetic computed tomography, sCT) for dose calculations, directly from MRI. The Statistical Decomposition Algorithm (SDA) is a method for automatically generating sCT images from a single MR image volume, based on automatic tissue classification in combination with a model trained using a multimodal template material. This study compares dose calculations between sCT generated by the SDA and conventional CT in the male pelvic region. Methods: The study comprised ten prostate cancer patients, for whommore » a 3D T2 weighted MRI and a conventional planning CT were acquired. For each patient, sCT images were generated from the acquired MRI using the SDA. In order to decouple the effect of variations in patient geometry between imaging modalities from the effect of uncertainties in the SDA, the conventional CT was nonrigidly registered to the MRI to assure that their geometries were well aligned. For each patient, a volumetric modulated arc therapy plan was created for the registered CT (rCT) and recalculated for both the sCT and the conventional CT. The results were evaluated using several methods, including mean average error (MAE), a set of dose-volume histogram parameters, and a restrictive gamma criterion (2% local dose/1 mm). Results: The MAE within the body contour was 36.5 ± 4.1 (1 s.d.) HU between sCT and rCT. Average mean absorbed dose difference to target was 0.0% ± 0.2% (1 s.d.) between sCT and rCT, whereas it was −0.3% ± 0.3% (1 s.d.) between CT and rCT. The average gamma pass rate was 99.9% for sCT vs rCT, whereas it was 90.3% for CT vs rCT. Conclusions: The SDA enables a highly accurate MRI only workflow in prostate radiotherapy planning. The dosimetric uncertainties originating from the SDA appear negligible and are notably lower than the uncertainties introduced by variations in patient geometry between imaging sessions.« less

Development of a semi-automated combined PET and CT lung lesion segmentation framework

NASA Astrophysics Data System (ADS)

Rossi, Farli; Mokri, Siti Salasiah; Rahni, Ashrani Aizzuddin Abd.

2017-03-01

Segmentation is one of the most important steps in automated medical diagnosis applications, which affects the accuracy of the overall system. In this paper, we propose a semi-automated segmentation method for extracting lung lesions from thoracic PET/CT images by combining low level processing and active contour techniques. The lesions are first segmented in PET images which are first converted to standardised uptake values (SUVs). The segmented PET images then serve as an initial contour for subsequent active contour segmentation of corresponding CT images. To evaluate its accuracy, the Jaccard Index (JI) was used as a measure of the accuracy of the segmented lesion compared to alternative segmentations from the QIN lung CT segmentation challenge, which is possible by registering the whole body PET/CT images to the corresponding thoracic CT images. The results show that our proposed technique has acceptable accuracy in lung lesion segmentation with JI values of around 0.8, especially when considering the variability of the alternative segmentations.

Nano-Computed Tomography: Technique and Applications.

PubMed

Kampschulte, M; Langheinirch, A C; Sender, J; Litzlbauer, H D; Althöhn, U; Schwab, J D; Alejandre-Lafont, E; Martels, G; Krombach, G A

2016-02-01

Nano-computed tomography (nano-CT) is an emerging, high-resolution cross-sectional imaging technique and represents a technical advancement of the established micro-CT technology. Based on the application of a transmission target X-ray tube, the focal spot size can be decreased down to diameters less than 400 nanometers (nm). Together with specific detectors and examination protocols, a superior spatial resolution up to 400 nm (10 % MTF) can be achieved, thereby exceeding the resolution capacity of typical micro-CT systems. The technical concept of nano-CT imaging as well as the basics of specimen preparation are demonstrated exemplarily. Characteristics of atherosclerotic plaques (intraplaque hemorrhage and calcifications) in a murine model of atherosclerosis (ApoE (-/-)/LDLR(-/-) double knockout mouse) are demonstrated in the context of superior spatial resolution in comparison to micro-CT. Furthermore, this article presents the application of nano-CT for imaging cerebral microcirculation (murine), lung structures (porcine), and trabecular microstructure (ovine) in contrast to micro-CT imaging. This review shows the potential of nano-CT as a radiological method in biomedical basic research and discusses the application of experimental, high resolution CT techniques in consideration of other high resolution cross-sectional imaging techniques. Nano-computed tomography is a high resolution CT-technology for 3D imaging at sub-micrometer resolution. The technical concept bases on a further development of the established ex-vivo-micro-CT technology. By improvement of the spatial resolution, structures at a cellular level become visible (e.g. osteocyte lacunae). © Georg Thieme Verlag KG Stuttgart · New York.

TU-A-12A-02: Novel Lung Ventilation Imaging with Single Energy CT After Single Inhalation of Xenon: Comparison with SPECT Ventilation Images

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

Negahdar, M; Yamamoto, T; Shultz, D

Purpose: We propose a novel lung functional imaging method to determine the spatial distribution of xenon (Xe) gas in a single inhalation as a measure of regional ventilation. We compare Xe-CT ventilation to single-photon emission CT (SPECT) ventilation, which is the current clinical reference. Regional lung ventilation information may be useful for the diagnosis and monitoring of pulmonary diseases such as COPD, radiotherapy planning, and assessing the progression of toxicity after radiation therapy. Methods: In an IRB-approved clinical study, Xe-CT and SPECT ventilation scans were acquired for three patients including one patient with severe emphysema and two lung cancer patientsmore » treated with radiotherapy. For Xe- CT, we acquired two breath-hold single energy CT images of the entire lung with inspiration of 100% O2 and a mixture of 70% Xe and 30% O2, respectively. A video biofeedback system was used to achieve reproducible breath-holds. We used deformable image registration to align the breathhold images with each other to accurately subtract them, producing a map of the distribution of Xe as a surrogate of lung ventilation. We divided each lung into twelve parts and correlated the Hounsfield unit (HU) enhancement at each part with the SPECT ventilation count of the corresponding part of the lung. Results: The mean of the Pearson linear correlation coefficient values between the Xe-CT and ventilation SPECT count for all three patients were 0.62 (p<0.01). The Xe-CT image had a higher resolution than SPECT, and did not show central airway deposition artifacts that were present in the SPECT image. Conclusion: We developed a rapid, safe, clinically practical, and potentially widely accessible method for regional lung functional imaging. We demonstrated strong correlations between the Xe-CT ventilation image and SPECT ventilation image as the clinical reference. This ongoing study will investigate more patients to confirm this finding.« less

Utility of Dual-Energy CT-based Monochromatic Imaging in the Assessment of Myocardial Delayed Enhancement in Patients with Cardiomyopathy.

PubMed

Chang, Suyon; Han, Kyunghwa; Youn, Jong-Chan; Im, Dong Jin; Kim, Jin Young; Suh, Young Joo; Hong, Yoo Jin; Hur, Jin; Kim, Young Jin; Choi, Byoung Wook; Lee, Hye-Jeong

2018-05-01

Purpose To investigate the diagnostic utility of dual-energy computed tomography (CT)-based monochromatic imaging for myocardial delayed enhancement (MDE) assessment in patients with cardiomyopathy. Materials and Methods The institutional review board approved this prospective study, and informed consent was obtained from all participants who were enrolled in the study. Forty patients (27 men and 13 women; mean age, 56 years ± 15 [standard deviation]; age range, 22-81 years) with cardiomyopathy underwent cardiac magnetic resonance (MR) imaging and dual-energy CT. Conventional (120-kV) and monochromatic (60-, 70-, and 80-keV) images were reconstructed from the dual-energy CT acquisition. Subjective quality score, contrast-to-noise ratio (CNR), and beam-hardening artifacts were compared pairwise with the Friedman test at post hoc analysis. With cardiac MR imaging as the reference standard, diagnostic performance of dual-energy CT in MDE detection and its predictive ability for pattern classification were compared pairwise by using logistic regression analysis with the generalized estimating equation in a per-segment analysis. The Bland-Altman method was used to find agreement between cardiac MR imaging and CT in MDE quantification. Results Among the monochromatic images, 70-keV CT images resulted in higher subjective quality (mean score, 3.38 ± 0.54 vs 3.15 ± 0.43; P = .0067), higher CNR (mean, 4.26 ± 1.38 vs 3.93 ± 1.33; P = .0047), and a lower value for beam-hardening artifacts (mean, 3.47 ± 1.56 vs 4.15 ± 1.67; P < .0001) when compared with conventional CT. When compared with conventional CT, 70-keV CT showed improved diagnostic performance for MDE detection (sensitivity, 94.6% vs 90.4% [P = .0032]; specificity, 96.0% vs 94.0% [P = .0031]; and accuracy, 95.6% vs 92.7% [P < .0001]) and improved predictive ability for pattern classification (subendocardial, 91.5% vs 84.3% [P = .0111]; epicardial, 94.3% vs 73.5% [P = .0001]; transmural, 93.0% vs 77.7% [P = .0018]; mesocardial, 85.4% vs 69.2% [P = .0047]; and patchy. 84.4% vs 78.4% [P = .1514]). For MDE quantification, 70-keV CT showed a small bias 0.1534% (95% limits of agreement: -4.7013, 5.0080). Conclusion Dual-energy CT-based 70-keV monochromatic images improve MDE assessment in patients with cardiomyopathy via improved image quality and CNR and reduced beam-hardening artifacts when compared with conventional CT images. © RSNA, 2017 Online supplemental material is available for this article.

Deep Learning MR Imaging-based Attenuation Correction for PET/MR Imaging.

PubMed

Liu, Fang; Jang, Hyungseok; Kijowski, Richard; Bradshaw, Tyler; McMillan, Alan B

2018-02-01

Purpose To develop and evaluate the feasibility of deep learning approaches for magnetic resonance (MR) imaging-based attenuation correction (AC) (termed deep MRAC) in brain positron emission tomography (PET)/MR imaging. Materials and Methods A PET/MR imaging AC pipeline was built by using a deep learning approach to generate pseudo computed tomographic (CT) scans from MR images. A deep convolutional auto-encoder network was trained to identify air, bone, and soft tissue in volumetric head MR images coregistered to CT data for training. A set of 30 retrospective three-dimensional T1-weighted head images was used to train the model, which was then evaluated in 10 patients by comparing the generated pseudo CT scan to an acquired CT scan. A prospective study was carried out for utilizing simultaneous PET/MR imaging for five subjects by using the proposed approach. Analysis of covariance and paired-sample t tests were used for statistical analysis to compare PET reconstruction error with deep MRAC and two existing MR imaging-based AC approaches with CT-based AC. Results Deep MRAC provides an accurate pseudo CT scan with a mean Dice coefficient of 0.971 ± 0.005 for air, 0.936 ± 0.011 for soft tissue, and 0.803 ± 0.021 for bone. Furthermore, deep MRAC provides good PET results, with average errors of less than 1% in most brain regions. Significantly lower PET reconstruction errors were realized with deep MRAC (-0.7% ± 1.1) compared with Dixon-based soft-tissue and air segmentation (-5.8% ± 3.1) and anatomic CT-based template registration (-4.8% ± 2.2). Conclusion The authors developed an automated approach that allows generation of discrete-valued pseudo CT scans (soft tissue, bone, and air) from a single high-spatial-resolution diagnostic-quality three-dimensional MR image and evaluated it in brain PET/MR imaging. This deep learning approach for MR imaging-based AC provided reduced PET reconstruction error relative to a CT-based standard within the brain compared with current MR imaging-based AC approaches. © RSNA, 2017 Online supplemental material is available for this article.

