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Sample records for dose lung ct

  1. Lung Cancer Screening with Low Dose CT

    PubMed Central

    Caroline, Chiles

    2014-01-01

    SUMMARY The announcement of the results of the NLST, showing a 20% reduction in lung-cancer specific mortality with LDCT screening in a high risk population, marked a turning point in lung cancer screening. This was the first time that a randomized controlled trial had shown a mortality reduction with an imaging modality aimed at early detection of lung cancer. Current guidelines endorse LDCT screening for smokers and former smokers ages 55 to 74, with at least a 30 pack year smoking history. Adherence to published algorithms for nodule follow-up is strongly encouraged. Future directions for screening research include risk stratification for selection of the screening population, and improvements in the diagnostic follow-up for indeterminate pulmonary nodules. As with screening for other malignancies, screening for lung cancer with LDCT has revealed that there are indolent lung cancers which may not be fatal. More research is necessary if we are to maximize the risk-benefit ratio in lung cancer screening. PMID:24267709

  2. 20 percent lower lung cancer mortality with low-dose CT vs chest X-ray

    Cancer.gov

    Scientists have found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with low-dose helical computed tomography (CT) versus those screened by chest X-ray.

  3. Low-dose high-resolution CT of lung parenchyma

    SciTech Connect

    Zwirewich, C.V.; Mayo, J.R.; Mueller, N.L. )

    1991-08-01

    To evaluate the efficacy of low-dose high-resolution computed tomography (HRCT) in the assessment of lung parenchyma, three observers reviewed the scans of 31 patients. The 1.5-mm-collimation, 2-second, 120-kVp scans were obtained at 20 and 200 mA at selected identical levels in the chest. The observers evaluated the visualization of normal pulmonary anatomy, various parenchymal abnormalities and their distribution, and artifacts. The low-dose and conventional scans were equivalent in the evaluation of vessels, lobar and segmental bronchi, and anatomy of secondary pulmonary lobules, and in characterizing the extent and distribution of reticulation, honeycomb cysts, and thickened interlobular septa. The low-dose technique failed to demonstrate ground-glass opacity in two of 10 cases (20%) and emphysema in one of nine cases (11%), in which they were evident but subtle on the high-dose scans. These differences were not statistically significant. Linear streak artifact was more prominent on images acquired with the low-dose technique, but the two techniques were judged equally diagnostic in 97% of cases. The authors conclude that HRCT images acquired at 20 mA yield anatomic information equivalent to that obtained with 200-mA scans in the majority of patients, without significant loss of spatial resolution or image degradation due to linear streak artifact.

  4. Lung cancer screening with low-dose chest CT: current issues.

    PubMed

    Ahn, Myeong Im

    2004-06-01

    Computed tomography offers many advantages over routine radiographs in screening for lung cancer, and it is clear that low-dose spiral CT screening can more frequently find considerably smaller lung cancers than previous detection tools. Recently, investigators have performed low-dose spiral CT scanning for screening of lung cancer, and have suggested that CT screening can depict lung cancers at smaller sizes and at earlier stages. With technological advances in spiral CT scanners, the detection rate of small noncalcified pulmonary nodules has markedly increased, with higher rates noted with thinner collimation of CT scanning. Unfortunately, the majority of these have proved to be benign, i.e. false positive results. If, even in part, CT features could be found to predict benign nodules without follow-up, the false-positive rate would be reduced, and consequently, the cost, emotional stress, radiation dose, morbidity and mortality associated with interventional procedures would also be reduced. There have been several studies trying to establish reliable CT features for benign lesions in small pulmonary nodules and to determine their outcome. Although these efforts have not completely resolved the issue of false positive results, it is expected that lessons will be learnt on how to manage these small nodules through experience with screening in the near future. Because pulmonary nodules on CT are much more common in Korea than in western countries, the management algorithm for screening CT-detected nodules should be modified according to different circumstances, with consensus among related physicians and radiologists. In addition, to enhance patient care and avoid misunderstanding of inherent limitation of CT screening by the screening subjects, physicians, hospital managers as well as radiologists should provide proper information regarding CT screening to the screenees.

  5. Lung Dose Calculation With SPECT/CT for {sup 90}Yittrium Radioembolization of Liver Cancer

    SciTech Connect

    Yu, Naichang; Srinivas, Shaym M.; DiFilippo, Frank P.; Shrikanthan, Sankaran; Levitin, Abraham; McLennan, Gordon; Spain, James; Xia, Ping; Wilkinson, Allan

    2013-03-01

    Purpose: To propose a new method to estimate lung mean dose (LMD) using technetium-99m labeled macroaggregated albumin ({sup 99m}Tc-MAA) single photon emission CT (SPECT)/CT for {sup 90}Yttrium radioembolization of liver tumors and to compare the LMD estimated using SPECT/CT with clinical estimates of LMD using planar gamma scintigraphy (PS). Methods and Materials: Images of 71 patients who had SPECT/CT and PS images of {sup 99m}Tc-MAA acquired before TheraSphere radioembolization of liver cancer were analyzed retrospectively. LMD was calculated from the PS-based lung shunt assuming a lung mass of 1 kg and 50 Gy per GBq of injected activity shunted to the lung. For the SPECT/CT-based estimate, the LMD was calculated with the activity concentration and lung volume derived from SPECT/CT. The effect of attenuation correction and the patient's breathing on the calculated LMD was studied with the SPECT/CT. With these effects correctly taken into account in a more rigorous fashion, we compared the LMD calculated with SPECT/CT with the LMD calculated with PS. Results: The mean dose to the central region of the lung leads to a more accurate estimate of LMD. Inclusion of the lung region around the diaphragm in the calculation leads to an overestimate of LMD due to the misregistration of the liver activity to the lung from the patient's breathing. LMD calculated based on PS is a poor predictor of the actual LMD. For the subpopulation with large lung shunt, the mean overestimation from the PS method for the lung shunt was 170%. Conclusions: A new method of calculating the LMD for TheraSphere and SIR-Spheres radioembolization of liver cancer based on {sup 99m}Tc-MAA SPECT/CT is presented. The new method provides a more accurate estimate of radiation risk to the lungs. For patients with a large lung shunt calculated from PS, a recalculation of LMD based on SPECT/CT is recommended.

  6. SU-E-P-03: Implementing a Low Dose Lung Screening CT Program Meeting Regulatory Requirements

    SciTech Connect

    LaFrance, M; Marsh, S; O'Donnell, G

    2014-06-01

    Purpose: To provide information pertaining to IROC Houston QA Center's (RPC) credentialing process for institutions participating in NCI-sponsored clinical trials. Purpose: Provide guidance to the Radiology Departments with the intent of implementing a Low Dose CT Screening Program using different CT Scanners with multiple techniques within the framework of the required state regulations. Method: State Requirements for the purpose of implementing a Low Dose CT Lung Protocol required working with the Radiology and Pulmonary Department in setting up a Low Dose Screening Protocol designed to reduce the radiation burden to the patients enrolled. Radiation dose measurements (CTDIvol) for various CT manufacturers (Siemens16, Siemens 64, Philips 64, and Neusoft128) for three different weight based protocols. All scans were reviewed by the Radiologist. Prior to starting a low dose lung screening protocol, information had to be submitted to the state for approval. Performing a Healing Arts protocol requires extensive information. This not only includes name and address of the applicant but a detailed description of the disease, the x-ray examination and the population to be examined. The unit had to be tested by a qualified expert using the technique charts. The credentials of all the operators, the supervisors and the Radiologists had to be submitted to the state. Results: All the appropriate documentation was sent to the state for review. The measured results between the Low Dose Protocol versus the default Adult Chest Protocol showed that there was a dose reduction of 65% for small (100-150 lb.) patient, 75% for the Medium patient (151-250 lbs.), and a 55% reduction for the Large patient ( over 250 lbs.). Conclusion: Measured results indicated that the Low Dose Protocol indeed lowered the screening patient's radiation dose and the institution was able to submit the protocol to the State's regulators.

  7. Automated detection and classification of interstitial lung diseases from low-dose CT images

    NASA Astrophysics Data System (ADS)

    Zheng, Bin; Leader, Joseph K.; Fuhrman, Carl R.; Sciurba, Frank C.; Gur, David

    2004-05-01

    We developed a computer-aided diagnosis (CAD) scheme to detect and quantitatively assess interstitial lung diseases (ILD) depicted on low-dose and multi-slice helical high-resolution computed tomography (CT) examinations. Eighteen CT cases acquired from patients who underwent routine low-dose whole-lung screening examinations for the detection of lung cancer were used to test the scheme. ILD was identified in all of these cases. The CAD scheme involves multiple steps to segment lung areas, identify suspicious ILD regions depicted on each CT slice, and generate volumetric ILD lesions by grouping and matching ILD regions detected on multiple adjacent slices. The scheme computes five "global" features for each identified ILD region, which include size (or volume), contrast, average local pixel value fluctuation, mean of stochastic fractal dimension, and geometric fractal dimension. Two sets of classification rules are applied to remove false-positive detections. The severity of ILD in each case was rated by one experienced chest radiologist into one of the three categories (mild, moderate, and severe). A distance-weighted k-nearest neighbor algorithm and round-robin validation method was applied to classify each testing case into one of the three categories of severity. In this experiment, the CAD scheme classified 78% (14 out of 18) cases into the same categories as rated by the radiologist.

  8. Computer-aided detection of early interstitial lung diseases using low-dose CT images

    NASA Astrophysics Data System (ADS)

    Park, Sang Cheol; Tan, Jun; Wang, Xingwei; Lederman, Dror; Leader, Joseph K.; Kim, Soo Hyung; Zheng, Bin

    2011-02-01

    This study aims to develop a new computer-aided detection (CAD) scheme to detect early interstitial lung disease (ILD) using low-dose computed tomography (CT) examinations. The CAD scheme classifies each pixel depicted on the segmented lung areas into positive or negative groups for ILD using a mesh-grid-based region growth method and a multi-feature-based artificial neural network (ANN). A genetic algorithm was applied to select optimal image features and the ANN structure. In testing each CT examination, only pixels selected by the mesh-grid region growth method were analyzed and classified by the ANN to improve computational efficiency. All unselected pixels were classified as negative for ILD. After classifying all pixels into the positive and negative groups, CAD computed a detection score based on the ratio of the number of positive pixels to all pixels in the segmented lung areas, which indicates the likelihood of the test case being positive for ILD. When applying to an independent testing dataset of 15 positive and 15 negative cases, the CAD scheme yielded the area under receiver operating characteristic curve (AUC = 0.884 ± 0.064) and 80.0% sensitivity at 85.7% specificity. The results demonstrated the feasibility of applying the CAD scheme to automatically detect early ILD using low-dose CT examinations.

  9. [Breast dose reduction in female CT screening for lung cancer using various metallic shields].

    PubMed

    Takada, Kenta; Kaneko, Junichi; Aoki, Kiyoshi

    2009-12-20

    We evaluated the effectiveness of metallic shields that were used for reduction of the breast dose in thoracic computed tomography(CT). For the evaluation, we measured breast surface dose and image standard deviation(SD)in the lung area. The metallic shields were made from bismuth, zinc, copper, and iron. The bismuth shield has been marketed and used for dose reduction. The other three metallic shields were chosen because they have lower atomic numbers and a lower yield of characteristic X-rays. As a result, use of the metallic shields showed a lower breast dose than the decrement of the tube current in the same image SD. The insertion of a thin aluminum sheet between the shield and a phantom was also effective in reducing breast surface dose. We calculated the dose reduction rate to evaluate the effectiveness of these metallic shields. This dose reduction rate was defined as the ratio of the decrease in breast surface dose by metallic shields to the breast surface dose measured with the tube current decrement in the same image SD. The maximum dose reduction rate was 6.4% for the bismuth shield, and 12.0-13.3% for the other shields. These results indicate that the shields made from zinc, copper, and iron are more effective for dose reduction than the shield made form bismuth. The best dose reduction rate, 13.3%, has been achieved when the zinc shield placed 20 mm apart from a phantom with 0.2 mm aluminum was used.

  10. Low-Dose CT Screening for Lung Cancer: Computer-aided Detection of Missed Lung Cancers.

    PubMed

    Liang, Mingzhu; Tang, Wei; Xu, Dong Ming; Jirapatnakul, Artit C; Reeves, Anthony P; Henschke, Claudia I; Yankelevitz, David

    2016-10-01

    Purpose To update information regarding the usefulness of computer-aided detection (CAD) systems with a focus on the most critical category, that of missed cancers at earlier imaging, for cancers that manifest as a solid nodule. Materials and Methods By using a HIPAA-compliant institutional review board-approved protocol where informed consent was obtained, 50 lung cancers that manifested as a solid nodule on computed tomographic (CT) scans in annual rounds of screening (time 1) were retrospectively identified that could, in retrospect, be identified on the previous CT scans (time 0). Four CAD systems were compared, which were referred to as CAD 1, CAD 2, CAD 3, and CAD 4. The total number of accepted CAD-system-detected nodules at time 0 was determined by consensus of two radiologists and the number of CAD-system-detected nodules that were rejected by the radiologists was also documented. Results At time 0 when all the cancers had been missed, CAD system detection rates for the cancers were 56%, 70%, 68%, and 60% (κ = 0.45) for CAD systems 1, 2, 3, and 4, respectively. At time 1, the rates were 74%, 82%, 82%, and 78% (κ = 0.32), respectively. The average diameter of the 50 cancers at time 0 and time 1 was 4.8 mm and 11.4 mm, respectively. The number of CAD-system-detected nodules that were rejected per CT scan for CAD systems 1-4 at time 0 was 7.4, 1.7, 0.6, and 4.5 respectively. Conclusion CAD systems detected up to 70% of lung cancers that were not detected by the radiologist but failed to detect about 20% of the lung cancers when they were identified by the radiologist, which suggests that CAD may be useful in the role of second reader. (©) RSNA, 2016.

  11. Comparison of measured and estimated maximum skin doses during CT fluoroscopy lung biopsies

    SciTech Connect

    Zanca, F.; Jacobs, A.; Crijns, W.; De Wever, W.

    2014-07-15

    Purpose: To measure patient-specific maximum skin dose (MSD) associated with CT fluoroscopy (CTF) lung biopsies and to compare measured MSD with the MSD estimated from phantom measurements, as well as with the CTDIvol of patient examinations. Methods: Data from 50 patients with lung lesions who underwent a CT fluoroscopy-guided biopsy were collected. The CT protocol consisted of a low-kilovoltage (80 kV) protocol used in combination with an algorithm for dose reduction to the radiology staff during the interventional procedure, HandCare (HC). MSD was assessed during each intervention using EBT2 gafchromic films positioned on patient skin. Lesion size, position, total fluoroscopy time, and patient-effective diameter were registered for each patient. Dose rates were also estimated at the surface of a normal-size anthropomorphic thorax phantom using a 10 cm pencil ionization chamber placed at every 30°, for a full rotation, with and without HC. Measured MSD was compared with MSD values estimated from the phantom measurements and with the cumulative CTDIvol of the procedure. Results: The median measured MSD was 141 mGy (range 38–410 mGy) while the median cumulative CTDIvol was 72 mGy (range 24–262 mGy). The ratio between the MSD estimated from phantom measurements and the measured MSD was 0.87 (range 0.12–4.1) on average. In 72% of cases the estimated MSD underestimated the measured MSD, while in 28% of the cases it overestimated it. The same trend was observed for the ratio of cumulative CTDIvol and measured MSD. No trend was observed as a function of patient size. Conclusions: On average, estimated MSD from dose rate measurements on phantom as well as from CTDIvol of patient examinations underestimates the measured value of MSD. This can be attributed to deviations of the patient's body habitus from the standard phantom size and to patient positioning in the gantry during the procedure.

  12. Investigating the low-dose limits of multidetector CT in lung nodule surveillance.

    PubMed

    Paul, N S; Siewerdsen, J H; Patsios, D; Chung, T B

    2007-09-01

    The purpose of this study was to evaluate the factors limiting nodule detection in thoracic computed tomography (CT) and to determine whether prior knowledge of nodule size and attenuation, available from a baseline CT study, influences the minimum radiation dose at which nodule surveillance CT scans can be performed while maintaining current levels of nodule detectability. Multiple nodules varying in attenuation (-509 to + 110 HU) and diameter (1.6 to 9.5 mm) were layered in random and ordered sequences within 2 lung cylinders made of Rando lung material and suspended within a custom-built CT phantom. Multiple CT scans were performed at varying kVp (120, 100, and 80), mA (200, 150, 100, 50, 20, and 10), and beam collimation (5, 2.5, and 1.25 mm) on a four-row multidetector scanner (Lightspeed, General Electric, Milwaukee, WI) using 0.8 s gantry rotation. The corresponding range of radiation dose over which images were acquired was 0.3-26.4 mGy. Nine observers independently performed three specific tasks, namely: (1) To detect a 3.2 mm nodule of 23 HU; (2) To detect 3.2 mm nodules of varying attenuation (-509 to -154 HU); and (3) To detect nodules varying in size (1.6-9 mm) and attenuation (-509 to 110 HU). A two-alternative forced-choice test was used in order to determine the limits of nodule detection in terms of the proportion of correct responses (Pcorr, related to the area under the ROC curve) as a summary metric of observer performance. The radiation dose levels for detection of 99% of nodules in each task were as follows: Task 1 (1 mGy); Task 2 (5 mGy); and Task 3 (7 mGy). The corresponding interobserver confidence limits were 1, 5, and 10 mGy for Tasks 1, 2, and 3, respectively. There was a fivefold increase in the radiation dose required for detection of lower-density nodules (Tasks 1 to 2). Absence of prior knowledge of the nodule size and density (Task 3) corresponds to a significant increase in the minimum required radiation dose. Significant image

  13. Lung Cancer Screening With Low-Dose CT in the United States.

    PubMed

    Eberth, Jan M

    2015-12-01

    The findings of the landmark National Lung Screening Trial (NLST)-showing a 20% reduction in lung cancer mortality when screening with low-dose CT (LDCT), compared with chest radiography-marked a turning point in the field of lung cancer screening, influencing organizational recommendations and leading to increasing acceptance of LDCT for screening of individuals at high risk for lung cancer. However, many practices and institutions have experienced barriers in their attempts to implement successful screening programs; these include challenges in maintaining the same high caliber of screening programs as those in the NLST, confusion regarding insurance reimbursement protocols, and a lack of resources to help physicians discuss the specifics of LDCT screening with their patients. To address these challenges, standards are being established to ensure consistent quality of screening programs, including certification standards and protocols maintained by the ACR. In addition, the US Preventive Services Task Force's "B" rating, given to LDCT screening in late 2013, resulted in mandated private insurance coverage beginning in 2015 and the 2015 CMS coverage determination has spurred previously reluctant organizations to prepare for population-based screening. Despite these successes, protocols for billing and claims processing are still evolving and organizations are considering how best to implement the shared decision-making process required by CMS. Despite some procedural setbacks that have yet to be resolved, LDCT screening for individuals at high risk of lung cancer has grown substantially since its effectiveness was shown by the NLST in 2011. PMID:26614885

  14. A decrease in lung cancer mortality following the introduction of low-dose chest CT screening in Hitachi, Japan.

    PubMed

    Nawa, Takeshi; Nakagawa, Tohru; Mizoue, Tetsuya; Kusano, Suzushi; Chonan, Tatsuya; Hayashihara, Kenji; Suito, Tetsushi; Endo, Katsuyuki

    2012-12-01

    Recent US clinical trial demonstrated that CT screening prevents lung cancer death among high risk individuals. However, it remains unclear whether wide implementation of low-dose CT screening for lung cancer can decrease mortality in the community. Among residents in Hitachi City (Japan), where nearly 40% of inhabitants aged 50-69 years were estimated to have participated in the screening at least once from 1998 through 2009, the trend of lung cancer mortality was described in relation to the timing of implementation of the CT screening. Cancer mortality data were obtained from regional cancer registry and standardized mortality ratio (SMR) of lung cancer was calculated for each 5-year period during 1995-2009. In both men and women aged 60 years or older, age-specific lung cancer mortality rates were generally lower during 2005-2009 as compared with those during 1995-2004. For combined men and women aged 50-79 years, SMR was nearly unity prior to or during introductory phase of CT screening and during early period of implementation; however, it was significantly decreased during 2005-2009, well after the implementation of CT screening, with SMR (95% confidence interval) being 0.76 (0.67-0.86). Results suggest that wide implementation of low-dose chest CT screening may decrease lung cancer mortality in the community 4-8 years after introduction of the screening.

  15. Automatic lobar segmentation for diseased lungs using an anatomy-based priority knowledge in low-dose CT images

    NASA Astrophysics Data System (ADS)

    Park, Sang Joon; Kim, Jung Im; Goo, Jin Mo; Lee, Doohee

    2014-03-01

    Lung lobar segmentation in CT images is a challenging tasks because of the limitations in image quality inherent to CT image acquisition, especially low-dose CT for clinical routine environment. Besides, complex anatomy and abnormal lesions in the lung parenchyma makes segmentation difficult because contrast in CT images are determined by the differential absorption of X-rays by neighboring structures, such as tissue, vessel or several pathological conditions. Thus, we attempted to develop a robust segmentation technique for normal and diseased lung parenchyma. The images were obtained with low-dose chest CT using soft reconstruction kernel (Sensation 16, Siemens, Germany). Our PC-based in-house software segmented bronchial trees and lungs with intensity adaptive region-growing technique. Then the horizontal and oblique fissures were detected by using eigenvalues-ratio of the Hessian matrix in the lung regions which were excluded from airways and vessels. To enhance and recover the faithful 3-D fissure plane, our proposed fissure enhancing scheme were applied to the images. After finishing above steps, for careful smoothening of fissure planes, 3-D rolling-ball algorithm in xyz planes were performed. Results show that success rate of our proposed scheme was achieved up to 89.5% in the diseased lung parenchyma.

  16. The evidence for low-dose CT screening of lung cancer.

    PubMed

    Ruchalski, Kathleen; Gutierrez, Antonio; Genshaft, Scott; Abtin, Fereidoun; Suh, Robert

    2016-01-01

    Lung cancer remains the leading cause of cancer-related death in the United States. An effective screening tool for early lung cancer detection has long been sought. Early chest radiograph and low-dose computed tomography (LDCT) screening trials were promising and demonstrated increased cancer detection. However, these studies were not able to improve lung cancer mortality. The National Lung Screening Trial resulted in decreased lung cancer mortality with LDCT screening in a high-risk population. Similar trials are currently underway in Europe. With LDCT now being widely implemented, it is paramount for radiologists to understand the evidence for lung cancer screening.

  17. Effects of CT dose and nodule characteristics on lung-nodule detectability in a cohort of 90 national lung screening trial patients

    NASA Astrophysics Data System (ADS)

    Young, Stefano; Lo, Pechin; Hoffman, John M.; Kim, H. J. Grace; Brown, Matthew S.; McNitt-Gray, Michael F.

    2016-03-01

    Lung cancer screening CT is already performed at low dose. There are many techniques to reduce the dose even further, but it is not clear how such techniques will affect nodule detectability. In this work, we used an in-house CAD algorithm to evaluate detectability. 90348 patients and their raw CT data files were drawn from the National Lung Screening Trial (NLST) database. All scans were acquired at ~2 mGy CTDIvol with fixed tube current, 1 mm slice thickness, and B50 reconstruction kernel on a Sensation 64 scanner (Siemens Healthcare). We used the raw CT data to simulate two additional reduced-dose scans for each patient corresponding to 1 mGy (50%) and 0.5 mGy (25%). Radiologists' findings on the NLST reader forms indicated 65 nodules in the cohort, which we subdivided based on LungRADS criteria. For larger category 4 nodules, median sensitivities were 100% at all three dose levels, and mean sensitivity decreased with dose. For smaller nodules meeting the category 2 or 3 criteria, the dose dependence was less obvious. Overall, mean patient-level sensitivity varied from 38.5% at 100% dose to 40.4% at 50% dose, a difference of only 1.9%. However, the false-positive rate quadrupled from 1 per case at 100% dose to 4 per case at 25% dose. Dose reduction affected lung-nodule detectability differently depending on the LungRADS category, and the false-positive rate was very sensitive at sub-screening dose levels. Thus, care should be taken to adapt CAD for the very challenging noise characteristics of screening.

  18. Longitudinal follow-up study of smoking-induced emphysema progression in low-dose CT screening of lung cancer

    NASA Astrophysics Data System (ADS)

    Suzuki, H.; Matsuhiro, M.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, Masahiro; Moriyama, N.

    2014-03-01

    Chronic obstructive pulmonary disease is a major public health problem that is predicted to be third leading cause of death in 2030. Although spirometry is traditionally used to quantify emphysema progression, it is difficult to detect the loss of pulmonary function by emphysema in early stage, and to assess the susceptibility to smoking. This study presents quantification method of smoking-induced emphysema progression based on annual changes of low attenuation volume (LAV) by each lung lobe acquired from low-dose CT images in lung cancer screening. The method consists of three steps. First, lung lobes are segmented using extracted interlobar fissures by enhancement filter based on fourdimensional curvature. Second, LAV of each lung lobe is segmented. Finally, smoking-induced emphysema progression is assessed by statistical analysis of the annual changes represented by linear regression of LAV percentage in each lung lobe. This method was applied to 140 participants in lung cancer CT screening for six years. The results showed that LAV progressions of nonsmokers, past smokers, and current smokers are different in terms of pack-year and smoking cessation duration. This study demonstrates effectiveness in diagnosis and prognosis of early emphysema in lung cancer CT screening.

  19. SU-E-I-25: Determining Tube Current, Tube Voltage and Pitch Suitable for Low- Dose Lung Screening CT

    SciTech Connect

    Williams, K; Matthews, K

    2014-06-01

    Purpose: The quality of a computed tomography (CT) image and the dose delivered during its acquisition depend upon the acquisition parameters used. Tube current, tube voltage, and pitch are acquisition parameters that potentially affect image quality and dose. This study investigated physicians' abilities to characterize small, solid nodules in low-dose CT images for combinations of current, voltage and pitch, for three CT scanner models. Methods: Lung CT images was acquired of a Data Spectrum anthropomorphic torso phantom with various combinations of pitch, tube current, and tube voltage; this phantom was used because acrylic beads of various sizes could be placed within the lung compartments to simulate nodules. The phantom was imaged on two 16-slice scanners and a 64-slice scanner. The acquisition parameters spanned a range of estimated CTDI levels; the CTDI estimates from the acquisition software were verified by measurement. Several experienced radiologists viewed the phantom lung CT images and noted nodule location, size and shape, as well as the acceptability of overall image quality. Results: Image quality for assessment of nodules was deemed unsatisfactory for all scanners at 80 kV (any tube current) and at 35 mA (any tube voltage). Tube current of 50 mA or more at 120 kV resulted in similar assessments from all three scanners. Physician-measured sphere diameters were closer to actual diameters for larger spheres, higher tube current, and higher kV. Pitch influenced size measurements less for larger spheres than for smaller spheres. CTDI was typically overestimated by the scanner software compared to measurement. Conclusion: Based on this survey of acquisition parameters, a low-dose CT protocol of 120 kV, 50 mA, and pitch of 1.4 is recommended to balance patient dose and acceptable image quality. For three models of scanners, this protocol resulted in estimated CTDIs from 2.9–3.6 mGy.

  20. SU-E-I-34: Evaluating Use of AEC to Lower Dose for Lung Cancer Screening CT Protocols

    SciTech Connect

    Arbique, G; Anderson, J; Guild, J; Duan, X; Malguria, N; Omar, H; Brewington, C; Zhang, D

    2015-06-15

    Purpose: The National Lung Screening Trial mandated manual low dose CT technique factors, where up to a doubling of radiation output could be used over a regular to large patient size range. Recent guidance from the AAPM and ACR for lung cancer CT screening recommends radiation output adjustment for patient size either through AEC or a manual technique chart. This study evaluated the use of AEC for output control and dose reduction. Methods: The study was performed on a multidetector helical CT scanner (Aquillion ONE, Toshiba Medical) equipped with iterative reconstruction (ADIR-3D), AEC was adjusted with a standard deviation (SD) image quality noise index. The protocol SD parameter was incrementally increased to reduce patient population dose while image quality was evaluated by radiologist readers scoring the clinical utility of images on a Likert scale. Results: Plots of effective dose vs. body size (water cylinder diameter reported by the scanner) demonstrate monotonic increase in patient dose with increasing patient size. At the initial SD setting of 19 the average CTDIvol for a standard size patient was ∼ 2.0 mGy (1.2 mSv effective dose). This was reduced to ∼1.0 mGy (0.5 mSv) at an SD of 25 with no noticeable reduction in clinical utility of images as demonstrated by Likert scoring. Plots of effective patient diameter and BMI vs body size indicate that these metrics could also be used for manual technique charts. Conclusion: AEC offered consistent and reliable control of radiation output in this study. Dose for a standard size patient was reduced to one-third of the 3 mGy CTDIvol limit required for ACR accreditation of lung cancer CT screening. Gary Arbique: Research Grant, Toshiba America Medical Systems; Cecelia Brewington: Research Grant, Toshiba America Medical Systems; Di Zhang: Employee, Toshiba America Medical Systems.

  1. TU-A-12A-07: CT-Based Biomarkers to Characterize Lung Lesion: Effects of CT Dose, Slice Thickness and Reconstruction Algorithm Based Upon a Phantom Study

    SciTech Connect

    Zhao, B; Tan, Y; Tsai, W; Lu, L; Schwartz, L; So, J; Goldman, J; Lu, Z

    2014-06-15

    Purpose: Radiogenomics promises the ability to study cancer tumor genotype from the phenotype obtained through radiographic imaging. However, little attention has been paid to the sensitivity of image features, the image-based biomarkers, to imaging acquisition techniques. This study explores the impact of CT dose, slice thickness and reconstruction algorithm on measuring image features using a thorax phantom. Methods: Twentyfour phantom lesions of known volume (1 and 2mm), shape (spherical, elliptical, lobular and spicular) and density (-630, -10 and +100 HU) were scanned on a GE VCT at four doses (25, 50, 100, and 200 mAs). For each scan, six image series were reconstructed at three slice thicknesses of 5, 2.5 and 1.25mm with continuous intervals, using the lung and standard reconstruction algorithms. The lesions were segmented with an in-house 3D algorithm. Fifty (50) image features representing lesion size, shape, edge, and density distribution/texture were computed. Regression method was employed to analyze the effect of CT dose, slice of thickness and reconstruction algorithm on these features adjusting 3 confounding factors (size, density and shape of phantom lesions). Results: The coefficients of CT dose, slice thickness and reconstruction algorithm are presented in Table 1 in the supplementary material. No significant difference was found between the image features calculated on low dose CT scans (25mAs and 50mAs). About 50% texture features were found statistically different between low doses and high doses (100 and 200mAs). Significant differences were found for almost all features when calculated on 1.25mm, 2.5mm, and 5mm slice thickness images. Reconstruction algorithms significantly affected all density-based image features, but not morphological features. Conclusions: There is a great need to standardize the CT imaging protocols for radiogenomics study because CT dose, slice thickness and reconstruction algorithm impact quantitative image features to

  2. Effect of deformable registration on the dose calculated in radiation therapy planning CT scans of lung cancer patients

    SciTech Connect

    Cunliffe, Alexandra R.; Armato, Samuel G.; White, Bradley; Justusson, Julia; Contee, Clay; Malik, Renuka; Al-Hallaq, Hania A.

    2015-01-15

    Purpose: To characterize the effects of deformable image registration of serial computed tomography (CT) scans on the radiation dose calculated from a treatment planning scan. Methods: Eighteen patients who received curative doses (≥60 Gy, 2 Gy/fraction) of photon radiation therapy for lung cancer treatment were retrospectively identified. For each patient, a diagnostic-quality pretherapy (4–75 days) CT scan and a treatment planning scan with an associated dose map were collected. To establish correspondence between scan pairs, a researcher manually identified anatomically corresponding landmark point pairs between the two scans. Pretherapy scans then were coregistered with planning scans (and associated dose maps) using the demons deformable registration algorithm and two variants of the Fraunhofer MEVIS algorithm (“Fast” and “EMPIRE10”). Landmark points in each pretherapy scan were automatically mapped to the planning scan using the displacement vector field output from each of the three algorithms. The Euclidean distance between manually and automatically mapped landmark points (d{sub E}) and the absolute difference in planned dose (|ΔD|) were calculated. Using regression modeling, |ΔD| was modeled as a function of d{sub E}, dose (D), dose standard deviation (SD{sub dose}) in an eight-pixel neighborhood, and the registration algorithm used. Results: Over 1400 landmark point pairs were identified, with 58–93 (median: 84) points identified per patient. Average |ΔD| across patients was 3.5 Gy (range: 0.9–10.6 Gy). Registration accuracy was highest using the Fraunhofer MEVIS EMPIRE10 algorithm, with an average d{sub E} across patients of 5.2 mm (compared with >7 mm for the other two algorithms). Consequently, average |ΔD| was also lowest using the Fraunhofer MEVIS EMPIRE10 algorithm. |ΔD| increased significantly as a function of d{sub E} (0.42 Gy/mm), D (0.05 Gy/Gy), SD{sub dose} (1.4 Gy/Gy), and the algorithm used (≤1 Gy). Conclusions: An

  3. The assessment of the role of baseline low-dose CT scan in patients at high risk of lung cancer

    PubMed Central

    Kołaczyk, Katarzyna; Walecka, Anna; Grodzki, Tomasz; Alchimowicz, Jacek; Smereczyński, Andrzej; Kiedrowicz, Radosław

    2014-01-01

    Summary Background Despite the progress in contemporary medicine comprising diagnostic and therapeutic methods, lung cancer is still one of the biggest health concerns in many countries of the world. The main purpose of the study was to evaluate the detection rate of pulmonary nodules and lung cancer in the initial, helical low-dose CT of the chest as well as the analysis of the relationship between the size and the histopathological character of the detected nodules. Material/Methods We retrospectively evaluated 1999 initial, consecutive results of the CT examinations performed within the framework of early lung cancer detection program initiated in Szczecin. The project enrolled persons of both sexes, aged 55–65 years, with at least 20 pack-years of cigarette smoking or current smokers. The analysis included assessment of the number of positive results and the evaluation of the detected nodules in relationship to their size. All of the nodules were classified into I of VI groups and subsequently compared with histopathological type of the neoplastic and nonneoplastic pulmonary lesions. Results Pulmonary nodules were detected in 921 (46%) subjects. What is more, malignant lesions as well as lung cancer were significantly, more frequently discovered in the group of asymptomatic nodules of the largest dimension exceeding 15 mm. Conclusions The initial, low-dose helical CT of the lungs performed in high risk individuals enables detection of appreciable number of indeterminate pulmonary nodules. In most of the asymptomatic patients with histopathologically proven pulmonary nodules greater than 15 mm, the mentioned lesions are malignant, what warrants further, intensified diagnostics. PMID:25057333

  4. 4D cone beam CT-based dose assessment for SBRT lung cancer treatment.

    PubMed

    Cai, Weixing; Dhou, Salam; Cifter, Fulya; Myronakis, Marios; Hurwitz, Martina H; Williams, Christopher L; Berbeco, Ross I; Seco, Joao; Lewis, John H

    2016-01-21

    The purpose of this research is to develop a 4DCBCT-based dose assessment method for calculating actual delivered dose for patients with significant respiratory motion or anatomical changes during the course of SBRT. To address the limitation of 4DCT-based dose assessment, we propose to calculate the delivered dose using time-varying ('fluoroscopic') 3D patient images generated from a 4DCBCT-based motion model. The method includes four steps: (1) before each treatment, 4DCBCT data is acquired with the patient in treatment position, based on which a patient-specific motion model is created using a principal components analysis algorithm. (2) During treatment, 2D time-varying kV projection images are continuously acquired, from which time-varying 'fluoroscopic' 3D images of the patient are reconstructed using the motion model. (3) Lateral truncation artifacts are corrected using planning 4DCT images. (4) The 3D dose distribution is computed for each timepoint in the set of 3D fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach is validated using six modified XCAT phantoms with lung tumors and different respiratory motions derived from patient data. The estimated doses are compared to that calculated using ground-truth XCAT phantoms. For each XCAT phantom, the calculated delivered tumor dose values generally follow the same trend as that of the ground truth and at most timepoints the difference is less than 5%. For the overall delivered dose, the normalized error of calculated 3D dose distribution is generally less than 3% and the tumor D95 error is less than 1.5%. XCAT phantom studies indicate the potential of the proposed method to accurately estimate 3D tumor dose distributions for SBRT lung treatment based on 4DCBCT imaging and motion modeling. Further research is necessary to investigate its performance for clinical patient data.

  5. 4D cone beam CT-based dose assessment for SBRT lung cancer treatment

    NASA Astrophysics Data System (ADS)

    Cai, Weixing; Dhou, Salam; Cifter, Fulya; Myronakis, Marios; Hurwitz, Martina H.; Williams, Christopher L.; Berbeco, Ross I.; Seco, Joao; Lewis, John H.

    2016-01-01

    The purpose of this research is to develop a 4DCBCT-based dose assessment method for calculating actual delivered dose for patients with significant respiratory motion or anatomical changes during the course of SBRT. To address the limitation of 4DCT-based dose assessment, we propose to calculate the delivered dose using time-varying (‘fluoroscopic’) 3D patient images generated from a 4DCBCT-based motion model. The method includes four steps: (1) before each treatment, 4DCBCT data is acquired with the patient in treatment position, based on which a patient-specific motion model is created using a principal components analysis algorithm. (2) During treatment, 2D time-varying kV projection images are continuously acquired, from which time-varying ‘fluoroscopic’ 3D images of the patient are reconstructed using the motion model. (3) Lateral truncation artifacts are corrected using planning 4DCT images. (4) The 3D dose distribution is computed for each timepoint in the set of 3D fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach is validated using six modified XCAT phantoms with lung tumors and different respiratory motions derived from patient data. The estimated doses are compared to that calculated using ground-truth XCAT phantoms. For each XCAT phantom, the calculated delivered tumor dose values generally follow the same trend as that of the ground truth and at most timepoints the difference is less than 5%. For the overall delivered dose, the normalized error of calculated 3D dose distribution is generally less than 3% and the tumor D95 error is less than 1.5%. XCAT phantom studies indicate the potential of the proposed method to accurately estimate 3D tumor dose distributions for SBRT lung treatment based on 4DCBCT imaging and motion modeling. Further research is necessary to investigate its performance for clinical patient data.

  6. NIH-funded study shows 20 percent reduction in lung cancer mortality with low-dose CT compared to chest X-ray: | Division of Cancer Prevention

    Cancer.gov

    Scientists have found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with low-dose helical computed tomography (CT) versus those screened by chest X-ray. The primary research results from the National Lung Screening Trial (NLST) were published online today in the New England Journal of Medicine. |

  7. Variability in CT lung-nodule quantification: Effects of dose reduction and reconstruction methods on density and texture based features

    PubMed Central

    Lo, P.; Young, S.; Kim, H. J.; Brown, M. S.

    2016-01-01

    Purpose: To investigate the effects of dose level and reconstruction method on density and texture based features computed from CT lung nodules. Methods: This study had two major components. In the first component, a uniform water phantom was scanned at three dose levels and images were reconstructed using four conventional filtered backprojection (FBP) and four iterative reconstruction (IR) methods for a total of 24 different combinations of acquisition and reconstruction conditions. In the second component, raw projection (sinogram) data were obtained for 33 lung nodules from patients scanned as a part of their clinical practice, where low dose acquisitions were simulated by adding noise to sinograms acquired at clinical dose levels (a total of four dose levels) and reconstructed using one FBP kernel and two IR kernels for a total of 12 conditions. For the water phantom, spherical regions of interest (ROIs) were created at multiple locations within the water phantom on one reference image obtained at a reference condition. For the lung nodule cases, the ROI of each nodule was contoured semiautomatically (with manual editing) from images obtained at a reference condition. All ROIs were applied to their corresponding images reconstructed at different conditions. For 17 of the nodule cases, repeat contours were performed to assess repeatability. Histogram (eight features) and gray level co-occurrence matrix (GLCM) based texture features (34 features) were computed for all ROIs. For the lung nodule cases, the reference condition was selected to be 100% of clinical dose with FBP reconstruction using the B45f kernel; feature values calculated from other conditions were compared to this reference condition. A measure was introduced, which the authors refer to as Q, to assess the stability of features across different conditions, which is defined as the ratio of reproducibility (across conditions) to repeatability (across repeat contours) of each feature. Results: The

  8. Estimation of the delivered patient dose in lung IMRT treatment based on deformable registration of 4D-CT data and Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Flampouri, Stella; Jiang, Steve B.; Sharp, Greg C.; Wolfgang, John; Patel, Abhijit A.; Choi, Noah C.

    2006-06-01

    The purpose of this study is to accurately estimate the difference between the planned and the delivered dose due to respiratory motion and free breathing helical CT artefacts for lung IMRT treatments, and to estimate the impact of this difference on clinical outcome. Six patients with representative tumour motion, size and position were selected for this retrospective study. For each patient, we had acquired both a free breathing helical CT and a ten-phase 4D-CT scan. A commercial treatment planning system was used to create four IMRT plans for each patient. The first two plans were based on the GTV as contoured on the free breathing helical CT set, with a GTV to PTV expansion of 1.5 cm and 2.0 cm, respectively. The third plan was based on the ITV, a composite volume formed by the union of the CTV volumes contoured on free breathing helical CT, end-of-inhale (EOI) and end-of-exhale (EOE) 4D-CT. The fourth plan was based on GTV contoured on the EOE 4D-CT. The prescribed dose was 60 Gy for all four plans. Fluence maps and beam setup parameters of the IMRT plans were used by the Monte Carlo dose calculation engine MCSIM for absolute dose calculation on both the free breathing CT and 4D-CT data. CT deformable registration between the breathing phases was performed to estimate the motion trajectory for both the tumour and healthy tissue. Then, a composite dose distribution over the whole breathing cycle was calculated as a final estimate of the delivered dose. EUD values were computed on the basis of the composite dose for all four plans. For the patient with the largest motion effect, the difference in the EUD of CTV between the planed and the delivered doses was 33, 11, 1 and 0 Gy for the first, second, third and fourth plan, respectively. The number of breathing phases required for accurate dose prediction was also investigated. With the advent of 4D-CT, deformable registration and Monte Carlo simulations, it is feasible to perform an accurate calculation of the

  9. Estimation of the delivered patient dose in lung IMRT treatment based on deformable registration of 4D-CT data and Monte Carlo simulations.