SU-F-303-12: Implementation of MR-Only Simulation for Brain Cancer: A Virtual Clinical Trial

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

Glide-Hurst, C; Zheng, W; Kim, J

2015-06-15

Purpose: To perform a retrospective virtual clinical trial using an MR-only workflow for a variety of brain cancer cases by incorporating novel imaging sequences, tissue segmentation using phase images, and an innovative synthetic CT (synCT) solution. Methods: Ten patients (16 lesions) were evaluated using a 1.0T MR-SIM including UTE-DIXON imaging (TE = 0.144/3.4/6.9ms). Bone-enhanced images were generated from DIXON-water/fat and inverted UTE. Automated air segmentation was performed using unwrapped UTE phase maps. Segmentation accuracy was assessed by calculating intersection and Dice similarity coefficients (DSC) using CT-SIM as ground truth. SynCTs were generated using voxel-based weighted summation incorporating T2, FLAIR, UTE1,more » and bone-enhanced images. Mean absolute error (MAE) characterized HU differences between synCT and CT-SIM. Dose was recalculated on synCTs; differences were quantified using planar gamma analysis (2%/2 mm dose difference/distance to agreement) at isocenter. Digitally reconstructed radiographs (DRRs) were compared. Results: On average, air maps intersected 80.8 ±5.5% (range: 71.8–88.8%) between MR-SIM and CT-SIM yielding DSCs of 0.78 ± 0.04 (range: 0.70–0.83). Whole-brain MAE between synCT and CT-SIM was 160.7±8.8 HU, with the largest uncertainty arising from bone (MAE = 423.3±33.2 HU). Gamma analysis revealed pass rates of 99.4 ± 0.04% between synCT and CT-SIM for the cohort. Dose volume histogram analysis revealed that synCT tended to yield slightly higher doses. Organs at risk such as the chiasm and optic nerves were most sensitive due to their proximities to air/bone interfaces. DRRs generated via synCT and CT-SIM were within clinical tolerances. Conclusion: Our approach for MR-only simulation for brain cancer treatment planning yielded clinically acceptable results relative to the CT-based benchmark. While slight dose differences were observed, reoptimization of treatment plans and improved image registration can address this limitation. Future work will incorporate automated registration between setup images (cone-beam CT and kilovoltage images) for synCT and CT-SIM. Submitting institution holds research agreements with Philips HealthCare, Best, Netherlands and Varian Medical Systems, Palo Alto, CA. Research partially sponsored via an Internal Mentored Research Grant.« less

View-interpolation of sparsely sampled sinogram using convolutional neural network

NASA Astrophysics Data System (ADS)

Lee, Hoyeon; Lee, Jongha; Cho, Suengryong

2017-02-01

Spare-view sampling and its associated iterative image reconstruction in computed tomography have actively investigated. Sparse-view CT technique is a viable option to low-dose CT, particularly in cone-beam CT (CBCT) applications, with advanced iterative image reconstructions with varying degrees of image artifacts. One of the artifacts that may occur in sparse-view CT is the streak artifact in the reconstructed images. Another approach has been investigated for sparse-view CT imaging by use of the interpolation methods to fill in the missing view data and that reconstructs the image by an analytic reconstruction algorithm. In this study, we developed an interpolation method using convolutional neural network (CNN), which is one of the widely used deep-learning methods, to find missing projection data and compared its performances with the other interpolation techniques.

SU-E-J-242: Volume-Dependence of Quantitative Imaging Features From CT and CE-CT Images of NSCLC

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

Fave, X; Fried, D; UT Health Science Center Graduate School of Biomedical Sciences, Houston, TX

Purpose: To determine whether tumor volume plays a significant role in the values obtained for texture features when they are extracted from computed tomography (CT) images of non-small cell lung cancer (NSCLC). We also sought to identify whether features can be reliably measured at all volumes or if a minimum volume threshold should be recommended. Methods: Eleven features were measured on 40 CT and 32 contrast-enhanced CT (CECT) patient images for this study. Features were selected for their prognostic/diagnostic value in previous publications. Direct correlations between these textures and volume were evaluated using the Spearman correlation coefficient. Any texture thatmore » the Wilcoxon rank-sum test was used to compare the variation above and below a volume cutoff. Four different volume thresholds (5, 10, 15, and 20 cm{sup 3}) were tested. Results: Four textures were found to be significantly correlated with volume in both the CT and CE-CT images. These were busyness, coarseness, gray-level nonuniformity, and run-length nonuniformity with correlation coefficients of 0.92, −0.96, 0.94, and 0.98 for the CT images and 0.95, −0.97, 0.98, and 0.98 for the CE-CT images. After volume normalization, the correlation coefficients decreased substantially. For the data obtained from the CT images, the results of the Wilcoxon rank-sum test were significant when volume thresholds of 5–15 cm3 were used. No volume threshold was shown to be significant for the CE-CT data. Conclusion: Equations for four features that have been used in several published studies were found to be volume-dependent. Future studies should consider implementing normalization factors or removing these features entirely to prevent this potential source of redundancy or bias. This work was supported in part by National Cancer Institute grant R03CA178495-01. Xenia Fave is a recipient of the American Association of Physicists in Medicine Graduate Fellowship.« less

TU-H-CAMPUS-IeP3-01: Simultaneous PET Restoration and PET/CT Co-Segmentation Using a Variational Method

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

Li, L; Tan, S; Lu, W

Purpose: PET images are usually blurred due to the finite spatial resolution, while CT images suffer from low contrast. Segment a tumor from either a single PET or CT image is thus challenging. To make full use of the complementary information between PET and CT, we propose a novel variational method for simultaneous PET image restoration and PET/CT images co-segmentation. Methods: The proposed model was constructed based on the Γ-convergence approximation of Mumford-Shah (MS) segmentation model for PET/CT co-segmentation. Moreover, a PET de-blur process was integrated into the MS model to improve the segmentation accuracy. An interaction edge constraint termmore » over the two modalities were specially designed to share the complementary information. The energy functional was iteratively optimized using an alternate minimization (AM) algorithm. The performance of the proposed method was validated on ten lung cancer cases and five esophageal cancer cases. The ground truth were manually delineated by an experienced radiation oncologist using the complementary visual features of PET and CT. The segmentation accuracy was evaluated by Dice similarity index (DSI) and volume error (VE). Results: The proposed method achieved an expected restoration result for PET image and satisfactory segmentation results for both PET and CT images. For lung cancer dataset, the average DSI (0.72) increased by 0.17 and 0.40 than single PET and CT segmentation. For esophageal cancer dataset, the average DSI (0.85) increased by 0.07 and 0.43 than single PET and CT segmentation. Conclusion: The proposed method took full advantage of the complementary information from PET and CT images. This work was supported in part by the National Cancer Institute Grants R01CA172638. Shan Tan and Laquan Li were supported in part by the National Natural Science Foundation of China, under Grant Nos. 60971112 and 61375018.« less

Zero-Echo-Time and Dixon Deep Pseudo-CT (ZeDD CT): Direct Generation of Pseudo-CT Images for Pelvic PET/MRI Attenuation Correction Using Deep Convolutional Neural Networks with Multiparametric MRI.

PubMed

Leynes, Andrew P; Yang, Jaewon; Wiesinger, Florian; Kaushik, Sandeep S; Shanbhag, Dattesh D; Seo, Youngho; Hope, Thomas A; Larson, Peder E Z

2018-05-01

Accurate quantification of uptake on PET images depends on accurate attenuation correction in reconstruction. Current MR-based attenuation correction methods for body PET use a fat and water map derived from a 2-echo Dixon MRI sequence in which bone is neglected. Ultrashort-echo-time or zero-echo-time (ZTE) pulse sequences can capture bone information. We propose the use of patient-specific multiparametric MRI consisting of Dixon MRI and proton-density-weighted ZTE MRI to directly synthesize pseudo-CT images with a deep learning model: we call this method ZTE and Dixon deep pseudo-CT (ZeDD CT). Methods: Twenty-six patients were scanned using an integrated 3-T time-of-flight PET/MRI system. Helical CT images of the patients were acquired separately. A deep convolutional neural network was trained to transform ZTE and Dixon MR images into pseudo-CT images. Ten patients were used for model training, and 16 patients were used for evaluation. Bone and soft-tissue lesions were identified, and the SUV max was measured. The root-mean-squared error (RMSE) was used to compare the MR-based attenuation correction with the ground-truth CT attenuation correction. Results: In total, 30 bone lesions and 60 soft-tissue lesions were evaluated. The RMSE in PET quantification was reduced by a factor of 4 for bone lesions (10.24% for Dixon PET and 2.68% for ZeDD PET) and by a factor of 1.5 for soft-tissue lesions (6.24% for Dixon PET and 4.07% for ZeDD PET). Conclusion: ZeDD CT produces natural-looking and quantitatively accurate pseudo-CT images and reduces error in pelvic PET/MRI attenuation correction compared with standard methods. © 2018 by the Society of Nuclear Medicine and Molecular Imaging.

Measurement of myocardial extracellular volume fraction by using equilibrium contrast-enhanced CT: validation against histologic findings.