    PubMed

    Flampouri, Stella; Jiang, Steve B; Sharp, Greg C; Wolfgang, John; Patel, Abhijit A; Choi, Noah C

    2006-06-01

    The purpose of this study is to accurately estimate the difference between the planned and the delivered dose due to respiratory motion and free breathing helical CT artefacts for lung IMRT treatments, and to estimate the impact of this difference on clinical outcome. Six patients with representative tumour motion, size and position were selected for this retrospective study. For each patient, we had acquired both a free breathing helical CT and a ten-phase 4D-CT scan. A commercial treatment planning system was used to create four IMRT plans for each patient. The first two plans were based on the GTV as contoured on the free breathing helical CT set, with a GTV to PTV expansion of 1.5 cm and 2.0 cm, respectively. The third plan was based on the ITV, a composite volume formed by the union of the CTV volumes contoured on free breathing helical CT, end-of-inhale (EOI) and end-of-exhale (EOE) 4D-CT. The fourth plan was based on GTV contoured on the EOE 4D-CT. The prescribed dose was 60 Gy for all four plans. Fluence maps and beam setup parameters of the IMRT plans were used by the Monte Carlo dose calculation engine MCSIM for absolute dose calculation on both the free breathing CT and 4D-CT data. CT deformable registration between the breathing phases was performed to estimate the motion trajectory for both the tumour and healthy tissue. Then, a composite dose distribution over the whole breathing cycle was calculated as a final estimate of the delivered dose. EUD values were computed on the basis of the composite dose for all four plans. For the patient with the largest motion effect, the difference in the EUD of CTV between the planed and the delivered doses was 33, 11, 1 and 0 Gy for the first, second, third and fourth plan, respectively. The number of breathing phases required for accurate dose prediction was also investigated. With the advent of 4D-CT, deformable registration and Monte Carlo simulations, it is feasible to perform an accurate calculation of the

  10. Lung cancer incidence and mortality in National Lung Screening Trial participants who underwent low-dose CT prevalence screening: a retrospective cohort analysis of a randomised, multicentre, diagnostic screening trial

    PubMed Central

    Patz, Edward F; Greco, Erin; Gatsonis, Constantine; Pinsky, Paul; Kramer, Barnett S; Aberle, Denise R

    2016-01-01

    Summary Background Annual low-dose CT screening for lung cancer has been recommended for high-risk individuals, but the necessity of yearly low-dose CT in all eligible individuals is uncertain. This study examined rates of lung cancer in National Lung Screening Trial (NLST) participants who had a negative prevalence (initial) low-dose CT screen to explore whether less frequent screening could be justified in some lower-risk subpopulations. Methods We did a retrospective cohort analysis of data from the NLST, a randomised, multicentre screening trial comparing three annual low-dose CT assessments with three annual chest radiographs for the early detection of lung cancer in high-risk, eligible individuals (aged 55–74 years with at least a 30 pack-year history of cigarette smoking, and, if a former smoker, had quit within the past 15 years), recruited from US medical centres between Aug 5, 2002, and April 26, 2004. Participants were followed up for up to 5 years after their last annual screen. For the purposes of this analysis, our cohort consisted of all NLST participants who had received a low-dose CT prevalence (T0) screen. We determined the frequency, stage, histology, study year of diagnosis, and incidence of lung cancer, as well as overall and lung cancer-specific mortality, and whether lung cancers were detected as a result of screening or within 1 year of a negative screen. We also estimated the effect on mortality if the first annual (T1) screen in participants with a negative T0 screen had not been done. The NLST is registered with ClinicalTrials.gov, number NCT00047385. Findings Our cohort consisted of 26 231 participants assigned to the low-dose CT screening group who had undergone their T0 screen. The 19 066 participants with a negative T0 screen had a lower incidence of lung cancer than did all 26 231 T0-screened participants (371·88 [95% CI 337·97–408·26] per 100 000 person-years vs 661·23 [622·07–702·21]) and had lower lung cancer

  11. TU-F-BRF-03: Effect of Radiation Therapy Planning Scan Registration On the Dose in Lung Cancer Patient CT Scans

    SciTech Connect

    Cunliffe, A; Contee, C; White, B; Justusson, J; Armato, S; Malik, R; Al-Hallaq, H

    2014-06-15

    Purpose: To characterize the effect of deformable registration of serial computed tomography (CT) scans on the radiation dose calculated from a treatment planning scan. Methods: Eighteen patients who received curative doses (≥60Gy, 2Gy/fraction) of photon radiation therapy for lung cancer treatment were retrospectively identified. For each patient, a diagnostic-quality pre-therapy (4–75 days) CT scan and a treatment planning scan with an associated dose map calculated in Pinnacle were collected. To establish baseline correspondence between scan pairs, a researcher manually identified anatomically corresponding landmark point pairs between the two scans. Pre-therapy scans were co-registered with planning scans (and associated dose maps) using the Plastimatch demons and Fraunhofer MEVIS deformable registration algorithms. Landmark points in each pretherapy scan were automatically mapped to the planning scan using the displacement vector field output from both registration algorithms. The absolute difference in planned dose (|ΔD|) between manually and automatically mapped landmark points was calculated. Using regression modeling, |ΔD| was modeled as a function of the distance between manually and automatically matched points (registration error, E), the dose standard deviation (SD-dose) in the eight-pixel neighborhood, and the registration algorithm used. Results: 52–92 landmark point pairs (median: 82) were identified in each patient's scans. Average |ΔD| across patients was 3.66Gy (range: 1.2–7.2Gy). |ΔD| was significantly reduced by 0.53Gy using Plastimatch demons compared with Fraunhofer MEVIS. |ΔD| increased significantly as a function of E (0.39Gy/mm) and SD-dose (2.23Gy/Gy). Conclusion: An average error of <4Gy in radiation dose was introduced when points were mapped between CT scan pairs using deformable registration. Dose differences following registration were significantly increased when the Fraunhofer MEVIS registration algorithm was used

  12. SU-E-T-541: Measurement of CT Density Model Variations and the Impact On the Accuracy of Monte Carlo (MC) Dose Calculation in Stereotactic Body Radiation Therapy for Lung Cancer

    SciTech Connect

    Xiang, H; Li, B; Behrman, R; Russo, G; Kachnic, L; Lu, H; Fernando, H

    2015-06-15

    Purpose: To measure the CT density model variations between different CT scanners used for treatment planning and impact on the accuracy of MC dose calculation in lung SBRT. Methods: A Gammex electron density phantom (RMI 465) was scanned on two 64-slice CT scanners (GE LightSpeed VCT64) and a 16-slice CT (Philips Brilliance Big Bore CT). All three scanners had been used to acquire CT for CyberKnife lung SBRT treatment planning. To minimize the influences of beam hardening and scatter for improving reproducibility, three scans were acquired with the phantom rotated 120° between scans. The mean CT HU of each density insert, averaged over the three scans, was used to build the CT density models. For 14 patient plans, repeat MC dose calculations were performed by using the scanner-specific CT density models and compared to a baseline CT density model in the base plans. All dose re-calculations were done using the same plan beam configurations and MUs. Comparisons of dosimetric parameters included PTV volume covered by prescription dose, mean PTV dose, V5 and V20 for lungs, and the maximum dose to the closest critical organ. Results: Up to 50.7 HU variations in CT density models were observed over the baseline CT density model. For 14 patient plans examined, maximum differences in MC dose re-calculations were less than 2% in 71.4% of the cases, less than 5% in 85.7% of the cases, and 5–10% for 14.3% of the cases. As all the base plans well exceeded the clinical objectives of target coverage and OAR sparing, none of the observed differences led to clinically significant concerns. Conclusion: Marked variations of CT density models were observed for three different CT scanners. Though the differences can cause up to 5–10% differences in MC dose calculations, it was found that they caused no clinically significant concerns.

  13. QUANTITATIVE CT ANALYSIS, AIRFLOW OBSTRUCTION AND LUNG CANCER IN THE PITTSBURGH LUNG SCREENING STUDY

    PubMed Central

    Wilson, David O; Leader, Joseph K; Fuhrman, Carl R; Reilly, John J; Sciurba, Frank C.; Weissfeld, Joel L

    2011-01-01

    Background To study the relationship between emphysema, airflow obstruction and lung cancer in a high risk population we performed quantitative analysis of screening computed tomography (CT) scans. Methods Subjects completed questionnaires, spirometry and low-dose helical chest CT. Analyses compared cases and controls according to automated quantitative analysis of lung parenchyma and airways measures. Results Our case-control study of 117 matched pairs of lung cancer cases and controls did not reveal any airway or lung parenchymal findings on quantitative analysis of screening CT scans that were associated with increased lung cancer risk. Airway measures including wall area %, lumen perimeter, lumen area and average wall HU, and parenchymal measures including lung fraction < −910 Hounsfield Units (HU), were not statistically different between cases and controls. Conclusions The relationship between visual assessment of emphysema and increased lung cancer risk could not be verified by quantitative analysis of low-dose screening CT scans in a high risk tobacco exposed population. PMID:21610523

  14. From cellular doses to average lung dose.

    PubMed

    Hofmann, W; Winkler-Heil, R

    2015-11-01

    Sensitive basal and secretory cells receive a wide range of doses in human bronchial and bronchiolar airways. Variations of cellular doses arise from the location of target cells in the bronchial epithelium of a given airway and the asymmetry and variability of airway dimensions of the lung among airways in a given airway generation and among bronchial and bronchiolar airway generations. To derive a single value for the average lung dose which can be related to epidemiologically observed lung cancer risk, appropriate weighting scenarios have to be applied. Potential biological weighting parameters are the relative frequency of target cells, the number of progenitor cells, the contribution of dose enhancement at airway bifurcations, the promotional effect of cigarette smoking and, finally, the application of appropriate regional apportionment factors. Depending on the choice of weighting parameters, detriment-weighted average lung doses can vary by a factor of up to 4 for given radon progeny exposure conditions.

  15. Organ doses to adult patients for chest CT

    SciTech Connect

    Huda, Walter; Sterzik, Alexander; Tipnis, Sameer; Schoepf, U. Joseph

    2010-02-15

    Purpose: The goal of this study was to estimate organ doses for chest CT examinations using volume computed tomography dose index (CTDI{sub vol}) data as well as accounting for patient weight. Methods: A CT dosimetry spreadsheet (ImPACT CT patient dosimetry calculator) was used to compute organ doses for a 70 kg patient undergoing chest CT examinations, as well as volume computed tomography dose index (CTDI{sub vol}) in a body CT dosimetry phantom at the same CT technique factors. Ratios of organ dose to CTDI{sub vol} (f{sub organ}) were generated as a function of anatomical location in the chest for the breasts, lungs, stomach, red bone marrow, liver, thyroid, liver, and thymus. Values of f{sub organ} were obtained for x-ray tube voltages ranging from 80 to 140 kV for 1, 4, 16, and 64 slice CT scanners from two vendors. For constant CT techniques, we computed ratios of dose in water phantoms of differing diameter. By modeling patients of different weights as equivalent water cylinders of different diameters, we generated factors that permit the estimation of the organ doses in patients weighing between 50 and 100 kg who undergo chest CT examinations relative to the corresponding organ doses received by a 70 kg adult. Results: For a 32 cm long CT scan encompassing the complete lungs, values of f{sub organ} ranged from 1.7 (thymus) to 0.3 (stomach). Organs that are directly in the x-ray beam, and are completely irradiated, generally had f{sub organ} values well above 1 (i.e., breast, lung, heart, and thymus). Organs that are not completely irradiated in a total chest CT scan generally had f{sub organ} values that are less than 1 (e.g., red bone marrow, liver, and stomach). Increasing the x-ray tube voltage from 80 to 140 kV resulted in modest increases in f{sub organ} for the heart (9%) and thymus (8%), but resulted in larger increases for the breast (19%) and red bone marrow (21%). Adult patient chests have been modeled by water cylinders with diameters between

  16. Organ Dose and Attributable Cancer Risk in Lung Cancer Screening with Low-Dose Computed Tomography

    PubMed Central

    Saltybaeva, Natalia; Martini, Katharina; Frauenfelder, Thomas; Alkadhi, Hatem

    2016-01-01

    Purpose Lung cancer screening with CT has been recently recommended for decreasing lung cancer mortality. The radiation dose of CT, however, must be kept as low as reasonably achievable for reducing potential stochastic risks from ionizing radiation. The purpose of this study was to calculate individual patients’ lung doses and to estimate cancer risks in low-dose CT (LDCT) in comparison with a standard dose CT (SDCT) protocol. Materials and Methods This study included 47 adult patients (mean age 63.0 ± 5.7 years) undergoing chest CT on a third-generation dual-source scanner. 23/47 patients (49%) had a non-enhanced chest SDCT, 24 patients (51%) underwent LDCT at 100 kVp with spectral shaping at a dose equivalent to a chest x-ray. 3D-dose distributions were obtained from Monte Carlo simulations for each patient, taking into account their body size and individual CT protocol. Based on the dose distributions, patient-specific lung doses were calculated and relative cancer risk was estimated according to BEIR VII recommendations. Results As compared to SDCT, the LDCT protocol allowed for significant organ dose and cancer risk reductions (p<0.001). On average, lung dose was reduced from 7.7 mGy to 0.3 mGy when using LDCT, which was associated with lowering of the cancer risk from 8.6 to 0.35 per 100’000 cases. A strong linear correlation between lung dose and patient effective diameter was found for both protocols (R2 = 0.72 and R2 = 0.75 for SDCT and LDCT, respectively). Conclusion Use of a LDCT protocol for chest CT with a dose equivalent to a chest x-ray allows for significant lung dose and cancer risk reduction from ionizing radiation. PMID:27203720

  17. Radiation dose measurements in coronary CT angiography

    PubMed Central

    Sabarudin, Akmal; Sun, Zhonghua

    2013-01-01

    Coronary computed tomography (CT) angiography is associated with high radiation dose and this has raised serious concerns in the literature. Awareness of various parameters for dose estimates and measurements of coronary CT angiography plays an important role in increasing our understanding of the radiation exposure to patients, thus, contributing to the implementation of dose-saving strategies. This article provides an overview of the radiation dose quantity and its measurement during coronary CT angiography procedures. PMID:24392190

  18. Reducing CT dose in myocardial perfusion SPECT/CT.

    PubMed

    O'Shaughnessy, Emma; Dixon, Kat L

    2015-11-01

    The aim of this study was to reduce the radiation dose arising from computed tomography (CT) attenuation correction to single photon emission computed tomography myocardial perfusion imaging studies without adversely affecting its accuracy. Using the Perspex CTDI phantom with the Xi detector to measure dose, CT scans were acquired using the Siemens Symbia T over the full range of CT settings available. Using the default setting 'AECmean', the measured dose at the centre of the phantom was 1.68 mGy and the breast dose from the scout view was 0.30 mGy. The lowest dose was achieved using the dose modulation setting in which the doses were reduced to 1.21 mGy and undetectable (<0.01 mGy), respectively. To observe the effect of changing these settings, 30 patients received a stress scan with default CT settings and a rest scan utilizing single photon emission computed tomography-guided CT and the dose modulation CT settings. Results showed a mean effective dose reduction of 23.6%. The dose reduction was greatest for larger patients, with the largest dose reduction for one patient being 72%. There was no apparent difference in attenuation correction between the two sets of resultant images. These new lower-dose settings are now applied to all clinical myocardial perfusion imaging studies. PMID:26302461

  19. Nutrient intake and nutrient patterns and risk of lung cancer among heavy smokers: results from the COSMOS screening study with annual low-dose CT.

    PubMed

    Gnagnarella, Patrizia; Maisonneuve, Patrick; Bellomi, Massimo; Rampinelli, Cristiano; Bertolotti, Raffaella; Spaggiari, Lorenzo; Palli, Domenico; Veronesi, Giulia

    2013-06-01

    The role of nutrients in lung cancer aetiology remains controversial and has never been evaluated in the context of screening. Our aim was to investigate the role of single nutrients and nutrient patterns in the aetiology of lung cancer in heavy smokers. Asymptomatic heavy smokers (≥20 pack-years) were invited to undergo annual low-dose computed tomography. We assessed diet using a self-administered food frequency questionnaire and collected information on multivitamin supplement use. We performed principal component analysis identifying four nutrient patterns and used Cox proportional Hazards regression to assess the association between nutrients and nutrients patterns and lung cancer risk. During a mean follow-up of 5.7 years, 178 of 4,336 participants were diagnosed with lung cancer by screening. We found a significant risk reduction of lung cancer with increasing vegetable fat consumption (HR for highest vs. lowest quartile = 0.50, 95% CI = 0.31-0.80; P-trend = 0.02). Participants classified in the high "vitamins and fiber" pattern score had a significant risk reduction of lung cancer (HR = 0.57; 95% CI = 0.36-0.90, P-trend = 0.01). Among heavy smokers enrolled in a screening trial, high vegetable fat intake and adherence to the "vitamin and fiber" nutrient pattern were associated with reduced lung cancer incidence.

  20. CT densitometry of the lungs: Scanner performance

    SciTech Connect

    Kemerink, G.J.; Lamers, R.J.S.; Thelissen, G.R.P.; Engelshoven, J.M.A. van

    1996-01-01

    Our goal was to establish the reproducibility and accuracy of the CT scanner in densitometry of the lungs. Scanner stability was assessed by analysis of daily quality checks. Studies using a humanoid phantom and polyethylene foams for lung were performed to measure reproducibility and accuracy. The dependence of the CT-estimated density on reconstruction filter, zoom factor, slice thickness, table height, data truncation, and objects outside the scan field was determined. Stability of the system at air density was within {approx}1 HU and at water density within {approx}2 HU. Reproducibility and accuracy for densities found for lung were within 2-3%. Dependence on the acquisition and reconstruction parameters was neglible, with the exceptions of the ultra high resolution reconstruction algorithm in the case of emphysema, and objects outside the scan field. The performance of the CT scanner tested is quite adequate for densitometry of the lungs. 26 refs., 5 figs., 4 tabs.

  1. Patient-specific dose estimation for pediatric chest CT

    SciTech Connect

    Li Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P.

    2008-12-15

    Current methods for organ and effective dose estimations in pediatric CT are largely patient generic. Physical phantoms and computer models have only been developed for standard/limited patient sizes at discrete ages (e.g., 0, 1, 5, 10, 15 years old) and do not reflect the variability of patient anatomy and body habitus within the same size/age group. In this investigation, full-body computer models of seven pediatric patients in the same size/protocol group (weight: 11.9-18.2 kg) were created based on the patients' actual multi-detector array CT (MDCT) data. Organs and structures in the scan coverage were individually segmented. Other organs and structures were created by morphing existing adult models (developed from visible human data) to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. Organ and effective dose of these patients from a chest MDCT scan protocol (64 slice LightSpeed VCT scanner, 120 kVp, 70 or 75 mA, 0.4 s gantry rotation period, pitch of 1.375, 20 mm beam collimation, and small body scan field-of-view) was calculated using a Monte Carlo program previously developed and validated to simulate radiation transport in the same CT system. The seven patients had normalized effective dose of 3.7-5.3 mSv/100 mAs (coefficient of variation: 10.8%). Normalized lung dose and heart dose were 10.4-12.6 mGy/100 mAs and 11.2-13.3 mGy/100 mAs, respectively. Organ dose variations across the patients were generally small for large organs in the scan coverage (<7%), but large for small organs in the scan coverage (9%-18%) and for partially or indirectly exposed organs (11%-77%). Normalized effective dose correlated weakly with body weight (correlation coefficient: r=-0.80). Normalized lung dose and heart dose correlated strongly with mid-chest equivalent diameter (lung: r=-0.99, heart: r=-0.93); these strong correlation relationships can be used to estimate patient-specific organ dose for

  2. Analytical modelling of regional radiotherapy dose response of lung

    NASA Astrophysics Data System (ADS)

    Lee, Sangkyu; Stroian, Gabriela; Kopek, Neil; AlBahhar, Mahmood; Seuntjens, Jan; El Naqa, Issam

    2012-06-01

    Knowledge of the dose-response of radiation-induced lung disease (RILD) is necessary for optimization of radiotherapy (RT) treatment plans involving thoracic cavity irradiation. This study models the time-dependent relationship between local radiation dose and post-treatment lung tissue damage measured by computed tomography (CT) imaging. Fifty-eight follow-up diagnostic CT scans from 21 non-small-cell lung cancer patients were examined. The extent of RILD was segmented on the follow-up CT images based on the increase of physical density relative to the pre-treatment CT image. The segmented RILD was locally correlated with dose distribution calculated by analytical anisotropic algorithm and the Monte Carlo method to generate the corresponding dose-response curves. The Lyman-Kutcher-Burman (LKB) model was fit to the dose-response curves at six post-RT time periods, and temporal change in the LKB parameters was recorded. In this study, we observed significant correlation between the probability of lung tissue damage and the local dose for 96% of the follow-up studies. Dose-injury correlation at the first three months after RT was significantly different from later follow-up periods in terms of steepness and threshold dose as estimated from the LKB model. Dependence of dose response on superior-inferior tumour position was also observed. The time-dependent analytical modelling of RILD might provide better understanding of the long-term behaviour of the disease and could potentially be applied to improve inverse treatment planning optimization.

  3. Patient radiation doses for electron beam CT.

    PubMed

    Castellano, Isabel A; Dance, David R; Skinner, Claire L; Evans, Phil M

    2005-08-01

    A Monte Carlo based computer model has been developed for electron beam computed tomography (EBCT) to calculate organ and effective doses in a humanoid hermaphrodite phantom. The program has been validated by comparison with experimental measurements of the CT dose index in standard head and body CT dose phantoms; agreement to better than 8% has been found. The robustness of the model has been established by varying the input parameters. The amount of energy deposited at the 12:00 position of the standard body CT dose phantom is most susceptible to rotation angle, whereas that in the central region is strongly influenced by the beam quality. The program has been used to investigate the changes in organ absorbed doses arising from partial and full rotation about supine and prone subjects. Superficial organs experience the largest changes in absorbed dose with a change in subject orientation and for partial rotation. Effective doses for typical clinical scan protocols have been calculated and compared with values obtained using existing dosimetry techniques based on full rotation. Calculations which make use of Monte Carlo conversion factors for the scanner that best matches the EBCT dosimetric characteristics consistently overestimate the effective dose in supine subjects by typically 20%, and underestimate the effective dose in prone subjects by typically 13%. These factors can therefore be used to correct values obtained in this way. Empirical dosimetric techniques based on the dose-length product yield errors as great as 77%. This is due to the sensitivity of the dose length product to individual scan lengths. The magnitude of these errors is reduced if empirical dosimetric techniques based on the average absorbed dose in the irradiated volume (CTDIvol) are used. Therefore conversion factors specific to EBCT have been calculated to convert the CTDIvol to an effective dose. PMID:16193782

  4. Patient radiation doses for electron beam CT

    SciTech Connect

    Castellano, Isabel A.; Dance, David R.; Skinner, Claire L.; Evans, Phil M.

    2005-08-15

    A Monte Carlo based computer model has been developed for electron beam computed tomography (EBCT) to calculate organ and effective doses in a humanoid hermaphrodite phantom. The program has been validated by comparison with experimental measurements of the CT dose index in standard head and body CT dose phantoms; agreement to better than 8% has been found. The robustness of the model has been established by varying the input parameters. The amount of energy deposited at the 12:00 position of the standard body CT dose phantom is most susceptible to rotation angle, whereas that in the central region is strongly influenced by the beam quality. The program has been used to investigate the changes in organ absorbed doses arising from partial and full rotation about supine and prone subjects. Superficial organs experience the largest changes in absorbed dose with a change in subject orientation and for partial rotation. Effective doses for typical clinical scan protocols have been calculated and compared with values obtained using existing dosimetry techniques based on full rotation. Calculations which make use of Monte Carlo conversion factors for the scanner that best matches the EBCT dosimetric characteristics consistently overestimate the effective dose in supine subjects by typically 20%, and underestimate the effective dose in prone subjects by typically 13%. These factors can therefore be used to correct values obtained in this way. Empirical dosimetric techniques based on the dose-length product yield errors as great as 77%. This is due to the sensitivity of the dose length product to individual scan lengths. The magnitude of these errors is reduced if empirical dosimetric techniques based on the average absorbed dose in the irradiated volume (CTDI{sub vol}) are used. Therefore conversion factors specific to EBCT have been calculated to convert the CTDI{sub vol} to an effective dose.

  5. Mass preserving registration for lung CT

    NASA Astrophysics Data System (ADS)

    Gorbunova, Vladlena; Lo, Pechin; Loeve, Martine; Tiddens, Harm A.; Sporring, Jon; Nielsen, Mads; de Bruijne, Marleen

    2009-02-01

    In this paper, we evaluate a novel image registration method on a set of expiratory-inspiratory pairs of computed tomography (CT) lung scans. A free-form multi resolution image registration technique is used to match two scans of the same subject. To account for the differences in the lung intensities due to differences in inspiration level, we propose to adjust the intensity of lung tissue according to the local expansion or compression. An image registration method without intensity adjustment is compared to the proposed method. Both approaches are evaluated on a set of 10 pairs of expiration and inspiration CT scans of children with cystic fibrosis lung disease. The proposed method with mass preserving adjustment results in significantly better alignment of the vessel trees. Analysis of local volume change for regions with trapped air compared to normally ventilated regions revealed larger differences between these regions in the case of mass preserving image registration, indicating that mass preserving registration is better at capturing localized differences in lung deformation.

  6. Automated size-specific CT dose monitoring program: Assessing variability in CT dose

    SciTech Connect

    Christianson, Olav; Li Xiang; Frush, Donald; Samei, Ehsan

    2012-11-15

    Purpose: The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CT imaging. Methods: The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED{sub adj}). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED{sub adj} between scanner models and across institutions. Results: No significant difference was found between computer measurements of patient thickness and observer measurements (p= 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED{sub adj} that differed by up to 44% from effective dose estimates

  7. Dose impact in radiographic lung injury following lung SBRT: Statistical analysis and geometric interpretation

    SciTech Connect

    Yu, Victoria; Kishan, Amar U.; Cao, Minsong; Low, Daniel; Lee, Percy; Ruan, Dan

    2014-03-15

    Purpose: To demonstrate a new method of evaluating dose response of treatment-induced lung radiographic injury post-SBRT (stereotactic body radiotherapy) treatment and the discovery of bimodal dose behavior within clinically identified injury volumes. Methods: Follow-up CT scans at 3, 6, and 12 months were acquired from 24 patients treated with SBRT for stage-1 primary lung cancers or oligometastic lesions. Injury regions in these scans were propagated to the planning CT coordinates by performing deformable registration of the follow-ups to the planning CTs. A bimodal behavior was repeatedly observed from the probability distribution for dose values within the deformed injury regions. Based on a mixture-Gaussian assumption, an Expectation-Maximization (EM) algorithm was used to obtain characteristic parameters for such distribution. Geometric analysis was performed to interpret such parameters and infer the critical dose level that is potentially inductive of post-SBRT lung injury. Results: The Gaussian mixture obtained from the EM algorithm closely approximates the empirical dose histogram within the injury volume with good consistency. The average Kullback-Leibler divergence values between the empirical differential dose volume histogram and the EM-obtained Gaussian mixture distribution were calculated to be 0.069, 0.063, and 0.092 for the 3, 6, and 12 month follow-up groups, respectively. The lower Gaussian component was located at approximately 70% prescription dose (35 Gy) for all three follow-up time points. The higher Gaussian component, contributed by the dose received by planning target volume, was located at around 107% of the prescription dose. Geometrical analysis suggests the mean of the lower Gaussian component, located at 35 Gy, as a possible indicator for a critical dose that induces lung injury after SBRT. Conclusions: An innovative and improved method for analyzing the correspondence between lung radiographic injury and SBRT treatment dose has

  8. Highly accurate fast lung CT registration

    NASA Astrophysics Data System (ADS)

    Rühaak, Jan; Heldmann, Stefan; Kipshagen, Till; Fischer, Bernd

    2013-03-01

    Lung registration in thoracic CT scans has received much attention in the medical imaging community. Possible applications range from follow-up analysis, motion correction for radiation therapy, monitoring of air flow and pulmonary function to lung elasticity analysis. In a clinical environment, runtime is always a critical issue, ruling out quite a few excellent registration approaches. In this paper, a highly efficient variational lung registration method based on minimizing the normalized gradient fields distance measure with curvature regularization is presented. The method ensures diffeomorphic deformations by an additional volume regularization. Supplemental user knowledge, like a segmentation of the lungs, may be incorporated as well. The accuracy of our method was evaluated on 40 test cases from clinical routine. In the EMPIRE10 lung registration challenge, our scheme ranks third, with respect to various validation criteria, out of 28 algorithms with an average landmark distance of 0.72 mm. The average runtime is about 1:50 min on a standard PC, making it by far the fastest approach of the top-ranking algorithms. Additionally, the ten publicly available DIR-Lab inhale-exhale scan pairs were registered to subvoxel accuracy at computation times of only 20 seconds. Our method thus combines very attractive runtimes with state-of-the-art accuracy in a unique way.

  9. Pediatric organ dose measurements in axial and helical multislice CT

    SciTech Connect

    McDermott, Alanna; White, R. Allen; Mc-Nitt-Gray, Mike; Angel, Erin; Cody, Dianna

    2009-05-15

    An anthropomorphic pediatric phantom (5-yr-old equivalent) was used to determine organ doses at specific surface and internal locations resulting from computed tomography (CT) scans. This phantom contains four different tissue-equivalent materials: Soft tissue, bone, brain, and lung. It was imaged on a 64-channel CT scanner with three head protocols (one contiguous axial scan and two helical scans [pitch=0.516 and 0.984]) and four chest protocols (one contiguous axial scan and three helical scans [pitch=0.516, 0.984, and 1.375]). Effective mA s [=(tube currentxrotation time)/pitch] was kept nearly constant at 200 effective mA s for head and 290 effective mA s for chest protocols. Dose measurements were acquired using thermoluminescent dosimeter powder in capsules placed at locations internal to the phantom and on the phantom surface. The organs of interest were the brain, both eyes, thyroid, sternum, both breasts, and both lungs. The organ dose measurements from helical scans were lower than for contiguous axial scans by 0% to 25% even after adjusting for equivalent effective mA s. There was no significant difference (p>0.05) in organ dose values between the 0.516 and 0.984 pitch values for both head and chest scans. The chest organ dose measurements obtained at a pitch of 1.375 were significantly higher than the dose values obtained at the other helical pitches used for chest scans (p<0.05). This difference was attributed to the automatic selection of the large focal spot due to a higher tube current value. These findings suggest that there may be a previously unsuspected radiation dose benefit associated with the use of helical scan mode during computed tomography scanning.

  10. RONI Based Secured and Authenticated Indexing of Lung CT Images

    PubMed Central

    Jasmine Selvakumari Jeya, I.; Suganthi, J.

    2015-01-01

    Medical images need to be transmitted with the patient's information without altering the image data. The present paper discusses secured indexing of lung CT image (SILI) which is a secured way of indexing the lung CT images with the patient information. Authentication is provided using the sender's logo information and the secret key is used for embedding the watermark into the host image. Watermark is embedded into the region of Noninterest (RONI) of the lung CT image. RONI is identified by segmenting the lung tissue from the CT scan image. The experimental results show that the proposed approach is robust against unauthorized access, noise, blurring, and intensity based attacks. PMID:26078782

  11. RONI Based Secured and Authenticated Indexing of Lung CT Images.

    PubMed

    Jasmine Selvakumari Jeya, I; Suganthi, J

    2015-01-01

    Medical images need to be transmitted with the patient's information without altering the image data. The present paper discusses secured indexing of lung CT image (SILI) which is a secured way of indexing the lung CT images with the patient information. Authentication is provided using the sender's logo information and the secret key is used for embedding the watermark into the host image. Watermark is embedded into the region of Noninterest (RONI) of the lung CT image. RONI is identified by segmenting the lung tissue from the CT scan image. The experimental results show that the proposed approach is robust against unauthorized access, noise, blurring, and intensity based attacks.

  12. RONI Based Secured and Authenticated Indexing of Lung CT Images.

    PubMed

    Jasmine Selvakumari Jeya, I; Suganthi, J

    2015-01-01

    Medical images need to be transmitted with the patient's information without altering the image data. The present paper discusses secured indexing of lung CT image (SILI) which is a secured way of indexing the lung CT images with the patient information. Authentication is provided using the sender's logo information and the secret key is used for embedding the watermark into the host image. Watermark is embedded into the region of Noninterest (RONI) of the lung CT image. RONI is identified by segmenting the lung tissue from the CT scan image. The experimental results show that the proposed approach is robust against unauthorized access, noise, blurring, and intensity based attacks. PMID:26078782

  13. [Indications for low-dose CT in the emergency setting].

    PubMed

    Poletti, Pierre-Alexandre; Andereggen, Elisabeth; Rutschmann, Olivier; de Perrot, Thomas; Caviezel, Alessandro; Platon, Alexandra

    2009-08-19

    CT delivers a large dose of radiation, especially in abdominal imaging. Recently, a low-dose abdominal CT protocol (low-dose CT) has been set-up in our institution. "Low-dose CT" is almost equivalent to a single standard abdominal radiograph in term of dose of radiation (about one sixth of those delivered by a standard CT). "Low-dose CT" is now used routinely in our emergency service in two main indications: patients with a suspicion of renal colic and those with right lower quadrant pain. It is obtained without intravenous contrast media. Oral contrast is given to patients with suspicion of appendicitis. "Low-dose CT" is used in the frame of well defined clinical algorithms, and does only replace standard CT when it can reach a comparable diagnostic quality.

  14. Radiation Therapy Alone in cT1-3N0 Non-small Cell Lung Cancer Patients Who Are Unfit for Surgical Resection or Stereotactic Radiation Therapy: Comparison of Risk-Adaptive Dose Schedules

    PubMed Central

    Cho, Won Kyung; Noh, Jae Myoung; Ahn, Yong Chan; Oh, Dongryul; Pyo, Hongryull

    2016-01-01

    Purpose High dose definitive radiation therapy (RT) alone is recommended to patients with cT1-3N0 non-small cell lung cancer, who are unfit for surgery or stereotactic RT. This study was conducted to evaluate the clinical outcomes and cost-effectiveness following RT alone using two different modest hypofractionation dose schemes. Materials and Methods Between 2001 and 2014, 124 patients underwent RT alone. From 2001 till 2010, 60 Gy in 20 fractions was delivered to 79 patients (group 1). Since 2011, 60 Gy in 20 fractions (group 2, 20 patients), and 60 Gy in 15 fractions (group 3, 25 patients) were selectively chosen depending on estimated risk of esophagitis. Results At follow-up of 16.7 months, 2-year rates of local control, progression-free survival, and overall survival were 62.6%, 39.1%, and 59.1%, respectively. Overall survival was significantly better in group 3 (p=0.002). In multivariate analyses, cT3 was the most powerful adverse factor affecting clinical outcomes. Incidence and severity of radiation pneumonitis were not different among groups, while no patients developed grade 2 esophagitis in group 3 (p=0.003). Under current Korean Health Insurance Policy, RT cost per person was 22.5% less in group 3 compared with others. Conclusion The current study demonstrated that 60 Gy in 15 fractions instead of 60 Gy in 20 fractions resulted in comparable clinical outcomes with excellent safety, direct cost saving, and improved convenience to the patients with tumors located at ≥ 1.5 cm from the esophagus. PMID:26987393

  15. SU-E-J-87: Ventilation Weighting Effect On Mean Doses of Both Side Lungs for Patients with Advanced Stage Lung Cancer

    SciTech Connect

    Qu, H; Xia, P; Yu, N

    2015-06-15

    Purpose: To study ventilation weighting effect on radiation doses to both side lungs for patients with advanced stage lung cancer. Methods: Fourteen patients with advanced stage lung cancer were included in this retrospective study. Proprietary software was developed to calculate the lung ventilation map based on 4DCT images acquired for radiation therapy. Two phases of inhale (0%) and exhale (50%) were used for the lung ventilation calculations. For each patient, the CT images were resampled to the same dose calculation resolution of 3mmx3mmx3mm. The ventilation distribution was then normalized by the mean value of the ventilation. The ventilation weighted dose was calculated by applying linearly weighted ventilation to the dose of each pixel. The lung contours were automatically delineated from patient CT image with lung window, excluding the tumor and high density tissues. For contralateral and ipsilateral lungs, the mean lung doses from the original plan and ventilation weighted mean lung doses were compared using two tail t-Test. Results: The average of mean dose was 6.1 ±3.8Gy for the contralateral lungs, and 26.2 ± 14.0Gy for the ipsilateral lungs. The average of ventilation weighted dose was 6.3± 3.8Gy for the contralateral lungs and 24.6 ± 13.1Gy for the ipsilateral lungs. The statistics analysis shows the significance of the mean dose increase (p<0.015) for the contralateral lungs and decrease (p<0.005) for the ipsilateral lungs. Conclusion: Ventilation weighted doses were greater than the un-weighted doses for contralateral lungs and smaller for ipsilateral lungs. This Result may be helpful to understand the radiation dosimetric effect on the lung function and provide planning guidance for patients with advance stage lung cancer.

  16. Uncertainties on lung doses from inhaled plutonium.

    PubMed

    Puncher, Matthew; Birchall, Alan; Bull, Richard K

    2011-10-01

    In a recent epidemiological study, Bayesian uncertainties on lung doses have been calculated to determine lung cancer risk from occupational exposures to plutonium. These calculations used a revised version of the Human Respiratory Tract Model (HRTM) published by the ICRP. In addition to the Bayesian analyses, which give probability distributions of doses, point estimates of doses (single estimates without uncertainty) were also provided for that study using the existing HRTM as it is described in ICRP Publication 66; these are to be used in a preliminary analysis of risk. To infer the differences between the point estimates and Bayesian uncertainty analyses, this paper applies the methodology to former workers of the United Kingdom Atomic Energy Authority (UKAEA), who constituted a subset of the study cohort. The resulting probability distributions of lung doses are compared with the point estimates obtained for each worker. It is shown that mean posterior lung doses are around two- to fourfold higher than point estimates and that uncertainties on doses vary over a wide range, greater than two orders of magnitude for some lung tissues. In addition, we demonstrate that uncertainties on the parameter values, rather than the model structure, are largely responsible for these effects. Of these it appears to be the parameters describing absorption from the lungs to blood that have the greatest impact on estimates of lung doses from urine bioassay. Therefore, accurate determination of the chemical form of inhaled plutonium and the absorption parameter values for these materials is important for obtaining reliable estimates of lung doses and hence risk from occupational exposures to plutonium.

  17. NCICT: a computational solution to estimate organ doses for pediatric and adult patients undergoing CT scans.

    PubMed

    Lee, Choonsik; Kim, Kwang Pyo; Bolch, Wesley E; Moroz, Brian E; Folio, Les

    2015-12-01

    We developed computational methods and tools to assess organ doses for pediatric and adult patients undergoing computed tomography (CT) examinations. We used the International Commission on Radiological Protection (ICRP) reference pediatric and adult phantoms combined with the Monte Carlo simulation of a reference CT scanner to establish comprehensive organ dose coefficients (DC), organ absorbed dose per unit volumetric CT Dose Index (CTDIvol) (mGy/mGy). We also developed methods to estimate organ doses with tube current modulation techniques and size specific dose estimates. A graphical user interface was designed to obtain user input of patient- and scan-specific parameters, and to calculate and display organ doses. A batch calculation routine was also integrated into the program to automatically calculate organ doses for a large number of patients. We entitled the computer program, National Cancer Institute dosimetry system for CT(NCICT). We compared our dose coefficients with those from CT-Expo, and evaluated the performance of our program using CT patient data. Our pediatric DCs show good agreements of organ dose estimation with those from CT-Expo except for thyroid. Our results support that the adult phantom in CT-Expo seems to represent a pediatric individual between 10 and 15 years rather than an adult. The comparison of CTDIvol values between NCICT and dose pages from 10 selected CT scans shows good agreements less than 12% except for two cases (up to 20%). The organ dose comparison between mean and modulated mAs shows that mean mAs-based calculation significantly overestimates dose (up to 2.4-fold) to the organs in close proximity to lungs in chest and chest-abdomen-pelvis scans. Our program provides more realistic anatomy based on the ICRP reference phantoms, higher age resolution, the most up-to-date bone marrow dosimetry, and several convenient features compared to previous tools. The NCICT will be available for research purpose in the near future.

  18. Ultra-low dose CT attenuation correction for PET/CT.

    PubMed

    Xia, Ting; Alessio, Adam M; De Man, Bruno; Manjeshwar, Ravindra; Asma, Evren; Kinahan, Paul E

    2012-01-21

    A challenge for positron emission tomography/computed tomography (PET/CT) quantitation is patient respiratory motion, which can cause an underestimation of lesion activity uptake and an overestimation of lesion volume. Several respiratory motion correction methods benefit from longer duration CT scans that are phase matched with PET scans. However, even with the currently available, lowest dose CT techniques, extended duration cine CT scans impart a substantially high radiation dose. This study evaluates methods designed to reduce CT radiation dose in PET/CT scanning. We investigated selected combinations of dose reduced acquisition and noise suppression methods that take advantage of the reduced requirement of CT for PET attenuation correction (AC). These include reducing CT tube current, optimizing CT tube voltage, adding filtration, CT sinogram smoothing and clipping. We explored the impact of these methods on PET quantitation via simulations on different digital phantoms. CT tube current can be reduced much lower for AC than that in low dose CT protocols. Spectra that are higher energy and narrower are generally more dose efficient with respect to PET image quality. Sinogram smoothing could be used to compensate for the increased noise and artifacts at radiation dose reduced CT images, which allows for a further reduction of CT dose with no penalty for PET image quantitation. When CT is not used for diagnostic and anatomical localization purposes, we showed that ultra-low dose CT for PET/CT is feasible. The significant dose reduction strategies proposed here could enable respiratory motion compensation methods that require extended duration CT scans and reduce radiation exposure in general for all PET/CT imaging. PMID:22156174

  19. Ultra-low dose CT attenuation correction for PET/CT

    NASA Astrophysics Data System (ADS)

    Xia, Ting; Alessio, Adam M.; De Man, Bruno; Manjeshwar, Ravindra; Asma, Evren; Kinahan, Paul E.

    2012-01-01

    A challenge for positron emission tomography/computed tomography (PET/CT) quantitation is patient respiratory motion, which can cause an underestimation of lesion activity uptake and an overestimation of lesion volume. Several respiratory motion correction methods benefit from longer duration CT scans that are phase matched with PET scans. However, even with the currently available, lowest dose CT techniques, extended duration cine CT scans impart a substantially high radiation dose. This study evaluates methods designed to reduce CT radiation dose in PET/CT scanning. We investigated selected combinations of dose reduced acquisition and noise suppression methods that take advantage of the reduced requirement of CT for PET attenuation correction (AC). These include reducing CT tube current, optimizing CT tube voltage, adding filtration, CT sinogram smoothing and clipping. We explored the impact of these methods on PET quantitation via simulations on different digital phantoms. CT tube current can be reduced much lower for AC than that in low dose CT protocols. Spectra that are higher energy and narrower are generally more dose efficient with respect to PET image quality. Sinogram smoothing could be used to compensate for the increased noise and artifacts at radiation dose reduced CT images, which allows for a further reduction of CT dose with no penalty for PET image quantitation. When CT is not used for diagnostic and anatomical localization purposes, we showed that ultra-low dose CT for PET/CT is feasible. The significant dose reduction strategies proposed here could enable respiratory motion compensation methods that require extended duration CT scans and reduce radiation exposure in general for all PET/CT imaging.

  20. Tissue heterogeneity in IMRT dose calculation for lung cancer.

    PubMed

    Pasciuti, Katia; Iaccarino, Giuseppe; Strigari, Lidia; Malatesta, Tiziana; Benassi, Marcello; Di Nallo, Anna Maria; Mirri, Alessandra; Pinzi, Valentina; Landoni, Valeria

    2011-01-01

    The aim of this study was to evaluate the differences in accuracy of dose calculation between 3 commonly used algorithms, the Pencil Beam algorithm (PB), the Anisotropic Analytical Algorithm (AAA), and the Collapsed Cone Convolution Superposition (CCCS) for intensity-modulated radiation therapy (IMRT). The 2D dose distributions obtained with the 3 algorithms were compared on each CT slice pixel by pixel, using the MATLAB code (The MathWorks, Natick, MA) and the agreement was assessed with the γ function. The effect of the differences on dose-volume histograms (DVHs), tumor control, and normal tissue complication probability (TCP and NTCP) were also evaluated, and its significance was quantified by using a nonparametric test. In general PB generates regions of over-dosage both in the lung and in the tumor area. These differences are not always in DVH of the lung, although the Wilcoxon test indicated significant differences in 2 of 4 patients. Disagreement in the lung region was also found when the Γ analysis was performed. The effect on TCP is less important than for NTCP because of the slope of the curve at the level of the dose of interest. The effect of dose calculation inaccuracy is patient-dependent and strongly related to beam geometry and to the localization of the tumor. When multiple intensity-modulated beams are used, the effect of the presence of the heterogeneity on dose distribution may not always be easily predictable. PMID:20970989

  1. Computer-aided lung nodule detection and assessment by using a hybrid PET/CT scanner

    NASA Astrophysics Data System (ADS)

    Franquiz, Juan; Vaddadi, Sulohita; Soler, George

    2004-04-01

    In this study we present an automatic algorithm for the detection and functional assessment of lung nodules on three-dimensional slices derived from a hybrid PET/CT scanner. In addition to differentiate malignant from benign lesions, the algorithm was mainly designed for assessing the response of lung cancer to therapy. The automated algorithm involves three major steps. First, the lung region is segmented from low resolution multislice CT images. Once the lung is segmented on CT images, a search of seed pixels with maximum activity of 18FDG is undertaken into the lung regions of the electronically registered PET images. A 3D growing algorithm identified the lesion pixels around the maximum 18FDG activity seed pixels. In the third step, the total activity (Bq), concentration (Bq/ml), metabolically active volume (ml) and standard uptake values (SUV) were calculated for lesions on PET images. A threshold and filtering method was applied to high resolution CT scans to determine the CT volume of these lesions identified on PET images. All PET images were corrected for attenuation and partial volume effect and cross calibrated with a standard activity measured in a dose calibrator. Studies were performed using a hybrid PET/CT Discovery LS (GE Medical Systems). The feasibility and robustness of the automatic algorithm was demonstrated in studies with a lung-chest phantom and by retrospective analysis of clinical studies.

  2. Extracting Information From Previous Full-Dose CT Scan for Knowledge-Based Bayesian Reconstruction of Current Low-Dose CT Images.

    PubMed

    Zhang, Hao; Han, Hao; Liang, Zhengrong; Hu, Yifan; Liu, Yan; Moore, William; Ma, Jianhua; Lu, Hongbing

    2016-03-01

    Markov random field (MRF) model has been widely employed in edge-preserving regional noise smoothing penalty to reconstruct piece-wise smooth images in the presence of noise, such as in low-dose computed tomography (LdCT). While it preserves edge sharpness, its regional smoothing may sacrifice tissue image textures, which have been recognized as useful imaging biomarkers, and thus it may compromise clinical tasks such as differentiating malignant vs. benign lesions, e.g., lung nodules or colon polyps. This study aims to shift the edge-preserving regional noise smoothing paradigm to texture-preserving framework for LdCT image reconstruction while retaining the advantage of MRF's neighborhood system on edge preservation. Specifically, we adapted the MRF model to incorporate the image textures of muscle, fat, bone, lung, etc. from previous full-dose CT (FdCT) scan as a priori knowledge for texture-preserving Bayesian reconstruction of current LdCT images. To show the feasibility of the proposed reconstruction framework, experiments using clinical patient scans were conducted. The experimental outcomes showed a dramatic gain by the a priori knowledge for LdCT image reconstruction using the commonly-used Haralick texture measures. Thus, it is conjectured that the texture-preserving LdCT reconstruction has advantages over the edge-preserving regional smoothing paradigm for texture-specific clinical applications.

  3. [Radiation dosage of various CT techniques in diagnostic lung imaging].

    PubMed

    Heinz-Peer, G; Weninger, F; Nowotny, R; Herold, C J

    1996-06-01

    Introduction of the computed tomography index CTDI and the multiple scan average dose (MSAD) has led to standardization of the dose description in CT examinations. Despite the use of these dose parameters, many different dosages are reported in the literature for different CT methods. In addition, there is still a wide range of radiation dosimetry results reported for conventional CT, helical CT, and HRCT used in chest examinations. The variations in dosage are mainly due to differences in factors affecting the dose, i.e. beam geometry, beam quality, scanner geometry ("generation"), and operating parameters. In addition, CT dosimetry instrumentation and methodology make a contribution to dosages. Recent studies calculating differences in factors affecting dosage and CT dosimetry and using similar operating parameters, show similar results in CT dosimetry for conventional and helical CT. On the other hand, dosages for HRCT were greatly reduced. This was mainly caused by narrow beam collimation and increasing section spacing.

  4. What to do when a smoker's CT scan is "normal"?: Implications for lung cancer screening.

    PubMed

    Zurawska, Joanna H; Jen, Rachel; Lam, Stephen; Coxson, Harvey O; Leipsic, Jonathon; Sin, Don D

    2012-05-01

    Lung cancer is the leading cause of cancer-related mortality in the United States and around the world. There are > 90 million current and ex-smokers in the United States who are at increased risk of lung cancer. The published data from the National Lung Screening Trial (NLST) suggest that yearly screening with low-dose thoracic CT scan in heavy smokers can reduce lung cancer mortality by 20% and all-cause mortality by 7%. However, to implement this program nationwide using the NLST inclusion and exclusion criteria would be extremely expensive, with CT scan costs alone > $2 billion per annum. In this article, we offer a possible low-cost strategy to risk-stratify smokers on the basis of spirometry measurements and emphysema scoring by radiologists on CT scans. PMID:22553261

  5. Asbestos Surveillance Program Aachen (ASPA): initial results from baseline screening for lung cancer in asbestos-exposed high-risk individuals using low-dose multidetector-row CT.