PubMed

Bandula, Steve; White, Steven K; Flett, Andrew S; Lawrence, David; Pugliese, Francesca; Ashworth, Michael T; Punwani, Shonit; Taylor, Stuart A; Moon, James C

2013-11-01

To develop and validate equilibrium contrast material-enhanced computed tomography (CT) to measure myocardial extracellular volume (ECV) fraction by using a histologic reference standard and to compare equilibrium CT with equilibrium contrast-enhanced magnetic resonance (MR) imaging. A local ethics committee approved the study, and all subjects gave fully informed written consent. An equilibrium CT protocol was developed using iohexol at 300 mg of iodine per milliliter (bolus of 1 mg per kilogram of body weight administered at a rate of 3 mL/sec, followed immediately by an infusion of 1.88 mL/kg per hour with CT imaging before and at 25 minutes after injection of bolus of contrast agent) and ECV within the myocardial septum measured using both equilibrium CT and equilibrium MR imaging in patients with severe aortic stenosis. Biopsy samples of the myocardial septum collected during valve replacement surgery were used for histologic quantification of extracellular fibrosis with picrosirius red staining. Equilibrium CT- and equilibrium MR imaging-derived ECV measurements were compared with histologically quantified fibrosis by using Pearson correlation. Agreement between equilibrium CT and equilibrium MR imaging was assessed by using Bland-Altman comparison. Twenty-three patients (16 male, seven female; mean age, 70.8 years; standard deviation, 8.3) were recruited. The mean percentage of histologic fibrosis was 18% (intersubject range, 5%-40%). There was a significant correlation between both equilibrium CT- and equilibrium MR imaging-derived ECV and percentage of histologic fibrosis (r = 0.71 [P < .001] and r = 0.84 [P < .0001], respectively). Equilibrium CT-derived ECV was significantly correlated to equilibrium MR imaging-derived ECV (r = 0.73). ECV measured by using equilibrium CT in patients with aortic stenosis correlates with histologic quantification of myocardial fibrosis and with ECV derived by using equilibrium MR imaging. RSNA, 2013

A registration-based segmentation method with application to adiposity analysis of mice microCT images

NASA Astrophysics Data System (ADS)

Bai, Bing; Joshi, Anand; Brandhorst, Sebastian; Longo, Valter D.; Conti, Peter S.; Leahy, Richard M.

2014-04-01

Obesity is a global health problem, particularly in the U.S. where one third of adults are obese. A reliable and accurate method of quantifying obesity is necessary. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) are two measures of obesity that reflect different associated health risks, but accurate measurements in humans or rodent models are difficult. In this paper we present an automatic, registration-based segmentation method for mouse adiposity studies using microCT images. We co-register the subject CT image and a mouse CT atlas. Our method is based on surface matching of the microCT image and an atlas. Surface-based elastic volume warping is used to match the internal anatomy. We acquired a whole body scan of a C57BL6/J mouse injected with contrast agent using microCT and created a whole body mouse atlas by manually delineate the boundaries of the mouse and major organs. For method verification we scanned a C57BL6/J mouse from the base of the skull to the distal tibia. We registered the obtained mouse CT image to our atlas. Preliminary results show that we can warp the atlas image to match the posture and shape of the subject CT image, which has significant differences from the atlas. We plan to use this software tool in longitudinal obesity studies using mouse models.

Investigation of ultra low-dose scans in the context of quantum-counting clinical CT

NASA Astrophysics Data System (ADS)

Weidinger, T.; Buzug, T. M.; Flohr, T.; Fung, G. S. K.; Kappler, S.; Stierstorfer, K.; Tsui, B. M. W.

2012-03-01

In clinical computed tomography (CT), images from patient examinations taken with conventional scanners exhibit noise characteristics governed by electronics noise, when scanning strongly attenuating obese patients or with an ultra-low X-ray dose. Unlike CT systems based on energy integrating detectors, a system with a quantum counting detector does not suffer from this drawback. Instead, the noise from the electronics mainly affects the spectral resolution of these detectors. Therefore, it does not contribute to the image noise in spectrally non-resolved CT images. This promises improved image quality due to image noise reduction in scans obtained from clinical CT examinations with lowest X-ray tube currents or obese patients. To quantify the benefits of quantum counting detectors in clinical CT we have carried out an extensive simulation study of the complete scanning and reconstruction process for both kinds of detectors. The simulation chain encompasses modeling of the X-ray source, beam attenuation in the patient, and calculation of the detector response. Moreover, in each case the subsequent image preprocessing and reconstruction is modeled as well. The simulation-based, theoretical evaluation is validated by experiments with a novel prototype quantum counting system and a Siemens Definition Flash scanner with a conventional energy integrating CT detector. We demonstrate and quantify the improvement from image noise reduction achievable with quantum counting techniques in CT examinations with ultra-low X-ray dose and strong attenuation.

3D printing from microfocus computed tomography (micro-CT) in human specimens: education and future implications.

PubMed

Shelmerdine, Susan C; Simcock, Ian C; Hutchinson, John Ciaran; Aughwane, Rosalind; Melbourne, Andrew; Nikitichev, Daniil I; Ong, Ju-Ling; Borghi, Alessandro; Cole, Garrard; Kingham, Emilia; Calder, Alistair D; Capelli, Claudio; Akhtar, Aadam; Cook, Andrew C; Schievano, Silvia; David, Anna; Ourselin, Sebastian; Sebire, Neil J; Arthurs, Owen J

2018-06-14

Microfocus CT (micro-CT) is an imaging method that provides three-dimensional digital data sets with comparable resolution to light microscopy. Although it has traditionally been used for non-destructive testing in engineering, aerospace industries and in preclinical animal studies, new applications are rapidly becoming available in the clinical setting including post-mortem fetal imaging and pathological specimen analysis. Printing three-dimensional models from imaging data sets for educational purposes is well established in the medical literature, but typically using low resolution (0.7 mm voxel size) data acquired from CT or MR examinations. With higher resolution imaging (voxel sizes below 1 micron, <0.001 mm) at micro-CT, smaller structures can be better characterised, and data sets post-processed to create accurate anatomical models for review and handling. In this review, we provide examples of how three-dimensional printing of micro-CT imaged specimens can provide insight into craniofacial surgical applications, developmental cardiac anatomy, placental imaging, archaeological remains and high-resolution bone imaging. We conclude with other potential future usages of this emerging technique.

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.

Improving the imaging of calcifications in CT by histogram-based selective deblurring

NASA Astrophysics Data System (ADS)

Rollano-Hijarrubia, Empar; van der Meer, Frits; van der Lugt, Add; Weinans, Harrie; Vrooman, Henry; Vossepoel, Albert; Stokking, Rik

2005-04-01

Imaging of small high-density structures, such as calcifications, with computed tomography (CT) is limited by the spatial resolution of the system. Blur causes small calcifications to be imaged with lower contrast and overestimated volume, thereby hampering the analysis of vessels. The aim of this work is to reduce the blur of calcifications by applying three-dimensional (3D) deconvolution. Unfortunately, the high-frequency amplification of the deconvolution produces edge-related ring artifacts and enhances noise and original artifacts, which degrades the imaging of low-density structures. A method, referred to as Histogram-based Selective Deblurring (HiSD), was implemented to avoid these negative effects. HiSD uses the histogram information to generate a restored image in which the low-intensity voxel information of the observed image is combined with the high-intensity voxel information of the deconvolved image. To evaluate HiSD we scanned four in-vitro atherosclerotic plaques of carotid arteries with a multislice spiral CT and with a microfocus CT (μCT), used as reference. Restored images were generated from the observed images, and qualitatively and quantitatively compared with their corresponding μCT images. Transverse views and maximum-intensity projections of restored images show the decrease of blur of the calcifications in 3D. Measurements of the areas of 27 calcifications and total volumes of calcification of 4 plaques show that the overestimation of calcification was smaller for restored images (mean-error: 90% for area; 92% for volume) than for observed images (143%; 213%, respectively). The qualitative and quantitative analyses show that the imaging of calcifications in CT can be improved considerably by applying HiSD.

Point spread function modeling and image restoration for cone-beam CT

NASA Astrophysics Data System (ADS)

Zhang, Hua; Huang, Kui-Dong; Shi, Yi-Kai; Xu, Zhe

2015-03-01

X-ray cone-beam computed tomography (CT) has such notable features as high efficiency and precision, and is widely used in the fields of medical imaging and industrial non-destructive testing, but the inherent imaging degradation reduces the quality of CT images. Aimed at the problems of projection image degradation and restoration in cone-beam CT, a point spread function (PSF) modeling method is proposed first. The general PSF model of cone-beam CT is established, and based on it, the PSF under arbitrary scanning conditions can be calculated directly for projection image restoration without the additional measurement, which greatly improved the application convenience of cone-beam CT. Secondly, a projection image restoration algorithm based on pre-filtering and pre-segmentation is proposed, which can make the edge contours in projection images and slice images clearer after restoration, and control the noise in the equivalent level to the original images. Finally, the experiments verified the feasibility and effectiveness of the proposed methods. Supported by National Science and Technology Major Project of the Ministry of Industry and Information Technology of China (2012ZX04007021), Young Scientists Fund of National Natural Science Foundation of China (51105315), Natural Science Basic Research Program of Shaanxi Province of China (2013JM7003) and Northwestern Polytechnical University Foundation for Fundamental Research (JC20120226, 3102014KYJD022)

Photon counting spectral breast CT: effect of adaptive filtration on CT numbers, noise, and contrast to noise ratio.

PubMed

Silkwood, Justin D; Matthews, Kenneth L; Shikhaliev, Polad M

2013-05-01

Photon counting spectral (PCS) computed tomography (CT) shows promise for breast imaging. An issue with current photon-counting detectors is low count rate capabilities, artifacts resulting from nonuniform count rate across the field of view, and suboptimal spectral information. These issues are addressed in part by using tissue-equivalent adaptive filtration of the x-ray beam. The purpose of the study was to investigate the effect of adaptive filtration on different aspects of PCS breast CT. The theoretical formulation for the filter shape was derived for different filter materials and evaluated by simulation and an experimental prototype of the filter was fabricated from a tissue-like material (acrylic). The PCS CT images of a glandular breast phantom with adipose and iodine contrast elements were simulated at 40, 60, 90, and 120 kVp tube voltages, with and without adaptive filter. The CT numbers, CT noise, and contrast-to-noise ratio (CNR) were compared for spectral CT images acquired with and without adaptive filters. Similar comparison was made for material-decomposed PCS CT images. The adaptive filter improved the uniformity of CT numbers, CT noise, and CNR in both ordinary and material decomposed PCS CT images. At the same tube output the average CT noise with adaptive filter, although uniform, was higher than the average noise without adaptive filter due to x-ray absorption by the filter. Increasing tube output, so that average skin exposure with the adaptive filter was same as without filter, made the noise with adaptive filter comparable to or lower than that without adaptive filter. Similar effects were observed when energy weighting was applied, and when material decompositions were performed using energy selective CT data. An adaptive filter decreases count rate requirements to the photon counting detectors which enables PCS breast CT based on commercially available detector technologies. Adaptive filter also improves image quality in PCS breast CT by decreasing beam hardening artifacts and by eliminating spatial nonuniformities of CT numbers, noise, and CNR.