    PubMed

    Das, Marco; Mühlenbruch, Georg; Mahnken, Andreas H; Hering, K G; Sirbu, H; Zschiesche, W; Knoll, Lars; Felten, Michael K; Kraus, Thomas; Günther, Rolf W; Wildberger, Joachim E

    2007-05-01

    The purpose of this study was to assess the prevalence of lung cancer in a high-risk asbestos-exposed cohort using low-dose MDCT. Of a population of 5,389 former power-plant workers, 316 were characterized as individuals at highest risk for lung cancer according to a lung-cancer risk model including age, asbestos exposure and smoking habits. Of these 316, 187 (mean age: 66.6 years) individuals were included in a prospective trial. Mean asbestos exposure time was 29.65 years and 89% were smokers. Screening was performed on a 16-slice MDCT (Siemens) with low-dose technique (10/20 mAs(eff.); 1 mm/0.5 mm increment). In addition to soft copy PACS reading analysis on a workstation with a dedicated lung analysis software (LungCARE; Siemens) was performed. One strongly suspicious mass and eight cases of histologically proven lung cancer were found plus 491 additional pulmonary nodules (average volume: 40.72 ml, average diameter 4.62 mm). Asbestos-related changes (pleural plaques, fibrosis) were visible in 80 individuals. Lung cancer screening in this high-risk cohort showed a prevalence of lung cancer of 4.28% (8/187) at baseline screening with an additional large number of indeterminate pulmonary nodules. Low-dose MDCT proved to be feasible in this highly selected population.

  6. AAPM/RSNA Physics Tutorial for Residents: Topics in CT. Radiation dose in CT.

    PubMed

    McNitt-Gray, Michael F

    2002-01-01

    This article describes basic radiation dose concepts as well as those specifically developed to describe the radiation dose from computed tomography (CT). Basic concepts of radiation dose are reviewed, including exposure, absorbed dose, and effective dose. Radiation dose from CT demonstrates variations within the scan plane and along the z axis because of its unique geometry and usage. Several CT-specific dose descriptors have been developed: the Multiple Scan Average Dose descriptor, the Computed Tomography Dose Index (CTDI) and its variations (CTDI(100), CTDI(w), CTDI(vol)), and the dose-length product. Factors that affect radiation dose from CT include the beam energy, tube current-time product, pitch, collimation, patient size, and dose reduction options. Methods of reducing the radiation dose to a patient from CT include reducing the milliampere-seconds value, increasing the pitch, varying the milliampere-seconds value according to patient size, and reducing the beam energy. The effective dose from CT can be estimated by using Monte Carlo methods to simulate CT of a mathematical patient model, by estimating the energy imparted to the body region being scanned, or by using conversion factors for general anatomic regions. Issues related to radiation dose from CT are being addressed by the Society for Pediatric Radiology, the American Association of Physicists in Medicine, the American College of Radiology, and the Center for Devices and Radiological Health of the Food and Drug Administration.

  7. Is internal target volume accurate for dose evaluation in lung cancer stereotactic body radiotherapy?

    PubMed Central

    Peng, Jiayuan; Zhang, Zhen; Wang, Jiazhou; Xie, Jiang; Hu, Weigang

    2016-01-01

    Purpose 4DCT delineated internal target volume (ITV) was applied to determine the tumor motion and used as planning target in treatment planning in lung cancer stereotactic body radiotherapy (SBRT). This work is to study the accuracy of using ITV to predict the real target dose in lung cancer SBRT. Materials and methods Both for phantom and patient cases, the ITV and gross tumor volumes (GTVs) were contoured on the maximum intensity projection (MIP) CT and ten CT phases, respectively. A SBRT plan was designed using ITV as the planning target on average projection (AVG) CT. This plan was copied to each CT phase and the dose distribution was recalculated. The GTV_4D dose was acquired through accumulating the GTV doses over all ten phases and regarded as the real target dose. To analyze the ITV dose error, the ITV dose was compared to the real target dose by endpoints of D99, D95, D1 (doses received by the 99%, 95% and 1% of the target volume), and dose coverage endpoint of V100(relative volume receiving at least the prescription dose). Results The phantom study shows that the ITV underestimates the real target dose by 9.47%∼19.8% in D99, 4.43%∼15.99% in D95, and underestimates the dose coverage by 5% in V100. The patient cases show that the ITV underestimates the real target dose and dose coverage by 3.8%∼10.7% in D99, 4.7%∼7.2% in D95, and 3.96%∼6.59% in V100 in motion target cases. Conclusions Cautions should be taken that ITV is not accurate enough to predict the real target dose in lung cancer SBRT with large tumor motions. Restricting the target motion or reducing the target dose heterogeneity could reduce the ITV dose underestimation effect in lung SBRT. PMID:26968812

  8. SU-E-J-190: Characterization of Radiation Induced CT Number Changes in Tumor and Normal Lung During Radiation Therapy for Lung Cancer

    SciTech Connect

    Yang, C; Liu, F; Tai, A; Gore, E; Johnstone, C; Li, X

    2014-06-01

    Purpose: To measure CT number (CTN) changes in tumor and normal lung as a function of radiation therapy (RT) dose during the course of RT delivery for lung cancer using daily IGRT CT images and single respiration phase CT images. Methods: 4D CT acquired during planning simulation and daily 3D CT acquired during daily IGRT for 10 lung cancer cases randomly selected in terms of age, caner type and stage, were analyzed using an in-house developed software tool. All patients were treated in 2 Gy fractions to primary tumors and involved nodal regions. Regions enclosed by a series of isodose surfaces in normal lung were delineated. The obtained contours along with target contours (GTVs) were populated to each singlephase planning CT and daily CT. CTN in term of Hounsfield Unit (HU) of each voxel in these delineated regions were collectively analyzed using histogram, mean, mode and linear correlation. Results: Respiration induced normal lung CTN change, as analyzed from single-phase planning CTs, ranged from 9 to 23 (±2) HU for the patients studied. Normal lung CTN change was as large as 50 (±12) HU over the entire treatment course, was dose and patient dependent and was measurable with dose changes as low as 1.5 Gy. For patients with obvious tumor volume regression, CTN within the GTV drops monotonically as much as 10 (±1) HU during the early fractions with a total dose of 20 Gy delivered. The GTV and CTN reductions are significantly correlated with correlation coefficient >0.95. Conclusion: Significant RT dose induced CTN changes in lung tissue and tumor region can be observed during even the early phase of RT delivery, and may potentially be used for early prediction of radiation response. Single respiration phase CT images have dramatically reduced statistical noise in ROIs, making daily dose response evaluation possible.

  9. Panel Reviews Benefits and Harms of CT Scans for Lung Cancer Screening | Division of Cancer Prevention

    Cancer.gov

    A panel of experts has reviewed the evidence regarding the benefits and harms of screening for lung cancer with low-dose computed tomography (CT) and concluded that the technology may benefit some individuals at high risk for lung cancer. But the panel cautioned that many questions remain about the potential harms of screening and how to translate screening into clinical practice. |

  10. CT dose optimisation and reduction in osteoarticular disease.

    PubMed

    Gervaise, A; Teixeira, P; Villani, N; Lecocq, S; Louis, M; Blum, A

    2013-04-01

    With an improvement in the temporal and spatial resolution, computed tomography (CT) is indicated in the evaluation of a great many osteoarticular diseases. New exploration techniques such as the dynamic CT and CT bone perfusion also provide new indications. However, CT is still an irradiating imaging technique and dose optimisation and reduction remains primordial. In this paper, the authors first present the typical doses delivered during CT in osteoarticular disease. They then discuss the different ways to optimise and reduce these doses by distinguishing the behavioural factors from the technical factors. Among the latter, the optimisation of the milliamps and kilovoltage is indispensable and should be adapted to the type of exploration and the morphotype of each individual. These technical factors also benefit from recent technological evolutions with the distribution of iterative reconstructions. In this way, the dose may be divided by two and provide an image of equal quality. With these dose optimisation and reduction techniques, it is now possible, while maintaining an excellent quality of the image, to obtain low-dose or even very low-dose acquisitions with a dose sometimes similar that of a standard X-ray assessment. Nevertheless, although these technical factors provide a major reduction in the dose delivered, behavioural factors, such as compliance with the indications, remain fundamental. Finally, the authors describe how to optimise and reduce the dose with specific applications in musculoskeletal imaging such as the dynamic CT, CT bone perfusion and dual energy CT.

  11. The Use of 4DCT to Reduce Lung Dose: A Dosimetric Analysis

    SciTech Connect

    Khan, Fazal; Bell, Glenn; Antony, Jacob; Palmer, Matt; Balter, Peter; Bucci, Kara; Chapman, Melissa Jane

    2009-01-01

    Dosimetric studies on respiratory movement suggest several advantages toward the use of 4-dimensional computed tomography (4DCT) in radiation treatment planning. 4DCT is a method to obtain a series of CT scans each representing a different respiratory phase. The use of 4DCT has provided substantial information on tumor movement in the lung, allowing for the creation of custom planning margins explicitly including respiratory motion. These custom motion margins may result in an increase in the amount of normal lung in the field; however, it is believed less normal lung is irradiated than if generic motion margins were used. Clinical data regarding dose to normal lung by using 4DCT remain rather limited. Thus, a study presenting figures on the change in normal lung dose between planned free breathing CT and 4DCT cases would be useful to the dosimetry community. We have generated plans comparing fast spiral CT and 4DCT in regard to tumor coverage and the resulting dose to normal lung for the clinical target volume (CTV) and planning target volume (PTV) expansions used at our institution. These data were analyzed for free breathing and 4D plans of 6 lung cancer patients using intensity modulated radiation therapy (IMRT). We compared doses to normal lung tissue between free breathing and 4DCT plans.

  12. Development of lung cancer CT screening operating support system

    NASA Astrophysics Data System (ADS)

    Ishigaki, Rikuta; Hanai, Kozou; Suzuki, Masahiro; Kawata, Yoshiki; Niki, Noboru; Eguchi, Kenji; Kakinuma, Ryutaro; Moriyama, Noriyuki

    2009-02-01

    In Japan, lung cancer death ranks first among men and third among women. Lung cancer death is increasing yearly, thus early detection and treatment are needed. For this reason, CT screening for lung cancer has been introduced. The CT screening services are roughly divided into three sections: office, radiology and diagnosis sections. These operations have been performed through paper-based or a combination of paper-based and an existing electronic health recording system. This paper describes an operating support system for lung cancer CT screening in order to make the screening services efficient. This operating support system is developed on the basis of 1) analysis of operating processes, 2) digitalization of operating information, and 3) visualization of operating information. The utilization of the system is evaluated through an actual application and users' survey questionnaire obtained from CT screening centers.

  13. CT in the diagnosis of interstitial lung disease

    SciTech Connect

    Bergin, C.J.; Mueller, N.L.

    1985-09-01

    The computed tomographic (CT) appearance of interstitial lung disease was assessed in 23 patients with known interstitial disease. These included seven patients with fibrosing alveolitis, six with silicosis, two with hypersensitivity pneumonitis, three with lymphangitic spread of tumor, two with sarcoidosis, one with rheumatoid lung disease, and two with neurofibromatosis. The CT appearance of the interstitial changes in the different disease entities was assessed. Nodules were a prominent CT feature in silicosis, sarcoidosis, and lymphangitic spread of malignancy. Distribution of nodules and associated interlobular septal thickening provided further distinguishing features in these diseases. Reticular densities were the predominant CT change in fibrosing alveolitis, rheumatoid lung disease, and extrinsic allergic alveolitis. CT can be useful in the investigation of selected instances of interstitial pulmonary disease.

  14. Dose conversion coefficients for CT examinations of adults with automatic tube current modulation

    NASA Astrophysics Data System (ADS)

    Schlattl, H.; Zankl, M.; Becker, J.; Hoeschen, C.

    2010-10-01

    Automatic tube current modulation (TCM) is used in modern CT devices. This is implemented in the numerical calculation of dose conversion coefficients for CT examinations. For four models of adults, the female and male reference models of ICRP and ICRU and a lighter and a heavier female model, dose conversion coefficients normalized to CTDIvol (DCCCT) have been computed with a Monte Carlo transport code for CT scans with and without TCM. It could be shown for both cases that reliable values for spiral CT scans are obtained when combining the results from an appropriate set of axial scans. The largest organ DCCCT are presented for typical CT examinations for all four models. The impact of TCM is greatest for chest, pelvis and whole-trunk CT examinations, where with TCM the effective DCCCT can be 20-25% lower than without TCM. Typical organs with strong dependence on TCM are thyroid, urinary bladder, lungs and oesophagus. While the DCCCT of thyroid and urinary bladder are mainly sensitive to angular TCM, the DCCCT of lungs and oesophagus are influenced primarily by longitudinal TCM. The impact of the body stature on the effective DCCCT is of the same order as the effect of TCM. Thus, for CT scans in the trunk region, accurate dose values can only be obtained when different sets of DCCCT are employed that are appropriate for the patient's sex and stature and the actual TCM settings.

  15. Pericardial Tamponade Following CT-Guided Lung Biopsy

    SciTech Connect

    Mitchell, Michael J.; Montgomery, Mark; Reiter, Charles G.; Culp, William C.

    2008-07-15

    While not free from hazards, CT-guided biopsy of the lung is a safe procedure, with few major complications. Despite its safety record, however, potentially fatal complications do rarely occur. We report a case of pericardial tamponade following CT-guided lung biopsy. Rapid diagnosis and therapy allowed for complete patient recovery. Physicians who perform this procedure should be aware of the known complications and be prepared to treat them appropriately.

  16. Volumetric expiratory high-resolution CT of the lung.

    PubMed

    Nishino, Mizuki; Hatabu, Hiroto

    2004-11-01

    We developed a volumetric expiratory high-resolution CT (HRCT) protocol that provides combined inspiratory and expiratory volumetric imaging of the lung without increasing radiation exposure, and conducted a preliminary feasibility assessment of this protocol to evaluate diffuse lung disease with small airway abnormalities. The volumetric expiratory high-resolution CT increased the detectability of the conducting airway to the areas of air trapping (P<0.0001), and added significant information about extent and distribution of air trapping (P<0.0001).

  17. Joint Lung CT Image Segmentation: A Hierarchical Bayesian Approach

    PubMed Central

    Cheng, Wenjun; Ma, Luyao; Yang, Tiejun; Liang, Jiali

    2016-01-01

    Accurate lung CT image segmentation is of great clinical value, especially when it comes to delineate pathological regions including lung tumor. In this paper, we present a novel framework that jointly segments multiple lung computed tomography (CT) images via hierarchical Dirichlet process (HDP). In specifics, based on the assumption that lung CT images from different patients share similar image structure (organ sets and relative positioning), we derive a mathematical model to segment them simultaneously so that shared information across patients could be utilized to regularize each individual segmentation. Moreover, compared to many conventional models, the algorithm requires little manual involvement due to the nonparametric nature of Dirichlet process (DP). We validated proposed model upon clinical data consisting of healthy and abnormal (lung cancer) patients. We demonstrate that, because of the joint segmentation fashion, more accurate and consistent segmentations could be obtained. PMID:27611188

  18. Joint Lung CT Image Segmentation: A Hierarchical Bayesian Approach.

    PubMed

    Cheng, Wenjun; Ma, Luyao; Yang, Tiejun; Liang, Jiali; Zhang, Yan

    2016-01-01

    Accurate lung CT image segmentation is of great clinical value, especially when it comes to delineate pathological regions including lung tumor. In this paper, we present a novel framework that jointly segments multiple lung computed tomography (CT) images via hierarchical Dirichlet process (HDP). In specifics, based on the assumption that lung CT images from different patients share similar image structure (organ sets and relative positioning), we derive a mathematical model to segment them simultaneously so that shared information across patients could be utilized to regularize each individual segmentation. Moreover, compared to many conventional models, the algorithm requires little manual involvement due to the nonparametric nature of Dirichlet process (DP). We validated proposed model upon clinical data consisting of healthy and abnormal (lung cancer) patients. We demonstrate that, because of the joint segmentation fashion, more accurate and consistent segmentations could be obtained. PMID:27611188

  19. Evaluation of organ doses and specific k effective dose of 64-slice CT thorax examination using an adult anthropomorphic phantom

    NASA Astrophysics Data System (ADS)

    Hashim, S.; Karim, M. K. A.; Bakar, K. A.; Sabarudin, A.; Chin, A. W.; Saripan, M. I.; Bradley, D. A.

    2016-09-01

    The magnitude of radiation dose in computed tomography (CT) depends on the scan acquisition parameters, investigated herein using an anthropomorphic phantom (RANDO®) and thermoluminescence dosimeters (TLD). Specific interest was in the organ doses resulting from CT thorax examination, the specific k coefficient for effective dose estimation for particular protocols also being determined. For measurement of doses representing five main organs (thyroid, lung, liver, esophagus and skin), TLD-100 (LiF:Mg, Ti) were inserted into selected holes in a phantom slab. Five CT thorax protocols were investigated, one routine (R1) and four that were modified protocols (R2 to R5). Organ doses were ranked from greatest to least, found to lie in the order: thyroid>skin>lung>liver>breast. The greatest dose, for thyroid at 25 mGy, was that in use of R1 while the lowest, at 8.8 mGy, was in breast tissue using R3. Effective dose (E) was estimated using three standard methods: the International Commission on Radiological Protection (ICRP)-103 recommendation (E103), the computational phantom CT-EXPO (E(CTEXPO)) method, and the dose-length product (DLP) based approach. E103 k factors were constant for all protocols, ~8% less than that of the universal k factor. Due to inconsistency in tube potential and pitch factor the k factors from CTEXPO were found to vary between 0.015 and 0.010 for protocols R3 and R5. With considerable variation between scan acquisition parameters and organ doses, optimization of practice is necessary in order to reduce patient organ dose.

  20. Texture-preserving Bayesian image reconstruction for low-dose CT

    NASA Astrophysics Data System (ADS)

    Zhang, Hao; Han, Hao; Hu, Yifan; Liu, Yan; Ma, Jianhua; Li, Lihong; Moore, William; Liang, Zhengrong

    2016-03-01

    Markov random field (MRF) model has been widely used in Bayesian image reconstruction to reconstruct piecewise smooth images in the presence of noise, such as in low-dose X-ray computed tomography (LdCT). While it can preserve edge sharpness via edge-preserving potential function, its regional smoothing may sacrifice tissue image textures, which have been recognized as useful imaging biomarkers, and thus it compromises clinical tasks such as differentiating malignant vs. benign lesions, e.g., lung nodule or colon polyp. This study aims to shift the edge preserving regional noise smoothing paradigm to texture-preserving framework for LdCT image reconstruction while retaining the advantage of MRF's neighborhood system on edge preservation. Specifically, we adapted the MRF model to incorporate the image textures of lung, bone, fat, muscle, etc. from previous full-dose CT scan as a priori knowledge for texture-preserving Bayesian reconstruction of current LdCT images. To show the feasibility of proposed reconstruction framework, experiments using clinical patient scans (with lung nodule or colon polyp) were conducted. The experimental outcomes showed noticeable gain by the a priori knowledge for LdCT image reconstruction with the well-known Haralick texture measures. Thus, it is conjectured that texture-preserving LdCT reconstruction has advantages over edge-preserving regional smoothing paradigm for texture-specific clinical applications.

  1. Impact of temporal probability in 4D dose calculation for lung tumors.

    PubMed

    Rouabhi, Ouided; Ma, Mingyu; Bayouth, John; Xia, Junyi

    2015-11-08

    The purpose of this study was to evaluate the dosimetric uncertainty in 4D dose calculation using three temporal probability distributions: uniform distribution, sinusoidal distribution, and patient-specific distribution derived from the patient respiratory trace. Temporal probability, defined as the fraction of time a patient spends in each respiratory amplitude, was evaluated in nine lung cancer patients. Four-dimensional computed tomography (4D CT), along with deformable image registration, was used to compute 4D dose incorporating the patient's respiratory motion. First, the dose of each of 10 phase CTs was computed using the same planning parameters as those used in 3D treatment planning based on the breath-hold CT. Next, deformable image registration was used to deform the dose of each phase CT to the breath-hold CT using the deformation map between the phase CT and the breath-hold CT. Finally, the 4D dose was computed by summing the deformed phase doses using their corresponding temporal probabilities. In this study, 4D dose calculated from the patient-specific temporal probability distribution was used as the ground truth. The dosimetric evaluation matrix included: 1) 3D gamma analysis, 2) mean tumor dose (MTD), 3) mean lung dose (MLD), and 4) lung V20. For seven out of nine patients, both uniform and sinusoidal temporal probability dose distributions were found to have an average gamma passing rate > 95% for both the lung and PTV regions. Compared with 4D dose calculated using the patient respiratory trace, doses using uniform and sinusoidal distribution showed a percentage difference on average of -0.1% ± 0.6% and -0.2% ± 0.4% in MTD, -0.2% ± 1.9% and -0.2% ± 1.3% in MLD, 0.09% ± 2.8% and -0.07% ± 1.8% in lung V20, -0.1% ± 2.0% and 0.08% ± 1.34% in lung V10, 0.47% ± 1.8% and 0.19% ± 1.3% in lung V5, respectively. We concluded that four-dimensional dose computed using either a uniform or sinusoidal temporal probability distribution can

  2. Ultra-low dose CT attenuation correction for PET/CT: analysis of sparse view data acquisition and reconstruction algorithms.

    PubMed

    Rui, Xue; Cheng, Lishui; Long, Yong; Fu, Lin; Alessio, Adam M; Asma, Evren; Kinahan, Paul E; De Man, Bruno

    2015-10-01

    For PET/CT systems, PET image reconstruction requires corresponding CT images for anatomical localization and attenuation correction. In the case of PET respiratory gating, multiple gated CT scans can offer phase-matched attenuation and motion correction, at the expense of increased radiation dose. We aim to minimize the dose of the CT scan, while preserving adequate image quality for the purpose of PET attenuation correction by introducing sparse view CT data acquisition.We investigated sparse view CT acquisition protocols resulting in ultra-low dose CT scans designed for PET attenuation correction. We analyzed the tradeoffs between the number of views and the integrated tube current per view for a given dose using CT and PET simulations of a 3D NCAT phantom with lesions inserted into liver and lung. We simulated seven CT acquisition protocols with {984, 328, 123, 41, 24, 12, 8} views per rotation at a gantry speed of 0.35 s. One standard dose and four ultra-low dose levels, namely, 0.35 mAs, 0.175 mAs, 0.0875 mAs, and 0.043 75 mAs, were investigated. Both the analytical Feldkamp, Davis and Kress (FDK) algorithm and the Model Based Iterative Reconstruction (MBIR) algorithm were used for CT image reconstruction. We also evaluated the impact of sinogram interpolation to estimate the missing projection measurements due to sparse view data acquisition. For MBIR, we used a penalized weighted least squares (PWLS) cost function with an approximate total-variation (TV) regularizing penalty function. We compared a tube pulsing mode and a continuous exposure mode for sparse view data acquisition. Global PET ensemble root-mean-squares-error (RMSE) and local ensemble lesion activity error were used as quantitative evaluation metrics for PET image quality.With sparse view sampling, it is possible to greatly reduce the CT scan dose when it is primarily used for PET attenuation correction with little or no measureable effect on the PET image. For the four ultra-low dose levels

  3. Ultra-low dose CT attenuation correction for PET/CT: analysis of sparse view data acquisition and reconstruction algorithms.

    PubMed

    Rui, Xue; Cheng, Lishui; Long, Yong; Fu, Lin; Alessio, Adam M; Asma, Evren; Kinahan, Paul E; De Man, Bruno

    2015-10-01

    For PET/CT systems, PET image reconstruction requires corresponding CT images for anatomical localization and attenuation correction. In the case of PET respiratory gating, multiple gated CT scans can offer phase-matched attenuation and motion correction, at the expense of increased radiation dose. We aim to minimize the dose of the CT scan, while preserving adequate image quality for the purpose of PET attenuation correction by introducing sparse view CT data acquisition.We investigated sparse view CT acquisition protocols resulting in ultra-low dose CT scans designed for PET attenuation correction. We analyzed the tradeoffs between the number of views and the integrated tube current per view for a given dose using CT and PET simulations of a 3D NCAT phantom with lesions inserted into liver and lung. We simulated seven CT acquisition protocols with {984, 328, 123, 41, 24, 12, 8} views per rotation at a gantry speed of 0.35 s. One standard dose and four ultra-low dose levels, namely, 0.35 mAs, 0.175 mAs, 0.0875 mAs, and 0.043 75 mAs, were investigated. Both the analytical Feldkamp, Davis and Kress (FDK) algorithm and the Model Based Iterative Reconstruction (MBIR) algorithm were used for CT image reconstruction. We also evaluated the impact of sinogram interpolation to estimate the missing projection measurements due to sparse view data acquisition. For MBIR, we used a penalized weighted least squares (PWLS) cost function with an approximate total-variation (TV) regularizing penalty function. We compared a tube pulsing mode and a continuous exposure mode for sparse view data acquisition. Global PET ensemble root-mean-squares-error (RMSE) and local ensemble lesion activity error were used as quantitative evaluation metrics for PET image quality.With sparse view sampling, it is possible to greatly reduce the CT scan dose when it is primarily used for PET attenuation correction with little or no measureable effect on the PET image. For the four ultra-low dose levels

  4. Ultra-low dose CT attenuation correction for PET/CT: analysis of sparse view data acquisition and reconstruction algorithms

    NASA Astrophysics Data System (ADS)

    Rui, Xue; Cheng, Lishui; Long, Yong; Fu, Lin; Alessio, Adam M.; Asma, Evren; Kinahan, Paul E.; De Man, Bruno

    2015-09-01

    For PET/CT systems, PET image reconstruction requires corresponding CT images for anatomical localization and attenuation correction. In the case of PET respiratory gating, multiple gated CT scans can offer phase-matched attenuation and motion correction, at the expense of increased radiation dose. We aim to minimize the dose of the CT scan, while preserving adequate image quality for the purpose of PET attenuation correction by introducing sparse view CT data acquisition. We investigated sparse view CT acquisition protocols resulting in ultra-low dose CT scans designed for PET attenuation correction. We analyzed the tradeoffs between the number of views and the integrated tube current per view for a given dose using CT and PET simulations of a 3D NCAT phantom with lesions inserted into liver and lung. We simulated seven CT acquisition protocols with {984, 328, 123, 41, 24, 12, 8} views per rotation at a gantry speed of 0.35 s. One standard dose and four ultra-low dose levels, namely, 0.35 mAs, 0.175 mAs, 0.0875 mAs, and 0.043 75 mAs, were investigated. Both the analytical Feldkamp, Davis and Kress (FDK) algorithm and the Model Based Iterative Reconstruction (MBIR) algorithm were used for CT image reconstruction. We also evaluated the impact of sinogram interpolation to estimate the missing projection measurements due to sparse view data acquisition. For MBIR, we used a penalized weighted least squares (PWLS) cost function with an approximate total-variation (TV) regularizing penalty function. We compared a tube pulsing mode and a continuous exposure mode for sparse view data acquisition. Global PET ensemble root-mean-squares-error (RMSE) and local ensemble lesion activity error were used as quantitative evaluation metrics for PET image quality. With sparse view sampling, it is possible to greatly reduce the CT scan dose when it is primarily used for PET attenuation correction with little or no measureable effect on the PET image. For the four ultra-low dose

  5. CT radiation dose optimization and estimation: an update for radiologists.

    PubMed

    Goo, Hyun Woo

    2012-01-01

    In keeping with the increasing utilization of CT examinations, the greater concern about radiation hazards from examinations has been addressed. In this regard, CT radiation dose optimization has been given a great deal of attention by radiologists, referring physicians, technologists, and physicists. Dose-saving strategies are continuously evolving in terms of imaging techniques as well as dose management. Consequently, regular updates of this issue are necessary especially for radiologists who play a pivotal role in this activity. This review article will provide an update on how we can optimize CT dose in order to maximize the benefit-to-risk ratio of this clinically useful diagnostic imaging method. PMID:22247630

  6. PET/CT imaging in lung cancer: indications and findings*

    PubMed Central

    Hochhegger, Bruno; Alves, Giordano Rafael Tronco; Irion, Klaus Loureiro; Fritscher, Carlos Cezar; Fritscher, Leandro Genehr; Concatto, Natália Henz; Marchiori, Edson

    2015-01-01

    The use of PET/CT imaging in the work-up and management of patients with lung cancer has greatly increased in recent decades. The ability to combine functional and anatomical information has equipped PET/CT to look into various aspects of lung cancer, allowing more precise disease staging and providing useful data during the characterization of indeterminate pulmonary nodules. In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer. However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders. Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment. This review article aimed to summarize the basic principles, indications, cancer staging considerations, and future applications related to the use of PET/CT in lung cancer. PMID:26176525

  7. PET/CT imaging in lung cancer: indications and findings.

    PubMed

    Hochhegger, Bruno; Alves, Giordano Rafael Tronco; Irion, Klaus Loureiro; Fritscher, Carlos Cezar; Fritscher, Leandro Genehr; Concatto, Natália Henz; Marchiori, Edson

    2015-01-01

    The use of PET/CT imaging in the work-up and management of patients with lung cancer has greatly increased in recent decades. The ability to combine functional and anatomical information has equipped PET/CT to look into various aspects of lung cancer, allowing more precise disease staging and providing useful data during the characterization of indeterminate pulmonary nodules. In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer. However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders. Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment. This review article aimed to summarize the basic principles, indications, cancer staging considerations, and future applications related to the use of PET/CT in lung cancer. PMID:26176525

  8. A Simple Low-dose X-ray CT Simulation from High-dose Scan

    PubMed Central

    Zeng, Dong; Huang, Jing; Bian, Zhaoying; Niu, Shanzhou; Zhang, Hua; Feng, Qianjin; Liang, Zhengrong

    2015-01-01

    Low-dose X-ray computed tomography (CT) simulation from high-dose scan is required in optimizing radiation dose to patients. In this study, we propose a simple low-dose CT simulation strategy in sinogram domain using the raw data from high-dose scan. Specially, a relationship between the incident fluxes of low- and high- dose scans is first determined according to the repeated projection measurements and analysis. Second, the incident flux level of the simulated low-dose scan is generated by properly scaling the incident flux level of high-dose scan via the determined relationship in the first step. Third, the low-dose CT transmission data by energy integrating detection is simulated by adding a statistically independent Poisson noise distribution plus a statistically independent Gaussian noise distribution. Finally, a filtered back-projection (FBP) algorithm is implemented to reconstruct the resultant low-dose CT images. The present low-dose simulation strategy is verified on the simulations and real scans by comparing it with the existing low-dose CT simulation tool. Experimental results demonstrated that the present low-dose CT simulation strategy can generate accurate low-dose CT sinogram data from high-dose scan in terms of qualitative and quantitative measurements. PMID:26543245

  9. CT acquisition technique and quantitative analysis of the lung parenchyma: variability and corrections

    NASA Astrophysics Data System (ADS)

    Zheng, Bin; Leader, J. K.; Coxson, Harvey O.; Scuirba, Frank C.; Fuhrman, Carl R.; Balkan, Arzu; Weissfeld, Joel L.; Maitz, Glenn S.; Gur, David

    2006-03-01

    The fraction of lung voxels below a pixel value "cut-off" has been correlated with pathologic estimates of emphysema. We performed a "standard" quantitative CT (QCT) lung analysis using a -950 HU cut-off to determine the volume fraction of emphysema (below the cut-off) and a "corrected" QCT analysis after removing small group (5 and 10 pixels) of connected pixels ("blobs") below the cut-off. CT examinations two dataset of 15 subjects each with a range of visible emphysema and pulmonary obstruction were acquired at "low-dose and conventional dose reconstructed using a high-spatial frequency kernel at 2.5 mm section thickness for the same subject. The "blob" size (i.e., connected-pixels) removed was inversely related to the computed fraction of emphysema. The slopes of emphysema fraction versus blob size were 0.013, 0.009, and 0.005 for subjects with both no emphysema and no pulmonary obstruction, moderate emphysema and pulmonary obstruction, and severe emphysema and severe pulmonary obstruction, respectively. The slopes of emphysema fraction versus blob size were 0.008 and 0.006 for low-dose and conventional CT examinations, respectively. The small blobs of pixels removed are most likely CT image artifacts and do not represent actual emphysema. The magnitude of the blob correction was appropriately associated with COPD severity. The blob correction appears to be applicable to QCT analysis in low-dose and conventional CT exams.

  10. [CT-expo--a novel program for dose evaluation in CT].

    PubMed

    Stamm, G; Nagel, H D

    2002-12-01

    CT-Expo is a novel MS Excel application for assessing the radiation doses delivered to patients undergoing CT examinations, based on computational methods that were used to analyze the data collected in the German survey on CT practice in 1999. The program enables the calculation of all dose quantities of practical value, such as axial dose free-in-air, weighted CTDI, dose-length product, effective dose and uterine dose. In contrast to existing programs for CT dose assessment, CT-Expo offers a number of unique features, such as gender-specific dose calculation for all age groups (adults, children, newborns), applicability to all existing scanner models including correction of scanner-specific influences, and the possibility of comparison with the results from the German CT survey on CT practice. Three different application modules offer free and standardized dose calculations as well as a comprehensive benchmarking section including guidance on dose optimization. The program is available as shareware in both German and English version. Additional information and a demo version free of charge can be requested via e-mail from the author's address stamm.georg@mh-hannover. de) or from the web page http://www.mh-hannover.de/kliniken/radiologie/str_04.html.

  11. Limits of Ultra-Low Dose CT Attenuation Correction for PET/CT.

    PubMed

    Xia, Ting; Alessio, Adam M; Kinahan, Paul E

    2010-01-29

    We present an analysis of the effects of ultra-low dose X-ray computerized tomography (CT) based attenuation correction for positron emission tomography (PET). By ultra low dose we mean less than approximately 5 mAs or 0.5 mSv total effective whole body dose. The motivation is the increased interest in using respiratory motion information acquired during the CT scan for both phase-matched CT-based attenuation correction and for motion estimation. Since longer duration CT scans are desired, radiation dose to the patient can be a limiting factor. In this study we evaluate the impact of reducing photon flux rates in the CT data on the reconstructed PET image by using the CATSIM simulation tool for the CT component and the ASIM simulation tool for the PET component. The CT simulation includes effects of the x-ray tube spectra, beam conditioning, bowtie filter, detector noise, and bean hardening correction. The PET simulation includes the effect of attenuation and photon counting. Noise and bias in the PET image were evaluated from multiple realizations of test objects. We show that techniques can be used to significantly reduce the mAs needed for CT based attenuation correction if the CT is not used for diagnostic purposes. The limiting factor, however, is not the noise in the CT image but rather the bias introduced by CT sinogram elements with no detected flux. These results constrain the methods that can be used to lower CT dose in a manner suitable for attenuation correction of PET data. We conclude that ultra-low-dose CT for attenuation correction of PET data is feasible with current PET/CT scanners.

  12. Quantitative assessment of smoking-induced emphysema progression in longitudinal CT screening for lung cancer

    NASA Astrophysics Data System (ADS)

    Suzuki, H.; Mizuguchi, R.; Matsuhiro, M.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, M.; Moriyama, N.

    2015-03-01

    Computed tomography has been used for assessing structural abnormalities associated with emphysema. It is important to develop a robust CT based imaging biomarker that would allow quantification of emphysema progression in early stage. This paper presents effect of smoking on emphysema progression using annual changes of low attenuation volume (LAV) by each lung lobe acquired from low-dose CT images in longitudinal screening for lung cancer. The percentage of LAV (LAV%) was measured after applying CT value threshold method and small noise reduction. Progression of emphysema was assessed by statistical analysis of the annual changes represented by linear regression of LAV%. This method was applied to 215 participants in lung cancer CT screening for five years (18 nonsmokers, 85 past smokers, and 112 current smokers). The results showed that LAV% is useful to classify current smokers with rapid progression of emphysema (0.2%/year, p<0.05). This paper demonstrates effectiveness of the proposed method in diagnosis and prognosis of early emphysema in CT screening for lung cancer.

  13. CT reconstruction techniques for improved accuracy of lung CT airway measurement

    SciTech Connect

    Rodriguez, A.; Ranallo, F. N.; Judy, P. F.; Gierada, D. S.; Fain, S. B.

    2014-11-01

    Purpose: To determine the impact of constrained reconstruction techniques on quantitative CT (qCT) of the lung parenchyma and airways for low x-ray radiation dose. Methods: Measurement of small airways with qCT remains a challenge, especially for low x-ray dose protocols. Images of the COPDGene quality assurance phantom (CTP698, The Phantom Laboratory, Salem, NY) were obtained using a GE discovery CT750 HD scanner for helical scans at x-ray radiation dose-equivalents ranging from 1 to 4.12 mSv (12–100 mA s current–time product). Other parameters were 40 mm collimation, 0.984 pitch, 0.5 s rotation, and 0.625 mm thickness. The phantom was sandwiched between 7.5 cm thick water attenuating phantoms for a total length of 20 cm to better simulate the scatter conditions of patient scans. Image data sets were reconstructed using STANDARD (STD), DETAIL, BONE, and EDGE algorithms for filtered back projection (FBP), 100% adaptive statistical iterative reconstruction (ASIR), and Veo reconstructions. Reduced (half) display field of view (DFOV) was used to increase sampling across airway phantom structures. Inner diameter (ID), wall area percent (WA%), and wall thickness (WT) measurements of eight airway mimicking tubes in the phantom, including a 2.5 mm ID (42.6 WA%, 0.4 mm WT), 3 mm ID (49.0 WA%, 0.6 mm WT), and 6 mm ID (49.0 WA%, 1.2 mm WT) were performed with Airway Inspector (Surgical Planning Laboratory, Brigham and Women’s Hospital, Boston, MA) using the phase congruency edge detection method. The average of individual measures at five central slices of the phantom was taken to reduce measurement error. Results: WA% measures were greatly overestimated while IDs were underestimated for the smaller airways, especially for reconstructions at full DFOV (36 cm) using the STD kernel, due to poor sampling and spatial resolution (0.7 mm pixel size). Despite low radiation dose, the ID of the 6 mm ID airway was consistently measured accurately for all methods other than STD

  14. Analysis of patient CT dose data using virtualdose

    NASA Astrophysics Data System (ADS)

    Bennett, Richard

    X-ray computer tomography has many benefits to medical and research applications. Recently, over the last decade CT has had a large increase in usage in hospitals and medical diagnosis. In pediatric care, from 2000 to 2006, abdominal CT scans increased by 49 % and chest CT by 425 % in the emergency room (Broder 2007). Enormous amounts of effort have been performed across multiple academic and government groups to determine an accurate measure of organ dose to patients who undergo a CT scan due to the inherent risks with ionizing radiation. Considering these intrinsic risks, CT dose estimating software becomes a necessary tool that health care providers and radiologist must use to determine many metrics to base the risks versus rewards of having an x-ray CT scan. This thesis models the resultant organ dose as body mass increases for patients with all other related scan parameters fixed. In addition to this,this thesis compares a modern dose estimating software, VirtualDose CT to two other programs, CT-Expo and ImPACT CT. The comparison shows how the software's theoretical basis and the phantom they use to represent the human body affect the range of results in organ dose. CT-Expo and ImPACT CT dose estimating software uses a different model for anatomical representation of the organs in the human body and the results show how that approach dramatically changes the outcome. The results categorizes four datasets as compared to the three software types where the appropriate phantom was available. Modeling was done to simulate chest abdominal pelvis scans and whole body scans. Organ dose difference versus body mass index shows as body mass index (BMI) ranges from 23.5 kg/m 2 to 45 kg/m2 the amount of organ dose also trends a percent change from -4.58 to -176.19 %. Comparing organ dose difference with increasing x-ray tube potential from 120 kVp to 140 kVp the percent change in organ dose increases from 55 % to 65 % across all phantoms. In comparing VirtualDose to CT

  15. Quantitative assessment of emphysema from whole lung CT scans: comparison with visual grading

    NASA Astrophysics Data System (ADS)

    Keller, Brad M.; Reeves, Anthony P.; Apanosovich, Tatiyana V.; Wang, Jianwei; Yankelevitz, David F.; Henschke, Claudia I.

    2009-02-01

    Emphysema is a disease of the lungs that destroys the alveolar air sacs and induces long-term respiratory dysfunction. CT scans allow for imaging of the anatomical basis of emphysema and for visual assessment by radiologists of the extent present in the lungs. Several measures have been introduced for the quantification of the extent of disease directly from CT data in order to add to the qualitative assessments made by radiologists. In this paper we compare emphysema index, mean lung density, histogram percentiles, and the fractal dimension to visual grade in order to evaluate the predictability of radiologist visual scoring of emphysema from low-dose CT scans through quantitative scores, in order to determine which measures can be useful as surrogates for visual assessment. All measures were computed over nine divisions of the lung field (whole lung, individual lungs, and upper/middle/lower thirds of each lung) for each of 148 low-dose, whole lung scans. In addition, a visual grade of each section was also given by an expert radiologist. One-way ANOVA and multinomial logistic regression were used to determine the ability of the measures to predict visual grade from quantitative score. We found that all measures were able to distinguish between normal and severe grades (p<0.01), and between mild/moderate and all other grades (p<0.05). However, no measure was able to distinguish between mild and moderate cases. Approximately 65% prediction accuracy was achieved from using quantitative score to predict visual grade, with 73% if mild and moderate cases are considered as a single class.

  16. Dose to lung from inhaled tritiated particles.

    PubMed

    Richardson, R B; Hong, A

    2001-09-01

    Tritiated particulate materials are of potential hazard in fission, fusion, and other tritium handling facilities. The absorbed fractions (fraction of energy emitted that is absorbed by the target region) are calculated for tritiated particles deposited in the alveolar-interstitial (AI) region of the respiratory tract. The energy absorbed by radiologically sensitive tissue irradiated by tritiated particles, in regions of the lung other than in the AI region, is negligible. The ICRP Publication 71 assumes the absorbed fraction is unity for tritium deposited in the AI region. We employed Monte Carlo methods in a model to evaluate the energy deposition in the wall of the alveolar sac from particles of tritiated beryllium, tritiated graphite, titanium tritide, tritiated iron hydroxide and zirconium tritide. For the five materials examined, the absorbed fraction in alveolar tissue ranged from 0.31 to 0.61 for particles of 1 microm physical diameter and 0.07 to 0.21 for 5 microm diameter particles. The dose to alveolar tissue, for an acute inhalation of tritiated particles by an adult male worker, was calculated based on the ICRP 66 lung model and the particle dissolution model of Mercer (1967). For particles of 5 microm activity median aerodynamic diameter (AMAD), the committed equivalent dose to alveolar tissue, calculated for the five materials, ranged from 32-42%, respectively, of the committed equivalent dose derived assuming the absorbed fractions were unity. PMID:11513464

  17. Toward computer-aided emphysema quantification on ultralow-dose CT: reproducibility of ventrodorsal gravity effect measurement and correction

    NASA Astrophysics Data System (ADS)

    Wiemker, Rafael; Opfer, Roland; Bülow, Thomas; Rogalla, Patrik; Steinberg, Amnon; Dharaiya, Ekta; Subramanyan, Krishna

    2007-03-01

    Computer aided quantification of emphysema in high resolution CT data is based on identifying low attenuation areas below clinically determined Hounsfield thresholds. However, the emphysema quantification is prone to error since a gravity effect can influence the mean attenuation of healthy lung parenchyma up to +/- 50 HU between ventral and dorsal lung areas. Comparing ultra-low-dose (7 mAs) and standard-dose (70 mAs) CT scans of each patient we show that measurement of the ventrodorsal gravity effect is patient specific but reproducible. It can be measured and corrected in an unsupervised way using robust fitting of a linear function.

  18. Three-Dimensions Segmentation of Pulmonary Vascular Trees for Low Dose CT Scans

    NASA Astrophysics Data System (ADS)

    Lai, Jun; Huang, Ying; Wang, Ying; Wang, Jun

    2016-12-01

    Due to the low contrast and the partial volume effects, providing an accurate and in vivo analysis for pulmonary vascular trees from low dose CT scans is a challenging task. This paper proposes an automatic integration segmentation approach for the vascular trees in low dose CT scans. It consists of the following steps: firstly, lung volumes are acquired by the knowledge based method from the CT scans, and then the data are smoothed by the 3D Gaussian filter; secondly, two or three seeds are gotten by the adaptive 2D segmentation and the maximum area selecting from different position scans; thirdly, each seed as the start voxel is inputted for a quick multi-seeds 3D region growing to get vascular trees; finally, the trees are refined by the smooth filter. Through skeleton analyzing for the vascular trees, the results show that the proposed method can provide much better and lower level vascular branches.

  19. The relationship between organ dose and patient size in tube current modulated adult thoracic CT scans

    NASA Astrophysics Data System (ADS)

    Khatonabadi, Maryam; Zhang, Di; Yang, Jeffrey; DeMarco, John J.; Cagnon, Chris C.; McNitt-Gray, Michael F.

    2012-03-01

    Recently published AAPM Task Group 204 developed conversion coefficients that use scanner reported CTDIvol to estimate dose to the center of patient undergoing fixed tube current body exam. However, most performed CT exams use TCM to reduce dose to patients. Therefore, the purpose of this study was to investigate the correlation between organ dose and a variety of patient size metrics in adult chest CT scans that use tube current modulation (TCM). Monte Carlo simulations were performed for 32 voxelized models with contoured lungs and glandular breasts tissue, consisting of females and males. These simulations made use of patient's actual TCM data to estimate organ dose. Using image data, different size metrics were calculated, these measurements were all performed on one slice, at the level of patient's nipple. Estimated doses were normalized by scanner-reported CTDIvol and plotted versus different metrics. CTDIvol values were plotted versus different metrics to look at scanner's output versus size. The metrics performed similarly in terms of correlating with organ dose. Looking at each gender separately, for male models normalized lung dose showed a better linear correlation (r2=0.91) with effective diameter, while female models showed higher correlation (r2=0.59) with the anterior-posterior measurement. There was essentially no correlation observed between size and CTDIvol-normalized breast dose. However, a linear relationship was observed between absolute breast dose and size. Dose to lungs and breasts were consistently higher in females with similar size as males which could be due to shape and composition differences between genders in the thoracic region.