SU-E-T-504: Usefulness of CT-MR Fusion in Radiotherapy Planning for Prostate Cancer Patient with Bilateral Hip Replacements

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

He, R.; Giri, Shankar; VA Medical Center at Jackson, Mississippi

2014-06-01

Purpose: Target localization of prostate for Intensity Modulated Radiation Therapy (IMRT) in patients with bilateral hip replacements is difficult due to artifacts in Computed Tomography (CT) images generated from the prostheses high Z materials. In this study, Magnetic Resonance (MR) images fused with CT images are tested as a solution. Methods: CT images of 2.5 mm slice thickness were acquired on a GE Lightspeed scanner with a flat-topped couch for a prostate cancer patient with bilateral hip replacements. T2 weighted images of 5 mm separation were acquired on a MR Scanner. After the MR-CT registration on a radiotherapy treatment planningmore » system (Eclipse, Varian), the target volumes were defined by the radiation oncologists on MR images and then transferred to CT images for planning and dose calculation. The CT Hounsfield Units (HU) was reassigned to zero (as water) for artifacts. The Varian flat panel treatment couch was modeled for dose calculation accuracy with heterogeneity correction. A Volume Matrix Arc Therapy (VMAT) and a seven-field IMRT plans were generated, each avoiding any beam transversing the prostheses; the two plans were compared. The superior VMAT plan was used for treating the patient. In-vivo dosimetry was performed using MOSFET (Best Canada) placed in a surgical tube inserted into the patient rectum during therapy. The measured dose was compared with planned dose for MOSFET location. Results: The registration of MR-CT images and the agreement of target volumes were confirmed by three physicians. VMAT plan was deemed superior to IMRT based on dose to critical nearby structures and overall conformality of target dosing. In-vivo measured dose compared with calculated dose was -4.5% which was likely due to attenuation of the surgical tube surrounding MOSFET. Conclusion: When artifacts are present on planning CT due to bilateral hip prostheses, MR-CT image fusion is a feasible solution for target delineation.« less

Quality Assurance Assessment of Diagnostic and Radiation Therapy–Simulation CT Image Registration for Head and Neck Radiation Therapy: Anatomic Region of Interest–based Comparison of Rigid and Deformable Algorithms

PubMed Central

Mohamed, Abdallah S. R.; Ruangskul, Manee-Naad; Awan, Musaddiq J.; Baron, Charles A.; Kalpathy-Cramer, Jayashree; Castillo, Richard; Castillo, Edward; Guerrero, Thomas M.; Kocak-Uzel, Esengul; Yang, Jinzhong; Court, Laurence E.; Kantor, Michael E.; Gunn, G. Brandon; Colen, Rivka R.; Frank, Steven J.; Garden, Adam S.; Rosenthal, David I.

2015-01-01

Purpose To develop a quality assurance (QA) workflow by using a robust, curated, manually segmented anatomic region-of-interest (ROI) library as a benchmark for quantitative assessment of different image registration techniques used for head and neck radiation therapy–simulation computed tomography (CT) with diagnostic CT coregistration. Materials and Methods Radiation therapy–simulation CT images and diagnostic CT images in 20 patients with head and neck squamous cell carcinoma treated with curative-intent intensity-modulated radiation therapy between August 2011 and May 2012 were retrospectively retrieved with institutional review board approval. Sixty-eight reference anatomic ROIs with gross tumor and nodal targets were then manually contoured on images from each examination. Diagnostic CT images were registered with simulation CT images rigidly and by using four deformable image registration (DIR) algorithms: atlas based, B-spline, demons, and optical flow. The resultant deformed ROIs were compared with manually contoured reference ROIs by using similarity coefficient metrics (ie, Dice similarity coefficient) and surface distance metrics (ie, 95% maximum Hausdorff distance). The nonparametric Steel test with control was used to compare different DIR algorithms with rigid image registration (RIR) by using the post hoc Wilcoxon signed-rank test for stratified metric comparison. Results A total of 2720 anatomic and 50 tumor and nodal ROIs were delineated. All DIR algorithms showed improved performance over RIR for anatomic and target ROI conformance, as shown for most comparison metrics (Steel test, P < .008 after Bonferroni correction). The performance of different algorithms varied substantially with stratification by specific anatomic structures or category and simulation CT section thickness. Conclusion Development of a formal ROI-based QA workflow for registration assessment demonstrated improved performance with DIR techniques over RIR. After QA, DIR implementation should be the standard for head and neck diagnostic CT and simulation CT allineation, especially for target delineation. © RSNA, 2014 Online supplemental material is available for this article. PMID:25380454

SU-E-J-224: Using UTE and T1 Weighted Spin Echo Pulse Sequences for MR-Only Treatment Planning; Phantom Study

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

Yu, H; Fatemi, A; Sahgal, A

Purpose: Investigating a new approach in MRI based treatment planning using the combination of (Ultrashort Echo Time) UTE and T1 weighted spin echo pulse sequences to delineate air, bone and water (soft tissues) in generating pseudo CT images comparable with CT. Methods: A gel phantom containing chicken bones, ping pang balls filled with distilled water and air bubbles, was made. It scanned with MRI using UTE and 2D T1W SE pulse sequences with (in plane resolution= 0.53mm, slice thickness= 2 mm) and CT with (in plane resolution= 0.5 mm and slice thickness= 0.75mm) as a ground truth for geometrical accuracy.more » The UTE and T1W SE images were registered with CT using mutual information registration algorithm provided by Philips Pinnacle treatment planning system. The phantom boundaries were detected using Canny edge detection algorithm for CT, and MR images. The bone, air bubbles and water in ping pong balls were segmented from CT images using threshold 300HU, - 950HU and 0HU, respectively. These tissue inserts were automatically segmented from combined UTE and T1W SE images using edge detection and relative intensity histograms of the phantom. The obtained segmentations of air, bone and water inserts were evaluated with those obtained from CT. Results: Bone and air can be clearly differentiated in UTE images comparable to CT. Combining UTE and T1W SE images successfully segmented the air, bone and water. The maximum segmentation differences from combine MRI images (UTE and T1W SE) and CT are within 1.3 mm, 1.1mm for bone, air, respectively. The geometric distortion of UTE sequence is small less than 1 pixel (0.53 mm) of MR image resolution. Conclusion: Our approach indicates that MRI can be used solely for treatment planning and its quality is comparable with CT.« less

Evaluation of motion-correction methods for dual-gated cardiac positron emission tomography/computed tomography imaging.

PubMed

Klén, Riku; Noponen, Tommi; Koikkalainen, Juha; Lötjönen, Jyrki; Thielemans, Kris; Hoppela, Erika; Sipilä, Hannu; Teräs, Mika; Knuuti, Juhani

2016-09-01

Dual gating is a method of dividing the data of a cardiac PET scan into smaller bins according to the respiratory motion and the ECG of the patient. It reduces the undesirable motion artefacts in images, but produces several images for interpretation and decreases the quality of single images. By using motion-correction techniques, the motion artefacts in the dual-gated images can be corrected and the images can be combined into a single motion-free image with good statistics. The aim of the present study is to develop and evaluate motion-correction methods for cardiac PET studies. We have developed and compared two different methods: computed tomography (CT)/PET-based and CT-only methods. The methods were implemented and tested with a cardiac phantom and three patient datasets. In both methods, anatomical information of CT images is used to create models for the cardiac motion. In the patient study, the CT-only method reduced motion (measured as the centre of mass of the myocardium) on average 43%, increased the contrast-to-noise ratio on average 6.0% and reduced the target size on average 10%. Slightly better figures (51, 6.9 and 28%) were obtained with the CT/PET-based method. Even better results were obtained in the phantom study for both the CT-only method (57, 68 and 43%) and the CT/PET-based method (61, 74 and 52%). We conclude that using anatomical information of CT for motion correction of cardiac PET images, both respiratory and pulsatile motions can be corrected with good accuracy.

Substitute CT generation from a single ultra short time echo MRI sequence: preliminary study

NASA Astrophysics Data System (ADS)

Ghose, Soumya; Dowling, Jason A.; Rai, Robba; Liney, Gary P.

2017-04-01

In MR guided radiation therapy planning both MR and CT images for a patient are acquired and co-registered to obtain a tissue specific HU map. Generation of the HU map directly from the MRI would eliminate the CT acquisition and may improve radiation therapy planning. In this preliminary study of substitute CT (sCT) generation, two porcine leg phantoms were scanned using a 3D ultrashort echo time (PETRA) sequence and co-registered to corresponding CT images to build tissue specific regression models. The model was created from one co-registered CT-PETRA pair to generate the sCT for the other PETRA image. An expectation maximization based clustering was performed on the co-registered PETRA image to identify the soft tissues, dense bone and air class membership probabilities. A tissue specific non linear regression model was built from one registered CT-PETRA pair dataset to predict the sCT of the second PETRA image in a two-fold cross validation schema. A complete substitute CT is generated in 3 min. The mean absolute HU error for air was 0.3 HU, bone was 95 HU, fat was 30 HU and for muscle it was 10 HU. The mean surface reconstruction error for the bone was 1.3 mm. The PETRA sequence enabled a low mean absolute surface distance for the bone and a low HU error for other classes. The sCT generated from a single PETRA sequence shows promise for the generation of fast sCT for MRI based radiation therapy planning.

Verification of computed tomographic estimates of cochlear implant array position: a micro-CT and histologic analysis.

PubMed

Teymouri, Jessica; Hullar, Timothy E; Holden, Timothy A; Chole, Richard A

2011-08-01

To determine the efficacy of clinical computed tomographic (CT) imaging to verify postoperative electrode array placement in cochlear implant (CI) patients. Nine fresh cadaver heads underwent clinical CT scanning, followed by bilateral CI insertion and postoperative clinical CT scanning. Temporal bones were removed, trimmed, and scanned using micro-CT. Specimens were then dehydrated, embedded in either methyl methacrylate or LR White resin, and sectioned with a diamond wafering saw. Histology sections were examined by 3 blinded observers to determine the position of individual electrodes relative to soft tissue structures within the cochlea. Electrodes were judged to be within the scala tympani, scala vestibuli, or in an intermediate position between scalae. The position of the array could be estimated accurately from clinical CT scans in all specimens using micro-CT and histology as a criterion standard. Verification using micro-CT yielded 97% agreement, and histologic analysis revealed 95% agreement with clinical CT results. A composite, 3-dimensional image derived from a patient's preoperative and postoperative CT images using a clinical scanner accurately estimates the position of the electrode array as determined by micro-CT imaging and histologic analyses. Information obtained using the CT method provides valuable insight into numerous variables of interest to patient performance such as surgical technique, array design, and processor programming and troubleshooting.

Comparison Study of Regularizations in Spectral Computed Tomography Reconstruction

NASA Astrophysics Data System (ADS)

Salehjahromi, Morteza; Zhang, Yanbo; Yu, Hengyong

2018-12-01

The energy-resolving photon-counting detectors in spectral computed tomography (CT) can acquire projections of an object in different energy channels. In other words, they are able to reliably distinguish the received photon energies. These detectors lead to the emerging spectral CT, which is also called multi-energy CT, energy-selective CT, color CT, etc. Spectral CT can provide additional information in comparison with the conventional CT in which energy integrating detectors are used to acquire polychromatic projections of an object being investigated. The measurements obtained by X-ray CT detectors are noisy in reality, especially in spectral CT where the photon number is low in each energy channel. Therefore, some regularization should be applied to obtain a better image quality for this ill-posed problem in spectral CT image reconstruction. Quadratic-based regularizations are not often satisfactory as they blur the edges in the reconstructed images. As a result, different edge-preserving regularization methods have been adopted for reconstructing high quality images in the last decade. In this work, we numerically evaluate the performance of different regularizers in spectral CT, including total variation, non-local means and anisotropic diffusion. The goal is to provide some practical guidance to accurately reconstruct the attenuation distribution in each energy channel of the spectral CT data.

Multi-energy spectral CT: adding value in emergency body imaging.

PubMed

Punjabi, Gopal V

2018-04-01

Most vendors offer scanners capable of dual- or multi-energy computed tomography (CT) imaging. Advantages of multi-energy CT scanning include superior tissue characterization, detection of subtle iodine uptake differences, and opportunities to reduce contrast dose. However, utilization of this technology in the emergency department (ED) remains low. The purpose of this pictorial essay is to illustrate the value of multi-energy CT scanning in emergency body imaging.

Incremental Role of Mammography in the Evaluation of Gynecomastia in Men Who Have Undergone Chest CT.

PubMed

Sonnenblick, Emily B; Salvatore, Mary; Szabo, Janet; Lee, Karen A; Margolies, Laurie R

2016-08-01

The purpose of this study was to determine whether additional breast imaging is clinically valuable in the evaluation of patients with gynecomastia incidentally observed on CT of the chest. In a retrospective analysis, 62 men were identified who had a mammographic diagnosis of gynecomastia and had also undergone CT within 8 months (median, 2 months). We compared the imaging findings of both modalities and correlated them with the clinical outcome. Gynecomastia was statistically significantly larger on mammograms than on CT images; however, there was a high level of concordance in morphologic features and distribution of gynecomastia between mammography and CT. In only one case was gynecomastia evident on mammographic but not CT images, owing to cachexia. Two of the 62 men had ductal carcinoma, which was obscured by gynecomastia. Both of these patients had symptoms suggesting malignancy. The appearance of gynecomastia on CT scans and mammograms was highly correlated. Mammography performed within 8 months of CT is unlikely to reveal cancer unless there is a suspicious clinical finding or a breast mass eccentric to the nipple. Men with clinical symptoms of gynecomastia do not need additional imaging with mammography to confirm the diagnosis if they have undergone recent cross-sectional imaging.

CT Angiography after 20 Years

PubMed Central

Rubin, Geoffrey D.; Leipsic, Jonathon; Schoepf, U. Joseph; Fleischmann, Dominik; Napel, Sandy

2015-01-01

Through a marriage of spiral computed tomography (CT) and graphical volumetric image processing, CT angiography was born 20 years ago. Fueled by a series of technical innovations in CT and image processing, over the next 5–15 years, CT angiography toppled conventional angiography, the undisputed diagnostic reference standard for vascular disease for the prior 70 years, as the preferred modality for the diagnosis and characterization of most cardiovascular abnormalities. This review recounts the evolution of CT angiography from its development and early challenges to a maturing modality that has provided unique insights into cardiovascular disease characterization and management. Selected clinical challenges, which include acute aortic syndromes, peripheral vascular disease, aortic stent-graft and transcatheter aortic valve assessment, and coronary artery disease, are presented as contrasting examples of how CT angiography is changing our approach to cardiovascular disease diagnosis and management. Finally, the recently introduced capabilities for multispectral imaging, tissue perfusion imaging, and radiation dose reduction through iterative reconstruction are explored with consideration toward the continued refinement and advancement of CT angiography. PMID:24848958

Comparison of distribution of lung aeration measured with EIT and CT in spontaneously breathing, awake patients1.

PubMed

Radke, Oliver C; Schneider, Thomas; Braune, Anja; Pirracchio, Romain; Fischer, Felix; Koch, Thea

2016-09-28

Both Electrical Impedance Tomography (EIT) and Computed Tomography (CT) allow the estimation of the lung area. We compared two algorithms for the detection of the lung area per quadrant from the EIT images with the lung areas derived from the CT images. 39 outpatients who were scheduled for an elective CT scan of the thorax were included in the study. For each patient we recorded EIT images immediately before the CT scan. The lung area per quadrant was estimated from both CT and EIT data using two different algorithms for the EIT data. Data showed considerable variation during spontaneous breathing of the patients. Overall correlation between EIT and CT was poor (0.58-0.77), the correlation between the two EIT algorithms was better (0.90-0.92). Bland-Altmann analysis revealed absence of bias, but wide limits of agreement. Lung area estimation from CT and EIT differs significantly, most probably because of the fundamental difference in image generation.

TU-G-BRA-02: Can We Extract Lung Function Directly From 4D-CT Without Deformable Image Registration?

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

Kipritidis, J; Woodruff, H; Counter, W

Purpose: Dynamic CT ventilation imaging (CT-VI) visualizes air volume changes in the lung by evaluating breathing-induced lung motion using deformable image registration (DIR). Dynamic CT-VI could enable functionally adaptive lung cancer radiation therapy, but its sensitivity to DIR parameters poses challenges for validation. We hypothesize that a direct metric using CT parameters derived from Hounsfield units (HU) alone can provide similar ventilation images without DIR. We compare the accuracy of Direct and Dynamic CT-VIs versus positron emission tomography (PET) images of inhaled {sup 68}Ga-labelled nanoparticles (‘Galligas’). Methods: 25 patients with lung cancer underwent Galligas 4D-PET/CT scans prior to radiation therapy.more » For each patient we produced three CT- VIs. (i) Our novel method, Direct CT-VI, models blood-gas exchange as the product of air and tissue density at each lung voxel based on time-averaged 4D-CT HU values. Dynamic CT-VIs were produced by evaluating: (ii) regional HU changes, and (iii) regional volume changes between the exhale and inhale 4D-CT phase images using a validated B-spline DIR method. We assessed the accuracy of each CT-VI by computing the voxel-wise Spearman correlation with free-breathing Galligas PET, and also performed a visual analysis. Results: Surprisingly, Direct CT-VIs exhibited better global correlation with Galligas PET than either of the dynamic CT-VIs. The (mean ± SD) correlations were (0.55 ± 0.16), (0.41 ± 0.22) and (0.29 ± 0.27) for Direct, Dynamic HU-based and Dynamic volume-based CT-VIs respectively. Visual comparison of Direct CT-VI to PET demonstrated similarity for emphysema defects and ventral-to-dorsal gradients, but inability to identify decreased ventilation distal to tumor-obstruction. Conclusion: Our data supports the hypothesis that Direct CT-VIs are as accurate as Dynamic CT-VIs in terms of global correlation with Galligas PET. Visual analysis, however, demonstrated that different CT-VI algorithms might have varying accuracy depending on the underlying cause of ventilation abnormality. This research was supported by a National Health and Medical Research Council (NHMRC) Australia Fellowship, an Cancer Institute New South Wales Early Career Fellowship 13-ECF-1/15 and NHMRC scholarship APP1038399. No commercial funding was received for this work.« less

WE-FG-207B-04: Noise Suppression for Energy-Resolved CT Via Variance Weighted Non-Local Filtration

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

Harms, J; Zhu, L

Purpose: The photon starvation problem is exacerbated in energy-resolved CT, since the detected photons are shared by multiple energy channels. Using pixel similarity-based non-local filtration, we aim to produce accurate and high-resolution energy-resolved CT images with significantly reduced noise. Methods: Averaging CT images reconstructed from different energy channels reduces noise at the price of losing spectral information, while conventional denoising techniques inevitably degrade image resolution. Inspired by the fact that CT images of the same object at different energies share the same structures, we aim to reduce noise of energy-resolved CT by averaging only pixels of similar materials - amore » non-local filtration technique. For each CT image, an empirical exponential model is used to calculate the material similarity between two pixels based on their CT values and the similarity values are organized in a matrix form. A final similarity matrix is generated by averaging these similarity matrices, with weights inversely proportional to the estimated total noise variance in the sinogram of different energy channels. Noise suppression is achieved for each energy channel via multiplying the image vector by the similarity matrix. Results: Multiple scans on a tabletop CT system are used to simulate 6-channel energy-resolved CT, with energies ranging from 75 to 125 kVp. On a low-dose acquisition at 15 mA of the Catphan©600 phantom, our method achieves the same image spatial resolution as a high-dose scan at 80 mA with a noise standard deviation (STD) lower by a factor of >2. Compared with another non-local noise suppression algorithm (ndiNLM), the proposed algorithms obtains images with substantially improved resolution at the same level of noise reduction. Conclusion: We propose a noise-suppression method for energy-resolved CT. Our method takes full advantage of the additional structural information provided by energy-resolved CT and preserves image values at each energy level. Research reported in this publication was supported by the National Institute Of Biomedical Imaging And Bioengineering of the National Institutes of Health under Award Number R21EB019597. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.« less

Dual-source CT imaging to plan transcatheter aortic valve replacement: accuracy for diagnosis of obstructive coronary artery disease.