  20. Strategies for reduction of radiation dose in cardiac multislice CT.

    PubMed

    Paul, Jean-François; Abada, Hicham T

    2007-08-01

    Because cardiac computed tomography (CT) (mainly coronary CT angiography) is a very promising technique, used more and more for coronary artery evaluation, the benefits and risks of this new low-invasive technique must be balanced. Radiation dose is a major concern for coronary CT angiography, especially in case of repeated examinations or in particular subgroups of patients (for example young female patients). Radiation dose to patient tends to increase from 16- to 64-slice CT. Radiation exposure in ECG-gated acquisitions may reach up to 40 mSv; considerable differences are attributable to the performance of CT machines, to technical dose-sparing tools, but also to radiological habits. Setting radiation dose at the lowest level possible should be a constant goal for the radiologist. Current technological tools are detailed in regard to their efficiency. Optimisation is necessary, by a judicious use of technological tools and also by individual adaptation of kV or mAs. This paper reviews the different current strategies for radiation dose reduction, keeping image quality constant. Data from the literature are discussed, and future technological developments are considered in regards to radiation dose reduction. The particular case of paediatric patients with congenital heart disease is also addressed.

  1. Resolution enhancement of lung 4D-CT via group-sparsity

    SciTech Connect

    Bhavsar, Arnav; Wu, Guorong; Shen, Dinggang; Lian, Jun

    2013-12-15

    Purpose: 4D-CT typically delivers more accurate information about anatomical structures in the lung, over 3D-CT, due to its ability to capture visual information of the lung motion across different respiratory phases. This helps to better determine the dose during radiation therapy for lung cancer. However, a critical concern with 4D-CT that substantially compromises this advantage is the low superior-inferior resolution due to less number of acquired slices, in order to control the CT radiation dose. To address this limitation, the authors propose an approach to reconstruct missing intermediate slices, so as to improve the superior-inferior resolution.Methods: In this method the authors exploit the observation that sampling information across respiratory phases in 4D-CT can be complimentary due to lung motion. The authors’ approach uses this locally complimentary information across phases in a patch-based sparse-representation framework. Moreover, unlike some recent approaches that treat local patches independently, the authors’ approach employs the group-sparsity framework that imposes neighborhood and similarity constraints between patches. This helps in mitigating the trade-off between noise robustness and structure preservation, which is an important consideration in resolution enhancement. The authors discuss the regularizing ability of group-sparsity, which helps in reducing the effect of noise and enables better structural localization and enhancement.Results: The authors perform extensive experiments on the publicly available DIR-Lab Lung 4D-CT dataset [R. Castillo, E. Castillo, R. Guerra, V. Johnson, T. McPhail, A. Garg, and T. Guerrero, “A framework for evaluation of deformable image registration spatial accuracy using large landmark point sets,” Phys. Med. Biol. 54, 1849–1870 (2009)]. First, the authors carry out empirical parametric analysis of some important parameters in their approach. The authors then demonstrate, qualitatively as well as

  2. Resolution enhancement of lung 4D-CT data using multiscale interphase iterative nonlocal means

    SciTech Connect

    Zhang Yu; Yap, Pew-Thian; Wu Guorong; Feng Qianjin; Chen Wufan; Lian Jun; Shen Dinggang

    2013-05-15

    Purpose: Four-dimensional computer tomography (4D-CT) has been widely used in lung cancer radiotherapy due to its capability in providing important tumor motion information. However, the prolonged scanning duration required by 4D-CT causes considerable increase in radiation dose. To minimize the radiation-related health risk, radiation dose is often reduced at the expense of interslice spatial resolution. However, inadequate resolution in 4D-CT causes artifacts and increases uncertainty in tumor localization, which eventually results in extra damages of healthy tissues during radiotherapy. In this paper, the authors propose a novel postprocessing algorithm to enhance the resolution of lung 4D-CT data. Methods: The authors' premise is that anatomical information missing in one phase can be recovered from the complementary information embedded in other phases. The authors employ a patch-based mechanism to propagate information across phases for the reconstruction of intermediate slices in the longitudinal direction, where resolution is normally the lowest. Specifically, the structurally matching and spatially nearby patches are combined for reconstruction of each patch. For greater sensitivity to anatomical details, the authors employ a quad-tree technique to adaptively partition the image for more fine-grained refinement. The authors further devise an iterative strategy for significant enhancement of anatomical details. Results: The authors evaluated their algorithm using a publicly available lung data that consist of 10 4D-CT cases. The authors' algorithm gives very promising results with significantly enhanced image structures and much less artifacts. Quantitative analysis shows that the authors' algorithm increases peak signal-to-noise ratio by 3-4 dB and the structural similarity index by 3%-5% when compared with the standard interpolation-based algorithms. Conclusions: The authors have developed a new algorithm to improve the resolution of 4D-CT. It outperforms

  3. Eye dose monitoring of PET/CT workers

    PubMed Central

    O'Connor, U; O'Reilly, G

    2014-01-01

    Objective: The objective of the study was to measure eye dose [Hp(3)] to workers in a busy positron emission tomography (PET)/CT centre. Doses were compared with the proposed new annual dose limit of 20 mSv. Methods: We used a newly designed dosemeter to measure eye dose [Hp(3)]. Eye dosemeters were worn with an adjustable headband, with the dosemeter positioned adjacent to the left eye. The whole-body dose was also recorded using electronic personal dosemeter (EPD® Mk2; Thermo Electron Corporation, Waltham, MA). Exposed staff included radiographers, nurses and healthcare assistants. Results: The radiographers received the highest exposure of the staff groups studied, with one radiographer receiving an exposure of 0.5 mSv over the 3-month survey period. The estimated maximum eye dose for 1 year is approximately 2 mSv. The numeric value for eye dose was compared with the numeric value for personal dose equivalent to see if one could be used as an indicator for the other. From our data, a conservative estimate of eye dose Hp(3) (mSv) can be made as being up to approximately twice the numeric value for whole-body dose [Hp(10)] (mSv). Conclusion: Eye dose was found to be well within the new proposed annual limit at our PET/CT centre. Routine whole-body dose measurements may be a useful starting point for assessing whether eye dose monitoring should be prioritized in a PET facility. Advances in knowledge: Following the proposal of a reduced eye dose limit, this article provides new measurement data on staff eye doses for PET/CT workers. PMID:25109711

  4. Poster — Thur Eve — 12: Implementation of a Clinical Lung Tumour High Dose Containment Verification Procedure using Respiratory Cone-Beam CT (4DCBCT) on a Varian TrueBeam Linac

    SciTech Connect

    Beaudry, J.; Bergman, A.

    2014-08-15

    Lung tumours move due to respiratory motion. This is managed during planning by acquiring a 4DCT and capturing the excursion of the GTV (gross tumour volume) throughout the breathing cycle within an IGTV (Internal Gross Tumour Volume) contour. Patients undergo a verification cone-beam CT (CBCT) scan immediately prior to treatment. 3D reconstructed images do not consider tumour motion, resulting in image artefacts, such as blurring. This may lead to difficulty in identifying the tumour on reconstructed images. It would be valuable to create a 4DCBCT reconstruction of the tumour motion to confirm that does indeed remain within the planned IGTV. CBCT projections of a Quasar Respiratory Motion Phantom are acquired in Treatment mode (half-fan scan) on a Varian TrueBeam accelerator. This phantom contains a mobile, low-density lung insert with an embedded 3cm diameter tumour object. It is programmed to create a 15s periodic, 2cm (sup/inf) displacement. A Varian Real-time Position Management (RPM) tracking-box is placed on the phantom breathing platform. Breathing phase information is automatically integrated into the projection image files. Using in-house Matlab programs and RTK (Reconstruction Tool Kit) open-source toolboxes, the projections are re-binned into 10 phases and a 4DCBCT scan reconstructed. The planning IGTV is registered to the 4DCBCT and the tumour excursion is verified to remain within the planned contour. This technique successfully reconstructs 4DCBCT images using clinical modes for a breathing phantom. UBC-BCCA ethics approval has been obtained to perform 4DCBCT reconstructions on lung patients (REB#H12-00192). Clinical images will be accrued starting April 2014.

  5. Visualization and quantitative analysis of lung microstructure using micro CT images

    NASA Astrophysics Data System (ADS)

    Yamamoto, Tetsuo; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Matsui, Eisuke; Ohamatsu, Hironobu; Moriyama, Noriyuki

    2004-04-01

    Micro CT system is developed for lung function analysis at a high resolution of the micrometer order (up to 5 μm in spatial resolution). This system reveals the lung distal structures such as interlobular septa, terminal bronchiole, respiratory bronchiole, alveolar duct, and alveolus. In order to visualize lung 3-D microstructures using micro CT images and to analyze them, this research presents a computerized approach. In this approach, the following things are performed: (1) extracting lung distal structures from micro CT images, (2) visualizing extracted lung microstructure in three dimensions, and (3) visualizing inside of lung distal area in three dimensions with fly-through. This approach is applied for to micro CT images of human lung tissue specimens that were obtained by surgical excision and were kept in the state of the inflated fixed lung. And this research succeeded in visualization of lung microstructures using micro CT images to reveal the lung distal structures from bronchiole up to alveolus.

  6. Low-dose CT for quantitative analysis in acute respiratory distress syndrome

    PubMed Central

    2013-01-01

    Introduction The clinical use of serial quantitative computed tomography (CT) to characterize lung disease and guide the optimization of mechanical ventilation in patients with acute respiratory distress syndrome (ARDS) is limited by the risk of cumulative radiation exposure and by the difficulties and risks related to transferring patients to the CT room. We evaluated the effects of tube current-time product (mAs) variations on quantitative results in healthy lungs and in experimental ARDS in order to support the use of low-dose CT for quantitative analysis. Methods In 14 sheep chest CT was performed at baseline and after the induction of ARDS via intravenous oleic acid injection. For each CT session, two consecutive scans were obtained applying two different mAs: 60 mAs was paired with 140, 15 or 7.5 mAs. All other CT parameters were kept unaltered (tube voltage 120 kVp, collimation 32 × 0.5 mm, pitch 0.85, matrix 512 × 512, pixel size 0.625 × 0.625 mm). Quantitative results obtained at different mAs were compared via Bland-Altman analysis. Results Good agreement was observed between 60 mAs and 140 mAs and between 60 mAs and 15 mAs (all biases less than 1%). A further reduction of mAs to 7.5 mAs caused an increase in the bias of poorly aerated and nonaerated tissue (-2.9% and 2.4%, respectively) and determined a significant widening of the limits of agreement for the same compartments (-10.5% to 4.8% for poorly aerated tissue and -5.9% to 10.8% for nonaerated tissue). Estimated mean effective dose at 140, 60, 15 and 7.5 mAs corresponded to 17.8, 7.4, 2.0 and 0.9 mSv, respectively. Image noise of scans performed at 140, 60, 15 and 7.5 mAs corresponded to 10, 16, 38 and 74 Hounsfield units, respectively. Conclusions A reduction of effective dose up to 70% has been achieved with minimal effects on lung quantitative results. Low-dose computed tomography provides accurate quantitative results and could be used to characterize lung compartment distribution and

  7. Fast CT-CT fluoroscopy registration with respiratory motion compensation for image-guided lung intervention

    NASA Astrophysics Data System (ADS)

    Su, Po; Xue, Zhong; Lu, Kongkuo; Yang, Jianhua; Wong, Stephen T.

    2012-02-01

    CT-fluoroscopy (CTF) is an efficient imaging method for guiding percutaneous lung interventions such as biopsy. During CTF-guided biopsy procedure, four to ten axial sectional images are captured in a very short time period to provide nearly real-time feedback to physicians, so that they can adjust the needle as it is advanced toward the target lesion. Although popularly used in clinics, this traditional CTF-guided intervention procedure may require frequent scans and cause unnecessary radiation exposure to clinicians and patients. In addition, CTF only generates limited slices of images and provides limited anatomical information. It also has limited response to respiratory movements and has narrow local anatomical dynamics. To better utilize CTF guidance, we propose a fast CT-CTF registration algorithm with respiratory motion estimation for image-guided lung intervention using electromagnetic (EM) guidance. With the pre-procedural exhale and inhale CT scans, it would be possible to estimate a series of CT images of the same patient at different respiratory phases. Then, once a CTF image is captured during the intervention, our algorithm can pick the best respiratory phase-matched 3D CT image and performs a fast deformable registration to warp the 3D CT toward the CTF. The new 3D CT image can be used to guide the intervention by superimposing the EM-guided needle location on it. Compared to the traditional repetitive CTF guidance, the registered CT integrates both 3D volumetric patient data and nearly real-time local anatomy for more effective and efficient guidance. In this new system, CTF is used as a nearly real-time sensor to overcome the discrepancies between static pre-procedural CT and the patient's anatomy, so as to provide global guidance that may be supplemented with electromagnetic (EM) tracking and to reduce the number of CTF scans needed. In the experiments, the comparative results showed that our fast CT-CTF algorithm can achieve better registration

  8. [The use of PET/CT in radiotherapy of patients with non-small cell lung cancer].

    PubMed

    Lõcsei, Zoltán; Hideghéty, Katalin; Farkas, Róbert; Bellyei, Szabolcs; Sárosi, Veronika; Sebestyén, Klára; Sebestyén, Zsolt; Kovács, Péter; Mangel, László

    2011-11-01

    The goal of this paper was to investigate the influence of FDG-PET/CT scan on the modification of staging and irradiation planning in patients suffering from non-small cell lung cancer (NSCLC). Fifteen patients suffering from NSCLC were analyzed by the authors from January, 2008 to July, 2009. The aim of the analysis was to examine the influence of FDG-PET/CT on irradiation planning and on decision-making of the complex oncologic therapy. The FDG-PET/CT scan was carried out in the position of irradiation performed later. For irradiation planning, planning target volumes (PTV) and the organs of risk were contoured on the patients' topometric CT slides as well as on the fused FDG-PET/CT slides. We evaluated how the application of PET/CT modified the stage of the illness, the complex oncologic therapeutic plan, the volume and the localization of the PTV, and the irradiation doses of the organs at risk. The mean and maximum dose of the spinal cord, the mean and V20 dose load of the lungs and the mean dose loads of the heart as well as of the left ventricle were measured. In 8 of 15 cases the stage of the disease and the treatment strategy was modified, since distant metastases were detected by the PET/CT. We evaluated the modification of the PTV and dose load of the organs at risk in 7 cases. According to the PET/CT the PTV was reduced in 5 cases (mean: 393.6 cm3) and was increased in 2 cases (mean: 250.8 cm3). Concerning the risk organs we found that the average (8.8 Gy/9.5 Gy) and maximum (33.4 Gy/36.4 Gy) dose load of the spinal cord increased, while the average (24.5 Gy/13.8 Gy) and V20 (33.7%/22.1%) dose load of the lungs decreased. We likewise found a decrease in the mean dose load of the heart (17.3 Gy/16.8 Gy) and left ventricle (12.9 Gy/9.6 Gy). In the majority of the cases the FDG-PET/CT scan modified the therapeutic decision, the size of the irradiated volume, and the dose load of the lung, the organ at risk causing the most difficulties at irradiation

  9. CT screening for lung cancer: countdown to implementation.

    PubMed

    Field, John K; Hansell, David M; Duffy, Stephen W; Baldwin, David R

    2013-12-01

    Implementation of lung cancer CT screening is currently the subject of a major policy decision within the USA. Findings of the US National Lung Screening Trial showed a 20% reduction in lung cancer mortality and a 6·7% decrease in all-cause mortality; subsequently, five US professional and clinical organisations and the US Preventive Services Task Force recommended that screening should be implemented. Should national health services in Europe follow suit? The European community awaits mortality and cost-effectiveness data from the NELSON trial in 2015-16 and pooled findings of European trials. In the intervening years, a recommendation is proposed that a demonstration trial is done in the UK. In this Review, we summarise the existing evidence and identify questions that remain to be answered before the implementation of international lung cancer screening programmes.

  10. Lung cancer risk prediction to select smokers for screening CT--a model based on the Italian COSMOS trial.

    PubMed

    Maisonneuve, Patrick; Bagnardi, Vincenzo; Bellomi, Massimo; Spaggiari, Lorenzo; Pelosi, Giuseppe; Rampinelli, Cristiano; Bertolotti, Raffaella; Rotmensz, Nicole; Field, John K; Decensi, Andrea; Veronesi, Giulia

    2011-11-01

    Screening with low-dose helical computed tomography (CT) has been shown to significantly reduce lung cancer mortality but the optimal target population and time interval to subsequent screening are yet to be defined. We developed two models to stratify individual smokers according to risk of developing lung cancer. We first used the number of lung cancers detected at baseline screening CT in the 5,203 asymptomatic participants of the COSMOS trial to recalibrate the Bach model, which we propose using to select smokers for screening. Next, we incorporated lung nodule characteristics and presence of emphysema identified at baseline CT into the Bach model and proposed the resulting multivariable model to predict lung cancer risk in screened smokers after baseline CT. Age and smoking exposure were the main determinants of lung cancer risk. The recalibrated Bach model accurately predicted lung cancers detected during the first year of screening. Presence of nonsolid nodules (RR = 10.1, 95% CI = 5.57-18.5), nodule size more than 8 mm (RR = 9.89, 95% CI = 5.84-16.8), and emphysema (RR = 2.36, 95% CI = 1.59-3.49) at baseline CT were all significant predictors of subsequent lung cancers. Incorporation of these variables into the Bach model increased the predictive value of the multivariable model (c-index = 0.759, internal validation). The recalibrated Bach model seems suitable for selecting the higher risk population for recruitment for large-scale CT screening. The Bach model incorporating CT findings at baseline screening could help defining the time interval to subsequent screening in individual participants. Further studies are necessary to validate these models.

  11. Sinogram restoration for ultra-low-dose x-ray multi-slice helical CT by nonparametric regression

    NASA Astrophysics Data System (ADS)

    Jiang, Lu; Siddiqui, Khan; Zhu, Bin; Tao, Yang; Siegel, Eliot

    2007-03-01

    During the last decade, x-ray computed tomography (CT) has been applied to screen large asymptomatic smoking and nonsmoking populations for early lung cancer detection. Because a larger population will be involved in such screening exams, more and more attention has been paid to studying low-dose, even ultra-low-dose x-ray CT. However, reducing CT radiation exposure will increase noise level in the sinogram, thereby degrading the quality of reconstructed CT images as well as causing more streak artifacts near the apices of the lung. Thus, how to reduce the noise levels and streak artifacts in the low-dose CT images is becoming a meaningful topic. Since multi-slice helical CT has replaced conventional stop-and-shoot CT in many clinical applications, this research mainly focused on the noise reduction issue in multi-slice helical CT. The experiment data were provided by Siemens SOMATOM Sensation 16-Slice helical CT. It included both conventional CT data acquired under 120 kvp voltage and 119 mA current and ultra-low-dose CT data acquired under 120 kvp and 10 mA protocols. All other settings are the same as that of conventional CT. In this paper, a nonparametric smoothing method with thin plate smoothing splines and the roughness penalty was proposed to restore the ultra-low-dose CT raw data. Each projection frame was firstly divided into blocks, and then the 2D data in each block was fitted to a thin-plate smoothing splines' surface via minimizing a roughness-penalized least squares objective function. By doing so, the noise in each ultra-low-dose CT projection was reduced by leveraging the information contained not only within each individual projection profile, but also among nearby profiles. Finally the restored ultra-low-dose projection data were fed into standard filtered back projection (FBP) algorithm to reconstruct CT images. The rebuilt results as well as the comparison between proposed approach and traditional method were given in the results and

  12. SU-E-T-500: Dose Escalation Strategy for Lung Cancer Patients Using a Biologically- Guided Target Definition

    SciTech Connect

    Shusharina, N; Khan, F; Choi, N; Sharp, G

    2014-06-01

    Purpose: Dose escalation strategy for lung cancer patients can lead to late symptoms such as pneumonitis and cardiac injury. We propose a strategy to increase radiation dose for improving local tumor control while simultaneously striving to minimize the injury of organs at risk (OAR). Our strategy is based on defining a small, biologically-guided target volume for receiving additional radiation dose. Methods: 106 patients with lung cancer treated with radiotherapy were selected for patients diagnosed with stage II and III disease. Previous research has shown that 50% of the maximum SUV threshold in FDG-PET imaging is appropriate for delineation of the most aggressive part of a tumor. After PET- and CT-derived targets were contoured, an IMRT treatment plan was designed to deliver 60 Gy to the GTV as delineated on a 4D CT (Plan 1). A second plan was designed with additional dose of 18 Gy to the PET-derived volume (Plan 2). A composite plan was generated by the addition of Plan 1 and Plan 2. Results: Plan 1 was compared to the composite plan and increases in OAR dose were assessed. For seven patients on average, lung V5 was increased by 1.4% and V20 by 4.2% for ipsilateral lung and by 13.5% and 7% for contralateral lung. For total lung, V5 and V20 were increased by 4.5% and 4.8% respectively. Mean lung dose was increased by 9.7% for the total lung. The maximum dose to the spinal cord increased by 16% on average. For the heart, V20 increased by 4.2% and V40 by 5.2%. Conclusion: It seems feasible that an additional 18 Gy of radiation dose can be delivered to FDG PET-derived subvolume of the CT-based GTV of the primary tumor without significant increase in total dose to the critical organs such as lungs, spinal cord and heart.

  13. Optical-CT imaging of complex 3D dose distributions

    NASA Astrophysics Data System (ADS)

    Oldham, Mark; Kim, Leonard; Hugo, Geoffrey

    2005-04-01

    The limitations of conventional dosimeters restrict the comprehensiveness of verification that can be performed for advanced radiation treatments presenting an immediate and substantial problem for clinics attempting to implement these techniques. In essence, the rapid advances in the technology of radiation delivery have not been paralleled by corresponding advances in the ability to verify these treatments. Optical-CT gel-dosimetry is a relatively new technique with potential to address this imbalance by providing high resolution 3D dose maps in polymer and radiochromic gel dosimeters. We have constructed a 1st generation optical-CT scanner capable of high resolution 3D dosimetry and applied it to a number of simple and increasingly complex dose distributions including intensity-modulated-radiation-therapy (IMRT). Prior to application to IMRT, the robustness of optical-CT gel dosimetry was investigated on geometry and variable attenuation phantoms. Physical techniques and image processing methods were developed to minimize deleterious effects of refraction, reflection, and scattered laser light. Here we present results of investigations into achieving accurate high-resolution 3D dosimetry with optical-CT, and show clinical examples of 3D IMRT dosimetry verification. In conclusion, optical-CT gel dosimetry can provide high resolution 3D dose maps that greatly facilitate comprehensive verification of complex 3D radiation treatments. Good agreement was observed at high dose levels (>50%) between planned and measured dose distributions. Some systematic discrepancies were observed however (rms discrepancy 3% at high dose levels) indicating further work is required to eliminate confounding factors presently compromising the accuracy of optical-CT 3D gel-dosimetry.

  14. SU-C-12A-05: Radiation Dose in High-Pitch Pediatric Cardiac CTA: Correlation Between Lung Dose and CTDIvol, DLP, and Size Specific Dose Estimates (SSDE)

    SciTech Connect

    Wang, J; Kino, A; Newman, B; Chan, F

    2014-06-01

    Purpose: To investigate the radiation dose for pediatric high pitch cardiac CTA Methods: A total of 14 cases were included in this study, with mean age of 6.2 years (ranges from 2 months to 15 years). Cardiac CTA was performed using a dual-source CT system (Definition Flash, Siemens). Tube voltage (70, 80 and 100kV) was chosen based on patient weight. All patients were scanned using a high-pitch spiral mode (pitch ranges from 2.5 to 3) with tube current modulation technique (CareDose4D, Siemens). For each case, the three dimensional dose distributions were calculated using a Monte Carlo software package (IMPACT-MC, CT Image GmbH). Scanning parameters of each exam, including tube voltage, tube current, beamshaping filters, beam collimation, were defined in the Monte Carlo calculation. Tube current profile along projection angles was obtained from projection data of each tube, which included data within the over-scanning range along z direction. The volume of lungs was segmented out with CT images (3DSlicer). Lung doses of all patients were calculated and compared with CTDIvol, DLP, and SSDE. Results: The average (range) of CTDIvol, DLP and SSDE of all patients was 1.19 mGy (0.58 to 3.12mGy), 31.54 mGy*cm (12.56 to 99 mGy*cm), 2.26 mGy (1.19 to 6.24 mGy), respectively. Radiation dose to the lungs ranged from 0.83 to 4.18 mGy. Lung doses correlated with CTDIvol, DLP and SSDE with correlation coefficients(k) at 0.98, 0.93, and 0.99. However, for the cases with CTDIvol less than 1mGy, only SSDE preserved a strong correlation with lung doses (k=0.83), while much weaker correlations were found for CTDIvol (k=0.29) and DLP (k=-0.47). Conclusion: Lung doses to pediatric patients during Cardiac CTA were estimated. SSDE showed the most robust correlation with lung doses in contrast to CTDIvol and DLP.

  15. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT

    PubMed Central

    Halliburton, Sandra S.; Abbara, Suhny; Chen, Marcus Y.; Gentry, Ralph; Mahesh, Mahadevappa; Raff, Gilbert L.; Shaw, Leslee J.; Hausleiter, Jörg

    2012-01-01

    Over the last few years, computed tomography (CT) has developed into a standard clinical test for a variety of cardiovascular conditions. The emergence of cardiovascular CT during a period of dramatic increase in radiation exposure to the population from medical procedures and heightened concern about the subsequent potential cancer risk has led to intense scrutiny of the radiation burden of this new technique. This has hastened the development and implementation of dose reduction tools and prompted closer monitoring of patient dose. In an effort to aid the cardiovascular CT community in incorporating patient-centered radiation dose optimization and monitoring strategies into standard practice, the Society of Cardiovascular Computed Tomography has produced a guideline document to review available data and provide recommendations regarding interpretation of radiation dose indices and predictors of risk, appropriate use of scanner acquisition modes and settings, development of algorithms for dose optimization, and establishment of procedures for dose monitoring. PMID:21723512

  16. CT effective dose per dose length product using ICRP 103 weighting factors

    SciTech Connect

    Huda, Walter; Magill, Dennise; He Wenjun

    2011-03-15

    Purpose: To generate effective dose per unit dose length product (E/DLP) conversion factors incorporating ICRP Publication 103 tissue weighting factors. Methods: Effective doses for CT examinations were obtained using the IMPACT Dosimetry Calculator using all 23 dose data sets that are offered by this spreadsheet. CT examinations were simulated for scans performed along the patient long axis for each dosimetry data set using a 4 cm beam width ranging from the upper thighs to top of the head. Five basic body regions (head, neck, chest, abdomen, and pelvis), as well as combinations of the regions (head/neck, chest/abdomen, abdomen/pelvis, and chest/abdomen/pelvis) and whole body CT scans were investigated. Correction factors were generated that can be applied to convert E/DLP conversion factors based on ICRP 60 data to conversion factors that are valid for ICRP 103 data (i.e., E{sub 103}/E{sub 60}). Results: Use of ICRP 103 weighting factors increase effective doses for head scans by {approx}11%, for chest scans by {approx}20%, and decrease effective doses for pelvis scans by {approx}25%. Current E/DLP conversion factors are estimated to be 2.4 {mu}Sv/mGy cm for head CT examinations and range between 14 and 20 {mu}Sv/mGy cm for body CT examinations. Conclusions: Factors that enable patient CT doses to be adjusted to account for ICRP 103 tissue weighting factors are provided, which result in E/DLP factors that were increased in head and chest CT, reduced in pelvis CT, and showed no marked change in neck and abdomen CT.

  17. SU-E-J-260: Dose Recomputation Versus Dose Deformation for Stereotactic Body Radiation Therapy in Lung Tumors: A Dosimetric Study

    SciTech Connect

    Ma, M; Flynn, R; Xia, J; Bayouth, J

    2014-06-01

    Purpose: To evaluate the dosimetric accuracy between recomputed dose and deformed dose for stereotactic body radiation therapy in lung tumors. Methods: Two non-small-cell lung cancer patients were analyzed in this study, both of whom underwent 4D-CT and breath-hold CT imaging. Treatment planning was performed using the breath-hold CT images for the dose calculation and the 4D-CT images for determining internal target volumes. 4D-CT images were reconstructed with ten breathing amplitude for each patient. Maximum tumor motion was 13 mm for patient 1, and 7 mm for patient 2. The delivered dose was calculated using the 4D-CT images and using the same planning parameters as for the breath-hold CT. The deformed dose was computed by deforming the planning dose using the deformable image registration between each binned CT and the breath-hold CT. Results: For patient 1, the difference between recomputed dose and deformed mean lung dose (MLD) ranged from 11.3%(0.5 Gy) to 1.1%(0.06 Gy), mean tumor dose (MTD) ranged from 0.4%(0.19 Gy) to −1.3%(−0.6 Gy), lung V20 ranged from +0.74% to −0.33%. The differences in all three dosimetric criteria remain relatively invariant to target motion. For patient 2, V20 ranged from +0.42% to −2.41%, MLD ranged from −0.2%(−0.05 Gy) to −10.4%(−2.12 Gy), and MTD ranged from −0.5%(−0.31 Gy) to −5.3%(−3.24 Gy). The difference between recomputed dose and deformed dose shows strong correlation with tumor motion in all three dosimetric measurements. Conclusion: The correlation between dosimetric criteria and tumor motion is patient-specific, depending on the tumor locations, motion pattern, and deformable image registration accuracy. Deformed dose can be a good approximation for recalculated dose when tumor motion is small. This research is supported by Siemens Medical Solutions USA, Inc and Iowa Center for Research By Undergraduates.

  18. Effects of Respiration-Induced Density Variations on Dose Distributions in Radiotherapy of Lung Cancer

    SciTech Connect

    Mexner, Vanessa; Wolthaus, Jochem W.H.; Herk, Marcel van; Damen, Eugene M.F.; Sonke, Jan-Jakob

    2009-07-15

    Purpose: To determine the effect of respiration-induced density variations on the estimated dose delivered to moving structures and, consequently, to evaluate the necessity of using full four-dimensional (4D) treatment plan optimization. Methods and Materials: In 10 patients with large tumor motion (median, 1.9 cm; range, 1.1-3.6 cm), the clinical treatment plan, designed using the mid-ventilation ([MidV]; i.e., the 4D-CT frame closest to the time-averaged mean position) CT scan, was recalculated on all 4D-CT frames. The cumulative dose was determined by transforming the doses in all breathing phases to the MidV geometry using deformable registration and then averaging the results. To determine the effect of density variations, this cumulative dose was compared with the accumulated dose after similarly deforming the planned (3D) MidV-dose in each respiratory phase using the same transformation (i.e., 'blurring the dose'). Results: The accumulated tumor doses, including and excluding density variations, were almost identical. Relative differences in the minimum gross tumor volume (GTV) dose were less than 2% for all patients. The relative differences were even smaller in the mean lung dose and the V20 (<0.5% and 1%, respectively). Conclusions: The effect of respiration-induced density variations on the dose accumulated over the respiratory cycle was very small, even in the presence of considerable respiratory motion. A full 4D-dose calculation for treatment planning that takes into account such density variations is therefore not required. Planning using the MidV-CT derived from 4D-CT with an appropriate margin for geometric uncertainties is an accurate and safe method to account for respiration-induced anatomy variations.

  19. Detecting airway remodeling in COPD and emphysema using low-dose CT imaging

    NASA Astrophysics Data System (ADS)

    Rudyanto, R.; Ceresa, M.; Muñoz-Barrutia, A.; Ortiz-de-Solorzano, C.

    2012-03-01

    In this study, we quantitatively characterize lung airway remodeling caused by smoking-related emphysema and Chronic Obstructive Pulmonary Disease (COPD), in low-dose CT scans. To that end, we established three groups of individuals: subjects with COPD (n=35), subjects with emphysema (n=38) and healthy smokers (n=28). All individuals underwent a low-dose CT scan, and the images were analyzed as described next. First the lung airways were segmented using a fast marching method and labeled according to its generation. Along each airway segment, cross-section images were resampled orthogonal to the airway axis. Next 128 rays were cast from the center of the airway lumen in each crosssection slice. Finally, we used an integral-based method, to measure lumen radius, wall thickness, mean wall percentage and mean peak wall attenuation on every cast ray. Our analysis shows that both the mean global wall thickness and the lumen radius of the airways of both COPD and emphysema groups were significantly different from those of the healthy group. In addition, the wall thickness change starts at the 3rd airway generation in the COPD patients compared with emphysema patients, who display the first significant changes starting in the 2nd generation. In conclusion, it is shown that airway remodeling happens in individuals suffering from either COPD or emphysema, with some local difference between both groups, and that we are able to detect and accurately quantify this process using images of low-dose CT scans.

  20. The effect of CT technical factors on quantification of lung fissure integrity

    NASA Astrophysics Data System (ADS)

    Chong, D.; Brown, M. S.; Ochs, R.; Abtin, F.; Brown, M.; Ordookhani, A.; Shaw, G.; Kim, H. J.; Gjertson, D.; Goldin, J. G.

    2009-02-01

    A new emphysema treatment uses endobronchial valves to perform lobar volume reduction. The degree of fissure completeness may predict treatment efficacy. This study investigated the behavior of a semiautomated algorithm for quantifying lung fissure integrity in CT with respect to reconstruction kernel and dose. Raw CT data was obtained for six asymptomatic patients from a high-risk population for lung cancer. The patients were scanned on either a Siemens Sensation 16 or 64, using a low-dose protocol of 120 kVp, 25 mAs. Images were reconstructed using kernels ranging from smooth to sharp (B10f, B30f, B50f, B70f). Research software was used to simulate an even lower-dose acquisition of 15 mAs, and images were generated at the same kernels resulting in 8 series per patient. The left major fissure was manually contoured axially at regular intervals, yielding 37 contours across all patients. These contours were read into an image analysis and pattern classification system which computed a Fissure Integrity Score (FIS) for each kernel and dose. FIS values were analyzed using a mixed-effects model with kernel and dose as fixed effects and patient as random effect to test for difference due to kernel and dose. Analysis revealed no difference in FIS between the smooth kernels (B10f, B30f) nor between sharp kernels (B50f, B70f), but there was a significant difference between the sharp and smooth groups (p = 0.020). There was no significant difference in FIS between the two low-dose reconstructions (p = 0.882). Using a cutoff of 90%, the number of incomplete fissures increased from 5 to 10 when the imaging protocol changed from B50f to B30f. Reconstruction kernel has a significant effect on quantification of fissure integrity in CT. This has potential implications when selecting patients for endobronchial valve therapy.

  1. SU-E-J-200: A Dosimetric Analysis of 3D Versus 4D Image-Based Dose Calculation for Stereotactic Body Radiation Therapy in Lung Tumors

    SciTech Connect

    Ma, M; Rouabhi, O; Flynn, R; Xia, J; Bayouth, J

    2014-06-01

    Purpose: To evaluate the dosimetric difference between 3D and 4Dweighted dose calculation using patient specific respiratory trace and deformable image registration for stereotactic body radiation therapy in lung tumors. Methods: Two dose calculation techniques, 3D and 4D-weighed dose calculation, were used for dosimetric comparison for 9 lung cancer patients. The magnitude of the tumor motion varied from 3 mm to 23 mm. Breath-hold exhale CT was used for 3D dose calculation with ITV generated from the motion observed from 4D-CT. For 4D-weighted calculation, dose of each binned CT image from the ten breathing amplitudes was first recomputed using the same planning parameters as those used in the 3D calculation. The dose distribution of each binned CT was mapped to the breath-hold CT using deformable image registration. The 4D-weighted dose was computed by summing the deformed doses with the temporal probabilities calculated from their corresponding respiratory traces. Dosimetric evaluation criteria includes lung V20, mean lung dose, and mean tumor dose. Results: Comparing with 3D calculation, lung V20, mean lung dose, and mean tumor dose using 4D-weighted dose calculation were changed by −0.67% ± 2.13%, −4.11% ± 6.94% (−0.36 Gy ± 0.87 Gy), −1.16% ± 1.36%(−0.73 Gy ± 0.85 Gy) accordingly. Conclusion: This work demonstrates that conventional 3D dose calculation method may overestimate the lung V20, MLD, and MTD. The absolute difference between 3D and 4D-weighted dose calculation in lung tumor may not be clinically significant. This research is supported by Siemens Medical Solutions USA, Inc and Iowa Center for Research By Undergraduates.

  2. PET/CT-guided Interventions: Personnel Radiation Dose

    SciTech Connect

    Ryan, E. Ronan Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P.; Hsu, Meier; Quinn, Brian; Dauer, Lawrence T.; Solomon, Stephen B.

    2013-08-01

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0-0.13) mSv for the primary operator, 0.01 (range 0-0.05) mSv for the nurse anesthetist, and 0.02 (range 0-0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0-0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient.

  3. Lung cancer screening beyond low-dose computed tomography: the role of novel biomarkers.

    PubMed

    Hasan, Naveed; Kumar, Rohit; Kavuru, Mani S

    2014-10-01

    Lung cancer is the most common and lethal malignancy in the world. The landmark National lung screening trial (NLST) showed a 20% relative reduction in mortality in high-risk individuals with screening low-dose computed tomography. However, the poor specificity and low prevalence of lung cancer in the NLST provide major limitations to its widespread use. Furthermore, a lung nodule on CT scan requires a nuanced and individualized approach towards management. In this regard, advances in high through-put technology (molecular diagnostics, multi-gene chips, proteomics, and bronchoscopic techniques) have led to discovery of lung cancer biomarkers that have shown potential to complement the current screening standards. Early detection of lung cancer can be achieved by analysis of biomarkers from tissue samples within the respiratory tract such as sputum, saliva, nasal/bronchial airway epithelial cells and exhaled breath condensate or through peripheral biofluids such as blood, serum and urine. Autofluorescence bronchoscopy has been employed in research setting to identify pre-invasive lesions not identified on CT scan. Although these modalities are not yet commercially available in clinic setting, they will be available in the near future and clinicians who care for patients with lung cancer should be aware. In this review, we present up-to-date state of biomarker development, discuss their clinical relevance and predict their future role in lung cancer management.

  4. Validation of CT dose-reduction simulation

    SciTech Connect

    Massoumzadeh, Parinaz; Don, Steven; Hildebolt, Charles F.; Bae, Kyongtae T.; Whiting, Bruce R.

    2009-01-15

    The objective of this research was to develop and validate a custom computed tomography dose-reduction simulation technique for producing images that have an appearance consistent with the same scan performed at a lower mAs (with fixed kVp, rotation time, and collimation). Synthetic noise is added to projection (sinogram) data, incorporating a stochastic noise model that includes energy-integrating detectors, tube-current modulation, bowtie beam filtering, and electronic system noise. Experimental methods were developed to determine the parameters required for each component of the noise model. As a validation, the outputs of the simulations were compared to measurements with cadavers in the image domain and with phantoms in both the sinogram and image domain, using an unbiased root-mean-square relative error metric to quantify agreement in noise processes. Four-alternative forced-choice (4AFC) observer studies were conducted to confirm the realistic appearance of simulated noise, and the effects of various system model components on visual noise were studied. The ''just noticeable difference (JND)'' in noise levels was analyzed to determine the sensitivity of observers to changes in noise level. Individual detector measurements were shown to be normally distributed (p>0.54), justifying the use of a Gaussian random noise generator for simulations. Phantom tests showed the ability to match original and simulated noise variance in the sinogram domain to within 5.6%{+-}1.6% (standard deviation), which was then propagated into the image domain with errors less than 4.1%{+-}1.6%. Cadaver measurements indicated that image noise was matched to within 2.6%{+-}2.0%. More importantly, the 4AFC observer studies indicated that the simulated images were realistic, i.e., no detectable difference between simulated and original images (p=0.86) was observed. JND studies indicated that observers' sensitivity to change in noise levels corresponded to a 25% difference in dose, which

  5. Estimating radiation dose to organs of patients undergoing conventional and novel multidetector CT exams using Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Angel, Erin

    Advances in Computed Tomography (CT) technology have led to an increase in the modality's diagnostic capabilities and therefore its utilization, which has in turn led to an increase in radiation exposure to the patient population. As a result, CT imaging currently constitutes approximately half of the collective exposure to ionizing radiation from medical procedures. In order to understand the radiation risk, it is necessary to estimate the radiation doses absorbed by patients undergoing CT imaging. The most widely accepted risk models are based on radiosensitive organ dose as opposed to whole body dose. In this research, radiosensitive organ dose was estimated using Monte Carlo based simulations incorporating detailed multidetector CT (MDCT) scanner models, specific scan protocols, and using patient models based on accurate patient anatomy and representing a range of patient sizes. Organ dose estimates were estimated for clinical MDCT exam protocols which pose a specific concern for radiosensitive organs or regions. These dose estimates include estimation of fetal dose for pregnant patients undergoing abdomen pelvis CT exams or undergoing exams to diagnose pulmonary embolism and venous thromboembolism. Breast and lung dose were estimated for patients undergoing coronary CTA imaging, conventional fixed tube current chest CT, and conventional tube current modulated (TCM) chest CT exams. The correlation of organ dose with patient size was quantified for pregnant patients undergoing abdomen/pelvis exams and for all breast and lung dose estimates presented. Novel dose reduction techniques were developed that incorporate organ location and are specifically designed to reduce close to radiosensitive organs during CT acquisition. A generalizable model was created for simulating conventional and novel attenuation-based TCM algorithms which can be used in simulations estimating organ dose for any patient model. The generalizable model is a significant contribution of this

  6. Dose calculation using megavoltage cone-beam CT

    SciTech Connect

    Morin, Olivier . E-mail: Morin@radonc17.ucsf.edu; Chen, Josephine; Aubin, Michele; Gillis, Amy; Aubry, Jean-Francois; Bose, Supratik; Chen Hong; Descovich, Martina; Xia Ping; Pouliot, Jean

    2007-03-15

    Purpose: To demonstrate the feasibility of performing dose calculation on megavoltage cone-beam CT (MVCBCT) of head-and-neck patients in order to track the dosimetric errors produced by anatomic changes. Methods and Materials: A simple geometric model was developed using a head-size water cylinder to correct an observed cupping artifact occurring with MVCBCT. The uniformity-corrected MVCBCT was calibrated for physical density. Beam arrangements and weights from the initial treatment plans defined using the conventional CT were applied to the MVCBCT image, and the dose distribution was recalculated. The dosimetric inaccuracies caused by the cupping artifact were evaluated on the water phantom images. An ideal test patient with no observable anatomic changes and a patient imaged with both CT and MVCBCT before and after considerable weight loss were used to clinically validate MVCBCT for dose calculation and to determine the dosimetric impact of large anatomic changes. Results: The nonuniformity of a head-size water phantom ({approx}30%) causes a dosimetric error of less than 5%. The uniformity correction method developed greatly reduces the cupping artifact, resulting in dosimetric inaccuracies of less than 1%. For the clinical cases, the agreement between the dose distributions calculated using MVCBCT and CT was better than 3% and 3 mm where all tissue was encompassed within the MVCBCT. Dose-volume histograms from the dose calculations on CT and MVCBCT were in excellent agreement. Conclusion: MVCBCT can be used to estimate the dosimetric impact of changing anatomy on several structures in the head-and-neck region.

  7. Optimal imaging protocols for lung cancer staging: CT, PET, MR imaging, and the role of imaging.

    PubMed

    Paul, Narinder S; Ley, Sebastian; Metser, Ur

    2012-09-01

    Chest radiography, the most commonly performed imaging technique for the detection of lung disease, is limited in accurately detecting early lung cancer. The main imaging modality for the staging of lung cancer is computed tomography (CT), supplemented by positron emission tomography (PET), usually as a hybrid technique in conjunction with CT (PET/CT). Magnetic resonance (MR) imaging is a useful diagnostic tool for specific indications and has the advantage of not using ionizing radiation. This article discusses the optimal imaging protocols for lung cancer staging using CT, PET (PET/CT), and MR imaging, and the role of imaging in patient management.

  8. CT of chronic infiltrative lung disease: Prevalence of mediastinal lymphadenopathy

    SciTech Connect

    Niimi, Hiroshi; Kang, Eun-Young; Kwong, S.

    1996-03-01

    Our goal was to determine the prevalence of mediastinal lymph node enlargement at CT in patients with diffuse infiltrative lung disease. The study was retrospective and included 175 consecutive patients with diffuse infiltrative lung diseases. Diagnoses included idiopathic pulmonary fibrosis (IPF) (n = 61), usual interstitial pneumonia associated with collagen vascular disease (CVD) (n = 20), idiopathic bronchiolitis obliterans organizing pneumonia (BOOP) (n = 22), extrinsic allergic alveolitis (EAA) (n = 17), and sarcoidosis (n = 55). Fifty-eight age-matched patients with CT of the chest performed for unrelated conditions served as controls. The presence, number, and sites of enlarged nodes (short axis {ge}10 mm in diameter) were recorded. Enlarged mediastinal nodes were present in 118 of 175 patients (67%) with infiltrative lung disease and 3 of 58 controls (5%) (p < 0.001). The prevalence of enlarged nodes was 84% (46 of 55) in sarcoidosis, 67% (41 of 61) in IPF, 70% (14 of 20) in CVD, 53% (9 of 17) in EAA, and 36% (8 of 22) in BOOP. The mean number of enlarged nodes was higher in sarcoidosis (mean 3.2) than in the other infiltrative diseases (mean 1.2) (p < 0.001). Enlarged nodes were most commonly present in station 10R, followed by 7, 4R, and 5. Patients with infiltrative lung disease frequently have enlarged mediastinal lymph nodes. However, in diseases other than sarcoid, usually only one or two nodes are enlarged and their maximal short axis diameter is <15 mm. 11 refs., 2 figs., 1 tab.

  9. Ultra Low Dose CT Pulmonary Angiography with Iterative Reconstruction

    PubMed Central

    Koehler, Thomas; Fingerle, Alexander A.; Brendel, Bernhard; Richter, Vivien; Rasper, Michael; Rummeny, Ernst J.; Noël, Peter B.; Münzel, Daniela

    2016-01-01

    Objective Evaluation of a new iterative reconstruction algorithm (IMR) for detection/rule-out of pulmonary embolism (PE) in ultra-low dose computed tomography pulmonary angiography (CTPA). Methods Lower dose CT data sets were simulated based on CTPA examinations of 16 patients with pulmonary embolism (PE) with dose levels (DL) of 50%, 25%, 12.5%, 6.3% or 3.1% of the original tube current setting. Original CT data sets and simulated low-dose data sets were reconstructed with three reconstruction algorithms: the standard reconstruction algorithm “filtered back projection” (FBP), the first generation iterative reconstruction algorithm iDose and the next generation iterative reconstruction algorithm “Iterative Model Reconstruction” (IMR). In total, 288 CTPA data sets (16 patients, 6 tube current levels, 3 different algorithms) were evaluated by two blinded radiologists regarding image quality, diagnostic confidence, detectability of PE and contrast-to-noise ratio (CNR). Results iDose and IMR showed better detectability of PE than FBP. With IMR, sensitivity for detection of PE was 100% down to a dose level of 12.5%. iDose and IMR showed superiority to FBP regarding all characteristics of subjective (diagnostic confidence in detection of PE, image quality, image noise, artefacts) and objective image quality. The minimum DL providing acceptable diagnostic performance was 12.5% (= 0.45 mSv) for IMR, 25% (= 0.89 mSv) for iDose and 100% (= 3.57 mSv) for FBP. CNR was significantly (p < 0.001) improved by IMR compared to FBP and iDose at all dose levels. Conclusion By using IMR for detection of PE, dose reduction for CTPA of up to 75% is possible while maintaining full diagnostic confidence. This would result in a mean effective dose of approximately 0.9 mSv for CTPA. PMID:27611830

  10. Methods of in-vivo mouse lung micro-CT

    NASA Astrophysics Data System (ADS)

    Recheis, Wolfgang A.; Nixon, Earl; Thiesse, Jacqueline; McLennan, Geoffrey; Ross, Alan; Hoffman, Eric

    2005-04-01

    Micro-CT will have a profound influence on the accumulation of anatomical and physiological phenotypic changes in natural and transgenetic mouse models. Longitudinal studies will be greatly facilitated, allowing for a more complete and accurate description of events if in-vivo studies are accomplished. The purpose of the ongoing project is to establish a feasible and reproducible setup for in-vivo mouse lung micro-computed tomography (μCT). We seek to use in-vivo respiratory-gated μCT to follow mouse models of lung disease with subsequent recovery of the mouse. Methodologies for optimizing scanning parameters and gating for the in-vivo mouse lung are presented. A Scireq flexiVent ventilated the gas-anesthetized mice at 60 breaths/minute, 30 cm H20 PEEP, 30 ml/kg tidal volume and provided a respiratory signal to gate a Skyscan 1076 μCT. Physiologic monitoring allowed the control of vital functions and quality of anesthesia, e.g. via ECG monitoring. In contrary to longer exposure times with ex-vivo scans, scan times for in-vivo were reduced using 35μm pixel size, 158ms exposure time and 18μm pixel size, 316ms exposure time to reduce motion artifacts. Gating via spontaneous breathing was also tested. Optimal contrast resolution was achieved at 50kVp, 200μA, applying an aluminum filter (0.5mm). There were minimal non-cardiac related motion artifacts. Both 35μm and 1μm voxel size images were suitable for evaluation of the airway lumen and parenchymal density. Total scan times were 30 and 65 minutes respectively. The mice recovered following scanning protocols. In-vivo lung scanning with recovery of the mouse delivered reasonable image quality for longitudinal studies, e.g. mouse asthma models. After examining 10 mice, we conclude μCT is a feasible tool evaluating mouse models of lung pathology in longitudinal studies with increasing anatomic detail available for evaluation as one moves from in-vivo to ex-vivo studies. Further developments include automated

  11. SU-E-T-117: Dose to Organs Outside of CT Scan Range- Monte Carlo and Hybrid Phantom Approach

    SciTech Connect

    Pelletier, C; Jung, J; Lee, C; Kim, J; Lee, C

    2014-06-01

    Purpose: Epidemiological study of second cancer risk for cancer survivors often requires the dose to normal tissues located outside the anatomy covered by radiological imaging, which is usually limited to tumor and organs at risk. We have investigated the feasibility of using whole body computational human phantoms for estimating out-of-field organ doses for patients treated by Intensity Modulated Radiation Therapy (IMRT). Methods: Identical 7-field IMRT prostate plans were performed using X-ray Voxel Monte Carlo (XVMC), a radiotherapy-specific Monte Carlo transport code, on the computed tomography (CT) images of the torso of an adult male patient (175 cm height, 66 kg weight) and an adult male hybrid computational phantom with the equivalent body size. Dose to the liver, right lung, and left lung were calculated and compared. Results: Considerable differences are seen between the doses calculated by XVMC for the patient CT and the hybrid phantom. One major contributing factor is the treatment method, deep inspiration breath hold (DIBH), used for this patient. This leads to significant differences in the organ position relative to the treatment isocenter. The transverse distances from the treatment isocenter to the inferior border of the liver, left lung, and right lung are 19.5cm, 29.5cm, and 30.0cm, respectively for the patient CT, compared with 24.3cm, 36.6cm, and 39.1cm, respectively, for the hybrid phantom. When corrected for the distance, the mean doses calculated using the hybrid phantom are within 28% of those calculated using the patient CT. Conclusion: This study showed that mean dose to the organs located in the missing CT coverage can be reconstructed by using whole body computational human phantoms within reasonable dosimetric uncertainty, however appropriate corrections may be necessary if the patient is treated with a technique that will significantly deform the size or location of the organs relative to the hybrid phantom.

  12. Automated segmentation of cardiac visceral fat in low-dose non-contrast chest CT images

    NASA Astrophysics Data System (ADS)

    Xie, Yiting; Liang, Mingzhu; Yankelevitz, David F.; Henschke, Claudia I.; Reeves, Anthony P.

    2015-03-01

    Cardiac visceral fat was segmented from low-dose non-contrast chest CT images using a fully automated method. Cardiac visceral fat is defined as the fatty tissues surrounding the heart region, enclosed by the lungs and posterior to the sternum. It is measured by constraining the heart region with an Anatomy Label Map that contains robust segmentations of the lungs and other major organs and estimating the fatty tissue within this region. The algorithm was evaluated on 124 low-dose and 223 standard-dose non-contrast chest CT scans from two public datasets. Based on visual inspection, 343 cases had good cardiac visceral fat segmentation. For quantitative evaluation, manual markings of cardiac visceral fat regions were made in 3 image slices for 45 low-dose scans and the Dice similarity coefficient (DSC) was computed. The automated algorithm achieved an average DSC of 0.93. Cardiac visceral fat volume (CVFV), heart region volume (HRV) and their ratio were computed for each case. The correlation between cardiac visceral fat measurement and coronary artery and aortic calcification was also evaluated. Results indicated the automated algorithm for measuring cardiac visceral fat volume may be an alternative method to the traditional manual assessment of thoracic region fat content in the assessment of cardiovascular disease risk.

  13. Lung vessel segmentation in CT images using graph-cuts

    NASA Astrophysics Data System (ADS)

    Zhai, Zhiwei; Staring, Marius; Stoel, Berend C.

    2016-03-01

    Accurate lung vessel segmentation is an important operation for lung CT analysis. Filters that are based on analyzing the eigenvalues of the Hessian matrix are popular for pulmonary vessel enhancement. However, due to their low response at vessel bifurcations and vessel boundaries, extracting lung vessels by thresholding the vesselness is not sufficiently accurate. Some methods turn to graph-cuts for more accurate segmentation, as it incorporates neighbourhood information. In this work, we propose a new graph-cuts cost function combining appearance and shape, where CT intensity represents appearance and vesselness from a Hessian-based filter represents shape. Due to the amount of voxels in high resolution CT scans, the memory requirement and time consumption for building a graph structure is very high. In order to make the graph representation computationally tractable, those voxels that are considered clearly background are removed from the graph nodes, using a threshold on the vesselness map. The graph structure is then established based on the remaining voxel nodes, source/sink nodes and the neighbourhood relationship of the remaining voxels. Vessels are segmented by minimizing the energy cost function with the graph-cuts optimization framework. We optimized the parameters used in the graph-cuts cost function and evaluated the proposed method with two manually labeled sub-volumes. For independent evaluation, we used 20 CT scans of the VESSEL12 challenge. The evaluation results of the sub-volume data show that the proposed method produced a more accurate vessel segmentation compared to the previous methods, with F1 score 0.76 and 0.69. In the VESSEL12 data-set, our method obtained a competitive performance with an area under the ROC curve of 0.975, especially among the binary submissions.

  14. Adaptively Tuned Iterative Low Dose CT Image Denoising.

    PubMed

    Hashemi, SayedMasoud; Paul, Narinder S; Beheshti, Soosan; Cobbold, Richard S C

    2015-01-01

    Improving image quality is a critical objective in low dose computed tomography (CT) imaging and is the primary focus of CT image denoising. State-of-the-art CT denoising algorithms are mainly based on iterative minimization of an objective function, in which the performance is controlled by regularization parameters. To achieve the best results, these should be chosen carefully. However, the parameter selection is typically performed in an ad hoc manner, which can cause the algorithms to converge slowly or become trapped in a local minimum. To overcome these issues a noise confidence region evaluation (NCRE) method is used, which evaluates the denoising residuals iteratively and compares their statistics with those produced by additive noise. It then updates the parameters at the end of each iteration to achieve a better match to the noise statistics. By combining NCRE with the fundamentals of block matching and 3D filtering (BM3D) approach, a new iterative CT image denoising method is proposed. It is shown that this new denoising method improves the BM3D performance in terms of both the mean square error and a structural similarity index. Moreover, simulations and patient results show that this method preserves the clinically important details of low dose CT images together with a substantial noise reduction. PMID:26089972

  15. Adaptively Tuned Iterative Low Dose CT Image Denoising

    PubMed Central

    Hashemi, SayedMasoud; Paul, Narinder S.; Beheshti, Soosan; Cobbold, Richard S. C.

    2015-01-01

    Improving image quality is a critical objective in low dose computed tomography (CT) imaging and is the primary focus of CT image denoising. State-of-the-art CT denoising algorithms are mainly based on iterative minimization of an objective function, in which the performance is controlled by regularization parameters. To achieve the best results, these should be chosen carefully. However, the parameter selection is typically performed in an ad hoc manner, which can cause the algorithms to converge slowly or become trapped in a local minimum. To overcome these issues a noise confidence region evaluation (NCRE) method is used, which evaluates the denoising residuals iteratively and compares their statistics with those produced by additive noise. It then updates the parameters at the end of each iteration to achieve a better match to the noise statistics. By combining NCRE with the fundamentals of block matching and 3D filtering (BM3D) approach, a new iterative CT image denoising method is proposed. It is shown that this new denoising method improves the BM3D performance in terms of both the mean square error and a structural similarity index. Moreover, simulations and patient results show that this method preserves the clinically important details of low dose CT images together with a substantial noise reduction. PMID:26089972

  16. Lung imaging in rodents using dual energy micro-CT

    NASA Astrophysics Data System (ADS)

    Badea, C. T.; Guo, X.; Clark, D.; Johnston, S. M.; Marshall, C.; Piantadosi, C.

    2012-03-01

    Dual energy CT imaging is expected to play a major role in the diagnostic arena as it provides material decomposition on an elemental basis. The purpose of this work is to investigate the use of dual energy micro-CT for the estimation of vascular, tissue, and air fractions in rodent lungs using a post-reconstruction three-material decomposition method. We have tested our method using both simulations and experimental work. Using simulations, we have estimated the accuracy limits of the decomposition for realistic micro-CT noise levels. Next, we performed experiments involving ex vivo lung imaging in which intact lungs were carefully removed from the thorax, were injected with an iodine-based contrast agent and inflated with air at different volume levels. Finally, we performed in vivo imaging studies in (n=5) C57BL/6 mice using fast prospective respiratory gating in endinspiration and end-expiration for three different levels of positive end-expiratory pressure (PEEP). Prior to imaging, mice were injected with a liposomal blood pool contrast agent. The mean accuracy values were for Air (95.5%), Blood (96%), and Tissue (92.4%). The absolute accuracy in determining all fraction materials was 94.6%. The minimum difference that we could detect in material fractions was 15%. As expected, an increase in PEEP levels for the living mouse resulted in statistically significant increases in air fractions at end-expiration, but no significant changes in end-inspiration. Our method has applicability in preclinical pulmonary studies where various physiological changes can occur as a result of genetic changes, lung disease, or drug effects.

  17. Estimation of Radiation Dose in CT Based on Projection Data.

    PubMed

    Tian, Xiaoyu; Yin, Zhye; De Man, Bruno; Samei, Ehsan

    2016-10-01

    Managing and optimizing radiation dose has become a core problem for the CT community. As a fundamental step for dose optimization, accurate and computationally efficient dose estimates are crucial. The purpose of this study was to devise a computationally efficient projection-based dose metric. The absorbed energy and object mass were individually modeled using the projection data. The absorbed energy was estimated using the difference between intensity of the primary photon and the exit photon. The mass was estimated using the volume under the attenuation profile. The feasibility of the approach was evaluated across phantoms with a broad size range, various kVp settings, and two bowtie filters, using a simulation tool, the Computer Assisted Tomography SIMulator (CATSIM) software. The accuracy of projection-based dose estimation was validated against Monte Carlo (MC) simulations. The relationship between projection-based dose metric and MC dose estimate was evaluated using regression models. The projection-based dose metric showed a strong correlation with Monte Carlo dose estimates (R (2) > 0.94). The prediction errors for the projection-based dose metric were all below 15 %. This study demonstrated the feasibility of computationally efficient dose estimation requiring only the projection data.

  18. Investigation of lung nodule detectability in low-dose 320-slice computed tomography

    SciTech Connect

    Silverman, J. D.; Paul, N. S.; Siewerdsen, J. H.

    2009-05-15

    Low-dose imaging protocols in chest CT are important in the screening and surveillance of suspicious and indeterminate lung nodules. Techniques that maintain nodule detectability yet permit dose reduction, particularly for large body habitus, were investigated. The objective of this study was to determine the extent to which radiation dose can be minimized while maintaining diagnostic performance through knowledgeable selection of reconstruction techniques. A 320-slice volumetric CT scanner (Aquilion ONE, Toshiba Medical Systems) was used to scan an anthropomorphic phantom at doses ranging from {approx}0.1 mGy up to that typical of low-dose CT (LDCT, {approx}5 mGy) and diagnostic CT ({approx}10 mGy). Radiation dose was measured via Farmer chamber and MOSFET dosimetry. The phantom presented simulated nodules of varying size and contrast within a heterogeneous background, and chest thickness was varied through addition of tissue-equivalent bolus about the chest. Detectability of a small solid lung nodule (3.2 mm diameter, -37 HU, typically the smallest nodule of clinical significance in screening and surveillance) was evaluated as a function of dose, patient size, reconstruction filter, and slice thickness by means of nine-alternative forced-choice (9AFC) observer tests to quantify nodule detectability. For a given reconstruction filter, nodule detectability decreased sharply below a threshold dose level due to increased image noise, especially for large body size. However, nodule detectability could be maintained at lower doses through knowledgeable selection of (smoother) reconstruction filters. For large body habitus, optimal filter selection reduced the dose required for nodule detection by up to a factor of {approx}3 (from {approx}3.3 mGy for sharp filters to {approx}1.0 mGy for the optimal filter). The results indicate that radiation dose can be reduced below the current low-dose (5 mGy) and ultralow-dose (1 mGy) levels with knowledgeable selection of

  19. Quantification of Proton Dose Calculation Accuracy in the Lung

    SciTech Connect

    Grassberger, Clemens; Daartz, Juliane; Dowdell, Stephen; Ruggieri, Thomas; Sharp, Greg; Paganetti, Harald

    2014-06-01

    Purpose: To quantify the accuracy of a clinical proton treatment planning system (TPS) as well as Monte Carlo (MC)–based dose calculation through measurements and to assess the clinical impact in a cohort of patients with tumors located in the lung. Methods and Materials: A lung phantom and ion chamber array were used to measure the dose to a plane through a tumor embedded in the lung, and to determine the distal fall-off of the proton beam. Results were compared with TPS and MC calculations. Dose distributions in 19 patients (54 fields total) were simulated using MC and compared to the TPS algorithm. Results: MC increased dose calculation accuracy in lung tissue compared with the TPS and reproduced dose measurements in the target to within ±2%. The average difference between measured and predicted dose in a plane through the center of the target was 5.6% for the TPS and 1.6% for MC. MC recalculations in patients showed a mean dose to the clinical target volume on average 3.4% lower than the TPS, exceeding 5% for small fields. For large tumors, MC also predicted consistently higher V5 and V10 to the normal lung, because of a wider lateral penumbra, which was also observed experimentally. Critical structures located distal to the target could show large deviations, although this effect was highly patient specific. Range measurements showed that MC can reduce range uncertainty by a factor of ∼2: the average (maximum) difference to the measured range was 3.9 mm (7.5 mm) for MC and 7 mm (17 mm) for the TPS in lung tissue. Conclusion: Integration of Monte Carlo dose calculation techniques into the clinic would improve treatment quality in proton therapy for lung cancer by avoiding systematic overestimation of target dose and underestimation of dose to normal lung. In addition, the ability to confidently reduce range margins would benefit all patients by potentially lowering toxicity.

  20. Fluence field optimization for noise and dose objectives in CT

    SciTech Connect

    Bartolac, Steven; Graham, Sean; Siewerdsen, Jeff; Jaffray, David

    2011-05-15

    Purpose: Selecting the appropriate imaging technique in computed tomography (CT) inherently involves balancing the tradeoff between image quality and imaging dose. Modulation of the x-ray fluence field, laterally across the beam, and independently for each projection, may potentially meet user-prescribed, regional image quality objectives, while reducing radiation to the patient. The proposed approach, called fluence field modulated CT (FFMCT), parallels the approach commonly used in intensity-modulated radiation therapy (IMRT), except ''image quality plans'' replace the ''dose plans'' of IMRT. This work studies the potential noise and dose benefits of FFMCT via objective driven optimization of fluence fields. Methods: Experiments were carried out in simulation. Image quality plans were defined by specifying signal-to-noise ratio (SNR) criteria for regions of interest (ROIs) in simulated cylindrical and oblong water phantoms, and an anthropomorphic phantom with bone, air, and water equivalent regions. X-ray fluence field patterns were generated using a simulated annealing optimization method that attempts to achieve the spatially-dependent prescribed SNR criteria in the phantoms while limiting dose (to the volume or subvolumes). The resulting SNR and dose distributions were analyzed and compared to results using a bowtie filtered fluence field. Results: Compared to using a fixed bowtie filtered fluence, FFMCT achieved superior agreement with the target image quality objectives, and resulted in integral dose reductions ranging from 39 to 52%. Prioritizing dose constraints for specific regions of interest resulted in a preferential reduction of dose to those regions with some tradeoff in SNR, particularly where the target low dose regions overlapped with regions where high SNR was prescribed. The method appeared fairly robust under increased complexity and heterogeneity of the object structure. Conclusions: These results support that FFMCT has the potential to meet

  1. An improved analytical model for CT dose simulation with a new look at the theory of CT dose

    SciTech Connect

    Dixon, Robert L.; Munley, Michael T.; Bayram, Ersin

    2005-12-15

    Gagne [Med. Phys. 16, 29-37 (1989)] has previously described a model for predicting the sensitivity and dose profiles in the slice-width (z) direction for CT scanners. The model, developed prior to the advent of multidetector CT scanners, is still widely used; however, it does not account for the effect of anode tilt on the penumbra or include the heel effect, both of which are increasingly important for the wider beams (up to 40 mm) of contemporary, multidetector scanners. Additionally, it applied only on (or near) the axis of rotation, and did not incorporate the photon energy spectrum. The improved model described herein transcends all of the aforementioned limitations of the Gagne model, including extension to the peripheral phantom axes. Comparison of simulated and measured dose data provides experimental validation of the model, including verification of the superior match to the penumbra provided by the tilted-anode model, as well as the observable effects on the cumulative dose distribution. The initial motivation for the model was to simulate the quasiperiodic dose distribution on the peripheral, phantom axes resulting from a helical scan series in order to facilitate the implementation of an improved method of CT dose measurement utilizing a short ion chamber, as proposed by Dixon [Med. Phys. 30, 1272-1280 (2003)]. A more detailed set of guidelines for implementing such measurements is also presented in this paper. In addition, some fundamental principles governing CT dose which have not previously been clearly enunciated follow from the model, and a fundamental (energy-based) quantity dubbed 'CTDI-aperture' is introduced.

  2. An improved analytical model for CT dose simulation with a new look at the theory of CT dose.

    PubMed

    Dixon, Robert L; Munley, Michael T; Bayram, Ersin

    2005-12-01

    Gagne [Med. Phys. 16, 29-37 (1989)] has previously described a model for predicting the sensitivity and dose profiles in the slice-width (z) direction for CT scanners. The model, developed prior to the advent of multidetector CT scanners, is still widely used; however, it does not account for the effect of anode tilt on the penumbra or include the heel effect, both of which are increasingly important for the wider beams (up to 40 mm) of contemporary, multidetector scanners. Additionally, it applied only on (or near) the axis of rotation, and did not incorporate the photon energy spectrum. The improved model described herein transcends all of the aforementioned limitations of the Gagne model, including extension to the peripheral phantom axes. Comparison of simulated and measured dose data provides experimental validation of the model, including verification of the superior match to the penumbra provided by the tilted-anode model, as well as the observable effects on the cumulative dose distribution. The initial motivation for the model was to simulate the quasiperiodic dose distribution on the peripheral, phantom axes resulting from a helical scan series in order to facilitate the implementation of an improved method of CT dose measurement utilizing a short ion chamber, as proposed by Dixon [Med. Phys. 30, 1272-1280 (2003)]. A more detailed set of guidelines for implementing such measurements is also presented in this paper. In addition, some fundamental principles governing CT dose which have not previously been clearly enunciated follow from the model, and a fundamental (energy-based) quantity dubbed "CTDI-aperture" is introduced.

  3. Evaluation of radiation dose of triple rule-out coronary angiography protocols with different scan length using 256-slice CT

    NASA Astrophysics Data System (ADS)

    Tsai, Chia-Jung; Lee, Jason J. S.; Chen, Liang-Kuang; Mok, Greta S. P.; Hsu, Shih-Ming; Wu, Tung-Hsin

    2011-10-01

    Triple rule-out coronary CT angiography (TRO-CTA) is a new approach for providing noninvasive visualization of coronary arteries with simultaneous evaluation of pulmonary arteries, thoracic aorta and other intrathoracic structures. The increasing use of TRO-CTA examination with longer scan length is associated with the concerns about radiation dose and their corresponding cancer risk. The purpose of this study is to evaluate organ dose and effective dose for the TRO-CTA examination with 2 scan lengths: TRO std and TRO ext, using 256-slice CT. TRO-CTA examinations were performed on a 256-slice CT scanner without ECG-based tube current modulation. Absorbed organ doses were measured using an anthropomorphic phantom and thermal-luminance dosimeters (TLDs). Effective dose was determined by taking a sum of the measured absorbed organ doses multiplied with the tissue weighting factor based on ICRP-103, and compared to that calculated using the dose-length product (DLP) method. We obtained high organ doses in the thyroid, esophagus, breast, heart and lung in both TRO-CTA protocols. Effective doses of the TRO std and TRO ext protocols with the phantom method were 26.37 and 42.49 mSv, while those with the DLP method were 19.68 and 38.96 mSv, respectively. Our quantitative dose information establishes a relationship between radiation dose and scanning length, and can provide a practical guidance to best clinical practice.

  4. VirtualDose: a software for reporting organ doses from CT for adult and pediatric patients.

    PubMed

    Ding, Aiping; Gao, Yiming; Liu, Haikuan; Caracappa, Peter F; Long, Daniel J; Bolch, Wesley E; Liu, Bob; Xu, X George

    2015-07-21

    This paper describes the development and testing of VirtualDose--a software for reporting organ doses for adult and pediatric patients who undergo x-ray computed tomography (CT) examinations. The software is based on a comprehensive database of organ doses derived from Monte Carlo (MC) simulations involving a library of 25 anatomically realistic phantoms that represent patients of different ages, body sizes, body masses, and pregnant stages. Models of GE Lightspeed Pro 16 and Siemens SOMATOM Sensation 16 scanners were carefully validated for use in MC dose calculations. The software framework is designed with the 'software as a service (SaaS)' delivery concept under which multiple clients can access the web-based interface simultaneously from any computer without having to install software locally. The RESTful web service API also allows a third-party picture archiving and communication system software package to seamlessly integrate with VirtualDose's functions. Software testing showed that VirtualDose was compatible with numerous operating systems including Windows, Linux, Apple OS X, and mobile and portable devices. The organ doses from VirtualDose were compared against those reported by CT-Expo and ImPACT-two dosimetry tools that were based on the stylized pediatric and adult patient models that were known to be anatomically simple. The organ doses reported by VirtualDose differed from those reported by CT-Expo and ImPACT by as much as 300% in some of the patient models. These results confirm the conclusion from past studies that differences in anatomical realism offered by stylized and voxel phantoms have caused significant discrepancies in CT dose estimations.

  5. VirtualDose: a software for reporting organ doses from CT for adult and pediatric patients.

    PubMed

    Ding, Aiping; Gao, Yiming; Liu, Haikuan; Caracappa, Peter F; Long, Daniel J; Bolch, Wesley E; Liu, Bob; Xu, X George

    2015-07-21

    This paper describes the development and testing of VirtualDose--a software for reporting organ doses for adult and pediatric patients who undergo x-ray computed tomography (CT) examinations. The software is based on a comprehensive database of organ doses derived from Monte Carlo (MC) simulations involving a library of 25 anatomically realistic phantoms that represent patients of different ages, body sizes, body masses, and pregnant stages. Models of GE Lightspeed Pro 16 and Siemens SOMATOM Sensation 16 scanners were carefully validated for use in MC dose calculations. The software framework is designed with the 'software as a service (SaaS)' delivery concept under which multiple clients can access the web-based interface simultaneously from any computer without having to install software locally. The RESTful web service API also allows a third-party picture archiving and communication system software package to seamlessly integrate with VirtualDose's functions. Software testing showed that VirtualDose was compatible with numerous operating systems including Windows, Linux, Apple OS X, and mobile and portable devices. The organ doses from VirtualDose were compared against those reported by CT-Expo and ImPACT-two dosimetry tools that were based on the stylized pediatric and adult patient models that were known to be anatomically simple. The organ doses reported by VirtualDose differed from those reported by CT-Expo and ImPACT by as much as 300% in some of the patient models. These results confirm the conclusion from past studies that differences in anatomical realism offered by stylized and voxel phantoms have caused significant discrepancies in CT dose estimations. PMID:26134511

  6. SU-E-T-94: Daily Fraction Dose Recalculation Based On Rigid Registration Using Cone Beam CT

    SciTech Connect

    Bosse, C; Tuohy, R; Mavroidis, P; Shi, Z; Crownover, R; Papanikolaou, N; Stathakis, S

    2014-06-01

    Purpose: To calculate the daily fraction dose for a CBCT recalculation based on rigid registration and compare it to the planned CT dose. Methods: For this study, 30 patients that were previously treated (10 SBRT lung, 10 prostate and 10 abdomen) were considered. The daily CBCT images were imported into the Pinnacle treatment planning system from Mosaic. The prescribing physician contoured the regions of interest (ROI) on each CBCT and then dose was computed on each CBCT. Each CBCT dose distribution was then compared against the plan. The evaluation was based on isodose line comparison and Dose Volume Histogram comparison. Results: In the case of lung patients the dose differences between daily dose and plan dose were considered small. The PTV coverage was not compromised and the dose to the organs at risk had negligible differences. Larger differences were observed for prostate and abdomen patients. In these cases, although the PTV doses did not change on a daily basis, the doses to the organs at risk had significant differences. For a prostate patient, the bladder dose at 35% volume was 2714.444 cGy for the CT plan and 2844.747, 2801.556, 3552.37, and 2970.968 cGy for subsequent CBCTs. For the PTV on a SBRT patient, however, the CT plan had a dose at 35% volume of 6917.71 cGy and 6815.385, 6892.5, 6896.25, and 6922.9 cGy for the CBCTs. Conclusion: Daily dose validation is feasible using CBCT and treatment planning system. It provides means to evaluate the course of treatment for the patient undergoing radiation therapy and can assist in the decision of the need of adaptation of the treatment plan.

  7. Estimating thyroid dose in pediatric CT exams from surface dose measurement

    NASA Astrophysics Data System (ADS)

    Al-Senan, Rani; Mueller, Deborah L.; Hatab, Mustapha R.

    2012-07-01

    The purpose of this study was to investigate the possibility of estimating pediatric thyroid doses from CT using surface neck doses. Optically stimulated luminescence dosimeters were used to measure the neck surface dose of 25 children ranging in ages between one and three years old. The neck circumference for each child was measured. The relationship between obtained surface doses and thyroid dose was studied using acrylic phantoms of various sizes and with holes of different depths. The ratios of hole-to-surface doses were used to convert patients' surface dose to thyroid dose. ImPACT software was utilized to calculate thyroid dose after applying the appropriate age correction factors. A paired t-test was performed to compare thyroid doses from our approach and ImPACT. The ratio of thyroid to surface dose was found to be 1.1. Thyroid doses ranged from 20 to 80 mGy. Comparison showed no statistical significance (p = 0.18). In addition, the average of surface dose variation along the z-axis in helical scans was studied and found to range between 5% (in 10 cm diameter phantom/24 mm collimation/pitch 1.0) and 8% (in 16 cm diameter phantom/12 mm collimation/pitch 0.7). We conclude that surface dose is an acceptable predictor for pediatric thyroid dose from CT. The uncertainty due to surface dose variability may be reduced if narrower collimation is used with a pitch factor close to 1.0. Also, the results did not show any effect of thyroid depth on the measured dose.

  8. Attenuation correction of PET cardiac data with low-dose average CT in PET/CT

    SciTech Connect

    Pan Tinsu; Mawlawi, Osama; Luo, Dershan; Liu, Hui H.; Chi Paichun, M.; Mar, Martha V.; Gladish, Gregory; Truong, Mylene; Erasmus, Jeremy Jr.; Liao Zhongxing; Macapinlac, H. A.

    2006-10-15

    We proposed a low-dose average computer tomography (ACT) for attenuation correction (AC) of the PET cardiac data in PET/CT. The ACT was obtained from a cine CT scan of over one breath cycle per couch position while the patient was free breathing. We applied this technique on four patients who underwent tumor imaging with {sup 18}F-FDG in PET/CT, whose PET data showed high uptake of {sup 18}F-FDG in the heart and whose CT and PET data had misregistration. All four patients did not have known myocardiac infarction or ischemia. The patients were injected with 555-740 MBq of {sup 18}F-FDG and scanned 1 h after injection. The helical CT (HCT) data were acquired in 16 s for the coverage of 100 cm. The PET acquisition was 3 min per bed of 15 cm. The duration of cine CT acquisition per 2 cm was 5.9 s. We used a fast gantry rotation cycle time of 0.5 s to minimize motion induced reconstruction artifacts in the cine CT images, which were averaged to become the ACT images for AC of the PET data. The radiation dose was about 5 mGy for 5.9 s cine duration. The selection of 5.9 s was based on our analysis of the respiratory signals of 600 patients; 87% of the patients had average breath cycles of less than 6 s and 90% had standard deviations of less than 1 s in the period of breath cycle. In all four patient studies, registrations between the CT and the PET data were improved. An increase of average uptake in the anterior and the lateral walls up to 48% and a decrease of average uptake in the septal and the inferior walls up to 16% with ACT were observed. We also compared ACT and conventional slow scan CT (SSCT) of 4 s duration in one patient study and found ACT was better than SSCT in depicting average respiratory motion and the SSCT images showed motion-induced reconstruction artifacts. In conclusion, low-dose ACT improved registration of the CT and the PET data in the heart region in our study of four patients. ACT was superior than SSCT for depicting average respiration

  9. Low dose CT perfusion using k-means clustering

    NASA Astrophysics Data System (ADS)

    Pisana, Francesco; Henzler, Thomas; Schönberg, Stefan; Klotz, Ernst; Schmidt, Bernhard; Kachelrieß, Marc

    2016-03-01

    We aim at improving low dose CT perfusion functional parameters maps and CT images quality, preserving quantitative information. In a dynamic CT perfusion dataset, each voxel is measured T times, where T is the number of acquired time points. In this sense, we can think about a voxel as a point in a T-dimensional space, where the coordinates of the voxels would be the values of its time attenuation curve (TAC). Starting from this idea, a k-means algorithm was designed to group voxels in K classes. A modified guided time-intensity profile similarity (gTIPS) filter was implemented and applied only for those voxels belonging to the same class. The approach was tested on a digital brain perfusion phantom as well as on clinical brain and body perfusion datasets, and compared to the original TIPS implementation. The TIPS filter showed the highest CNR improvement, but lowest spatial resolution. gTIPS proved to have the best combination of spatial resolution and CNR improvement for CT images, while k-gTIPS was superior to both gTIPS and TIPS in terms of perfusion maps image quality. We demonstrate k-means clustering analysis can be applied to denoise dynamic CT perfusion data and to improve functional maps. Beside the promising results, this approach has the major benefit of being independent from the perfusion model employed for functional parameters calculation. No similar approaches were found in literature.

  10. Fast reconstruction of low dose proton CT by sinogram interpolation

    NASA Astrophysics Data System (ADS)

    Hansen, David C.; Sangild Sørensen, Thomas; Rit, Simon

    2016-08-01

    Proton computed tomography (CT) has been demonstrated as a promising image modality in particle therapy planning. It can reduce errors in particle range calculations and consequently improve dose calculations. Obtaining a high imaging resolution has traditionally required computationally expensive iterative reconstruction techniques to account for the multiple scattering of the protons. Recently, techniques for direct reconstruction have been developed, but these require a higher imaging dose than the iterative methods. No previous work has compared the image quality of the direct and the iterative methods. In this article, we extend the methodology for direct reconstruction to be applicable for low imaging doses and compare the obtained results with three state-of-the-art iterative algorithms. We find that the direct method yields comparable resolution and image quality to the iterative methods, even at 1 mSv dose levels, while yielding a twentyfold speedup in reconstruction time over previously published iterative algorithms.

  11. Cone beam CT for dental and maxillofacial imaging: dose matters.

    PubMed

    Pauwels, Ruben

    2015-07-01

    The widespread use of cone-beam CT (CBCT) in dentistry has led to increasing concern regarding justification and optimisation of CBCT exposures. When used as a substitute to multidetector CT (MDCT), CBCT can lead to significant dose reduction; however, low-dose protocols of current-generation MDCTs show that there is an overlap between CBCT and MDCT doses. More importantly, although the 3D information provided by CBCT can often lead to improved diagnosis and treatment compared with 2D radiographs, a routine or excessive use of CBCT would lead to a substantial increase of the collective patient dose. The potential use of CBCT for paediatric patients (e.g. developmental disorders, trauma and orthodontic treatment planning) further increases concern regarding its proper application. This paper provides an overview of justification and optimisation issues in dental and maxillofacial CBCT. The radiation dose in CBCT will be briefly reviewed. The European Commission's Evidence Based Guidelines prepared by the SEDENTEXCT Project Consortium will be summarised, and (in)appropriate use of CBCT will be illustrated for various dental applications. PMID:25805884

  12. CT dose minimization using personalized protocol optimization and aggressive bowtie

    NASA Astrophysics Data System (ADS)

    Wang, Hui; Yin, Zhye; Jin, Yannan; Wu, Mingye; Yao, Yangyang; Tao, Kun; Kalra, Mannudeep K.; De Man, Bruno

    2016-03-01

    In this study, we propose to use patient-specific x-ray fluence control to reduce the radiation dose to sensitive organs while still achieving the desired image quality (IQ) in the region of interest (ROI). The mA modulation profile is optimized view by view, based on the sensitive organs and the ROI, which are obtained from an ultra-low-dose volumetric CT scout scan [1]. We use a clinical chest CT scan to demonstrate the feasibility of the proposed concept: the breast region is selected as the sensitive organ region while the cardiac region is selected as IQ ROI. Two groups of simulations are performed based on the clinical CT dataset: (1) a constant mA scan adjusted based on the patient attenuation (120 kVp, 300 mA), which serves as baseline; (2) an optimized scan with aggressive bowtie and ROI centering combined with patient-specific mA modulation. The results shows that the combination of the aggressive bowtie and the optimized mA modulation can result in 40% dose reduction in the breast region, while the IQ in the cardiac region is maintained. More generally, this paper demonstrates the general concept of using a 3D scout scan for optimal scan planning.

  13. IMRT treatment plans and functional planning with functional lung imaging from 4D-CT for thoracic cancer patients

    PubMed Central

    2013-01-01

    Background and purpose Currently, the inhomogeneity of the pulmonary function is not considered when treatment plans are generated in thoracic cancer radiotherapy. This study evaluates the dose of treatment plans on highly-functional volumes and performs functional treatment planning by incorporation of ventilation data from 4D-CT. Materials and methods Eleven patients were included in this retrospective study. Ventilation was calculated using 4D-CT. Two treatment plans were generated for each case, the first one without the incorporation of the ventilation and the second with it. The dose of the first plans was overlapped with the ventilation and analyzed. Highly-functional regions were avoided in the second treatment plans. Results For small targets in the first plans (PTV < 400 cc, 6 cases), all V5, V20 and the mean lung dose values for the highly-functional regions were lower than that of the total lung. For large targets, two out of five cases had higher V5 and V20 values for the highly-functional regions. All the second plans were within constraints. Conclusion Radiation treatments affect functional lung more seriously in large tumor cases. With compromise of dose to other critical organs, functional treatment planning to reduce dose in highly-functional lung volumes can be achieved PMID:23281734

  14. Visualization and quantitative analysis of lung microstructure using micro CT images

    NASA Astrophysics Data System (ADS)

    Yamamoto, Tetsuo; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Fujii, Masashi; Nakaya, Yoshihiro; Matsui, Eisuke; Ohmatsu, Hironobu; Moriyama, Noriyuki

    2005-04-01

    Micro CT system is developed for lung function analysis at a high resolution of the micrometer order (up to 5μm in spatial resolution). This system reveals the lung distal structures such as interlobular septa, terminal bronchiole, respiratory bronchiole, alveolar duct, and alveolus. In order to visualize lung 3-D microstructures using micro CT images and to analyze them, this research presents a computerized approach. This approach is applied for to micro CT images of human lung tissue specimens that were obtained by surgical excision and were kept in the state of the inflated fixed lung. This report states a wall area such as bronchus wall and alveolus wall about the extraction technique by using the surface thinning process to analyze the lung microstructures from micro CT images measured by the new-model micro CT system.

  15. SU-E-J-149: Establishing the Relationship Between Pre-Treatment Lung Ventilation, Dose, and Toxicity Outcome

    SciTech Connect

    Mistry, N; D'Souza, W; Sornsen de Koste, J; Senan, S

    2014-06-01

    Purpose: Recently, there has been an interest in incorporating functional information in treatment planning especially in thoracic tumors. The rationale is that healthy lung regions need to be spared from radiation if possible to help achieve better control on toxicity. However, it is still unclear whether high functioning regions need to be spared or have more capacity to deal with the excessive radiation as compared to the compromised regions of the lung. Our goal with this work is to establish the tools by which we can establish a relationship between pre-treatment lung function, dose, and radiographic outcomes of lung toxicity. Methods: Treatment planning was performed using a single phase of a 4DCT scan, and follow-up anatomical CT scans were performed every 3 months for most patients. In this study, we developed the pipeline of tools needed to analyze such a large dataset, while trying to establish a relationship between function, dose, and outcome. Pre-treatment lung function was evaluated using a recently published technique that evaluates Fractional Regional Ventilation (FRV). All images including the FRV map and the individual follow-up anatomical CT images were all spatially matched to the planning CT using a diffusion based Demons image registration algorithm. Change in HU value was used as a metric to capture the effects of lung toxicity. To validate the findings, a radiologist evaluated the follow-up anatomical CT images and scored lung toxicity. Results: Initial experience in 1 patient shows a relationship between the pre-treatment lung function, dose and toxicity outcome. The results are also correlated to the findings by the radiologist who was blinded to the analysis or dose. Conclusion: The pipeline we have established to study this enables future studies in large retrospective studies. However, the tools are dependent on the fidelity of 4DCT reconstruction for accurate evaluation of regional ventilation. Patent Pending for the technique

  16. SU-E-J-91: Biomechanical Deformable Image Registration of Longitudinal Lung CT Images

    SciTech Connect

    Cazoulat, G; Owen, D; Matuszak, M; Balter, J; Brock, K

    2015-06-15

    Purpose: Spatial correlation of lung tissue across longitudinal images, as the patient responds to treatment, is a critical step in adaptive radiotherapy. The goal of this work is to expand a biomechanical model-based deformable registration algorithm (Morfeus) to achieve accurate registration in the presence of significant anatomical changes. Methods: Four lung cancer patients previously treated with conventionally fractionated radiotherapy that exhibited notable tumor shrinkage during treatment were retrospectively evaluated. Exhale breathhold CT scans were obtained at treatment planning (PCT) and following three weeks (W3CT) of treatment. For each patient, the PCT was registered to the W3CT using Morfeus, a biomechanical model-based deformable registration algorithm, consisting of boundary conditions on the lungs and incorporating a sliding interface between the lung and chest wall. To model the complex response of the lung, an extension to Morfeus has been developed: (i) The vessel tree was segmented by thresholding a vesselness image based on the Hessian matrix’s eigenvalues and the centerline was extracted; (ii) A 3D shape context method was used to find correspondences between the trees of the two images; (ii) Correspondences were used as additional boundary conditions (Morfeus+vBC). An expert independently identified corresponding landmarks well distributed in the lung to compute Target Registration Errors (TRE). Results: The TRE within 15mm of the tumor boundaries (on average 11 landmarks) is: 6.1±1.8, 4.6±1.1 and 3.8±2.3 mm after rigid registration, Morfeus and Morfeus+vBC, respectively. The TRE in the rest of the lung (on average 13 landmarks) is: 6.4±3.9, 4.7±2.2 and 3.6±1.9 mm, which is on the order of the 2mm isotropic dose grid vector (3.5mm). Conclusion: The addition of boundary conditions on the vessels improved the accuracy in modeling the response of the lung and tumor over the course of radiotherapy. Minimizing and modeling these

  17. VirtualDose: a software for reporting organ doses from CT for adult and pediatric patients

    NASA Astrophysics Data System (ADS)

    Ding, Aiping; Gao, Yiming; Liu, Haikuan; Caracappa, Peter F.; Long, Daniel J.; Bolch, Wesley E.; Liu, Bob; Xu, X. George

    2015-07-01

    This paper describes the development and testing of VirtualDose—a software for reporting organ doses for adult and pediatric patients who undergo x-ray computed tomography (CT) examinations. The software is based on a comprehensive database of organ doses derived from Monte Carlo (MC) simulations involving a library of 25 anatomically realistic phantoms that represent patients of different ages, body sizes, body masses, and pregnant stages. Models of GE Lightspeed Pro 16 and Siemens SOMATOM Sensation 16 scanners were carefully validated for use in MC dose calculations. The software framework is designed with the ‘software as a service (SaaS)’ delivery concept under which multiple clients can access the web-based interface simultaneously from any computer without having to install software locally. The RESTful web service API also allows a third-party picture archiving and communication system software package to seamlessly integrate with VirtualDose’s functions. Software testing showed that VirtualDose was compatible with numerous operating systems including Windows, Linux, Apple OS X, and mobile and portable devices. The organ doses from VirtualDose were compared against those reported by CT-Expo and ImPACT—two dosimetry tools that were based on the stylized pediatric and adult patient models that were known to be anatomically simple. The organ doses reported by VirtualDose differed from those reported by CT-Expo and ImPACT by as much as 300% in some of the patient models. These results confirm the conclusion from past studies that differences in anatomical realism offered by stylized and voxel phantoms have caused significant discrepancies in CT dose estimations.

  18. Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

    SciTech Connect

    Zhang, Yakun; Li, Xiang; Segars, W. Paul; Samei, Ehsan

    2014-02-15

    metrics only increased slightly for radiographic modalities and for chest tomosynthesis. Effective and organ doses normalized to mAs all illustrated an exponential decrease with increasing patient size. As a surface organ, breast doses had less correlation with body size than that of lungs or liver. Conclusions: Patient body size has a much greater impact on radiation dose of chest CT examinations than chest radiography and tomosynthesis. The size of a patient should be considered when choosing the best thoracic imaging modality.