PubMed

Harris, Brett S; De Cecco, Carlo N; Schoepf, U Joseph; Steinberg, Daniel H; Bayer, Richard R; Krazinski, Aleksander W; Dyer, Kevin T; Sandhu, Monique K; Zile, Michael R; Meinel, Felix G

2015-04-01

To assess the accuracy of computed tomographic (CT) examinations performed for the purpose of transcatheter aortic valve replacement (TAVR) planning to diagnose obstructive coronary artery disease (CAD). With institutional review board approval, waivers of informed consent, and in compliance with HIPAA, 100 consecutive TAVR candidates (61 men, mean age 79.6 years ± 9.9) who underwent both TAVR planning CT (with a dual-source CT system) and coronary catheter (CC) angiographic imaging were retrospectively analyzed. At both modalities, the presence of stenosis in the native coronary arteries was assessed. Additionally, all coronary bypass grafts were rated as patent or occluded. With CC angiographic imaging as the reference standard, the accuracy of CT for lesion detection on a per-vessel and per-patient basis was calculated. The accuracy of CT for the assessment of graft patency was also analyzed. For per-vessel and per-patient analysis for the detection of stenosis that was 50% or more in the native coronary arteries, CT imaging had, respectively, 94.4% and 98.6% sensitivity, 68.4% and 55.6% specificity, 94.7% and 93.8% negative predictive value (NPV), and 67.0% and 85.7% positive predictive value. Per-patient sensitivity of stenosis 50% or greater with CT for greater than 70% stenosis at CC angiographic imaging was 100%. All 12 vessels in which percutaneous coronary intervention was performed were correctly identified as demonstrating stenosis 50% or greater with CT. There was agreement between CT and CC angiographic imaging regarding graft patency in 114 of 115 grafts identified with CC angiographic imaging. TAVR planning CT has high sensitivity and NPV in excluding obstructive CAD. An additional preprocedural CC angiographic examination may not be required in TAVR candidates with a CT examination that does not show obstructive CAD. © RSNA, 2014 Online supplemental material is available for this article.

Super resolution reconstruction of μ-CT image of rock sample using neighbour embedding algorithm

NASA Astrophysics Data System (ADS)

Wang, Yuzhu; Rahman, Sheik S.; Arns, Christoph H.

2018-03-01

X-ray computed tomography (μ-CT) is considered to be the most effective way to obtain the inner structure of rock sample without destructions. However, its limited resolution hampers its ability to probe sub-micro structures which is critical for flow transportation of rock sample. In this study, we propose an innovative methodology to improve the resolution of μ-CT image using neighbour embedding algorithm where low frequency information is provided by μ-CT image itself while high frequency information is supplemented by high resolution scanning electron microscopy (SEM) image. In order to obtain prior for reconstruction, a large number of image patch pairs contain high- and low- image patches are extracted from the Gaussian image pyramid generated by SEM image. These image patch pairs contain abundant information about tomographic evolution of local porous structures under different resolution spaces. Relying on the assumption of self-similarity of porous structure, this prior information can be used to supervise the reconstruction of high resolution μ-CT image effectively. The experimental results show that the proposed method is able to achieve the state-of-the-art performance.

Edge-oriented dual-dictionary guided enrichment (EDGE) for MRI-CT image reconstruction.

PubMed

Li, Liang; Wang, Bigong; Wang, Ge

2016-01-01

In this paper, we formulate the joint/simultaneous X-ray CT and MRI image reconstruction. In particular, a novel algorithm is proposed for MRI image reconstruction from highly under-sampled MRI data and CT images. It consists of two steps. First, a training dataset is generated from a series of well-registered MRI and CT images on the same patients. Then, an initial MRI image of a patient can be reconstructed via edge-oriented dual-dictionary guided enrichment (EDGE) based on the training dataset and a CT image of the patient. Second, an MRI image is reconstructed using the dictionary learning (DL) algorithm from highly under-sampled k-space data and the initial MRI image. Our algorithm can establish a one-to-one correspondence between the two imaging modalities, and obtain a good initial MRI estimation. Both noise-free and noisy simulation studies were performed to evaluate and validate the proposed algorithm. The results with different under-sampling factors show that the proposed algorithm performed significantly better than those reconstructed using the DL algorithm from MRI data alone.

Detection of osseous metastasis by 18F-NaF/18F-FDG PET/CT versus CT alone.

PubMed

Sampath, Srinath C; Sampath, Srihari C; Mosci, Camila; Lutz, Amelie M; Willmann, Juergen K; Mittra, Erik S; Gambhir, Sanjiv S; Iagaru, Andrei

2015-03-01

Sodium fluoride PET (18F-NaF) has recently reemerged as a valuable method for detection of osseous metastasis, with recent work highlighting the potential of coadministered 18F-NaF and 18F-FDG PET/CT in a single combined imaging examination. We further examined the potential of such combined examinations by comparing dual tracer 18F-NaF18/F-FDG PET/CT with CT alone for detection of osseous metastasis. Seventy-five participants with biopsy-proven malignancy were consecutively enrolled from a single center and underwent combined 18F-NaF/18F-FDG PET/CT and diagnostic CT scans. PET/CT as well as CT only images were reviewed in blinded fashion and compared with the results of clinical, imaging, or histological follow-up as a truth standard. Sensitivity of the combined 18F-NaF/18F-FDG PET/CT was higher than that of CT alone (97.4% vs 66.7%). CT and 18F-NaF/18F-FDG PET/CT were concordant in 73% of studies. Of 20 discordant cases, 18F-NaF/18F-FDG PET/CT was correct in 19 (95%). Three cases were interpreted concordantly but incorrectly, and all 3 were false positives. A single case of osseous metastasis was detected by CT alone, but not by 18F-NaF/18F-FDG PET/CT. Combined 18F-NaF/18F-FDG PET/CT outperforms CT alone and is highly sensitive and specific for detection of osseous metastases. The concordantly interpreted false-positive cases demonstrate the difficulty of distinguishing degenerative from malignant disease, whereas the single case of metastasis seen on CT but not PET highlights the need for careful review of CT images in multimodality studies.

Diagnostic accuracy of a volume-rendered computed tomography movie and other computed tomography-based imaging methods in assessment of renal vascular anatomy for laparoscopic donor nephrectomy.

PubMed

Yamamoto, Shingo; Tanooka, Masao; Ando, Kumiko; Yamano, Toshiko; Ishikura, Reiichi; Nojima, Michio; Hirota, Shozo; Shima, Hiroki

2009-12-01

To evaluate the diagnostic accuracy of computed tomography (CT)-based imaging methods for assessing renal vascular anatomy, imaging studies, including standard axial CT, three-dimensional volume-rendered CT (3DVR-CT), and a 3DVR-CT movie, were performed on 30 patients who underwent laparoscopic donor nephrectomy (10 right side, 20 left side) for predicting the location of the renal arteries and renal, adrenal, gonadal, and lumbar veins. These findings were compared with videos obtained during the operation. Two of 37 renal arteries observed intraoperatively were missed by standard axial CT and 3DVR-CT, whereas all arteries were identified by the 3DVR-CT movie. Two of 36 renal veins were missed by standard axial CT and 3DVR-CT, whereas 1 was missed by the 3DVR-CT movie. In 20 left renal hilar anatomical structures, 20 adrenal, 20 gonadal, and 22 lumbar veins were observed during the operation. Preoperatively, the standard axial CT, 3DVR-CT, and 3DVR-CT movie detected 11, 19, and 20 adrenal veins; 13, 14, and 19 gonadal veins; and 6, 11, and 15 lumbar veins, respectively. Overall, of 135 renal vascular structures, the standard axial CT, 3DVR-CT, and 3DVR-CT movie accurately detected 99 (73.3%), 113 (83.7%), and 126 (93.3%) vessels, respectively, which indicated that the 3DVR-CT movie demonstrated a significantly higher detection rate than other CT-based imaging methods (P < 0.05). The 3DVR-CT movie accurately provides essential information about the renal vascular anatomy before laparoscopic donor nephrectomy.

PET/CT: underlying physics, instrumentation, and advances.

PubMed

Torres Espallardo, I

Since it was first introduced, the main goal of PET/CT has been to provide both PET and CT images with high clinical quality and to present them to radiologists and specialists in nuclear medicine as a fused, perfectly aligned image. The use of fused PET and CT images quickly became routine in clinical practice, showing the great potential of these hybrid scanners. Thanks to this success, manufacturers have gone beyond considering CT as a mere attenuation corrector for PET, concentrating instead on design high performance PET and CT scanners with more interesting features. Since the first commercial PET/CT scanner became available in 2001, both the PET component and the CT component have improved immensely. In the case of PET, faster scintillation crystals with high stopping power such as LYSO crystals have enabled more sensitive devices to be built, making it possible to reduce the number of undesired coincidence events and to use time of flight (TOF) techniques. All these advances have improved lesion detection, especially in situations with very noisy backgrounds. Iterative reconstruction methods, together with the corrections carried out during the reconstruction and the use of the point-spread function, have improved image quality. In parallel, CT instrumentation has also improved significantly, and 64- and 128-row detectors have been incorporated into the most modern PET/CT scanners. This makes it possible to obtain high quality diagnostic anatomic images in a few seconds that both enable the correction of PET attenuation and provide information for diagnosis. Furthermore, nowadays nearly all PET/CT scanners have a system that modulates the dose of radiation that the patient is exposed to in the CT study in function of the region scanned. This article reviews the underlying physics of PET and CT imaging separately, describes the changes in the instrumentation and standard protocols in a combined PET/CT system, and finally points out the most important advances in this hybrid imaging modality. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Comparison of sensitivity of lung nodule detection between radiologists and technologists on low-dose CT lung cancer screening images

PubMed Central

Kakinuma, R; Ashizawa, K; Kobayashi, T; Fukushima, A; Hayashi, H; Kondo, T; Machida, M; Matsusako, M; Minami, K; Oikado, K; Okuda, M; Takamatsu, S; Sugawara, M; Gomi, S; Muramatsu, Y; Hanai, K; Muramatsu, Y; Kaneko, M; Tsuchiya, R; Moriyama, N

2012-01-01

Objectives The objective of this study was to compare the sensitivity of detection of lung nodules on low-dose screening CT images between radiologists and technologists. Methods 11 radiologists and 10 technologists read the low-dose screening CT images of 78 subjects. On images with a slice thickness of 5 mm, there were 60 lung nodules that were ≥5 mm in diameter: 26 nodules with pure ground-glass opacity (GGO), 7 nodules with mixed ground-glass opacity (GGO with a solid component) and 27 solid nodules. On images with a slice thickness of 2 mm, 69 lung nodules were ≥5 mm in diameter: 35 pure GGOs, 7 mixed GGOs and 27 solid nodules. The 21 observers read screening CT images of 5-mm slice thickness at first; then, 6 months later, they read screening CT images of 2-mm slice thickness from the 78 subjects. Results The differences in the mean sensitivities of detection of the pure GGOs, mixed GGOs and solid nodules between radiologists and technologists were not statistically significant, except for the case of solid nodules; the p-values of the differences for pure GGOs, mixed GGOs and solid nodules on the CT images with 5-mm slice thickness were 0.095, 0.461 and 0.005, respectively, and the corresponding p-values on CT images of 2-mm slice thickness were 0.971, 0.722 and 0.0037, respectively. Conclusion Well-trained technologists may contribute to the detection of pure and mixed GGOs ≥5 mm in diameter on low-dose screening CT images. PMID:22919013

Registration of PET and CT images based on multiresolution gradient of mutual information demons algorithm for positioning esophageal cancer patients.

PubMed

Jin, Shuo; Li, Dengwang; Wang, Hongjun; Yin, Yong

2013-01-07

Accurate registration of 18F-FDG PET (positron emission tomography) and CT (computed tomography) images has important clinical significance in radiation oncology. PET and CT images are acquired from (18)F-FDG PET/CT scanner, but the two acquisition processes are separate and take a long time. As a result, there are position errors in global and deformable errors in local caused by respiratory movement or organ peristalsis. The purpose of this work was to implement and validate a deformable CT to PET image registration method in esophageal cancer to eventually facilitate accurate positioning the tumor target on CT, and improve the accuracy of radiation therapy. Global registration was firstly utilized to preprocess position errors between PET and CT images, achieving the purpose of aligning these two images on the whole. Demons algorithm, based on optical flow field, has the features of fast process speed and high accuracy, and the gradient of mutual information-based demons (GMI demons) algorithm adds an additional external force based on the gradient of mutual information (GMI) between two images, which is suitable for multimodality images registration. In this paper, GMI demons algorithm was used to achieve local deformable registration of PET and CT images, which can effectively reduce errors between internal organs. In addition, to speed up the registration process, maintain its robustness, and avoid the local extremum, multiresolution image pyramid structure was used before deformable registration. By quantitatively and qualitatively analyzing cases with esophageal cancer, the registration scheme proposed in this paper can improve registration accuracy and speed, which is helpful for precisely positioning tumor target and developing the radiation treatment planning in clinical radiation therapy application.

Registration of PET and CT images based on multiresolution gradient of mutual information demons algorithm for positioning esophageal cancer patients

PubMed Central

Jin, Shuo; Li, Dengwang; Yin, Yong

2013-01-01

Accurate registration of  18F−FDG PET (positron emission tomography) and CT (computed tomography) images has important clinical significance in radiation oncology. PET and CT images are acquired from  18F−FDG PET/CT scanner, but the two acquisition processes are separate and take a long time. As a result, there are position errors in global and deformable errors in local caused by respiratory movement or organ peristalsis. The purpose of this work was to implement and validate a deformable CT to PET image registration method in esophageal cancer to eventually facilitate accurate positioning the tumor target on CT, and improve the accuracy of radiation therapy. Global registration was firstly utilized to preprocess position errors between PET and CT images, achieving the purpose of aligning these two images on the whole. Demons algorithm, based on optical flow field, has the features of fast process speed and high accuracy, and the gradient of mutual information‐based demons (GMI demons) algorithm adds an additional external force based on the gradient of mutual information (GMI) between two images, which is suitable for multimodality images registration. In this paper, GMI demons algorithm was used to achieve local deformable registration of PET and CT images, which can effectively reduce errors between internal organs. In addition, to speed up the registration process, maintain its robustness, and avoid the local extremum, multiresolution image pyramid structure was used before deformable registration. By quantitatively and qualitatively analyzing cases with esophageal cancer, the registration scheme proposed in this paper can improve registration accuracy and speed, which is helpful for precisely positioning tumor target and developing the radiation treatment planning in clinical radiation therapy application. PACS numbers: 87.57.nj, 87.57.Q‐, 87.57.uk PMID:23318381

Diagnosis of complications associated with acute cholecystitis using computed tomography and diffusion-weighted imaging with background body signal suppression/T2 image fusion.

PubMed

Tomizawa, Minoru; Shinozaki, Fuminobu; Tanaka, Satomi; Sunaoshi, Takafumi; Kano, Daisuke; Sugiyama, Eriko; Shite, Misaki; Haga, Ryouta; Fukamizu, Yoshiya; Fujita, Toshiyuki; Kagayama, Satoshi; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

2017-07-01

In a clinical setting, it is important to diagnose complications of acute cholecystitis accurately. Diffusion-weighted whole body imaging with background body signal suppression/T2-weighted image fusion (DWIBS/T2) provides high signal intensity with a strong contrast against surrounding tissues in anatomical settings. In the present study, patients who were being treated for acute cholecystitis and underwent DWIBS/T2 in the National Hospital Organization Shimoshizu Hospital between December 2012 and August 2015 were enrolled. A total of 10 men and 4 women underwent DWIBS/T2. Records, including DWIBS/T2 and computed tomography (CT) imaging, were retrospectively analyzed for patients with acute cholecystitis. CT images revealed thickened gallbladder walls in patients with acute cholecystitis, and high signal intensity was observed in DWIBS/T2 images for the thickened gallbladder wall. Inflammation of the pericholecystic space and the liver resulted in high intensity signals with DWIBS/T2 imaging, whereas CT imaging revealed a low-density area in the cholecystic space. Plain CT scanning identified a low-density area in the liver, which became more obvious with contrast-enhanced CT. DWIBS/T2 imaging showed the inflammation of the liver and pericholesyctic space as an area of high signal intensity. Detectability of inflammation of the pericholecystic space and the liver was the same for DWIBS/T2 and CT, which suggests that DWIBS/T2 has the same sensitivity as CT scanning for the diagnosis of complicated acute cholecystitis. However, the strong contrast shown by DWIBS/T2 allows for easier evaluation of acute cholecystitis than CT scanning.

A minimum spanning forest based classification method for dedicated breast CT images

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

Pike, Robert; Sechopoulos, Ioannis; Fei, Baowei, E-mail: bfei@emory.edu

Purpose: To develop and test an automated algorithm to classify different types of tissue in dedicated breast CT images. Methods: Images of a single breast of five different patients were acquired with a dedicated breast CT clinical prototype. The breast CT images were processed by a multiscale bilateral filter to reduce noise while keeping edge information and were corrected to overcome cupping artifacts. As skin and glandular tissue have similar CT values on breast CT images, morphologic processing is used to identify the skin based on its position information. A support vector machine (SVM) is trained and the resulting modelmore » used to create a pixelwise classification map of fat and glandular tissue. By combining the results of the skin mask with the SVM results, the breast tissue is classified as skin, fat, and glandular tissue. This map is then used to identify markers for a minimum spanning forest that is grown to segment the image using spatial and intensity information. To evaluate the authors’ classification method, they use DICE overlap ratios to compare the results of the automated classification to those obtained by manual segmentation on five patient images. Results: Comparison between the automatic and the manual segmentation shows that the minimum spanning forest based classification method was able to successfully classify dedicated breast CT image with average DICE ratios of 96.9%, 89.8%, and 89.5% for fat, glandular, and skin tissue, respectively. Conclusions: A 2D minimum spanning forest based classification method was proposed and evaluated for classifying the fat, skin, and glandular tissue in dedicated breast CT images. The classification method can be used for dense breast tissue quantification, radiation dose assessment, and other applications in breast imaging.« less

[Three-dimensional tooth model reconstruction based on fusion of dental computed tomography images and laser-scanned images].

PubMed

Zhang, Dongxia; Gan, Yangzhou; Xiong, Jing; Xia, Zeyang

2017-02-01

Complete three-dimensional(3D) tooth model provides essential information to assist orthodontists for diagnosis and treatment planning. Currently, 3D tooth model is mainly obtained by segmentation and reconstruction from dental computed tomography(CT) images. However, the accuracy of 3D tooth model reconstructed from dental CT images is low and not applicable for invisalign design. And another serious problem also occurs, i.e. frequentative dental CT scan during different intervals of orthodontic treatment often leads to radiation to the patients. Hence, this paper proposed a method to reconstruct tooth model based on fusion of dental CT images and laser-scanned images. A complete3 D tooth model was reconstructed with the registration and fusion between the root reconstructed from dental CT images and the crown reconstructed from laser-scanned images. The crown of the complete 3D tooth model reconstructed with the proposed method has higher accuracy. Moreover, in order to reconstruct complete 3D tooth model of each orthodontic treatment interval, only one pre-treatment CT scan is needed and in the orthodontic treatment process only the laser-scan is required. Therefore, radiation to the patients can be reduced significantly.

A prospective randomized multicentre study of the impact of gallium-68 prostate-specific membrane antigen (PSMA) PET/CT imaging for staging high-risk prostate cancer prior to curative-intent surgery or radiotherapy (proPSMA study): clinical trial protocol.

PubMed

Hofman, Michael S; Murphy, Declan G; Williams, Scott G; Nzenza, Tatenda; Herschtal, Alan; Lourenco, Richard De Abreu; Bailey, Dale L; Budd, Ray; Hicks, Rodney J; Francis, Roslyn J; Lawrentschuk, Nathan

2018-05-03

Accurate staging of patients with prostate cancer (PCa) is important for therapeutic decision-making. Relapse after surgery or radiotherapy of curative intent is not uncommon and, in part, represents a failure of staging with current diagnostic imaging techniques to detect disease spread. Prostate-specific membrane antigen (PSMA) positron-emission tomography (PET)/computed tomography (CT) is a new whole-body scanning technique that enables visualization of PCa with high contrast. The hypotheses of this study are that: (i) PSMA-PET/CT has improved diagnostic performance compared with conventional imaging; (ii) PSMA-PET/CT should be used as a first-line diagnostic test for staging; (iii) the improved diagnostic performance of PSMA-PET/CT will result in significant management impact; and (iv) there are economic benefits if PSMA-PET/CT is incorporated into the management algorithm. The proPSMA trial is a prospective, multicentre study in which patients with untreated high-risk PCa will be randomized to gallium-68-PSMA-11 PET/CT or conventional imaging, consisting of CT of the abdomen/pelvis and bone scintigraphy with single-photon emission CT/CT. Patients eligible for inclusion are those with newly diagnosed PCa with select high-risk features, defined as International Society of Urological Pathology grade group ≥3 (primary Gleason grade 4, or any Gleason grade 5), prostate-specific antigen level ≥20 ng/mL or clinical stage ≥T3. Patients with negative, equivocal or oligometastatic disease on first line-imaging will cross over to receive the other imaging arm. The primary objective is to compare the accuracy of PSMA-PET/CT with that of conventional imaging for detecting nodal or distant metastatic disease. Histopathological, imaging and clinical follow-up at 6 months will define the primary endpoint according to a predefined scoring system. Secondary objectives include comparing management impact, the number of equivocal studies, the incremental value of second-line imaging in patients who cross over, the cost of each imaging strategy, radiation exposure, inter-observer agreement and safety of PSMA-PET/CT. Longer-term follow-up will also assess the prognostic value of a negative PSMA-PET/CT. This trial will provide data to establish whether PSMA-PET/CT should replace conventional imaging in the primary staging of select high-risk localized PCa, or whether it should be used to provide incremental diagnostic information in selected cases. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

Combined use of iterative reconstruction and monochromatic imaging in spinal fusion CT images.