  19. CT screening for lung cancer: Is the evidence strong enough?

    PubMed

    Field, J K; Devaraj, A; Duffy, S W; Baldwin, D R

    2016-01-01

    The prevailing questions at this time in both the public mind and the clinical establishment is, do we have sufficient evidence to implement lung cancer Computed Tomography (CT) screening in Europe? If not, what is outstanding? This review addresses the twelve major areas, which are critical to any decision to implement CT screening and where we need to assess whether we have sufficient evidence to proceed to a recommendation for implementation in Europe. The readiness level of these twelve categories in 2015 have been with colour coded, where green indicates we have sufficient evidence, amber is borderline evidence and red requires further evidence. Recruitment from the 'Hard to Reach' community still remains at red, while mortality data, cost effectiveness and screening interval are all categorised as amber. The integration of smoking cessation into CT screening programmes is still considered to be category amber. The US Preventive Services Task Force have recommended that CT screening is implemented in the USA utilising the NLST criteria, apart from continuing screening to 80 years of age. The cost effectiveness of the NLST was calculated to be $81,000/QALY, however, its well recognised that the costs of medical care in the USA, is far higher than that of Europe. Medicare have agreed to cover the cost of screening but have stipulated a number of stringent requirements for inclusion. To date we do not have good CT screening mortality data available in Europe and eagerly await the publication of the NELSON trial data in 2016 and then the pooled UKLS and NELSON data thereafter. However in the meantime we should start planning for implementation in Europe, especially in the areas of the radiological service provision and accreditation, as well as identifying novel mechanisms to recruit from the hardest to reach communities. PMID:26711931

  20. CT screening for lung cancer: Is the evidence strong enough?

    PubMed

    Field, J K; Devaraj, A; Duffy, S W; Baldwin, D R

    2016-01-01

    The prevailing questions at this time in both the public mind and the clinical establishment is, do we have sufficient evidence to implement lung cancer Computed Tomography (CT) screening in Europe? If not, what is outstanding? This review addresses the twelve major areas, which are critical to any decision to implement CT screening and where we need to assess whether we have sufficient evidence to proceed to a recommendation for implementation in Europe. The readiness level of these twelve categories in 2015 have been with colour coded, where green indicates we have sufficient evidence, amber is borderline evidence and red requires further evidence. Recruitment from the 'Hard to Reach' community still remains at red, while mortality data, cost effectiveness and screening interval are all categorised as amber. The integration of smoking cessation into CT screening programmes is still considered to be category amber. The US Preventive Services Task Force have recommended that CT screening is implemented in the USA utilising the NLST criteria, apart from continuing screening to 80 years of age. The cost effectiveness of the NLST was calculated to be $81,000/QALY, however, its well recognised that the costs of medical care in the USA, is far higher than that of Europe. Medicare have agreed to cover the cost of screening but have stipulated a number of stringent requirements for inclusion. To date we do not have good CT screening mortality data available in Europe and eagerly await the publication of the NELSON trial data in 2016 and then the pooled UKLS and NELSON data thereafter. However in the meantime we should start planning for implementation in Europe, especially in the areas of the radiological service provision and accreditation, as well as identifying novel mechanisms to recruit from the hardest to reach communities.

  1. CT image construction of a totally deflated lung using deformable model extrapolation

    SciTech Connect

    Sadeghi Naini, Ali; Pierce, Greg; Lee, Ting-Yim; and others

    2011-02-15

    Purpose: A novel technique is proposed to construct CT image of a totally deflated lung from a free-breathing 4D-CT image sequence acquired preoperatively. Such a constructed CT image is very useful in performing tumor ablative procedures such as lung brachytherapy. Tumor ablative procedures are frequently performed while the lung is totally deflated. Deflating the lung during such procedures renders preoperative images ineffective for targeting the tumor. Furthermore, the problem cannot be solved using intraoperative ultrasound (U.S.) images because U.S. images are very sensitive to small residual amount of air remaining in the deflated lung. One possible solution to address these issues is to register high quality preoperative CT images of the deflated lung with their corresponding low quality intraoperative U.S. images. However, given that such preoperative images correspond to an inflated lung, such CT images need to be processed to construct CT images pertaining to the lung's deflated state. Methods: To obtain the CT images of deflated lung, we present a novel image construction technique using extrapolated deformable registration to predict the deformation the lung undergoes during full deflation. The proposed construction technique involves estimating the lung's air volume in each preoperative image automatically in order to track the respiration phase of each 4D-CT image throughout a respiratory cycle; i.e., the technique does not need any external marker to form a respiratory signal in the process of curve fitting and extrapolation. The extrapolated deformation field is then applied on a preoperative reference image in order to construct the totally deflated lung's CT image. The technique was evaluated experimentally using ex vivo porcine lung. Results: The ex vivo lung experiments led to very encouraging results. In comparison with the CT image of the deflated lung we acquired for the purpose of validation, the constructed CT image was very similar. The

  2. SU-E-J-86: Lobar Lung Function Quantification by PET Galligas and CT Ventilation Imaging in Lung Cancer Patients

    SciTech Connect

    Eslick, E; Kipritidis, J; Keall, P; Bailey, D; Bailey, E

    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 using 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.

  3. A Survey of Pediatric CT Protocols and Radiation Doses in South Korean Hospitals to Optimize the Radiation Dose for Pediatric CT Scanning

    PubMed Central

    Hwang, Jae-Yeon; Do, Kyung-Hyun; Yang, Dong Hyun; Cho, Young Ah; Yoon, Hye-Kyung; Lee, Jin Seong; Koo, Hyun Jung

    2015-01-01

    Abstract Children are at greater risk of radiation exposure than adults because the rapidly dividing cells of children tend to be more radiosensitive and they have a longer expected life time in which to develop potential radiation injury. Some studies have surveyed computed tomography (CT) radiation doses and several studies have established diagnostic reference levels according to patient age or body size; however, no survey of CT radiation doses with a large number of patients has yet been carried out in South Korea. The aim of the present study was to investigate the radiation dose in pediatric CT examinations performed throughout South Korea. From 512 CT (222 brain CT, 105 chest CT, and 185 abdominopelvic CT) scans that were referred to our tertiary hospital, a dose report sheet was available for retrospective analysis of CT scan protocols and dose, including the volumetric CT dose index (CTDIvol), dose-length product (DLP), effective dose, and size-specific dose estimates (SSDE). At 55.2%, multiphase CT was the most frequently performed protocol for abdominopelvic CT. Tube current modulation was applied most often in abdominopelvic CT and chest CT, accounting for 70.1% and 62.7%, respectively. Regarding the CT dose, the interquartile ranges of the CTDIvol were 11.1 to 22.5 (newborns), 16.6 to 39.1 (≤1 year), 14.6 to 41.7 (2–5 years), 23.5 to 44.1 (6–10 years), and 31.4 to 55.3 (≤15 years) for brain CT; 1.3 to 5.7 (≤1 year), 3.9 to 6.8 (2–5 years), 3.9 to 9.3 (6–10 years), and 7.7 to 13.8 (≤15 years) for chest CT; and 4.0 to 7.5 (≤1 year), 4.2 to 8.9 (2–5 years), 5.7 to 12.4 (6–10 years), and 7.6 to 16.6 (≤15 years) for abdominopelvic CT. The SSDE and CTDIvol were well correlated for patients <5 years old, whereas the CTDIvol was lower in patients ≥6 years old. Our study describes the various parameters and dosimetry metrics of pediatric CT in South Korea. The CTDIvol, DLP, and effective dose were generally lower than in German and UK

  4. Algorithm-enabled low-dose micro-CT imaging.

    PubMed

    Han, Xiao; Bian, Junguo; Eaker, Diane R; Kline, Timothy L; Sidky, Emil Y; Ritman, Erik L; Pan, Xiaochuan

    2011-03-01

    Micro-computed tomography (micro-CT) is an important tool in biomedical research and preclinical applications that can provide visual inspection of and quantitative information about imaged small animals and biological samples such as vasculature specimens. Currently, micro-CT imaging uses projection data acquired at a large number (300-1000) of views, which can limit system throughput and potentially degrade image quality due to radiation-induced deformation or damage to the small animal or specimen. In this work, we have investigated low-dose micro-CT and its application to specimen imaging from substantially reduced projection data by using a recently developed algorithm, referred to as the adaptive-steepest-descent-projection-onto-convex-sets (ASD-POCS) algorithm, which reconstructs an image through minimizing the image total-variation and enforcing data constraints. To validate and evaluate the performance of the ASD-POCS algorithm, we carried out quantitative evaluation studies in a number of tasks of practical interest in imaging of specimens of real animal organs. The results show that the ASD-POCS algorithm can yield images with quality comparable to that obtained with existing algorithms, while using one-sixth to one quarter of the 361-view data currently used in typical micro-CT specimen imaging.

  5. Segmentation of individual ribs from low-dose chest CT

    NASA Astrophysics Data System (ADS)

    Lee, Jaesung; Reeves, Anthony P.

    2010-03-01

    Segmentation of individual ribs and other bone structures in chest CT images is important for anatomical analysis, as the segmented ribs may be used as a baseline reference for locating organs within a chest as well as for identification and measurement of any geometric abnormalities in the bone. In this paper we present a fully automated algorithm to segment the individual ribs from low-dose chest CT scans. The proposed algorithm consists of four main stages. First, all the high-intensity bone structure present in the scan is segmented. Second, the centerline of the spinal canal is identified using a distance transform of the bone segmentation. Then, the seed region for every rib is detected based on the identified centerline, and each rib is grown from the seed region and separated from the corresponding vertebra. This algorithm was evaluated using 115 low-dose chest CT scans from public databases with various slice thicknesses. The algorithm parameters were determined using 5 scans, and remaining 110 scans were used to evaluate the performance of the segmentation algorithm. The outcome of the algorithm was inspected by an author for the correctness of the segmentation. The results indicate that over 98% of the individual ribs were correctly segmented with the proposed algorithm.

  6. Degradation of proton depth dose distributions attributable to microstructures in lung-equivalent material

    SciTech Connect

    Titt, Uwe Mirkovic, Dragan; Mohan, Radhe; Sell, Martin; Unkelbach, Jan; Bangert, Mark; Oelfke, Uwe

    2015-11-15

    Purpose: The purpose of the work reported here was to investigate the influence of sub-millimeter size heterogeneities on the degradation of the distal edges of proton beams and to validate Monte Carlo (MC) methods’ ability to correctly predict such degradation. Methods: A custom-designed high-resolution plastic phantom approximating highly heterogeneous, lung-like structures was employed in measurements and in Monte Carlo simulations to evaluate the degradation of proton Bragg curves penetrating heterogeneous media. Results: Significant differences in distal falloff widths and in peak dose values were observed in the measured and the Monte Carlo simulated curves compared to pristine proton Bragg curves. Furthermore, differences between simulations of beams penetrating CT images of the phantom did not agree well with the corresponding experimental differences. The distal falloff widths in CT image-based geometries were underestimated by up to 0.2 cm in water (corresponding to 0.8–1.4 cm in lung tissue), and the peak dose values of pristine proton beams were overestimated by as much as ~35% compared to measured curves or depth-dose curves simulated on the basis of true geometry. The authors demonstrate that these discrepancies were caused by the limited spatial resolution of CT images that served as a basis for dose calculations and lead to underestimation of the impact of the fine structure of tissue heterogeneities. A convolution model was successfully applied to mitigate the underestimation. Conclusions: The results of this study justify further development of models to better represent heterogeneity effects in soft-tissue geometries, such as lung, and to correct systematic underestimation of the degradation of the distal edge of proton doses.

  7. WE-G-BRD-07: Investigation of Distal Lung Atelectasis Following Stereotactic Body Radiation Therapy Using Regional Lung Volume Changes Between Pre- and Post- Treatment CT Scans

    SciTech Connect

    Diot, Q; Kavanagh, B; Miften, M

    2014-06-15

    Purpose: To propose a quantitative method using lung deformations to differentiate between radiation-induced fibrosis and potential airway stenosis with distal atelectasis in patients treated with stereotactic body radiation therapy (SBRT) for lung tumors. Methods: Twenty-four lung patients with large radiation-induced density increases outside the high dose region had their pre- and post-treatment CT scans manually registered. They received SBRT treatments at our institution between 2002 and 2009 in 3 or 5 fractions, to a median total dose of 54Gy (range, 30–60). At least 50 anatomical landmarks inside the lung (airway branches) were paired for the pre- and post-treatment scans to guide the deformable registration of the lung structure, which was then interpolated to the whole lung using splines. Local volume changes between the planning and follow-up scans were calculated using the deformation field Jacobian. Hyperdense regions were classified as atelectatic or fibrotic based on correlations between regional density increases and significant volume contractions compared to the surrounding tissues. Results: Out of 24 patients, only 7 demonstrated a volume contraction that was at least one σ larger than the remaining lung average. Because they did not receive high doses, these shrunk hyperdense regions were likely showing distal atelectasis resulting from radiation-induced airway stenosis rather than conventional fibrosis. On average, the hyperdense regions extended 9.2 cm farther than the GTV contours but not significantly more than 8.6 cm for the other patients (p>0.05), indicating that a large offset between the radiation and hyperdense region centers is not a good surrogate for atelectasis. Conclusion: A method based on the relative comparison of volume changes between different dates was developed to identify potential lung regions experiencing distal atelectasis. Such a tool is essential to study which lung structures need to be avoided to prevent

  8. 3D Dose Verification Using Tomotherapy CT Detector Array

    SciTech Connect

    Sheng Ke; Jones, Ryan; Yang Wensha; Saraiya, Siddharth; Schneider, Bernard; Chen Quan; Sobering, Geoff; Olivera, Gustavo; Read, Paul

    2012-02-01

    Purpose: To evaluate a three-dimensional dose verification method based on the exit dose using the onboard detector of tomotherapy. Methods and Materials: The study included 347 treatment fractions from 24 patients, including 10 prostate, 5 head and neck (HN), and 9 spinal stereotactic body radiation therapy (SBRT) cases. Detector sonograms were retrieved and back-projected to calculate entrance fluence, which was then forward-projected on the CT images to calculate the verification dose, which was compared with ion chamber and film measurement in the QA plans and with the planning dose in patient plans. Results: Root mean square (RMS) errors of 2.0%, 2.2%, and 2.0% were observed comparing the dose verification (DV) and the ion chamber measured point dose in the phantom plans for HN, prostate, and spinal SBRT patients, respectively. When cumulative dose in the entire treatment is considered, for HN patients, the error of the mean dose to the planning target volume (PTV) varied from 1.47% to 5.62% with a RMS error of 3.55%. For prostate patients, the error of the mean dose to the prostate target volume varied from -5.11% to 3.29%, with a RMS error of 2.49%. The RMS error of maximum doses to the bladder and the rectum were 2.34% (-4.17% to 2.61%) and 2.64% (-4.54% to 3.94%), respectively. For the nine spinal SBRT patients, the RMS error of the minimum dose to the PTV was 2.43% (-5.39% to 2.48%). The RMS error of maximum dose to the spinal cord was 1.05% (-2.86% to 0.89%). Conclusions: An excellent agreement was observed between the measurement and the verification dose. In the patient treatments, the agreement in doses to the majority of PTVs and organs at risk is within 5% for the cumulative treatment course doses. The dosimetric error strongly depends on the error in multileaf collimator leaf opening time with a sensitivity correlating to the gantry rotation period.

  9. Radiation Doses of Various CT Protocols: a Multicenter Longitudinal Observation Study

    PubMed Central

    2016-01-01

    Emerging concerns regarding the hazard from medical radiation including CT examinations has been suggested. The purpose of this study was to observe the longitudinal changes of CT radiation doses of various CT protocols and to estimate the long-term efforts of supervising radiologists to reduce medical radiation. Radiation dose data from 11 representative CT protocols were collected from 12 hospitals. Attending radiologists had collected CT radiation dose data in two time points, 2007 and 2010. They collected the volume CT dose index (CTDIvol) of each phase, number of phases, dose length product (DLP) of each phase, and types of scanned CT machines. From the collected data, total DLP and effective dose (ED) were calculated. CTDIvol, total DLP, and ED of 2007 and 2010 were compared according to CT protocols, CT machine type, and hospital. During the three years, CTDIvol had significantly decreased, except for dynamic CT of the liver. Total DLP and ED were significantly decreased in all 11 protocols. The decrement was more evident in newer CT scanners. However, there was substantial variability of changes of ED during the three years according to hospitals. Although there was variability according to protocols, machines, and hospital, CT radiation doses were decreased during the 3 years. This study showed the effects of decreased CT radiation dose by efforts of radiologists and medical society. PMID:26908984

  10. Processing of CT images for analysis of diffuse lung disease in the lung tissue research consortium

    NASA Astrophysics Data System (ADS)

    Karwoski, Ronald A.; Bartholmai, Brian; Zavaletta, Vanessa A.; Holmes, David; Robb, Richard A.

    2008-03-01

    The goal of Lung Tissue Resource Consortium (LTRC) is to improve the management of diffuse lung diseases through a better understanding of the biology of Chronic Obstructive Pulmonary Disease (COPD) and fibrotic interstitial lung disease (ILD) including Idiopathic Pulmonary Fibrosis (IPF). Participants are subjected to a battery of tests including tissue biopsies, physiologic testing, clinical history reporting, and CT scanning of the chest. The LTRC is a repository from which investigators can request tissue specimens and test results as well as semi-quantitative radiology reports, pathology reports, and automated quantitative image analysis results from the CT scan data performed by the LTRC core laboratories. The LTRC Radiology Core Laboratory (RCL), in conjunction with the Biomedical Imaging Resource (BIR), has developed novel processing methods for comprehensive characterization of pulmonary processes on volumetric high-resolution CT scans to quantify how these diseases manifest in radiographic images. Specifically, the RCL has implemented a semi-automated method for segmenting the anatomical regions of the lungs and airways. In these anatomic regions, automated quantification of pathologic features of disease including emphysema volumes and tissue classification are performed using both threshold techniques and advanced texture measures to determine the extent and location of emphysema, ground glass opacities, "honeycombing" (HC) and "irregular linear" or "reticular" pulmonary infiltrates and normal lung. Wall thickness measurements of the trachea, and its branches to the 3 rd and limited 4 th order are also computed. The methods for processing, segmentation and quantification are described. The results are reviewed and verified by an expert radiologist following processing and stored in the public LTRC database for use by pulmonary researchers. To date, over 1200 CT scans have been processed by the RCL and the LTRC project is on target for recruitment of the

  11. Evaluation of radiation dose delivered by cone beam CT and tomosynthesis employed for setup of external breast irradiation

    SciTech Connect

    Winey, Brian; Zygmanski, Piotr; Lyatskaya, Yulia

    2009-01-15

    A systematic set of measurements is reported for evaluation of doses to critical organs resulting from cone-beam CT (CB-CT) and cone-beam tomosynthesis (CB-TS) as applied to breast setup for external beam irradiation. The specific focus of this study was on evaluation of doses from these modalities in a setting of volumetric breast imaging for target localization in radiotherapy treatments with the goal of minimizing radiation to healthy organs. Ion chamber measurements were performed in an anthropomorphic female thorax phantom at the center of each breast and lung and on the phantom surface at one anterior and two lateral locations (seven points total). The measurements were performed for three different isocenters located at the center of the phantom and at offset locations of the right and left breast. The dependence of the dose on angle selection for the CB-TS arc was also studied. For the most typical situation of centrally located CB-CT isocenter the measured doses ranged between 3 and 7 cGy, in good agreement with previous reports. Dose measurements were performed for a range of start/stop angles commonly used for CB-TS and the impact of direct and scatter dose on organs at risk was analyzed. All measured CB-TS doses were considerably lower than CB-CT doses, with greater decrease in dose for the organs outside of the beam (up to 98% decrease in dose). Remarkably, offsetting the isocenter towards the ipsilateral breast resulted on average to additional 46% dose reduction to organs at risk. The lowest doses to the contralateral breast and lung were less than 0.1 cGy when they were measured for the offset isocenter. The biggest reduction in dose was obtained by using CB-TS beams that completely avoid the critical organ. For points inside the CB-TS beam, the dose was reduced in a linear relation with distance from the center of the imaging arc. The data indicate that it is possible to reduce substantially radiation doses to the contralateral organs by proper

  12. Optimizing CT radiation dose based on patient size and image quality: the size-specific dose estimate method.

    PubMed

    Larson, David B

    2014-10-01

    The principle of ALARA (dose as low as reasonably achievable) calls for dose optimization rather than dose reduction, per se. Optimization of CT radiation dose is accomplished by producing images of acceptable diagnostic image quality using the lowest dose method available. Because it is image quality that constrains the dose, CT dose optimization is primarily a problem of image quality rather than radiation dose. Therefore, the primary focus in CT radiation dose optimization should be on image quality. However, no reliable direct measure of image quality has been developed for routine clinical practice. Until such measures become available, size-specific dose estimates (SSDE) can be used as a reasonable image-quality estimate. The SSDE method of radiation dose optimization for CT abdomen and pelvis consists of plotting SSDE for a sample of examinations as a function of patient size, establishing an SSDE threshold curve based on radiologists' assessment of image quality, and modifying protocols to consistently produce doses that are slightly above the threshold SSDE curve. Challenges in operationalizing CT radiation dose optimization include data gathering and monitoring, managing the complexities of the numerous protocols, scanners and operators, and understanding the relationship of the automated tube current modulation (ATCM) parameters to image quality. Because CT manufacturers currently maintain their ATCM algorithms as secret for proprietary reasons, prospective modeling of SSDE for patient populations is not possible without reverse engineering the ATCM algorithm and, hence, optimization by this method requires a trial-and-error approach.

  13. Weight preserving image registration for monitoring disease progression in lung CT.

    PubMed

    Gorbunova, Vladlena; Lol, Pechin; Ashraf, Haseem; Dirksen, Asger; Nielsen, Mads; de Bruijne, Marleen

    2008-01-01

    We present a new image registration based method for monitoring regional disease progression in longitudinal image studies of lung disease. A free-form image registration technique is used to match a baseline 3D CT lung scan onto a following scan. Areas with lower intensity in the following scan compared with intensities in the deformed baseline image indicate local loss of lung tissue that is associated with progression of emphysema. To account for differences in lung intensity owing to differences in the inspiration level in the two scans rather than disease progression, we propose to adjust the density of lung tissue with respect to local expansion or compression such that the total weight of the lungs is preserved during deformation. Our method provides a good estimation of regional destruction of lung tissue for subjects with a significant difference in inspiration level between CT scans and may result in a more sensitive measure of disease progression than standard quantitative CT measures.

  14. Dose reconstruction for real-time patient-specific dose estimation in CT

    SciTech Connect

    De Man, Bruno Yin, Zhye; Wu, Mingye; FitzGerald, Paul; Kalra, Mannudeep

    2015-05-15

    Purpose: Many recent computed tomography (CT) dose reduction approaches belong to one of three categories: statistical reconstruction algorithms, efficient x-ray detectors, and optimized CT acquisition schemes with precise control over the x-ray distribution. The latter category could greatly benefit from fast and accurate methods for dose estimation, which would enable real-time patient-specific protocol optimization. Methods: The authors present a new method for volumetrically reconstructing absorbed dose on a per-voxel basis, directly from the actual CT images. The authors’ specific implementation combines a distance-driven pencil-beam approach to model the first-order x-ray interactions with a set of Gaussian convolution kernels to model the higher-order x-ray interactions. The authors performed a number of 3D simulation experiments comparing the proposed method to a Monte Carlo based ground truth. Results: The authors’ results indicate that the proposed approach offers a good trade-off between accuracy and computational efficiency. The images show a good qualitative correspondence to Monte Carlo estimates. Preliminary quantitative results show errors below 10%, except in bone regions, where the authors see a bigger model mismatch. The computational complexity is similar to that of a low-resolution filtered-backprojection algorithm. Conclusions: The authors present a method for analytic dose reconstruction in CT, similar to the techniques used in radiation therapy planning with megavoltage energies. Future work will include refinements of the proposed method to improve the accuracy as well as a more extensive validation study. The proposed method is not intended to replace methods that track individual x-ray photons, but the authors expect that it may prove useful in applications where real-time patient-specific dose estimation is required.

  15. Long-term prognosis of patients with lung cancer detected on low-dose chest computed tomography screening.

    PubMed

    Nawa, Takeshi; Nakagawa, Tohru; Mizoue, Tetsuya; Kusano, Suzushi; Chonan, Tatsuya; Fukai, Shimao; Endo, Katsuyuki

    2012-02-01

    The effectiveness of lung cancer screening using low-dose chest computed tomography (CT) remains elusive. The present study examined the prognosis of patients with lung cancer detected on CT screening in Japanese men and women. Subjects were 210 patients with primary lung cancer identified on CT screening at two medical facilities in Hitachi, Japan, where a total of 61,914 CT screenings were performed among 25,385 screenees between 1998 and 2006. Prognostic status of these patients was sought by examining medical records at local hospitals, supplemented by vital status information from local government. The 5-year survival rate was estimated according to the characteristics of patients and lung nodule. A total of 203 (97%) patients underwent surgery. During a 5.7-year mean follow-up period, 19 patients died from lung cancer and 6 died from other causes. The estimated 5-year survival rate for all patients and for those on stage IA was 90% and 97%, respectively. Besides cancer stage, smoking and nodule appearance were independent predictors of a poor survival; multivariable-adjusted hazard ratio (95% confidence interval) was 4.7 (1.3, 16.5) for current and past smokers versus nonsmokers and 4.6 (1.6, 13.9) for solid nodule versus others. Even patients with solid shadow had a 5-year survival of 82% if the lesion was 20mm or less in size. Results suggest that lung cancers detected on CT screening are mostly curative. The impact of CT screening on mortality at community level needs to be clarified by monitoring lung cancer deaths.

  16. Spectrotemporal CT data acquisition and reconstruction at low dose

    PubMed Central

    Clark, Darin P.; Lee, Chang-Lung; Kirsch, David G.; Badea, Cristian T.

    2015-01-01

    Purpose: X-ray computed tomography (CT) is widely used, both clinically and preclinically, for fast, high-resolution anatomic imaging; however, compelling opportunities exist to expand its use in functional imaging applications. For instance, spectral information combined with nanoparticle contrast agents enables quantification of tissue perfusion levels, while temporal information details cardiac and respiratory dynamics. The authors propose and demonstrate a projection acquisition and reconstruction strategy for 5D CT (3D + dual energy + time) which recovers spectral and temporal information without substantially increasing radiation dose or sampling time relative to anatomic imaging protocols. Methods: The authors approach the 5D reconstruction problem within the framework of low-rank and sparse matrix decomposition. Unlike previous work on rank-sparsity constrained CT reconstruction, the authors establish an explicit rank-sparse signal model to describe the spectral and temporal dimensions. The spectral dimension is represented as a well-sampled time and energy averaged image plus regularly undersampled principal components describing the spectral contrast. The temporal dimension is represented as the same time and energy averaged reconstruction plus contiguous, spatially sparse, and irregularly sampled temporal contrast images. Using a nonlinear, image domain filtration approach, the authors refer to as rank-sparse kernel regression, the authors transfer image structure from the well-sampled time and energy averaged reconstruction to the spectral and temporal contrast images. This regularization strategy strictly constrains the reconstruction problem while approximately separating the temporal and spectral dimensions. Separability results in a highly compressed representation for the 5D data in which projections are shared between the temporal and spectral reconstruction subproblems, enabling substantial undersampling. The authors solved the 5D reconstruction

  17. Spectrotemporal CT data acquisition and reconstruction at low dose

    SciTech Connect

    Clark, Darin P.; Badea, Cristian T.; Lee, Chang-Lung; Kirsch, David G.

    2015-11-15

    Purpose: X-ray computed tomography (CT) is widely used, both clinically and preclinically, for fast, high-resolution anatomic imaging; however, compelling opportunities exist to expand its use in functional imaging applications. For instance, spectral information combined with nanoparticle contrast agents enables quantification of tissue perfusion levels, while temporal information details cardiac and respiratory dynamics. The authors propose and demonstrate a projection acquisition and reconstruction strategy for 5D CT (3D + dual energy + time) which recovers spectral and temporal information without substantially increasing radiation dose or sampling time relative to anatomic imaging protocols. Methods: The authors approach the 5D reconstruction problem within the framework of low-rank and sparse matrix decomposition. Unlike previous work on rank-sparsity constrained CT reconstruction, the authors establish an explicit rank-sparse signal model to describe the spectral and temporal dimensions. The spectral dimension is represented as a well-sampled time and energy averaged image plus regularly undersampled principal components describing the spectral contrast. The temporal dimension is represented as the same time and energy averaged reconstruction plus contiguous, spatially sparse, and irregularly sampled temporal contrast images. Using a nonlinear, image domain filtration approach, the authors refer to as rank-sparse kernel regression, the authors transfer image structure from the well-sampled time and energy averaged reconstruction to the spectral and temporal contrast images. This regularization strategy strictly constrains the reconstruction problem while approximately separating the temporal and spectral dimensions. Separability results in a highly compressed representation for the 5D data in which projections are shared between the temporal and spectral reconstruction subproblems, enabling substantial undersampling. The authors solved the 5D reconstruction

  18. Personalized low dose CT via variable kVp

    NASA Astrophysics Data System (ADS)

    Wang, Hui; Jin, Yannan; Yao, Yangyang; Wu, Mingye; Yan, Ming; Tao, Kun; Yin, Zhye; De Man, Bruno

    2015-03-01

    Computerized Tomography (CT) is a powerful radiographic imaging technology but the health risk due to the exposure of x-ray radiation has drawn wide concern. In this study, we propose to use kVp modulation to reduce the radiation dose and achieve the personalized low dose CT. Two sets of simulation are performed to demonstrate the effectiveness of kVp modulation and the corresponding calibration. The first simulation used the helical body phantom (HBP) that is an elliptical water cylinder with high density bone inserts. The second simulation uses the NCAT phantom to emulate the practical use of kVp modulation approach with region of interest (ROI) selected in the cardiac region. The kVp modulation profile could be optimized view by view based on the knowledge of patient attenuation. A second order correction is applied to eliminate the beam hardening artifacts. To simplify the calibration process, we first generate the calibration vectors for a few representative spectra and then acquire other calibration vectors with interpolation. The simulation results demonstrate the beam hardening artifacts in the images with kVp modulation can be eliminated with proper beam hardening correction. The results also show that the simplification of calibration did not impair the image quality: the calibration with the simplified and the complete vectors both eliminate the artifacts effectively and the results are comparable. In summary, this study demonstrates the feasibility of kVp modulation and gives a practical way to calibrate the high order beam hardening artifacts.

  19. Network-based reading system for lung cancer screening CT

    NASA Astrophysics Data System (ADS)

    Fujino, Yuichi; Fujimura, Kaori; Nomura, Shin-ichiro; Kawashima, Harumi; Tsuchikawa, Megumu; Matsumoto, Toru; Nagao, Kei-ichi; Uruma, Takahiro; Yamamoto, Shinji; Takizawa, Hotaka; Kuroda, Chikazumi; Nakayama, Tomio

    2006-03-01

    This research aims to support chest computed tomography (CT) medical checkups to decrease the death rate by lung cancer. We have developed a remote cooperative reading system for lung cancer screening over the Internet, a secure transmission function, and a cooperative reading environment. It is called the Network-based Reading System. A telemedicine system involves many issues, such as network costs and data security if we use it over the Internet, which is an open network. In Japan, broadband access is widespread and its cost is the lowest in the world. We developed our system considering human machine interface and security. It consists of data entry terminals, a database server, a computer aided diagnosis (CAD) system, and some reading terminals. It uses a secure Digital Imaging and Communication in Medicine (DICOM) encrypting method and Public Key Infrastructure (PKI) based secure DICOM image data distribution. We carried out an experimental trial over the Japan Gigabit Network (JGN), which is the testbed for the Japanese next-generation network, and conducted verification experiments of secure screening image distribution, some kinds of data addition, and remote cooperative reading. We found that network bandwidth of about 1.5 Mbps enabled distribution of screening images and cooperative reading and that the encryption and image distribution methods we proposed were applicable to the encryption and distribution of general DICOM images via the Internet.

  20. Effective doses from cone beam CT investigation of the jaws

    PubMed Central

    Davies, J; Johnson, B; Drage, NA

    2012-01-01

    Objectives The purpose of the study was to calculate the effective dose delivered to the patient undergoing cone beam (CB) CT of the jaws and maxillofacial complex using the i-CAT Next Generation CBCT scanner (Imaging Sciences International, Hatfield, PA). Methods A RANDO® phantom (The Phantom Laboratory, Salem, NY) containing thermoluminence dosemeters were scanned 10 times for each of the 6 imaging protocols. Effective doses for each protocol were calculated using the 1990 and approved 2007 International Commission on Radiological Protection (ICRP) recommended tissue weighting factors (E1990, E2007). Results The effective dose for E1990 and E2007, respectively, were: full field of view (FOV) of the head, 47 μSv and 78 μSv; 13 cm scan of the jaws, 44 μSv and 77 μSv; 6 cm standard mandible, 35 μSv and 58 μSv; 6 cm high resolution mandible, 69 μSv and 113 μSv; 6 cm standard maxilla, 18 μSv and 32 μSv; and 6 cm high resolution maxilla, 35 μSv and 60 μSv. Conclusions Using the new generation of CBCT scanner, the effective dose is lower than the original generation machine for a similar FOV using the ICRP 2007 tissue weighting factors. PMID:22184626

  1. Comparison of effective radiation doses from X-ray, CT, and PET/CT in pediatric patients with neuroblastoma using a dose monitoring program

    PubMed Central

    Kim, Yeun Yoon; Shin, Hyun Joo; Kim, Myung-Joon; Lee, Mi-Jung

    2016-01-01

    PURPOSE We aimed to evaluate the use of a dose monitoring program for calculating and comparing the diagnostic radiation doses in pediatric patients with neuroblastoma. METHODS We retrospectively reviewed diagnostic and therapeutic imaging studies performed on pediatric patients with neuroblastoma from 2003 to 2014. We calculated the mean effective dose per exam for X-ray, conventional computed tomography (CT), and CT of positron emission tomography/computed tomography (PET/CT) from the data collected using a dose monitoring program (DoseTrack group) since October 2012. Using the data, we estimated the cumulative dose per person and the relative dose from each modality in all patients (Total group). The effective dose from PET was manually calculated for all patients. RESULTS We included 63 patients with a mean age of 3.2±3.5 years; 28 had a history of radiation therapy, with a mean irradiated dose of 31.9±23.2 Gy. The mean effective dose per exam was 0.04±0.19 mSv for X-ray, 1.09±1.11 mSv for CT, and 8.35±7.45 mSv for CT of PET/CT in 31 patients of the Dose-Track group. The mean estimated cumulative dose per patient in the Total group was 3.43±2.86 mSv from X-ray (8.5%), 7.66±6.09 mSv from CT (19.1%), 18.35±13.52 mSv from CT of PET/CT (45.7%), and 10.71±10.05 mSv from PET (26.7%). CONCLUSION CT of PET/CT contributed nearly half of the total cumulative dose in pediatric patients with neuroblastoma. The radiation dose from X-ray was not negligible because of the large number of X-ray images. A dose monitoring program can be useful for calculating radiation doses in patients with cancer. PMID:27306659

  2. Dose distribution for dental cone beam CT and its implication for defining a dose index

    PubMed Central

    Pauwels, R; Theodorakou, C; Walker, A; Bosmans, H; Jacobs, R; Horner, K; Bogaerts, R

    2012-01-01

    Objectives To characterize the dose distribution for a range of cone beam CT (CBCT) units, investigating different field of view sizes, central and off-axis geometries, full or partial rotations of the X-ray tube and different clinically applied beam qualities. The implications of the dose distributions on the definition and practicality of a CBCT dose index were assessed. Methods Dose measurements on CBCT devices were performed by scanning cylindrical head-size water and polymethyl methacrylate phantoms, using thermoluminescent dosemeters, a small-volume ion chamber and radiochromic films. Results It was found that the dose distribution can be asymmetrical for dental CBCT exposures throughout a homogeneous phantom, owing to an asymmetrical positioning of the isocentre and/or partial rotation of the X-ray source. Furthermore, the scatter tail along the z-axis was found to have a distinct shape, generally resulting in a strong drop (90%) in absorbed dose outside the primary beam. Conclusions There is no optimal dose index available owing to the complicated exposure geometry of CBCT and the practical aspects of quality control measurements. Practical validation of different possible dose indices is needed, as well as the definition of conversion factors to patient dose. PMID:22752320

  3. SU-C-BRB-02: Symmetric and Asymmetric MLC Based Lung Shielding and Dose Optimization During Translating Bed TBI

    SciTech Connect

    Ahmed, S; Kakakhel, MB; Ahmed, SBS; Hussain, A

    2015-06-15

    Purpose: The primary aim was to introduce a dose optimization method for translating bed total body irradiation technique that ensures lung shielding dynamically. Symmetric and asymmetric dynamic MLC apertures were employed for this purpose. Methods: The MLC aperture sizes were defined based on the radiological depth values along the divergent ray lines passing through the individual CT slices. Based on these RD values, asymmetrically shaped MLC apertures were defined every 9 mm of the phantom in superior-inferior direction. Individual MLC files were created with MATLAB™ and were imported into Eclipse™ treatment planning system for dose calculations. Lungs can be shielded to an optimum level by reducing the MLC aperture width over the lungs. The process was repeated with symmetrically shaped apertures. Results: Dose-volume histogram (DVH) analysis shows that the asymmetric MLC based technique provides better dose coverage to the body and optimum shielding of the lungs compared to symmetrically shaped beam apertures. Midline dose homogeneity is within ±3% with asymmetric MLC apertures whereas it remains within ±4.5% with symmetric ones (except head region where it drops down to −7%). The substantial over and under dosage of ±5% at tissue interfaces has been reduced to ±2% with asymmetric MLC technique. Lungs dose can be reduced to any desired limit. In this experiment lungs dose was reduced to 80% of the prescribed dose, as was desired. Conclusion: The novel asymmetric MLC based technique assures optimum shielding of OARs (e.g. lungs) and better 3-D dose homogeneity and body-dose coverage in comparison with the symmetric MLC aperture optimization. The authors acknowledge the financial and infrastructural support provided by Pakistan Institute of Engineering & Applied Sciences (PIEAS), Islamabad and Aga Khan University Hospital (AKUH), Karachi during the course of this research project. Authors have no conflict of interest with any national / international

  4. Radiation dose reduction for coronary artery calcium scoring at 320-detector CT with adaptive iterative dose reduction 3D.

    PubMed

    Tatsugami, Fuminari; Higaki, Toru; Fukumoto, Wataru; Kaichi, Yoko; Fujioka, Chikako; Kiguchi, Masao; Yamamoto, Hideya; Kihara, Yasuki; Awai, Kazuo

    2015-06-01

    To assess the possibility of reducing the radiation dose for coronary artery calcium (CAC) scoring by using adaptive iterative dose reduction 3D (AIDR 3D) on a 320-detector CT scanner. Fifty-four patients underwent routine- and low-dose CT for CAC scoring. Low-dose CT was performed at one-third of the tube current used for routine-dose CT. Routine-dose CT was reconstructed with filtered back projection (FBP) and low-dose CT was reconstructed with AIDR 3D. We compared the calculated Agatston-, volume-, and mass scores of these images. The overall percentage difference in the Agatston-, volume-, and mass scores between routine- and low-dose CT studies was 15.9, 11.6, and 12.6%, respectively. There were no significant differences in the routine- and low-dose CT studies irrespective of the scoring algorithms applied. The CAC measurements of both imaging modalities were highly correlated with respect to the Agatston- (r = 0.996), volume- (r = 0.996), and mass score (r = 0.997; p < 0.001, all); the Bland-Altman limits of agreement scores were -37.4 to 51.4, -31.2 to 36.4 and -30.3 to 40.9%, respectively, suggesting that AIDR 3D was a good alternative for FBP. The mean effective radiation dose for routine- and low-dose CT was 2.2 and 0.7 mSv, respectively. The use of AIDR 3D made it possible to reduce the radiation dose by 67% for CAC scoring without impairing the quantification of coronary calcification.

  5. Radiation dose reduction for coronary artery calcium scoring at 320-detector CT with adaptive iterative dose reduction 3D.

    PubMed

    Tatsugami, Fuminari; Higaki, Toru; Fukumoto, Wataru; Kaichi, Yoko; Fujioka, Chikako; Kiguchi, Masao; Yamamoto, Hideya; Kihara, Yasuki; Awai, Kazuo

    2015-06-01

    To assess the possibility of reducing the radiation dose for coronary artery calcium (CAC) scoring by using adaptive iterative dose reduction 3D (AIDR 3D) on a 320-detector CT scanner. Fifty-four patients underwent routine- and low-dose CT for CAC scoring. Low-dose CT was performed at one-third of the tube current used for routine-dose CT. Routine-dose CT was reconstructed with filtered back projection (FBP) and low-dose CT was reconstructed with AIDR 3D. We compared the calculated Agatston-, volume-, and mass scores of these images. The overall percentage difference in the Agatston-, volume-, and mass scores between routine- and low-dose CT studies was 15.9, 11.6, and 12.6%, respectively. There were no significant differences in the routine- and low-dose CT studies irrespective of the scoring algorithms applied. The CAC measurements of both imaging modalities were highly correlated with respect to the Agatston- (r = 0.996), volume- (r = 0.996), and mass score (r = 0.997; p < 0.001, all); the Bland-Altman limits of agreement scores were -37.4 to 51.4, -31.2 to 36.4 and -30.3 to 40.9%, respectively, suggesting that AIDR 3D was a good alternative for FBP. The mean effective radiation dose for routine- and low-dose CT was 2.2 and 0.7 mSv, respectively. The use of AIDR 3D made it possible to reduce the radiation dose by 67% for CAC scoring without impairing the quantification of coronary calcification. PMID:25754302

  6. Heart region segmentation from low-dose CT scans: an anatomy based approach

    NASA Astrophysics Data System (ADS)

    Reeves, Anthony P.; Biancardi, Alberto M.; Yankelevitz, David F.; Cham, Matthew D.; Henschke, Claudia I.

    2012-02-01

    Cardiovascular disease is a leading cause of death in developed countries. The concurrent detection of heart diseases during low-dose whole-lung CT scans (LDCT), typically performed as part of a screening protocol, hinges on the accurate quantification of coronary calcification. The creation of fully automated methods is ideal as complete manual evaluation is imprecise, operator dependent, time consuming and thus costly. The technical challenges posed by LDCT scans in this context are mainly twofold. First, there is a high level image noise arising from the low radiation dose technique. Additionally, there is a variable amount of cardiac motion blurring due to the lack of electrocardiographic gating and the fact that heart rates differ between human subjects. As a consequence, the reliable segmentation of the heart, the first stage toward the implementation of morphologic heart abnormality detection, is also quite challenging. An automated computer method based on a sequential labeling of major organs and determination of anatomical landmarks has been evaluated on a public database of LDCT images. The novel algorithm builds from a robust segmentation of the bones and airways and embodies a stepwise refinement starting at the top of the lungs where image noise is at its lowest and where the carina provides a good calibration landmark. The segmentation is completed at the inferior wall of the heart where extensive image noise is accommodated. This method is based on the geometry of human anatomy and does not involve training through manual markings. Using visual inspection by an expert reader as a gold standard, the algorithm achieved successful heart and major vessel segmentation in 42 of 45 low-dose CT images. In the 3 remaining cases, the cardiac base was over segmented due to incorrect hemidiaphragm localization.

  7. Utilising pseudo-CT data for dose calculation and plan optimization in adaptive radiotherapy.

    PubMed

    Whelan, Brendan; Kumar, Shivani; Dowling, Jason; Begg, Jarrad; Lambert, Jonathan; Lim, Karen; Vinod, Shalini K; Greer, Peter B; Holloway, Lois

    2015-12-01

    To quantify the dose calculation error and resulting optimization uncertainty caused by performing inverse treatment planning on inaccurate electron density data (pseudo-CT) as needed for adaptive radiotherapy and Magnetic Resonance Imaging (MRI) based treatment planning. Planning Computer Tomography (CT) data from 10 cervix cancer patients was used to generate 4 pseudo-CT data sets. Each pseudo-CT was created based on an available method of assigning electron density to an anatomic image. An inversely modulated radiotherapy (IMRT) plan was developed on each planning CT. The dose calculation error caused by each pseudo-CT data set was quantified by comparing the dose calculated each pseudo-CT data set with that calculated on the original planning CT for the same IMRT plan. The optimization uncertainty introduced by the dose calculation error was quantified by re-optimizing the same optimization parameters on each pseudo-CT data set and comparing against the original planning CT. Dose differences were quantified by assessing the Equivalent Uniform Dose (EUD) for targets and relevant organs at risk. Across all pseudo-CT data sets and all organs, the absolute mean dose calculation error was 0.2 Gy, and was within 2 % of the prescription dose in 98.5 % of cases. Then absolute mean optimisation error was 0.3 Gy EUD, indicating that that inverse optimisation is impacted by the dose calculation error. However, the additional uncertainty introduced to plan optimisation is small compared the sources of variation which already exist. Use of inaccurate electron density data for inverse treatment planning results in a dose calculation error, which in turn introduces additional uncertainty into the plan optimization process. In this study, we showed that both of these effects are clinically acceptable for cervix cancer patients using four different pseudo-CT data sets. Dose calculation and inverse optimization on pseudo-CT is feasible for this patient cohort.

  8. Ultralow dose computed tomography attenuation correction for pediatric PET CT using adaptive statistical iterative reconstruction

    SciTech Connect

    Brady, Samuel L.; 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 images 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.

  9. Screening for lung cancer using low dose computed tomography.

    PubMed

    Tammemagi, Martin C; Lam, Stephen

    2014-01-01

    Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant screening and the appropriate management of lung nodules found at screening. An accurate risk prediction model is more efficient than age and pack years of smoking alone at identifying those who will develop lung cancer and die from the disease. Algorithms are available for assessing people who screen positive to determine who needs additional imaging or invasive investigations. Concerns about low dose computed tomography screening include false positive results, overdiagnosis, radiation exposure, and costs. Further work is needed to define the frequency and duration of screening and to refine risk prediction models so that they can be used to assess the risk of lung cancer in special populations. Another important area is the use of computer vision software tools to facilitate high throughput interpretation of low dose computed tomography images so that costs can be reduced and the consistency of scan interpretation can be improved. Sufficient data are available to support the implementation of screening programs at the population level in stages that can be expanded when found to perform well to improve the outcome of patients with lung cancer. PMID:24865600

  10. Personnel radiation dose considerations in the use of an integrated PET-CT scanner for radiotherapy treatment planning.

    PubMed

    Carson, K J; Young, V A L; Cosgrove, V P; Jarritt, P H; Hounsell, A R

    2009-11-01

    The acquisition of radiotherapy planning scans on positron emission tomography (PET)-CT scanners requires the involvement of radiotherapy radiographers. This study assessed the radiation dose received by these radiographers during this process. Radiotherapy planning (18)F-fluorodeoxyglucose ((18)F-FDG) PET-CT scans were acquired for 28 non-small cell lung cancer patients. In order to minimise the radiation dose received, a two-stage process was used in which the most time-consuming part of the set-up was performed before the patient received their (18)F-FDG injection. Throughout this process, the radiographers wore electronic personal dosemeters and recorded the doses received at different stages of the process. The mean total radiation dose received by a radiotherapy radiographer was 5.1+/-2.6 microSv per patient. The use of the two-stage process reduced the time spent in close proximity to the patient by approximately a factor of four. The two-stage process was effective in keeping radiation dose to a minimum. The use of a pre-injection set-up session reduces the radiation dose to the radiotherapy radiographers because of their involvement in PET-CT radiotherapy treatment planning scans by approximately a factor of three. PMID:19332513

  11. From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel.

    PubMed

    Su, Chunxia; Meyer, Mathias; Pirker, Robert; Voigt, Wieland; Shi, Jingyun; Pilz, Lothar; Huber, Rudolf M; Wu, Yilong; Wang, Jinghong; He, Yonglan; Wang, Xuan; Zhang, Jian; Zhi, Xiuyi; Shi, Meiqi; Zhu, Bo; Schoenberg, Stefan S; Henzler, Thomas; Manegold, Christian; Zhou, Caicun; Roessner, Eric Dominic

    2016-08-01

    The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations

  12. From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel.

    PubMed

    Su, Chunxia; Meyer, Mathias; Pirker, Robert; Voigt, Wieland; Shi, Jingyun; Pilz, Lothar; Huber, Rudolf M; Wu, Yilong; Wang, Jinghong; He, Yonglan; Wang, Xuan; Zhang, Jian; Zhi, Xiuyi; Shi, Meiqi; Zhu, Bo; Schoenberg, Stefan S; Henzler, Thomas; Manegold, Christian; Zhou, Caicun; Roessner, Eric Dominic

    2016-08-01

    The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations

  13. From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel

    PubMed Central

    Su, Chunxia; Meyer, Mathias; Pirker, Robert; Voigt, Wieland; Shi, Jingyun; Pilz, Lothar; Huber, Rudolf M.; Wu, Yilong; Wang, Jinghong; He, Yonglan; Wang, Xuan; Zhang, Jian; Zhi, Xiuyi; Shi, Meiqi; Zhu, Bo; Schoenberg, Stefan S.; Henzler, Thomas; Roessner, Eric Dominic

    2016-01-01

    The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations

  14. From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel

    PubMed Central

    Su, Chunxia; Meyer, Mathias; Pirker, Robert; Voigt, Wieland; Shi, Jingyun; Pilz, Lothar; Huber, Rudolf M.; Wu, Yilong; Wang, Jinghong; He, Yonglan; Wang, Xuan; Zhang, Jian; Zhi, Xiuyi; Shi, Meiqi; Zhu, Bo; Schoenberg, Stefan S.; Henzler, Thomas; Roessner, Eric Dominic

    2016-01-01

    The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations

  15. Management of CT screen-detected lung nodule: the thoracic surgeon perspective

    PubMed Central

    Al-Ayoubi, Adnan M.

    2016-01-01

    Implementation of lung cancer CT screening programs will increase the incidence of pulmonary nodules and require multidisciplinary efforts for devising appropriate treatment plans. The role of the thoracic surgeon is paramount in leading the discussion and shaping the treatment strategies. Management of CT screen-detected lung nodules differ from conventional lung cancer nodules given their smaller size, varied histologies and potentially indolent growth. Here we present a brief overview of the thoracic surgeon’s perspective on the clinical evaluation, diagnostic tests and surgical approach to these nodules in the setting of a comprehensive lung cancer screening program. PMID:27195274

  16. Low-Dose PET/CT and Full-Dose Contrast-Enhanced CT at the Initial Staging of Localized Diffuse Large B-Cell Lymphomas

    PubMed Central

    Sabaté-Llobera, Aida; Cortés-Romera, Montserrat; Mercadal, Santiago; Hernández-Gañán, Javier; Pomares, Helena; González-Barca, Eva; Gámez-Cenzano, Cristina

    2016-01-01

    Computed tomography (CT) has been used as the reference imaging technique for the initial staging of diffuse large B-cell lymphoma until recent days, when the introduction of positron emission tomography (PET)/CT imaging as a hybrid technique has become of routine use. However, the performance of both examinations is still common. The aim of this work was to compare the findings between low-dose 2-deoxy-2-(18F)fluoro-d-glucose (18F-FDG) PET/CT and full-dose contrast-enhanced CT (ceCT) in 28 patients with localized diffuse large B-cell lymphoma according to PET/CT findings, in order to avoid the performance of ceCT. For each technique, a comparison in the number of nodal and extranodal involved regions was performed. PET/CT showed more lesions than ceCT in both nodal (41 vs. 36) and extranodal localizations (16 vs. 15). Disease staging according to both techniques was concordant in 22 patients (79%) and discordant in 6 patients (21%), changing treatment management in 3 patients (11%). PET/CT determined a better staging and therapeutic approach, making the performance of an additional ceCT unnecessary. PMID:27559300

  17. Low-Dose PET/CT and Full-Dose Contrast-Enhanced CT at the Initial Staging of Localized Diffuse Large B-Cell Lymphomas.

    PubMed

    Sabaté-Llobera, Aida; Cortés-Romera, Montserrat; Mercadal, Santiago; Hernández-Gañán, Javier; Pomares, Helena; González-Barca, Eva; Gámez-Cenzano, Cristina

    2016-01-01

    Computed tomography (CT) has been used as the reference imaging technique for the initial staging of diffuse large B-cell lymphoma until recent days, when the introduction of positron emission tomography (PET)/CT imaging as a hybrid technique has become of routine use. However, the performance of both examinations is still common. The aim of this work was to compare the findings between low-dose 2-deoxy-2-((18)F)fluoro-d-glucose ((18)F-FDG) PET/CT and full-dose contrast-enhanced CT (ceCT) in 28 patients with localized diffuse large B-cell lymphoma according to PET/CT findings, in order to avoid the performance of ceCT. For each technique, a comparison in the number of nodal and extranodal involved regions was performed. PET/CT showed more lesions than ceCT in both nodal (41 vs. 36) and extranodal localizations (16 vs. 15). Disease staging according to both techniques was concordant in 22 patients (79%) and discordant in 6 patients (21%), changing treatment management in 3 patients (11%). PET/CT determined a better staging and therapeutic approach, making the performance of an additional ceCT unnecessary.

  18. CTC-ask: a new algorithm for conversion of CT numbers to tissue parameters for Monte Carlo dose calculations applying DICOM RS knowledge

    NASA Astrophysics Data System (ADS)

    Ottosson, Rickard O.; Behrens, Claus F.

    2011-11-01

    One of the building blocks in Monte Carlo (MC) treatment planning is to convert patient CT data to MC compatible phantoms, consisting of density and media matrices. The resulting dose distribution is highly influenced by the accuracy of the conversion. Two major contributing factors are precise conversion of CT number to density and proper differentiation between air and lung. Existing tools do not address this issue specifically. Moreover, their density conversion may depend on the number of media used. Differentiation between air and lung is an important task in MC treatment planning and misassignment may lead to local dose errors on the order of 10%. A novel algorithm, CTC-ask, is presented in this study. It enables locally confined constraints for the media assignment and is independent of the number of media used for the conversion of CT number to density. MC compatible phantoms were generated for two clinical cases using a CT-conversion scheme implemented in both CTC-ask and the DICOM-RT toolbox. Full MC dose calculation was subsequently conducted and the resulting dose distributions were compared. The DICOM-RT toolbox inaccurately assigned lung in 9.9% and 12.2% of the voxels located outside of the lungs for the two cases studied, respectively. This was completely avoided by CTC-ask. CTC-ask is able to reduce anatomically irrational media assignment. The CTC-ask source code can be made available upon request to the authors.

  19. A statistical description of 3D lung texture from CT data

    NASA Astrophysics Data System (ADS)

    Chaisaowong, Kraisorn; Paul, Andreas

    2015-03-01

    A method was described to create a statistical description of 3D lung texture from CT data. The second order statistics, i.e. the gray level co-occurrence matrix (GLCM), has been applied to characterize texture of lung by defining the joint probability distribution of pixel pairs. The required GLCM was extended to three-dimensional image regions to deal with CT volume data. For a fine-scale lung segmentation, both the 3D GLCM of lung and thorax without lung are required. Once the co-occurrence densities are measured, the 3D models of the joint probability density function for each describing direction of involving voxel pairs and for each class (lung or thorax) are estimated using mixture of Gaussians through the expectation-maximization algorithm. This leads to a feature space that describes the 3D lung texture.

  20. Phantom based evaluation of CT to CBCT image registration for proton therapy dose recalculation

    NASA Astrophysics Data System (ADS)

    Landry, Guillaume; Dedes, George; Zöllner, Christoph; Handrack, Josefine; Janssens, Guillaume; Orban de Xivry, Jonathan; Reiner, Michael; Paganelli, Chiara; Riboldi, Marco; Kamp, Florian; Söhn, Matthias; Wilkens, Jan J.; Baroni, Guido; Belka, Claus; Parodi, Katia

    2015-01-01

    The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. In conclusion, our phantom

  1. A hybrid approach for rapid, accurate, and direct kilovoltage radiation dose calculations in CT voxel space

    SciTech Connect

    Kouznetsov, Alexei; Tambasco, Mauro

    2011-03-15

    Purpose: To develop and validate a fast and accurate method that uses computed tomography (CT) voxel data to estimate absorbed radiation dose at a point of interest (POI) or series of POIs from a kilovoltage (kV) imaging procedure. Methods: The authors developed an approach that computes absorbed radiation dose at a POI by numerically evaluating the linear Boltzmann transport equation (LBTE) using a combination of deterministic and Monte Carlo (MC) techniques. This hybrid approach accounts for material heterogeneity with a level of accuracy comparable to the general MC algorithms. Also, the dose at a POI is computed within seconds using the Intel Core i7 CPU 920 2.67 GHz quad core architecture, and the calculations are performed using CT voxel data, making it flexible and feasible for clinical applications. To validate the method, the authors constructed and acquired a CT scan of a heterogeneous block phantom consisting of a succession of slab densities: Tissue (1.29 cm), bone (2.42 cm), lung (4.84 cm), bone (1.37 cm), and tissue (4.84 cm). Using the hybrid transport method, the authors computed the absorbed doses at a set of points along the central axis and x direction of the phantom for an isotropic 125 kVp photon spectral point source located along the central axis 92.7 cm above the phantom surface. The accuracy of the results was compared to those computed with MCNP, which was cross-validated with EGSnrc, and served as the benchmark for validation. Results: The error in the depth dose ranged from -1.45% to +1.39% with a mean and standard deviation of -0.12% and 0.66%, respectively. The error in the x profile ranged from -1.3% to +0.9%, with standard deviations of -0.3% and 0.5%, respectively. The number of photons required to achieve these results was 1x10{sup 6}. Conclusions: The voxel-based hybrid method evaluates the LBTE rapidly and accurately to estimate the absorbed x-ray dose at any POI or series of POIs from a kV imaging procedure.

  2. Experimental evaluation of actual delivered dose using mega-voltage cone-beam CT and direct point dose measurement

    SciTech Connect

    Matsubara, Kana; Kohno, Ryosuke; Nishioka, Shie; Shibuya, Toshiyuki; Ariji, Takaki; Akimoto, Tetsuo; Saitoh, Hidetoshi

    2013-07-01

    Radiation therapy in patients is planned by using computed tomography (CT) images acquired before start of the treatment course. Here, tumor shrinkage or weight loss or both, which are common during the treatment course for patients with head-and-neck (H and N) cancer, causes unexpected differences from the plan, as well as dose uncertainty with the daily positional error of patients. For accurate clinical evaluation, it is essential to identify these anatomical changes and daily positional errors, as well as consequent dosimetric changes. To evaluate the actual delivered dose, the authors proposed direct dose measurement and dose calculation with mega-voltage cone-beam CT (MVCBCT). The purpose of the present study was to experimentally evaluate dose calculation by MVCBCT. Furthermore, actual delivered dose was evaluated directly with accurate phantom setup. Because MVCBCT has CT-number variation, even when the analyzed object has a uniform density, a specific and simple CT-number correction method was developed and applied for the H and N site of a RANDO phantom. Dose distributions were calculated with the corrected MVCBCT images of a cylindrical polymethyl methacrylate phantom. Treatment processes from planning to beam delivery were performed for the H and N site of the RANDO phantom. The image-guided radiation therapy procedure was utilized for the phantom setup to improve measurement reliability. The calculated dose in the RANDO phantom was compared to the measured dose obtained by metal-oxide-semiconductor field-effect transistor detectors. In the polymethyl methacrylate phantom, the calculated and measured doses agreed within about +3%. In the RANDO phantom, the dose difference was less than +5%. The calculated dose based on simulation-CT agreed with the measured dose within±3%, even in the region with a high dose gradient. The actual delivered dose was successfully determined by dose calculation with MVCBCT, and the point dose measurement with the image

  3. Patient radiation dose in prospectively gated axial CT coronary angiography and retrospectively gated helical technique with a 320-detector row CT scanner

    SciTech Connect

    Seguchi, Shigenobu; Aoyama, Takahiko; Koyama, Shuji; Fujii, Keisuke; Yamauchi-Kawaura, Chiyo

    2010-11-15

    Purpose: The aim of this study was to evaluate radiation dose to patients undergoing computed tomography coronary angiography (CTCA) for prospectively gated axial (PGA) technique and retrospectively gated helical (RGH) technique. Methods: Radiation doses were measured for a 320-detector row CT scanner (Toshiba Aquilion ONE) using small sized silicon-photodiode dosimeters, which were implanted at various tissue and organ positions within an anthropomorphic phantom for a standard Japanese adult male. Output signals from photodiode dosimeters were read out on a personal computer, from which organ and effective doses were computed according to guidelines published in the International Commission on Radiological Protection Publication 103. Results: Organs that received high doses were breast, followed by lung, esophagus, and liver. Breast doses obtained with PGA technique and a phase window width of 16% at a simulated heart rate of 60 beats per minute were 13 mGy compared to 53 mGy with RGH technique using electrocardiographically dependent dose modulation at the same phase window width as that in PGA technique. Effective doses obtained in this case were 4.7 and 20 mSv for the PGA and RGH techniques, respectively. Conversion factors of dose length product to the effective dose in PGA and RGH were 0.022 and 0.025 mSv mGy{sup -1} cm{sup -1} with a scan length of 140 mm. Conclusions: CTCA performed with PGA technique provided a substantial effective dose reduction, i.e., 70%-76%, compared to RGH technique using the dose modulation at the same phase windows as those in PGA technique. Though radiation doses in CTCA with RGH technique were the same level as, or some higher than, those in conventional coronary angiography (CCA), the use of PGA technique reduced organ and effective doses to levels less than CCA except for breast dose.

  4. Converging Stereotactic Radiotherapy Using Kilovoltage X-Rays: Experimental Irradiation of Normal Rabbit Lung and Dose-Volume Analysis With Monte Carlo Simulation

    SciTech Connect

    Kawase, Takatsugu; Kunieda, Etsuo Deloar, Hossain M.; Tsunoo, Takanori; Seki, Satoshi; Oku, Yohei; Saitoh, Hidetoshi; Saito, Kimiaki; Ogawa, Eileen N.; Ishizaka, Akitoshi; Kameyama, Kaori; Kubo, Atsushi

    2009-10-01

    Purpose: To validate the feasibility of developing a radiotherapy unit with kilovoltage X-rays through actual irradiation of live rabbit lungs, and to explore the practical issues anticipated in future clinical application to humans through Monte Carlo dose simulation. Methods and Materials: A converging stereotactic irradiation unit was developed, consisting of a modified diagnostic computed tomography (CT) scanner. A tiny cylindrical volume in 13 normal rabbit lungs was individually irradiated with single fractional absorbed doses of 15, 30, 45, and 60 Gy. Observational CT scanning of the whole lung was performed every 2 weeks for 30 weeks after irradiation. After 30 weeks, histopathologic specimens of the lungs were examined. Dose distribution was simulated using the Monte Carlo method, and dose-volume histograms were calculated according to the data. A trial estimation of the effect of respiratory movement on dose distribution was made. Results: A localized hypodense change and subsequent reticular opacity around the planning target volume (PTV) were observed in CT images of rabbit lungs. Dose-volume histograms of the PTVs and organs at risk showed a focused dose distribution to the target and sufficient dose lowering in the organs at risk. Our estimate of the dose distribution, taking respiratory movement into account, revealed dose reduction in the PTV. Conclusions: A converging stereotactic irradiation unit using kilovoltage X-rays was able to generate a focused radiobiologic reaction in rabbit lungs. Dose-volume histogram analysis and estimated sagittal dose distribution, considering respiratory movement, clarified the characteristics of the irradiation received from this type of unit.

  5. RADIANCE: An automated, enterprise-wide solution for archiving and reporting CT radiation dose estimates.

    PubMed

    Cook, Tessa S; Zimmerman, Stefan L; Steingall, Scott R; Maidment, Andrew D A; Kim, Woojin; Boonn, William W

    2011-01-01

    There is growing interest in the ability to monitor, track, and report exposure to radiation from medical imaging. Historically, however, dose information has been stored on an image-based dose sheet, an arrangement that precludes widespread indexing. Although scanner manufacturers are beginning to include dose-related parameters in the Digital Imaging and Communications in Medicine (DICOM) headers of imaging studies, there remains a vast repository of retrospective computed tomographic (CT) data with image-based dose sheets. Consequently, it is difficult for imaging centers to monitor their dose estimates or participate in the American College of Radiology (ACR) Dose Index Registry. An automated extraction software pipeline known as Radiation Dose Intelligent Analytics for CT Examinations (RADIANCE) has been designed that quickly and accurately parses CT dose sheets to extract and archive dose-related parameters. Optical character recognition of information in the dose sheet leads to creation of a text file, which along with the DICOM study header is parsed to extract dose-related data. The data are then stored in a relational database that can be queried for dose monitoring and report creation. RADIANCE allows efficient dose analysis of CT examinations and more effective education of technologists, radiologists, and referring physicians regarding patient exposure to radiation at CT. RADIANCE also allows compliance with the ACR's dose reporting guidelines and greater awareness of patient radiation dose, ultimately resulting in improved patient care and treatment.

  6. RADIANCE: An automated, enterprise-wide solution for archiving and reporting CT radiation dose estimates.

    PubMed

    Cook, Tessa S; Zimmerman, Stefan L; Steingall, Scott R; Maidment, Andrew D A; Kim, Woojin; Boonn, William W

    2011-01-01

    There is growing interest in the ability to monitor, track, and report exposure to radiation from medical imaging. Historically, however, dose information has been stored on an image-based dose sheet, an arrangement that precludes widespread indexing. Although scanner manufacturers are beginning to include dose-related parameters in the Digital Imaging and Communications in Medicine (DICOM) headers of imaging studies, there remains a vast repository of retrospective computed tomographic (CT) data with image-based dose sheets. Consequently, it is difficult for imaging centers to monitor their dose estimates or participate in the American College of Radiology (ACR) Dose Index Registry. An automated extraction software pipeline known as Radiation Dose Intelligent Analytics for CT Examinations (RADIANCE) has been designed that quickly and accurately parses CT dose sheets to extract and archive dose-related parameters. Optical character recognition of information in the dose sheet leads to creation of a text file, which along with the DICOM study header is parsed to extract dose-related data. The data are then stored in a relational database that can be queried for dose monitoring and report creation. RADIANCE allows efficient dose analysis of CT examinations and more effective education of technologists, radiologists, and referring physicians regarding patient exposure to radiation at CT. RADIANCE also allows compliance with the ACR's dose reporting guidelines and greater awareness of patient radiation dose, ultimately resulting in improved patient care and treatment. PMID:21969661

  7. Contrast Agents for Quantitative MicroCT of Lung Tumors in Mice

    PubMed Central

    Lalwani, Kush; Giddabasappa, Anand; Li, Danan; Olson, Peter; Simmons, Brett; Shojaei, Farbod; Arsdale, Todd Van; Christensen, James; Jackson-Fisher, Amy; Wong, Anthony; Lappin, Patrick B; Eswaraka, Jeetendra

    2013-01-01

    The identification and quantitative evaluation of lung tumors in mouse models is challenging and an unmet need in preclinical arena. In this study, we developed a noninvasive contrast-enhanced microCTCT) method to longitudinally evaluate and quantitate lung tumors in mice. Commercially available μCT contrast agents were compared to determine the optimal agent for visualization of thoracic blood vessels and lung tumors in naïve mice and in non-small-cell lung cancer models. Compared with the saline control, iopamidol and iodinated lipid agents provided only marginal increases in contrast resolution. The inorganic nanoparticulate agent provided the best contrast and visualization of thoracic vascular structures; the density contrast was highest at 15 min after injection and was stable for more than 4 h. Differential contrast of the tumors, vascular structures, and thoracic air space by the nanoparticulate agent enabled identification of tumor margins and accurate quantification. μCT data correlated closely with traditional histologic measurements (Pearson correlation coefficient, 0.995). Treatment of ELM4–ALK mice with crizotinib yielded 65% reduction in tumor size and thus demonstrated the utility of quantitative μCT in longitudinal preclinical trials. Overall and among the 3 agents we tested, the inorganic nanoparticulate product was the best commercially available contrast agent for visualization of thoracic blood vessels and lung tumors. Contrast-enhanced μCT imaging is an excellent noninvasive method for longitudinal evaluation during preclinical lung tumor studies. PMID:24326223

  8. CFD simulations of a deforming human lung using dynamic and static CT images

    NASA Astrophysics Data System (ADS)

    Miyawaki, Shinjiro; Hoffman, Eric A.; Lin, Ching-Long

    2015-11-01

    The authors have developed a CFD model to simulate airflow in deforming lungs using dynamic (4D) CT images. After obtaining the surface mesh for one CT image, we deformed the surface mesh to match other CT images using an image registration technique. During the CFD simulations, we deformed the surface mesh by cubic interpolation as a function of lung volume, and deformed the volume mesh using a computational solid mechanics-based algorithm. To investigate the effect of CT scanning method and relative hysteresis with respect to lung volume on pressure drop along the central airways, we performed CFD simulations using different numbers of 4D and static CT images of one healthy subject. Based on the simulation with 13 4DCT images, we found that air flow fractions in airways remain nearly constant over time. By comparing the simulations with 13, 2, and 1 4DCT images, we found that the overall effect of relative hysteresis of lung structure on pressure drop along each branch at peak inspiration was 12%, and the effect of deformation was 16%. As a result of the comparison between simulations with 2 and 1 of 4D and static CT images, the effect of CT scanning method was 16-39%, depending on the deformation of the lung. NIH grants R01-HL094315, U01-HL114494, R01-HL112986, and S10-RR022421. Computer time provided by XSEDE.

  9. Feasibility of quantitative lung perfusion by 4D CT imaging by a new dynamic-scanning protocol in an animal model

    NASA Astrophysics Data System (ADS)

    Wang, Yang; Goldin, Jonathan G.; Abtin, Fereidoun G.; Brown, Matt; McNitt-Gray, Mike

    2008-03-01

    The purpose of this study is to test a new dynamic Perfusion-CT imaging protocol in an animal model and investigate the feasibility of quantifying perfusion of lung parenchyma to perform functional analysis from 4D CT image data. A novel perfusion-CT protocol was designed with 25 scanning time points: the first at baseline and 24 scans after a bolus injection of contrast material. Post-contrast CT scanning images were acquired with a high sampling rate before the first blood recirculation and then a relatively low sampling rate until 10 minutes after administrating contrast agent. Lower radiation techniques were used to keep the radiation dose to an acceptable level. 2 Yorkshire swine with pulmonary emboli underwent this perfusion- CT protocol at suspended end inspiration. The software tools were designed to measure the quantitative perfusion parameters (perfusion, permeability, relative blood volume, blood flow, wash-in & wash-out enhancement) of voxel or interesting area of lung. The perfusion values were calculated for further lung functional analysis and presented visually as contrast enhancement maps for the volume being examined. The results show increased CT temporal sampling rate provides the feasibility of quantifying lung function and evaluating the pulmonary emboli. Differences between areas with known perfusion defects and those without perfusion defects were observed. In conclusion, the techniques to calculate the lung perfusion on animal model have potential application in human lung functional analysis such as evaluation of functional effects of pulmonary embolism. With further study, these techniques might be applicable in human lung parenchyma characterization and possibly for lung nodule characterization.

  10. Prognostic significance of CT-emphysema score in patients with advanced squamous cell lung cancer

    PubMed Central

    Kim, Young Saing; Ahn, Hee Kyung; Cho, Eun Kyung; Jeong, Yu Mi; Kim, Jeong Ho

    2016-01-01

    Background Although emphysema is a known independent risk factor of lung cancer, no study has addressed the prognostic impact of computed tomography (CT)-emphysema score in advanced stage lung cancer. Methods For 84 consecutive patients with stage IIIB and IV squamous cell lung cancer that underwent palliative chemotherapy, severity of emphysema was semi-quantitatively scored using baseline chest CT images according to the Goddard scoring system (possible scores range, 0–24). The cutoff of high CT-emphysema score was determined using the maximum chi-squared test and the prognostic significance of the high CT-emphysema score was evaluated using Kaplan-Meier analysis and Cox proportional hazards analysis. Results The median CT-emphysema score was 5 (range, 0–22). Patients with a high CT-emphysema score (≥4) tended to have poorer overall survival (OS) (median: 6.3 vs. 13.7 months) than those with a score of <4 (P=0.071). Multivariable analysis revealed that a higher CT-emphysema score was a significant independent prognostic factor for poor OS [hazard ratio (HR) =2.06; 95% confidence interval (CI), 1.24–3.41; P=0.005), along with no response to first-line therapy (P=0.009) and no second-line therapy (P<0.001). Conclusions CT-emphysema score is significantly associated with poor prognosis in patients with advanced squamous cell lung cancer. PMID:27621848

  11. Average radiation dose in standard CT examinations of the head: results of the 1990 NEXT survey.

    PubMed

    Conway, B J; McCrohan, J L; Antonsen, R G; Rueter, F G; Slayton, R J; Suleiman, O H

    1992-07-01

    In 1990, as part of the Nationwide Evaluation of X-ray Trends (NEXT) program, 252 computed tomographic (CT) systems were evaluated to measure radiation doses associated with standard head CT in adults. The multiple-scan average dose (MSAD) was used as the dose descriptor. For most of the systems, the MSAD at the midpoint on the central axis of a standard dosimetry phantom was between 34 and 55 mGy. Doses were as high as 140 mGy, and dose sometimes varied by a factor of two or more for identical CT units. This range indicates that dose can potentially be reduced by careful selection of standard CT techniques. Users of CT systems should be aware of radiation dose delivered with CT, dose ranges associated with different systems, and doses delivered with their particular unit, which requires that dose performance of CT systems be assessed by means of a protocol that allows comparison of data collected for identical and/or different units.

  12. Improving abdomen tumor low-dose CT images using a fast dictionary learning based processing

    NASA Astrophysics Data System (ADS)

    Chen, Yang; Yin, Xindao; Shi, Luyao; Shu, Huazhong; Luo, Limin; Coatrieux, Jean-Louis; Toumoulin, Christine

    2013-08-01

    In abdomen computed tomography (CT), repeated radiation exposures are often inevitable for cancer patients who receive surgery or radiotherapy guided by CT images. Low-dose scans should thus be considered in order to avoid the harm of accumulative x-ray radiation. This work is aimed at improving abdomen tumor CT images from low-dose scans by using a fast dictionary learning (DL) based processing. Stemming from sparse representation theory, the proposed patch-based DL approach allows effective suppression of both mottled noise and streak artifacts. The experiments carried out on clinical data show that the proposed method brings encouraging improvements in abdomen low-dose CT images with tumors.

  13. Manifestations and pathological features of solitary thin-walled cavity lung cancer observed by CT and PET/CT imaging

    PubMed Central

    QI, YUANGANG; ZHANG, QING; HUANG, YONG; WANG, DAOQING

    2014-01-01

    The aim of the present study was to analyze and improve the understanding of computed tomography (CT) and positron emission tomography (PET)/CT imaging and the pathological features of solitary thin-walled cavity lung cancer. A total of 16 patients with pathologically confirmed solitary thin-walled cavity lung cancer were included in the present study. All of the patients received CT scans. Among these, two patients underwent an additional PET/CT examination. The CT and PET/CT images were analyzed and a cross-check analysis of the pathological results was conducted. In total, 16 cases of lesions demonstrated thin-walled cavities on the CT images. Among these cases, three presented with an uneven thickening of the cavity walls, 10 cases exhibited wall nodules and three cases presented with compartments in the cavity. The standard uptake value (SUV) of the cavity wall increased in two patients who underwent PET/CT examinations. The 16 cases of lesions were pathologically confirmed as adenocarcinomas. Light microscopy revealed that the tumor cells, which were observed in 12 cases of lesions, had diffused along the inner cavity wall and the tumor cells of four cases had invaded the bronchial wall. Images of the chest that demonstrated a single thin-walled cavity accompanied by uneven thickening of the cavity wall or wall nodules, in addition to an increase in the SUV and compartments in the cavity, indicated potential lung cancer. Valves formed as a result of bronchial wall damage may have led to the cavity. PMID:24959262

  14. Prefecture-wide multi-centre radiation dose survey as a useful tool for CT dose optimisation: report of Gunma radiation dose study.

    PubMed

    Fukushima, Yasuhiro; Taketomi-Takahashi, Ayako; Nakajima, Takahito; Tsushima, Yoshito

    2015-12-01

    The aim of this study was to verify the usefulness for the dose optimisation of setting a diagnostic reference level (DRL) based on the results of a prefecture-wide multi-centre radiation dose survey and providing data feedback. All hospitals/clinics in the authors' prefecture with computed tomography (CT) scanners were requested to report data. The first survey was done in July 2011, and the results of dose-length products (DLPs) for each CT scanner were fed back to all hospitals/clinics, with DRL set from all the data. One year later, a second survey was done in the same manner. The medians of DLP in the upper abdomen, whole body and coronary CT in 2012 were significantly smaller than those of the 2011 survey. The interquartile ranges of DLP in the head, chest, pelvis and coronary CT were also smaller in 2012. Radiation dose survey with data feedback may be helpful for CT dose optimisation.

  15. Assessment of phase based dose modulation for improved dose efficiency in cardiac CT on an anthropomorphic motion phantom

    NASA Astrophysics Data System (ADS)

    Budde, Adam; Nilsen, Roy; Nett, Brian

    2014-03-01

    State of the art automatic exposure control modulates the tube current across view angle and Z based on patient anatomy for use in axial full scan reconstructions. Cardiac CT, however, uses a fundamentally different image reconstruction that applies a temporal weighting to reduce motion artifacts. This paper describes a phase based mA modulation that goes beyond axial and ECG modulation; it uses knowledge of the temporal view weighting applied within the reconstruction algorithm to improve dose efficiency in cardiac CT scanning. Using physical phantoms and synthetic noise emulation, we measure how knowledge of sinogram temporal weighting and the prescribed cardiac phase can be used to improve dose efficiency. First, we validated that a synthetic CT noise emulation method produced realistic image noise. Next, we used the CT noise emulation method to simulate mA modulation on scans of a physical anthropomorphic phantom where a motion profile corresponding to a heart rate of 60 beats per minute was used. The CT noise emulation method matched noise to lower dose scans across the image within 1.5% relative error. Using this noise emulation method to simulate modulating the mA while keeping the total dose constant, the image variance was reduced by an average of 11.9% on a scan with 50 msec padding, demonstrating improved dose efficiency. Radiation dose reduction in cardiac CT can be achieved while maintaining the same level of image noise through phase based dose modulation that incorporates knowledge of the cardiac reconstruction algorithm.

  16. Evaluating the dose effects of a longitudinal micro-CT study on pulmonary tissue in C57BL/6 mice

    NASA Astrophysics Data System (ADS)

    Detombe, Sarah A.; Dunmore-Buyze, Joy; Petrov, Ivailo E.; Drangova, Maria

    2012-03-01

    Background: Micro-computed tomography offers numerous advantages for small animal imaging, including the ability to monitor the same animals throughout a longitudinal study. However, concerns are often raised regarding the effects of x-ray dose accumulated over the course of the experiment. In this study, we scan C57BL/6 mice multiple times per week for six weeks, to determine the effect of the cumulative dose on pulmonary tissue at the end of the study. Methods/Results: C57BL/6 male mice were split into two groups (irradiated group=10, control group=10). The irradiated group was scanned (80kVp/50mA) each week for 6 weeks; the weekly scan session had three scans. This resulted in a weekly dose of 0.84 Gy, and a total study dose of 5.04 Gy. The control group was scanned on the final week. Scans from weeks 1 and 6 were reconstructed and analyzed: overall, there was no significant difference in lung volume or lung density between the control group and the irradiated group. Similarly, there were no significant differences between the week 1 and week 6 scans in the irradiated group. Histological samples taken from excised lung tissue also showed no evidence of inflammation or fibrosis in the irradiated group. Conclusion: This study demonstrates that a 5 Gy x-ray dose accumulated over six weeks during a longitudinal micro-CT study has no significant effects on the pulmonary tissue of C57BL/6 mice. As a result, the many advantages of micro- CT imaging, including rapid acquisition of high-resolution, isotropic images in free-breathing mice, can be taken advantage of in longitudinal studies without concern for negative dose-related effects.

  17. Realistic simulation of reduced-dose CT with noise modeling and sinogram synthesis using DICOM CT images

    SciTech Connect

    Won Kim, Chang; Kim, Jong Hyo

    2014-01-15

    Purpose: Reducing the patient dose while maintaining the diagnostic image quality during CT exams is the subject of a growing number of studies, in which simulations of reduced-dose CT with patient data have been used as an effective technique when exploring the potential of various dose reduction techniques. Difficulties in accessing raw sinogram data, however, have restricted the use of this technique to a limited number of institutions. Here, we present a novel reduced-dose CT simulation technique which provides realistic low-dose images without the requirement of raw sinogram data. Methods: Two key characteristics of CT systems, the noise equivalent quanta (NEQ) and the algorithmic modulation transfer function (MTF), were measured for various combinations of object attenuation and tube currents by analyzing the noise power spectrum (NPS) of CT images obtained with a set of phantoms. Those measurements were used to develop a comprehensive CT noise model covering the reduced x-ray photon flux, object attenuation, system noise, and bow-tie filter, which was then employed to generate a simulated noise sinogram for the reduced-dose condition with the use of a synthetic sinogram generated from a reference CT image. The simulated noise sinogram was filtered with the algorithmic MTF and back-projected to create a noise CT image, which was then added to the reference CT image, finally providing a simulated reduced-dose CT image. The simulation performance was evaluated in terms of the degree of NPS similarity, the noise magnitude, the bow-tie filter effect, and the streak noise pattern at photon starvation sites with the set of phantom images. Results: The simulation results showed good agreement with actual low-dose CT images in terms of their visual appearance and in a quantitative evaluation test. The magnitude and shape of the NPS curves of the simulated low-dose images agreed well with those of real low-dose images, showing discrepancies of less than +/−3.2% in

  18. Lung cancer risk at low doses of alpha particles.

    PubMed

    Hofmann, W; Katz, R; Zhang, C X

    1986-10-01

    A survey of inhabitant exposures arising from the inhalation of 222Rn and 220Rn progeny, and lung cancer mortality has been carried out in two adjacent areas in Guangdong Province, People's Republic of China, designated as the "high background" and the "control" area. Annual exposure rates are 0.38 working level months (WLM) per year in the high background, and 0.16 WLM/yr in the control area. In 14 yr of continuous study, from 1970 to 1983, age-adjusted mortality rates were found to be 2.7 per 10(5) living persons of all ages in the high background area, and 2.9 per 10(5) living persons in the control area. From this data, we conclude that we are unable to determine excess lung cancers over the normal fluctuations below a cumulative exposure of 15 WLM. This conclusion is supported by lung cancer mortality data from Austrian and Finnish high-background areas. A theoretical analysis of epidemiological data on human lung cancer incidence from inhaled 222Rn and 220Rn progeny, which takes into account cell killing as competitive with malignant transformation, leads to the evaluation of a risk factor which is either a linear-exponential or a quadratic-exponential function of the alpha-particle dose. Animal lung cancer data and theoretical considerations can be supplied to support either hypothesis. Thus we conclude that at our current stage of knowledge both the linear-exponential and the quadratic-exponential extrapolation to low doses seem to be equally acceptable for Rn-induced lung cancer risk, possibly suggesting a linear-quadratic transformation function with an exponential cell-killing term, or the influence of risk-modifying factors such as repair or proliferation stimuli.

  19. Incorporating heterogeneity correction and 4DCT in lung stereotactic body radiation therapy (SBRT): The effect on target coverage, organ-at-risk doses, and dose conformity.

    PubMed

    Franks, Kevin N; Purdie, Thomas G; Dawson, Laura A; Bezjak, Andrea; Jaffray, David A; Bissonnette, Jean-Pierre

    2010-01-01

    This study evaluates the dosimetric impact of 4-dimensional computed tomography (4DCT) target volumes and heterogeneity correction (HC) on target coverage, organ-at-risk (OAR) doses, and dose conformity in lung stereotactic body radiation therapy (SBRT). Twelve patients with lung cancer, scanned using both helical CT and 4DCT, were treated with SBRT (60 Gy in 3 fractions). The clinical plans were calculated without HC and based on targets from the free-breathing helical CT scan (PTV(HEL)). Retrospectively, the clinical plans were recalculated with HC and were evaluated based on targets from 4DCT datasets (PTV(4D)) accounting for patient-specific target motion. The PTV(4D) was greater than PTV(HEL) when tumor motion exceeded 7.5 mm (vector). There were significant decreases in target coverage (V100) for the recalculated vs. clinical plans (0.84 vs. 0.94, p < 0.02) for the same monitor units. When the recalculated plans were optimized for equivalent V100 of the clinical plans, there were significant increases in the 60-Gy dose spillage (1.27 vs. 1.13, p < 0.001) and 30-Gy dose spillage (5.20 vs. 3.73, p < 0.001) vs. the clinical plans. There was a significant increase (p < 0.04) in the mean OAR doses between the optimized re-calculated and the clinical plan. Tumor motion is an important consideration for target volumes defined using helical CT. Lower prescription doses may be required when prospectively planning with HC to achieve a similar level of toxicity and dose spillage as expected when planning based on homogeneous dose calculations.

  20. Incorporating Heterogeneity Correction and 4DCT in Lung Stereotactic Body Radiation Therapy (SBRT): The Effect on Target Coverage, Organ-At-Risk Doses, and Dose Conformity

    SciTech Connect

    Franks, Kevin N.; Purdie, Thomas G. Dawson, Laura A.; Bezjak, Andrea; Jaffray, David A.; Bissonnette, Jean-Pierre

    2010-07-01

    This study evaluates the dosimetric impact of 4-dimensional computed tomography (4DCT) target volumes and heterogeneity correction (HC) on target coverage, organ-at-risk (OAR) doses, and dose conformity in lung stereotactic body radiation therapy (SBRT). Twelve patients with lung cancer, scanned using both helical CT and 4DCT, were treated with SBRT (60 Gy in 3 fractions). The clinical plans were calculated without HC and based on targets from the free-breathing helical CT scan (PTV{sub HEL}). Retrospectively, the clinical plans were recalculated with HC and were evaluated based on targets from 4DCT datasets (PTV{sub 4D}) accounting for patient-specific target motion. The PTV{sub 4D} was greater than PTV{sub HEL} when tumor motion exceeded 7.5 mm (vector). There were significant decreases in target coverage (V100) for the recalculated vs. clinical plans (0.84 vs. 0.94, p < 0.02) for the same monitor units. When the recalculated plans were optimized for equivalent V100 of the clinical plans, there were significant increases in the 60-Gy dose spillage (1.27 vs. 1.13, p < 0.001) and 30-Gy dose spillage (5.20 vs. 3.73, p < 0.001) vs. the clinical plans. There was a significant increase (p < 0.04) in the mean OAR doses between the optimized re-calculated and the clinical plan. Tumor motion is an important consideration for target volumes defined using helical CT. Lower prescription doses may be required when prospectively planning with HC to achieve a similar level of toxicity and dose spillage as expected when planning based on homogeneous dose calculations.

  1. The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer.

    PubMed Central

    Field, John K; Duffy, Stephen W; Baldwin, David R; Brain, Kate E; Devaraj, Anand; Eisen, Tim; Green, Beverley A; Holemans, John A; Kavanagh, Terry; Kerr, Keith M; Ledson, Martin; Lifford, Kate J; McRonald, Fiona E; Nair, Arjun; Page, Richard D; Parmar, Mahesh Kb; Rintoul, Robert C; Screaton, Nicholas; Wald, Nicholas J; Weller, David; Whynes, David K; Williamson, Paula R; Yadegarfar, Ghasem; Hansell, David M

    2016-01-01

    BACKGROUND Lung cancer kills more people than any other cancer in the UK (5-year survival < 13%). Early diagnosis can save lives. The USA-based National Lung Cancer Screening Trial reported a 20% relative reduction in lung cancer mortality and 6.7% all-cause mortality in low-dose computed tomography (LDCT)-screened subjects. OBJECTIVES To (1) analyse LDCT lung cancer screening in a high-risk UK population, determine optimum recruitment, screening, reading and care pathway strategies; and (2) assess the psychological consequences and the health-economic implications of screening. DESIGN A pilot randomised controlled trial comparing intervention with usual care. A population-based risk questionnaire identified individuals who were at high risk of developing lung cancer (≥ 5% over 5 years). SETTING Thoracic centres with expertise in lung cancer imaging, respiratory medicine, pathology and surgery: Liverpool Heart & Chest Hospital, Merseyside, and Papworth Hospital, Cambridgeshire. PARTICIPANTS Individuals aged 50-75 years, at high risk of lung cancer, in the primary care trusts adjacent to the centres. INTERVENTIONS A thoracic LDCT scan. Follow-up computed tomography (CT) scans as per protocol. Referral to multidisciplinary team clinics was determined by nodule size criteria. MAIN OUTCOME MEASURES Population-based recruitment based on risk stratification; management of the trial through web-based database; optimal characteristics of CT scan readers (radiologists vs. radiographers); characterisation of CT-detected nodules utilising volumetric analysis; prevalence of lung cancer at baseline; sociodemographic factors affecting participation; psychosocial measures (cancer distress, anxiety, depression, decision satisfaction); and cost-effectiveness modelling. RESULTS A total of 247,354 individuals were approached to take part in the trial; 30.7% responded positively to the screening invitation. Recruitment of participants resulted in 2028 in the CT arm and 2027 in

  2. Potential of Adaptive Radiotherapy to Escalate the Radiation Dose in Combined Radiochemotherapy for Locally Advanced Non-Small Cell Lung Cancer

    SciTech Connect

    Guckenberger, Matthias; Wilbert, Juergen; Richter, Anne; Baier, Kurt; Flentje, Michael

    2011-03-01

    Purpose: To evaluate the potential of adaptive radiotherapy (ART) for advanced-stage non-small cell lung cancer (NSCLC) in terms of lung sparing and dose escalation. Methods and Materials: In 13 patients with locally advanced NSCLC, weekly CT images were acquired during radio- (n = 1) or radiochemotherapy (n = 12) for simulation of ART. Three-dimensional (3D) conformal treatment plans were generated: conventionally fractionated doses of 66 Gy were prescribed to the planning target volume without elective lymph node irradiation (Plan{sub 3}D). Using a surface-based algorithm of deformable image registration, accumulated doses were calculated in the CT images acquired during the treatment course (Plan{sub 4}D). Field sizes were adapted to tumor shrinkage once in week 3 or 5 and twice in weeks 3 and 5. Results: A continuous tumor regression of 1.2% per day resulted in a residual gross tumor volume (GTV) of 49% {+-} 15% after six weeks of treatment. No systematic differences between Plan{sub 3}D and Plan{sub 4}D were observed regarding doses to the GTV, lung, and spinal cord. Plan adaptation to tumor shrinkage resulted in significantly decreased lung doses without compromising GTV coverage: single-plan adaptation in Week 3 or 5 and twice-plan adaptation in Weeks 3 and 5 reduced the mean lung dose by 5.0% {+-} 4.4%, 5.6% {+-} 2.9% and 7.9% {+-} 4.8%, respectively. This lung sparing with twice ART allowed an iso-mean lung dose escalation of the GTV dose from 66.8 Gy {+-} 0.8 Gy to 73.6 Gy {+-} 3.8 Gy. Conclusions: Adaptation of radiotherapy to continuous tumor shrinkage during the treatment course reduced doses to the lung, allowed significant dose escalation and has the potential of increased local control.

  3. Peripleural lung disease detection based on multi-slice CT images

    NASA Astrophysics Data System (ADS)

    Matsuhiro, M.; Suzuki, H.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, M.

    2015-03-01

    With the development of multi-slice CT technology, obtaining accurate 3D images of lung field in a short time become possible. To support that, a lot of image processing methods need to be developed. Detection peripleural lung disease is difficult due to its existence out of lung region, because lung extraction is often performed based on threshold processing. The proposed method uses thoracic inner region extracted by inner cavity of bone as well as air region, covers peripleural lung diseased cases such as lung nodule, calcification, pleural effusion and pleural plaque. We applied this method to 50 cases including 39 peripleural lung diseased cases. This method was able to detect 39 peripleural lung disease with 2.9 false positive per case.

  4. CT-guided brachytherapy of prostate cancer: reduction of effective dose from X-ray examination

    NASA Astrophysics Data System (ADS)

    Sanin, Dmitriy B.; Biryukov, Vitaliy A.; Rusetskiy, Sergey S.; Sviridov, Pavel V.; Volodina, Tatiana V.