PubMed

Wang, Fengdan; Zhang, Yan; Xue, Huadan; Han, Wei; Yang, Xianda; Jin, Zhengyu; Zwar, Richard

2017-01-01

Spinal fusion surgery is an important procedure for treating spinal diseases and computed tomography (CT) is a critical tool for postoperative evaluation. However, CT image quality is considerably impaired by metal artifacts and image noise. To explore whether metal artifacts and image noise can be reduced by combining two technologies, adaptive statistical iterative reconstruction (ASIR) and monochromatic imaging generated by gemstone spectral imaging (GSI) dual-energy CT. A total of 51 patients with 318 spinal pedicle screws were prospectively scanned by dual-energy CT using fast kV-switching GSI between 80 and 140 kVp. Monochromatic GSI images at 110 keV were reconstructed either without or with various levels of ASIR (30%, 50%, 70%, and 100%). The quality of five sets of images was objectively and subjectively assessed. With objective image quality assessment, metal artifacts decreased when increasing levels of ASIR were applied (P < 0.001). Moreover, adding ASIR to GSI also decreased image noise (P < 0.001) and improved the signal-to-noise ratio (P < 0.001). The subjective image quality analysis showed good inter-reader concordance, with intra-class correlation coefficients between 0.89 and 0.99. The visualization of peri-implant soft tissue was improved at higher ASIR levels (P < 0.001). Combined use of ASIR and GSI decreased image noise and improved image quality in post-spinal fusion CT scans. Optimal results were achieved with ASIR levels ≥70%. © The Foundation Acta Radiologica 2016.

Automated extraction of radiation dose information from CT dose report images.

PubMed

Li, Xinhua; Zhang, Da; Liu, Bob

2011-06-01

The purpose of this article is to describe the development of an automated tool for retrieving texts from CT dose report images. Optical character recognition was adopted to perform text recognitions of CT dose report images. The developed tool is able to automate the process of analyzing multiple CT examinations, including text recognition, parsing, error correction, and exporting data to spreadsheets. The results were precise for total dose-length product (DLP) and were about 95% accurate for CT dose index and DLP of scanned series.

Development of a Carbon Nanotube-Based Micro-CT and its Applications in Preclinical Research

NASA Astrophysics Data System (ADS)

Burk, Laurel May

Due to the dependence of researchers on mouse models for the study of human disease, diagnostic tools available in the clinic must be modified for use on these much smaller subjects. In addition to high spatial resolution, cardiac and lung imaging of mice presents extreme temporal challenges, and physiological gating methods must be developed in order to image these organs without motion blur. Commercially available micro-CT imaging devices are equipped with conventional thermionic x-ray sources and have a limited temporal response and are not ideal for in vivo small animal studies. Recent development of a field-emission x-ray source with carbon nanotube (CNT) cathode in our lab presented the opportunity to create a micro-CT device well-suited for in vivo lung and cardiac imaging of murine models for human disease. The goal of this thesis work was to present such a device, to develop and refine protocols which allow high resolution in vivo imaging of free-breathing mice, and to demonstrate the use of this new imaging tool for the study many different disease models. In Chapter 1, I provide background information about x-rays, CT imaging, and small animal micro-CT. In Chapter 2, CNT-based x-ray sources are explained, and details of a micro-focus x-ray tube specialized for micro-CT imaging are presented. In Chapter 3, the first and second generation CNT micro-CT devices are characterized, and successful respiratory- and cardiac-gated live animal imaging on normal, wild-type mice is achieved. In Chapter 4, respiratory-gated imaging of mouse disease models is demonstrated, limitations to the method are discussed, and a new contactless respiration sensor is presented which addresses many of these limitations. In Chapter 5, cardiac-gated imaging of disease models is demonstrated, including studies of aortic calcification, left ventricular hypertrophy, and myocardial infarction. In Chapter 6, several methods for image and system improvement are explored, and radiation therapy-related micro-CT imaging is present. Finally, in Chapter 7 I discuss future directions for this research and for the CNT micro-CT.

Dual-energy and low-kVp CT in the abdomen.

PubMed

Yeh, Benjamin M; Shepherd, John A; Wang, Zhen J; Teh, Hui Seong; Hartman, Robert P; Prevrhal, Sven

2009-07-01

The purpose of this article is to discuss the influence of tube potential on CT images and explore the potential impact of dual-energy CT on imaging of the abdomen and pelvis. Low peak tube voltage (kVp) settings provide high conspicuity of contrast materials at CT but may result in high image noise, particularly in larger patients. Material decomposition at dual-energy CT can differentiate renal stones by their composition, quantify tissue iron stores, improve the detection of pathologic hyperenhancement, and reduce contrast material and radiation dose compared with conventional CT. Further clinical research and technique refinement will be needed as the usage of these exciting technologies spreads.

CT scan (image)

MedlinePlus

CT stands for computerized tomography. In this procedure, a thin X-ray beam is rotated around the ... D image of a section through the body. CT scans are very detailed and provide excellent information ...

Head CT (image)

MedlinePlus

CT stands for computerized tomography. In this procedure, a thin X-ray beam is rotated around the ... D image of a section through the body. CT scans are very detailed and provide excellent information ...

Performance of CT examinations in children with suspected acute appendicitis in the community setting: a need for more education.

PubMed

Kim, Michael E; Orth, Robert C; Fallon, Sara C; Lopez, Monica E; Brandt, Mary L; Zhang, Wei; Bisset, George S

2015-04-01

Despite a recent focus on the preferential use of ultrasound over CT for pediatric appendicitis, most children transferred from community hospitals still undergo diagnostic CT scans. The purpose of this study was to evaluate CT techniques performed for children with acute appendicitis at nonpediatric treatment centers. All patients treated for acute appendicitis at our tertiary-care pediatric hospital from July 1, 2011, through June 30, 2012, were identified. Patient demographics, imaging modality used to diagnoses appendicitis (CT or ultrasound), location (home or referral institution), and CT technique parameters were collected. The estimated mean organ radiation dose, number of imaging phases, and use of contrast media were evaluated at home and referral institutions. During the study period, 1215 patients underwent appendectomies after imaging, with 442 (36.4%) imaged at referral facilities. Most referral patients received a diagnosis by CT (n=384, 87%), compared with 73 of 773 (9.4%) who received a diagnosis by CT at the home institution. The estimated mean (±SD) organ radiation dose was not statistically significantly different between home and referral institutions (13.5±7.3 vs 12.9±6.4 mGy; p=0.58) for single-phase examinations. Of 384 referral patients, 344 had images available for review. In total, 40% (138/344) of patients from referral centers were imaged with suboptimal CT techniques: 50 delayed phase only, 52 dual phase (eight of which were imaged twice in delayed phase), eight triple phase, and 36 without IV contrast agent. CT parameters and radiation doses from single-phase examinations in children with appendicitis were similar at nonpediatric treatment centers and a tertiary care children's hospital. Future educational outreach should focus on optimizing other technical parameters.

A denoising algorithm for CT image using low-rank sparse coding

NASA Astrophysics Data System (ADS)

Lei, Yang; Xu, Dong; Zhou, Zhengyang; Wang, Tonghe; Dong, Xue; Liu, Tian; Dhabaan, Anees; Curran, Walter J.; Yang, Xiaofeng

2018-03-01

We propose a denoising method of CT image based on low-rank sparse coding. The proposed method constructs an adaptive dictionary of image patches and estimates the sparse coding regularization parameters using the Bayesian interpretation. A low-rank approximation approach is used to simultaneously construct the dictionary and achieve sparse representation through clustering similar image patches. A variable-splitting scheme and a quadratic optimization are used to reconstruct CT image based on achieved sparse coefficients. We tested this denoising technology using phantom, brain and abdominal CT images. The experimental results showed that the proposed method delivers state-of-art denoising performance, both in terms of objective criteria and visual quality.

Emergency department CT screening of patients with nontraumatic neurological symptoms referred to the posterior fossa: comparison of thin versus thick slice images.

PubMed

Kamalian, Shervin; Atkinson, Wendy L; Florin, Lauren A; Pomerantz, Stuart R; Lev, Michael H; Romero, Javier M

2014-06-01

Evaluation of the posterior fossa (PF) on 5-mm-thick helical CT images (current default) has improved diagnostic accuracy compared to 5-mm sequential CT images; however, 5-mm-thick images may not be ideal for PF pathology due to volume averaging of rapid changes in anatomy in the Z-direction. Therefore, we sought to determine if routine review of 1.25-mm-thin helical CT images has superior accuracy in screening for nontraumatic PF pathology. MRI proof of diagnosis was obtained within 6 h of helical CT acquisition for 90 consecutive ED patients with, and 88 without, posterior fossa lesions. Helical CT images were post-processed at 1.25 and 5-mm-axial slice thickness. Two neuroradiologists blinded to the clinical/MRI findings reviewed both image sets. Interobserver agreement and accuracy were rated using Kappa statistics and ROC analysis, respectively. Of the 90/178 (51 %) who were MR positive, 60/90 (66 %) had stroke and 30/90 (33 %) had other etiologies. There was excellent interobserver agreement (κ > 0.97) for both thick and thin slice assessments. The accuracy, sensitivity, and specificity for 1.25-mm images were 65, 44, and 84 %, respectively, and for 5-mm images were 67, 45, and 85 %, respectively. The diagnostic accuracy was not significantly different (p > 0.5). In this cohort of patients with nontraumatic neurological symptoms referred to the posterior fossa, 1.25-mm-thin slice CT reformatted images do not have superior accuracy compared to 5-mm-thick images. This information has implications on optimizing resource utilizations and efficiency in a busy emergency room. Review of 1.25-mm-thin images may help diagnostic accuracy only when review of 5-mm-thick images as current default is inconclusive.

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

Normal cross-sectional anatomy of the bovine digit: comparison of computed tomography and limb anatomy.

PubMed

Raji, A R; Sardari, K; Mohammadi, H R

2008-06-01

The purpose of this study was to define the structures of the digits and hoof in Holstein dairy cattle by using computed tomography scan (CT scan). Transverse, sagittal and dorsoplantar CT images of two isolated cattle cadaver digits were obtained using a Siemens ARTX2 Somatom. The CT images were compared to corresponding frozen cross-sections. Relevant anatomical structures were identified and labelled at each level. The CT images provided anatomical detail of the digits and hoof in Holstein dairy cattle. Transversal images provided excellent depiction of anatomical structures when compared to corresponding frozen cross-sections. The information presented in this paper would serve as an initial reference to the evaluation of CT images of the digits and hoof in Holstein dairy cattle.