    2014-03-01

    Computed tomography (CT) is one of the most effective and informative diagnostic method. Though the number of CT scans among all radiographic procedures in the USA and European countries is 11% and 4% respectively, CT makes the highest contribution to the collective effective dose from all radiographic procedures, it is 67% in the USA and 40% in European countries [1-5]. Therefore it is necessary to understand the significance of dose value from CT imaging to a patient . Though CT dose from multiple scans and potential risk is of great concern in pediatric patients, this applies to adults as well. In this connection it is very important to develop optimal approaches to dose reduction and optimization of CT examination. International Commission on Radiological Protection (ICRP) in its publications recommends radiologists to be aware that often CT image quality is higher than it is necessary for diagnostic confidence[6], and there is a potential to reduce the dose which patient gets from CT examination [7]. In recent years many procedures, such as minimally invasive surgery, biopsy, brachytherapy and different types of ablation are carried out under guidance of computed tomography [6;7], and during a procedures multiple CT scans focusing on a specific anatomic region are performed. At the Clinics of MRRC different types of treatment for patients with prostate cancer are used, incuding conformal CT-guided brachytherapy, implantation of microsources of I into the gland under guidance of spiral CT [8]. So, the purpose of the study is to choose optimal method to reduce radiation dose from CT during CT-guided prostate brachytherapy and to obtain the image of desired quality.

  5. Effects of the difference in tube voltage of the CT scanner on dose calculation

    NASA Astrophysics Data System (ADS)

    Rhee, Dong Joo; Kim, Sung-woo; Jeong, Dong Hyeok; Moon, Young Min; Kim, Jung Ki

    2015-07-01

    Computed tomography (CT) measures the attenuation coefficient of an object and converts the value assigned to each voxel into a CT number. In radiation therapy, the CT number, which is directly proportional to the linear attenuation coefficient, must be converted to an electron density for radiation dose calculations for cancer treatment. However, if various tube voltages are applied to take the patient's CT image without applying the specific CT number to the electron density conversion curve, the accuracy of the dose calculation is not assured. In this study, changes in CT numbers for different materials due to changes in the tube voltage were demonstrated, and the dose calculation errors in the percentage depth dose (PDD), along with a clinical case were analyzed. The maximum dose difference in the PDD from the treatment planning system (TPS) dose calculation and from the Monte Carlo simulation were 1.3% and 1.1%, respectively, when applying the same CT number to the electron density conversion curve for the 80-kVp and 140-kVp images. In the clinical case, different CT number to electron density conversion curves at tube voltage of 80 kVp and 140 kVp were applied to the same image and the maximum differences in the mean, maximum, and minimum doses were 1.1%, 1.2%, and 1.0%, respectively, at the central region of the phantom and 0.6%, 0.9%, and 0.8%, respectively, at the peripheral region of the phantom.

  6. 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.

  7. Use of CT densitometry to predict lung toxicity in bone marrow transplant patients

    SciTech Connect

    el-Khatib, E.E.; Freeman, C.R.; Rybka, W.B.; Lehnert, S.; Podgorsak, E.B.

    1989-01-01

    Total body irradiation (TBI) is considered an integral part of the preparation of patients with hematological malignancies for marrow transplantation. One of the major causes of death following bone marrow transplantation is interstitial pneumonia. Its pathogenesis is complex but radiation may play a major role in its development. Computed tomography (CT) has been used in animal and human studies as a sensitive non-invasive method for detecting changes in the lung following radiotherapy. In the present study CT scans are studied before and up to 1 year after TBI. Average lung densities measured before TBI showed large variations among the individual patients. On follow-up scans, lung density decreases were measured for patients who did not develop lung complications. Significant lung density increases were measured in patients who subsequently had lung complications. These lung density increases were observed prior to the onset of respiratory complications and could be correlated with the clinical course of the patients, suggesting the possibility for the usage of CT lung densitometry to predict lung complications before the onset of clinical symptoms.

  8. A review of patient dose and optimisation methods in adult and paediatric CT scanning.

    PubMed

    Dougeni, E; Faulkner, K; Panayiotakis, G

    2012-04-01

    An increasing number of publications and international reports on computed tomography (CT) have addressed important issues on optimised imaging practice and patient dose. This is partially due to recent technological developments as well as to the striking rise in the number of CT scans being requested. CT imaging has extended its role to newer applications, such as cardiac CT, CT colonography, angiography and urology. The proportion of paediatric patients undergoing CT scans has also increased. The published scientific literature was reviewed to collect information regarding effective dose levels during the most common CT examinations in adults and paediatrics. Large dose variations were observed (up to 32-fold) with some individual sites exceeding the recommended dose reference levels, indicating a large potential to reduce dose. Current estimates on radiation-related cancer risks are alarming. CT doses account for about 70% of collective dose in the UK and are amongst the highest in diagnostic radiology, however the majority of physicians underestimate the risk, demonstrating a decreased level of awareness. Exposure parameters are not always adjusted appropriately to the clinical question or to patient size, especially for children. Dose reduction techniques, such as tube-current modulation, low-tube voltage protocols, prospective echocardiography-triggered coronary angiography and iterative reconstruction algorithms can substantially decrease doses. An overview of optimisation studies is provided. The justification principle is discussed along with tools that assist clinicians in the decision-making process. There is the potential to eliminate clinically non-indicated CT scans by replacing them with alternative examinations especially for children or patients receiving multiple CT scans.

  9. Average radiation doses in a standard head examination for 250 CT systems

    SciTech Connect

    McCrohan, J.L.; Patterson, J.F.; Gagne, R.M.; Goldstein, H.A.

    1987-04-01

    Approximately 250 computed tomography (CT) systems were surveyed in a nationwide study to determine the average radiation dose resulting from a typical adult head procedure. The multiple scan average dose (MSAD) was selected as the dose descriptor. For the typical adult CT head procedure, the MSAD was generally within 2.2-6.8 rads (22-68 mGy). Variations in dose by a factor of two or more were often seen for a given manufacturer and model. These dose ranges indicate a potential to reduce dose by carefully selecting imaging techniques. Overall, variations in dose can result from differences in the user's choice of technique (desired image quality) or from actual differences in scanner performance (caused by differences in collimation, filtration, or geometry). To use CT appropriately, a facility should consider dose as well as image quality in selecting optimal techniques for typical modes of operation.

  10. Average radiation doses in a standard head examination for 250 CT systems.

    PubMed

    McCrohan, J L; Patterson, J F; Gagne, R M; Goldstein, H A

    1987-04-01

    Approximately 250 computed tomography (CT) systems were surveyed in a nationwide study to determine the average radiation dose resulting from a typical adult head procedure. The multiple scan average dose (MSAD) was selected as the dose descriptor. For the typical adult CT head procedure, the MSAD was generally within 2.2-6.8 rads (22-68 mGy). Variations in dose by a factor of two or more were often seen for a given manufacturer and model. These dose ranges indicate a potential to reduce dose by carefully selecting imaging techniques. Overall, variations in dose can result from differences in the user's choice of technique (desired image quality) or from actual differences in scanner performance (caused by differences in collimation, filtration, or geometry). To use CT appropriately, a facility should consider dose as well as image quality in selecting optimal techniques for typical modes of operation.

  11. TH-E-BRF-04: Characterizing the Response of Texture-Based CT Image Features for Quantification of Radiation-Induced Normal Lung Damage

    SciTech Connect

    Krafft, S; Court, L; Briere, T; Martel, M

    2014-06-15

    Purpose: Radiation induced lung damage (RILD) is an important dose-limiting toxicity for patients treated with radiation therapy. Scoring systems for RILD are subjective and limit our ability to find robust predictors of toxicity. We investigate the dose and time-related response for texture-based lung CT image features that serve as potential quantitative measures of RILD. Methods: Pre- and post-RT diagnostic imaging studies were collected for retrospective analysis of 21 patients treated with photon or proton radiotherapy for NSCLC. Total lung and selected isodose contours (0–5, 5–15, 15–25Gy, etc.) were deformably registered from the treatment planning scan to the pre-RT and available follow-up CT studies for each patient. A CT image analysis framework was utilized to extract 3698 unique texture-based features (including co-occurrence and run length matrices) for each region of interest defined by the isodose contours and the total lung volume. Linear mixed models were fit to determine the relationship between feature change (relative to pre-RT), planned dose and time post-RT. Results: Seventy-three follow-up CT scans from 21 patients (median: 3 scans/patient) were analyzed to describe CT image feature change. At the p=0.05 level, dose affected feature change in 2706 (73.1%) of the available features. Similarly, time affected feature change in 408 (11.0%) of the available features. Both dose and time were significant predictors of feature change in a total of 231 (6.2%) of the extracted image features. Conclusion: Characterizing the dose and time-related response of a large number of texture-based CT image features is the first step toward identifying objective measures of lung toxicity necessary for assessment and prediction of RILD. There is evidence that numerous features are sensitive to both the radiation dose and time after RT. Beyond characterizing feature response, further investigation is warranted to determine the utility of these features as

  12. A clinical evaluation of total variation-Stokes image reconstruction strategy for low-dose CT imaging of the chest

    NASA Astrophysics Data System (ADS)

    Liu, Yan; Zhang, Hao; Moore, William; Bhattacharji, Priya; Liang, Zhengrong

    2015-03-01

    One hundred "normal-dose" computed tomography (CT) studies of the chest (i.e., 1,160 projection views, 120kVp, 100mAs) data sets were acquired from the patients who were scheduled for lung biopsy at Stony Brook University Hospital under informed consent approved by our Institutional Review Board. To mimic low-dose CT imaging scenario (i.e., sparse-view scan), sparse projection views were evenly extracted from the total 1,160 projections of each patient and the total radiation dose was reduced according to how many sparse views were selected. A standard filtered backprojection (FBP) algorithm was applied to the 1160 projections to produce reference images for comparison purpose. In the low-dose scenario, both the FBP and total variation-stokes (TVS) algorithms were applied to reconstruct the corresponding low-dose images. The reconstructed images were evaluated by an experienced thoracic radiologist against the reference images. Both the low-dose reconstructions and the reference images were displayed on a 4- megapixel monitor in soft tissue and lung windows. The images were graded by a five-point scale from 0 to 4 (0, nondiagnostic; 1, severe artifact with low confidence; 2, moderate artifact or moderate diagnostic confidences; 3, mild artifact or high confidence; 4, well depicted without artifacts). Quantitative evaluation measurements such as standard deviations for different tissue types and universal quality index were also studied and reported for the results. The evaluation concluded that the TVS can reduce the view number from 1,160 to 580 with slightly lower scores as the reference, resulting in a dose reduction to close 50%.

  13. Patient dose estimation from CT scans at the Mexican National Neurology and Neurosurgery Institute

    NASA Astrophysics Data System (ADS)

    Alva-Sánchez, Héctor; Reynoso-Mejía, Alberto; Casares-Cruz, Katiuzka; Taboada-Barajas, Jesús

    2014-11-01

    In the radiology department of the Mexican National Institute of Neurology and Neurosurgery, a dedicated institute in Mexico City, on average 19.3 computed tomography (CT) examinations are performed daily on hospitalized patients for neurological disease diagnosis, control scans and follow-up imaging. The purpose of this work was to estimate the effective dose received by hospitalized patients who underwent a diagnostic CT scan using typical effective dose values for all CT types and to obtain the estimated effective dose distributions received by surgical and non-surgical patients. Effective patient doses were estimated from values per study type reported in the applications guide provided by the scanner manufacturer. This retrospective study included all hospitalized patients who underwent a diagnostic CT scan between 1 January 2011 and 31 December 2012. A total of 8777 CT scans were performed in this two-year period. Simple brain scan was the CT type performed the most (74.3%) followed by contrasted brain scan (6.1%) and head angiotomography (5.7%). The average number of CT scans per patient was 2.83; the average effective dose per patient was 7.9 mSv; the mean estimated radiation dose was significantly higher for surgical (9.1 mSv) than non-surgical patients (6.0 mSv). Three percent of the patients had 10 or more brain CT scans and exceeded the organ radiation dose threshold set by the International Commission on Radiological Protection for deterministic effects of the eye-lens. Although radiation patient doses from CT scans were in general relatively low, 187 patients received a high effective dose (>20 mSv) and 3% might develop cataract from cumulative doses to the eye lens.

  14. Patient dose estimation from CT scans at the Mexican National Neurology and Neurosurgery Institute

    SciTech Connect

    Alva-Sánchez, Héctor

    2014-11-07

    In the radiology department of the Mexican National Institute of Neurology and Neurosurgery, a dedicated institute in Mexico City, on average 19.3 computed tomography (CT) examinations are performed daily on hospitalized patients for neurological disease diagnosis, control scans and follow-up imaging. The purpose of this work was to estimate the effective dose received by hospitalized patients who underwent a diagnostic CT scan using typical effective dose values for all CT types and to obtain the estimated effective dose distributions received by surgical and non-surgical patients. Effective patient doses were estimated from values per study type reported in the applications guide provided by the scanner manufacturer. This retrospective study included all hospitalized patients who underwent a diagnostic CT scan between 1 January 2011 and 31 December 2012. A total of 8777 CT scans were performed in this two-year period. Simple brain scan was the CT type performed the most (74.3%) followed by contrasted brain scan (6.1%) and head angiotomography (5.7%). The average number of CT scans per patient was 2.83; the average effective dose per patient was 7.9 mSv; the mean estimated radiation dose was significantly higher for surgical (9.1 mSv) than non-surgical patients (6.0 mSv). Three percent of the patients had 10 or more brain CT scans and exceeded the organ radiation dose threshold set by the International Commission on Radiological Protection for deterministic effects of the eye-lens. Although radiation patient doses from CT scans were in general relatively low, 187 patients received a high effective dose (>20 mSv) and 3% might develop cataract from cumulative doses to the eye lens.

  15. National Lung Screening Trial (NLST)

    Cancer.gov

    The National Lung Screening Trial (NLST), a research study sponsored by the National Cancer Institute that used low-dose helical CT scans or chest X-ray to screen men and women at risk for lung cancer.

  16. Poster — Thur Eve — 06: Dose assessment of cone beam CT imaging protocols as part of SPECT/CT examinations

    SciTech Connect

    Tonkopi, E; Ross, AA

    2014-08-15

    Purpose: To assess radiation dose from the cone beam CT (CBCT) component of SPECT/CT studies and to compare with other CT examinations performed in our institution. Methods: We used an anthropomorphic chest phantom and the 6 cc ion chamber to measure entrance breast dose for several CBCT and diagnostic CT acquisition protocols. The CBCT effective dose was calculated with ImPACT software; the CT effective dose was evaluated from the DLP value and conversion factor, dependent on the anatomic region. The RADAR medical procedure radiation dose calculator was used to assess the nuclear medicine component of exam dose. Results: The entrance dose to the breast measured with the anthropomorphic phantom was 0.48 mGy and 9.41 mGy for cardiac and chest CBCT scans; and 4.59 mGy for diagnostic thoracic CT. The effective doses were 0.2 mSv, 3.2 mSv and 2.8 mSv respectively. For a small patient represented by the anthropomorphic phantom, the dose from the diagnostic CT was lower than from the CBCT scan, as a result of the exposure reduction options available on modern CT scanners. The CBCT protocols used the same fixed scanning techniques. The diagnostic CT dose based on the patient data was 35% higher than the phantom dose. For most SPECT/CT studies the dose from the CBCT component was comparable with the dose from the radiopharmaceutical. Conclusions: The patient radiation dose from the cone beam CT scan can be higher than that from a diagnostic CT and should be taken into consideration in evaluating total SPECT/CT patient dose.

  17. Cone-Beam Computed Tomography (CBCT) Versus CT in Lung Ablation Procedure: Which is Faster?

    SciTech Connect

    Cazzato, Roberto Luigi Battistuzzi, Jean-Benoit Catena, Vittorio; Grasso, Rosario Francesco Zobel, Bruno Beomonte; Schena, Emiliano; Buy, Xavier Palussiere, Jean

    2015-10-15

    AimTo compare cone-beam CT (CBCT) versus computed tomography (CT) guidance in terms of time needed to target and place the radiofrequency ablation (RFA) electrode on lung tumours.Materials and MethodsPatients at our institution who received CBCT- or CT-guided RFA for primary or metastatic lung tumours were retrospectively included. Time required to target and place the RFA electrode within the lesion was registered and compared across the two groups. Lesions were stratified into three groups according to their size (<10, 10–20, >20 mm). Occurrences of electrode repositioning, repositioning time, RFA complications, and local recurrence after RFA were also reported.ResultsForty tumours (22 under CT, 18 under CBCT guidance) were treated in 27 patients (19 male, 8 female, median age 67.25 ± 9.13 years). Thirty RFA sessions (16 under CBCT and 14 under CT guidance) were performed. Multivariable linear regression analysis showed that CBCT was faster than CT to target and place the electrode within the tumour independently from its size (β = −9.45, t = −3.09, p = 0.004). Electrode repositioning was required in 10/22 (45.4 %) tumours under CT guidance and 5/18 (27.8 %) tumours under CBCT guidance. Pneumothoraces occurred in 6/14 (42.8 %) sessions under CT guidance and in 6/16 (37.5 %) sessions under CBCT guidance. Two recurrences were noted for tumours receiving CBCT-guided RFA (2/17, 11.7 %) and three after CT-guided RFA (3/19, 15.8 %).ConclusionCBCT with live 3D needle guidance is a useful technique for percutaneous lung ablation. Despite lesion size, CBCT allows faster lung RFA than CT.

  18. Reducing the low-dose lung radiation for central lung tumors by restricting the IMRT beams and arc arrangement.

    PubMed

    Rosca, Florin; Kirk, Michael; Soto, Daniel; Sall, Walter; McIntyre, James

    2012-01-01

    To compare the extent to which 7 different radiotherapy planning techniques for mediastinal lung targets reduces the lung volume receiving low doses of radiation. Thirteen non-small cell lung cancer patients with targets, including the mediastinal nodes, were identified. Treatment plans were generated to both 60- and 74-Gy prescription doses using 7 different planning techniques: conformal, hybrid conformal/intensity-modulated radiation treatment (IMRT), 7 equidistant IMRT beams, 2 restricted beam IMRT plans, a full (360°) modulated arc, and a restricted modulated arc plan. All plans were optimized to reduce total lung V5, V10, and V20 volumes, while meeting normal tissue and target coverage constraints. The mean values for the 13 patients are calculated for V5, V10, V20, V(ave), V0-20, and mean lung dose (MLD) lung parameters. For the 74-Gy prescription dose, the mean lung V10 was 42.7, 43.6, 48.2, 56.6, 57, 55.8, and 54.1% for the restricted ±36° IMRT, restricted modulated arc, restricted ±45° IMRT, full modulated arc, hybrid conformal/IMRT, equidistant IMRT, and conformal plans, respectively. A similar lung sparing hierarchy was found for the 60-Gy prescription dose. For the treatment of central lung targets, the ±36° restricted IMRT and restricted modulated arc planning techniques are superior in lowering the lung volume treated to low dose, as well as in minimizing MLD, followed by the ±45° restricted IMRT plan. All planning techniques that allow the use of lateral or lateral/oblique beams result in spreading the low dose over a higher lung volume. The area under the lung dose-volume histogram curve below 20 Gy, V0-20, is proposed as an alternative to individual V(dose) parameters, both as a measure of lung sparing and as a parameter to be minimized during IMRT optimization. PMID:22189028

  19. Quantification of Pathologic Air Trapping in Lung Transplant Patients Using CT Density Mapping: Comparison with Other CT Air Trapping Measures.

    PubMed

    Solyanik, Olga; Hollmann, Patrick; Dettmer, Sabine; Kaireit, Till; Schaefer-Prokop, Cornelia; Wacker, Frank; Vogel-Claussen, Jens; Shin, Hoen-oh

    2015-01-01

    To determine whether density mapping (DM) is more accurate for detection and quantification of pathologic air trapping (pAT) in patients after lung transplantation compared to other CT air trapping measures. One-hundred forty-seven lung and heart-lung transplant recipients underwent CT-examinations at functional residual capacity (FRC) and total lung capacity (TLC) and PFT six months after lung transplantation. Quantification of air trapping was performed with the threshold-based method in expiration (EXP), density mapping (DM) and the expiratory to inspiratory ratio of the mean lung density (E/I-ratio MLD). A non-rigid registration of inspiration-expiration CT-data with a following voxel-to-voxel mapping was carried out for DM. Systematic variation of attenuation ranges was performed for EXP and DM and correlated with the ratio of residual volume to total lung capacity (RV/TLC) by Spearman rank correlation test. AT was considered pathologic if RV/TLC was above the 95th percentile of the predicted upper limit of normal values. Receiver operating characteristic (ROC) analysis was performed. The optimal attenuation range for the EXP method was from -790 HU to -950 HU (EXP(-790 to -950HU)) (r = 0.524, p<0.001) to detect air trapping. Within the segmented lung parenchyma, AT was best defined as voxel difference less than 80 HU between expiration and registered inspiration using the DM method. DM correlated best with RV/TLC (r = 0.663, p<0.001). DM and E/I-ratio MLD showed a larger AUC (0.78; 95% CI 0.69-0.86; 0.76, 95% CI 0.67-0.85) than EXP(-790 HU to -950 HU) (0.71, 95% CI 0.63-0.78). DM and E/I-ratio MLD showed better correlation with RV/TLC and are more suited quantitative CT-methods to detect pAT in lung transplant patients than the EXP(-790HU to -950HU).

  20. Quantifying lung morphology with respiratory-gated micro-CT in a murine model of emphysema

    NASA Astrophysics Data System (ADS)

    Ford, N. L.; Martin, E. L.; Lewis, J. F.; Veldhuizen, R. A. W.; Holdsworth, D. W.; Drangova, M.

    2009-04-01

    Non-invasive micro-CT imaging techniques have been developed to investigate lung structure in free-breathing rodents. In this study, we investigate the utility of retrospectively respiratory-gated micro-CT imaging in an emphysema model to determine if anatomical changes could be observed in the image-derived quantitative analysis at two respiratory phases. The emphysema model chosen was a well-characterized, genetically altered model (TIMP-3 knockout mice) that exhibits a homogeneous phenotype. Micro-CT scans of the free-breathing, anaesthetized mice were obtained in 50 s and retrospectively respiratory sorted and reconstructed, providing 3D images representing peak inspiration and end expiration with 0.15 mm isotropic voxel spacing. Anatomical measurements included the volume and CT density of the lungs and the volume of the major airways, along with the diameters of the trachea, left bronchus and right bronchus. From these measurements, functional parameters such as functional residual capacity and tidal volume were calculated. Significant differences between the wild-type and TIMP-3 knockout groups were observed for measurements of CT density over the entire lung, indicating increased air content in the lungs of TIMP-3 knockout mice. These results demonstrate retrospective respiratory-gated micro-CT, providing images at multiple respiratory phases that can be analyzed quantitatively to investigate anatomical changes in murine models of emphysema.

  1. Respiratory Motional Effect on Cone-Beam CT in Lung Radiation Surgery

    SciTech Connect

    Song, Ju-Young Nam, Taek-Keun; Ahn, Sung-Ja; Chung, Woong-Ki; Yoon, Mee-Sun; Nah, Byunk-Sik

    2009-07-01

    The cone-beam CT (CBCT), which is acquired using an on-board imager (OBI) attached to a linear accelerator, is used effectively in the verification of setup accuracy for lung radiation surgery. In this study, the respiratory organ motional effect on the CBCT was evaluated with a properly devised phantom system, and the level of possible error in conditions of a real clinical process was assessed. In a comparison study between the CBCT in static status and CBCT images acquired in 20 different motional cases, we confirmed that the image quality and information of CBCT were degraded, with an increase of motional ranges in the region of inhomogeneous structures. The 4D-CT MIP (50{approx}55%) for the planning of lung radiation surgery and the 4D-CT MIP (full phase) were compared with CBCT in the various motional cases for the evaluation of the influence of the motional effect on CBCT in the process of the setup error correction. The average ratio of relative difference between plan CT: 4D-CT MIP (50%{approx}55%) and CBCT was 5.79% and between plan CT: 4D-CT MIP (50%{approx}55%) and 4D-CT MIP (full phase) was 42.95% in the phantom study. In the analysis of clinical cases of lung radiation surgery, the gross tumor volumes were compared in each CT image. The average ratio of relative difference between plan CT: 4D-CT MIP (50{approx}55%) and CBCT was 10.72% and between plan CT: 4D-CT MIP (50{approx}55%) and 4D-CT MIP (full phase) was 28.19%. These results showed that, although a respiratory organ motional effect on CBCT introduced variation in image quality, the error as a result of this variation could be estimated relatively low in the setup error correction for a gated-lung radiation surgery when the planning was performed in 4D-CT MIP (50{approx}55%), which already included a related signal of motional effect.

  2. Correction for ‘artificial’ electron disequilibrium due to cone-beam CT density errors: implications for on-line adaptive stereotactic body radiation therapy of lung

    NASA Astrophysics Data System (ADS)

    Disher, Brandon; Hajdok, George; Wang, An; Craig, Jeff; Gaede, Stewart; Battista, Jerry J.

    2013-06-01

    Cone-beam computed tomography (CBCT) has rapidly become a clinically useful imaging modality for image-guided radiation therapy. Unfortunately, CBCT images of the thorax are susceptible to artefacts due to scattered photons, beam hardening, lag in data acquisition, and respiratory motion during a slow scan. These limitations cause dose errors when CBCT image data are used directly in dose computations for on-line, dose adaptive radiation therapy (DART). The purpose of this work is to assess the magnitude of errors in CBCT numbers (HU), and determine the resultant effects on derived tissue density and computed dose accuracy for stereotactic body radiation therapy (SBRT) of lung cancer. Planning CT (PCT) images of three lung patients were acquired using a Philips multi-slice helical CT simulator, while CBCT images were obtained with a Varian On-Board Imaging system. To account for erroneous CBCT data, three practical correction techniques were tested: (1) conversion of CBCT numbers to electron density using phantoms, (2) replacement of individual CBCT pixel values with bulk CT numbers, averaged from PCT images for tissue regions, and (3) limited replacement of CBCT lung pixels values (LCT) likely to produce artificial lateral electron disequilibrium. For each corrected CBCT data set, lung SBRT dose distributions were computed for a 6 MV volume modulated arc therapy (VMAT) technique within the Philips Pinnacle treatment planning system. The reference prescription dose was set such that 95% of the planning target volume (PTV) received at least 54 Gy (i.e. D95). Further, we used the relative depth dose factor as an a priori index to predict the effects of incorrect low tissue density on computed lung dose in regions of severe electron disequilibrium. CT number profiles from co-registered CBCT and PCT patient lung images revealed many reduced lung pixel values in CBCT data, with some pixels corresponding to vacuum (-1000 HU). Similarly, CBCT data in a plastic lung

  3. SU-E-T-633: Dose Differences in Lung Cancer SBRT: The Influences of MLC Width

    SciTech Connect

    Chen, J; Yin, Y

    2014-06-15

    Purpose: The aim is to compare the plan dose distribution of lung SBRT with MLCs in different width. Methods: Cases with phase INSCLC were enrolled. 9 cases were undergone 4D-CT scanning in the supine position with both arms raised. 3D-CT images without IV contrast were afterwards acquired with 3mm thickness and used for dose calculations. ITV was generated by using the inspiration and expiration images. The ITV can be expanded by geometric set-up uncertainty (5 mm) to generate the PTV. All chest normal tissues including chest wall were contoured by doctors. A total dose of 55 Gy will be given in 5 fractions within 10–14 days with an inter fraction interval of 2–3 days. Guided by the RTOG trial 3502 protocol, 11–13 non-coplanar fields with 6MV photon were arranged. Three types of MLCs with width of 3mm, 5mm and 10mm at isocenter position, were used separately to generate a CRT plan for each case. Monte Carlo algorithm was applied to dose calculation. All plans were adjusted as possible to meet the dose constraints. Dose-volume parameters from plans as followed were compared and analysized: PTV V55Gy, COMPTV D70% (70% of normalization dose), volume A (body minus PTV), and R100% and R50% (the ratio of x% of prescription dose isoline volume to PTV volume). Results: MLCs, 3mm and 5mm wide, played the identical roles on dosimetry of the plans, excluding the parameter volume A (p<0.05). On the contrary, MLC with width of 10mm was significantly inferior to the other two types on most parameters (p<0.05). For R50%, all types contributed equally (p>0.05). Conclusion: For lung cancer SBRT, MLC width had influence to dosimetry, especially in irradiation area. Small size MLC, e.g. 3mm and 5mm, are helpful to generate a high quality treatment plan, which could meet the strict criteria for targets and OAR.

  4. Usefulness of CT imaging for segmental lung lobe torsion without typical radiographic imaging in a Pomeranian.

    PubMed

    Choi, Mihyun; Lee, Namsoon; Keh, Seoyeon; Choi, Heeyeon; Yim, Yoonji; Kim, Hyunwook; Jung, Joohyun; Choi, Mincheol

    2015-02-01

    A 3-year-old, intact female Pomeranian presented with a 1-month history of coughing. Thoracic radiography showed focal infiltration of the left cranial lung lobe and widening of the cranial mediastinum. Subsequent computed tomography revealed torsion of the caudal segment of the left cranial lung lobe, which was confirmed by exploratory thoracotomy. There was no apparent underlying etiology for the condition. To the authors' knowledge, this is the first report of lung lobe torsion in this breed and the first detailed CT imaging report for segmental lung lobe torsion. PMID:25728251

  5. EPID-guided 3D dose verification of lung SBRT

    SciTech Connect

    Aristophanous, M.; Rottmann, J.; Court, L. E.; Berbeco, R. I.

    2011-01-15

    Purpose: To investigate the feasibility of utilizing tumor tracks from electronic portal imaging device (EPID) images taken during treatment to verify the delivered dose. Methods: The proposed method is based on a computation of the delivered fluence by utilizing the planned fluence and the tumor motion track for each field. A phantom study was designed to assess the feasibility of the method. The CIRS dynamic thorax phantom was utilized with a realistic soft resin tumor, modeled after a real patient tumor. The dose calculated with the proposed method was compared to direct measurements taken with 15 metal oxide semiconductor field effect transistors (MOSFETs) inserted in small fissures made in the tumor model. The phantom was irradiated with the tumor static and moved with different range of motions and setup errors. EPID images were recorded throughout all deliveries and the tumor model was tracked post-treatment with in-house developed software. The planned fluence for each field was convolved with the tumor motion tracks to obtain the delivered fluence. Utilizing the delivered fluence from each field, the delivered dose was calculated. The estimated delivered dose was compared to the dose directly measured with the MOSFETs. The feasibility of the proposed method was also demonstrated on a real lung cancer patient, treated with stereotactic body radiotherapy. Results: The calculation of delivered dose with the delivered fluence method was in good agreement with the MOSFET measurements, with average differences ranging from 0.8% to 8.3% depending on the proximity of a dose gradient. For the patient treatment, the planned and delivered dose volume histograms were compared and verified the overall good coverage of the target volume. Conclusions: The delivered fluence method was applied successfully on phantom and clinical data and its accuracy was evaluated. Verifying each treatment fraction may enable correction strategies that can be applied during the course of

  6. Prospective optimization of CT under tube current modulation: I. organ dose

    NASA Astrophysics Data System (ADS)

    Tian, Xiaoyu; Li, Xiang; Segars, W. Paul; Frush, Donald; Samei, Ehsan

    2014-03-01

    In an environment in which computed tomography (CT) has become an indispensable diagnostic tool employed with great frequency, dose concerns at the population level have become a subject of public attention. In that regard, optimizing radiation dose has become a core problem to the CT community. As a fundamental step to optimize radiation dose, it is crucial to effectively quantify radiation dose for a given CT exam. Such dose estimates need to be patient-specific to reflect individual radiation burden. It further needs to be prospective so that the scanning parameters can be dynamically adjusted before the scan is performed. The purpose of this study was to prospectively estimate organ dose in abdominopelvic CT exams under tube current modulation (TCM). CTDIvol-normalized-organ dose coefficients ( hfixed ) for fixed tube current were first estimated using a validated Monte Carlo simulation program and 58 computational phantoms. To account for the effect of TCM scheme, a weighted CTDIvol was computed for each organ based on the tube current modulation profile. The organ dose was predicted by multiplying the weighted CTDIvol with the organ dose coefficients ( hfixed ). To quantify prediction accuracy, each predicted organ dose was compared with organ dose simulated from Monte Carlo program with TCM profile explicitly modeled. The predicted organ dose showed good agreement with simulated organ dose across all organs and modulation strengths. For an average CTDIvol of a CT exam of 10 mGy, the absolute median error across all organs were 0.64 mGy (-0.21 and 0.97 for 25th and 75th percentiles, respectively). The percentage differences (normalized by CTDIvol of the exam) were within 15%. This study developed a quantitative model to predict organ dose under clinical abdominopelvic scans. Such information may aid in the optimization of CT protocols.

  7. MO-E-17A-03: Monte Carlo CT Dose Calculation: A Comparison Between Experiment and Simulation Using ARCHER-CT

    SciTech Connect

    Liu, T; Du, X; Su, L; Gao, Y; Ji, W; Xu, X; Zhang, D; Shi, J; Liu, B; Kalra, M

    2014-06-15

    Purpose: To compare the CT doses derived from the experiments and GPU-based Monte Carlo (MC) simulations, using a human cadaver and ATOM phantom. Methods: The cadaver of an 88-year old male and the ATOM phantom were scanned by a GE LightSpeed Pro 16 MDCT. For the cadaver study, the Thimble chambers (Model 10×5−0.6CT and 10×6−0.6CT) were used to measure the absorbed dose in different deep and superficial organs. Whole-body scans were first performed to construct a complete image database for MC simulations. Abdomen/pelvis helical scans were then conducted using 120/100 kVps, 300 mAs and a pitch factor of 1.375:1. For the ATOM phantom study, the OSL dosimeters were used and helical scans were performed using 120 kVp and x, y, z tube current modulation (TCM). For the MC simulations, sufficient particles were run in both cases such that the statistical errors of the results by ARCHER-CT were limited to 1%. Results: For the human cadaver scan, the doses to the stomach, liver, colon, left kidney, pancreas and urinary bladder were compared. The difference between experiments and simulations was within 19% for the 120 kVp and 25% for the 100 kVp. For the ATOM phantom scan, the doses to the lung, thyroid, esophagus, heart, stomach, liver, spleen, kidneys and thymus were compared. The difference was 39.2% for the esophagus, and within 16% for all other organs. Conclusion: In this study the experimental and simulated CT doses were compared. Their difference is primarily attributed to the systematic errors of the MC simulations, including the accuracy of the bowtie filter modeling, and the algorithm to generate voxelized phantom from DICOM images. The experimental error is considered small and may arise from the dosimeters. R01 grant (R01EB015478) from National Institute of Biomedical Imaging and Bioengineering.

  8. TH-C-18A-08: A Management Tool for CT Dose Monitoring, Analysis, and Protocol Review

    SciTech Connect

    Wang, J; Chan, F; Newman, B; Larson, D; Leung, A; Fleischmann, D; Molvin, L; Marsh, D; Zorich, C; Phillips, L

    2014-06-15

    Purpose: To develop a customizable tool for enterprise-wide managing of CT protocols and analyzing radiation dose information of CT exams for a variety of quality control applications Methods: All clinical CT protocols implemented on the 11 CT scanners at our institution were extracted in digital format. The original protocols had been preset by our CT management team. A commercial CT dose tracking software (DoseWatch,GE healthcare,WI) was used to collect exam information (exam date, patient age etc.), scanning parameters, and radiation doses for all CT exams. We developed a Matlab-based program (MathWorks,MA) with graphic user interface which allows to analyze the scanning protocols with the actual dose estimates, and compare the data to national (ACR,AAPM) and internal reference values for CT quality control. Results: The CT protocol review portion of our tool allows the user to look up the scanning and image reconstruction parameters of any protocol on any of the installed CT systems among about 120 protocols per scanner. In the dose analysis tool, dose information of all CT exams (from 05/2013 to 02/2014) was stratified on a protocol level, and within a protocol down to series level, i.e. each individual exposure event. This allows numerical and graphical review of dose information of any combination of scanner models, protocols and series. The key functions of the tool include: statistics of CTDI, DLP and SSDE, dose monitoring using user-set CTDI/DLP/SSDE thresholds, look-up of any CT exam dose data, and CT protocol review. Conclusion: our inhouse CT management tool provides radiologists, technologists and administration a first-hand near real-time enterprise-wide knowledge on CT dose levels of different exam types. Medical physicists use this tool to manage CT protocols, compare and optimize dose levels across different scanner models. It provides technologists feedback on CT scanning operation, and knowledge on important dose baselines and thresholds.

  9. Development of CT scanner models for patient organ dose calculations using Monte Carlo methods

    NASA Astrophysics Data System (ADS)

    Gu, Jianwei

    There is a serious and growing concern about the CT dose delivered by diagnostic CT examinations or image-guided radiation therapy imaging procedures. To better understand and to accurately quantify radiation dose due to CT imaging, Monte Carlo based CT scanner models are needed. This dissertation describes the development, validation, and application of detailed CT scanner models including a GE LightSpeed 16 MDCT scanner and two image guided radiation therapy (IGRT) cone beam CT (CBCT) scanners, kV CBCT and MV CBCT. The modeling process considered the energy spectrum, beam geometry and movement, and bowtie filter (BTF). The methodology of validating the scanner models using reported CTDI values was also developed and implemented. Finally, the organ doses to different patients undergoing CT scan were obtained by integrating the CT scanner models with anatomically-realistic patient phantoms. The tube current modulation (TCM) technique was also investigated for dose reduction. It was found that for RPI-AM, thyroid, kidneys and thymus received largest dose of 13.05, 11.41 and 11.56 mGy/100 mAs from chest scan, abdomen-pelvis scan and CAP scan, respectively using 120 kVp protocols. For RPI-AF, thymus, small intestine and kidneys received largest dose of 10.28, 12.08 and 11.35 mGy/100 mAs from chest scan, abdomen-pelvis scan and CAP scan, respectively using 120 kVp protocols. The dose to the fetus of the 3 month pregnant patient phantom was 0.13 mGy/100 mAs and 0.57 mGy/100 mAs from the chest and kidney scan, respectively. For the chest scan of the 6 month patient phantom and the 9 month patient phantom, the fetal doses were 0.21 mGy/100 mAs and 0.26 mGy/100 mAs, respectively. For MDCT with TCM schemas, the fetal dose can be reduced with 14%-25%. To demonstrate the applicability of the method proposed in this dissertation for modeling the CT scanner, additional MDCT scanner was modeled and validated by using the measured CTDI values. These results demonstrated that the

  10. Implementation of radiochromic film dosimetry protocol for volumetric dose assessments to various organs during diagnostic CT procedures

    SciTech Connect

    Brady, Samuel; Yoshizumi, Terry; Toncheva, Greta; Frush, Donald; and others

    2010-09-15

    Purpose: The authors present a means to measure high-resolution, two-dimensional organ dose distributions in an anthropomorphic phantom of heterogeneous tissue composition using XRQA radiochromic film. Dose distributions are presented for the lungs, liver, and kidneys to demonstrate the organ volume dosimetry technique. XRQA film response accuracy was validated using thermoluminescent dosimeters (TLDs). Methods: XRQA film and TLDs were first exposed at the center of two CTDI head phantoms placed end-to-end, allowing for a simple cylindrical phantom of uniform scatter material for verification of film response accuracy and sensitivity in a computed tomography (CT) exposure geometry; the TLD and film dosimeters were exposed separately. In a similar manner, TLDs and films were placed between cross-sectional slabs of a 5 yr old anthropomorphic phantom's thorax and abdomen regions. The anthropomorphic phantom was used to emulate real pediatric patient geometry and scatter conditions. The phantom consisted of five different tissue types manufactured to attenuate the x-ray beam within 1%-3% of normal tissues at CT beam energies. Software was written to individually calibrate TLD and film dosimeter responses for different tissue attenuation factors, to spatially register dosimeters, and to extract dose responses from film for TLD comparison. TLDs were compared to film regions of interest extracted at spatial locations corresponding to the TLD locations. Results: For the CTDI phantom exposure, the film and TLDs measured an average difference in dose response of 45%(SD{+-}2%). Similar comparisons within the anthropomorphic phantom also indicated a consistent difference, tracking along the low and high dose regions, for the lung (28%) (SD{+-}8%) and liver and kidneys (15%) (SD{+-}4%). The difference between the measured film and TLD dose values was due to the lower response sensitivity of the film that arose when the film was oriented with its large surface area parallel to

  11. 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

  12. Lung cancer and internal lung doses among plutonium workers at the Rocky Flats Plant: a case-control study.

    PubMed

    Brown, Shannon C; Schonbeck, Margaret F; McClure, David; Barón, Anna E; Navidi, William C; Byers, Tim; Ruttenber, A James

    2004-07-15

    The authors conducted a nested case-control study of the association between lung cancer mortality and cumulative internal lung doses among a cohort of workers employed at the Rocky Flats Plant in Colorado from 1951 to 1989. Cases (n = 180) were individually matched with controls (n = 720) on age, sex, and birth year. Annual doses to the lung from plutonium, americium, and uranium isotopes were calculated for each worker with an internal dosimetry model. Lung cancer risk was elevated among workers with cumulative internal lung doses of more than 400 mSv in several different analytical models. The dose-response relation was not consistent at high doses. Restricting analysis to those employed for 15-25 years produced a statistically significant linear trend with dose (chi-square = 67.2, p < 0.001), suggesting a strong healthy worker survivor effect. The association between age at first internal lung dose and lung cancer mortality was statistically significant (odds ratio = 1.05, 95% confidence interval: 1.01, 1.10). No associations were found between lung cancer mortality and cumulative external penetrating radiation dose or cumulative exposures to asbestos, beryllium, hexavalent chromium, or nickel. PMID:15234938

  13. TU-PIS-Exhibit Hall-01: CT Dose Optimization Technologies II

    SciTech Connect

    Driesser, I; Angel, E

    2014-06-15

    Partners in Solutions is an exciting new program in which AAPM partners with our vendors to present practical “hands-on” information about the equipment and software systems that we use in our clinics. The imaging topic this year is CT scanner dose optimization capabilities. Note that the sessions are being held in a special purpose room built on the Exhibit Hall Floor, to encourage further interaction with the vendors. Siemens‘ Commitment to the Right Dose in Computed Tomography Presentation Time: 11:15 - 11:45 AM Providing sustainable clinical results at highest patient safety: This is the challenge in medical imaging. Especially for Computed Tomography this means applying not simply the lowest, but the right dose for sound diagnostic imaging. Consequently, Siemens is committed to deliver the right dose in CT. In order to reduce radiation to the right dose, the first step is to provide the right dose technology. Through decades of research and development in CT imaging, Siemens CT has constantly introduced new ideas leading to a comprehensive portfolio of unique CARE technologies to deliver the right dose. For example automated kV adjustment based on patient size and the clinical question with CARE kV and three generations of iterative reconstruction. Based on the right dose technology, the next step is to actually scan at the right dose. For this, it is key to know the right dose targets for every examination. Siemens continuously involves CT experts to push developments further and outline how users can best adapt their procedures to the right dose. For users to know whether they met the right dose targets, it is therefore important to understand and monitor the actual absolute dose values. All scanners are delivered with defined default protocols which automatically use the available right dose technologies. Finally, to deliver the right dose not just in singular cases, but ideally to patients everywhere, organizations need then to manage dose across

  14. A method for smoothing segmented lung boundary in chest CT images

    NASA Astrophysics Data System (ADS)

    Yim, Yeny; Hong, Helen

    2007-03-01

    To segment low density lung regions in chest CT images, most of methods use the difference in gray-level value of pixels. However, radiodense pulmonary vessels and pleural nodules that contact with the surrounding anatomy are often excluded from the segmentation result. To smooth lung boundary segmented by gray-level processing in chest CT images, we propose a new method using scan line search. Our method consists of three main steps. First, lung boundary is extracted by our automatic segmentation method. Second, segmented lung contour is smoothed in each axial CT slice. We propose a scan line search to track the points on lung contour and find rapidly changing curvature efficiently. Finally, to provide consistent appearance between lung contours in adjacent axial slices, 2D closing in coronal plane is applied within pre-defined subvolume. Our method has been applied for performance evaluation with the aspects of visual inspection, accuracy and processing time. The results of our method show that the smoothness of lung contour was considerably increased by compensating for pulmonary vessels and pleural nodules.

  15. Segmentation and Image Analysis of Abnormal Lungs at CT: Current Approaches, Challenges, and Future Trends.

    PubMed

    Mansoor, Awais; Bagci, Ulas; Foster, Brent; Xu, Ziyue; Papadakis, Georgios Z; Folio, Les R; Udupa, Jayaram K; Mollura, Daniel J

    2015-01-01

    The computer-based process of identifying the boundaries of lung from surrounding thoracic tissue on computed tomographic (CT) images, which is called segmentation, is a vital first step in radiologic pulmonary image analysis. Many algorithms and software platforms provide image segmentation routines for quantification of lung abnormalities; however, nearly all of the current image segmentation approaches apply well only if the lungs exhibit minimal or no pathologic conditions. When moderate to high amounts of disease or abnormalities with a challenging shape or appearance exist in the lungs, computer-aided detection systems may be highly likely to fail to depict those abnormal regions because of inaccurate segmentation methods. In particular, abnormalities such as pleural effusions, consolidations, and masses often cause inaccurate lung segmentation, which greatly limits the use of image processing methods in clinical and research contexts. In this review, a critical summary of the current methods for lung segmentation on CT images is provided, with special emphasis on the accuracy and performance of the methods in cases with abnormalities and cases with exemplary pathologic findings. The currently available segmentation methods can be divided into five major classes: (a) thresholding-based, (b) region-based, (c) shape-based, (d) neighboring anatomy-guided, and (e) machine learning-based methods. The feasibility of each class and its shortcomings are explained and illustrated with the most common lung abnormalities observed on CT images. In an overview, practical applications and evolving technologies combining the presented approaches for the practicing radiologist are detailed.

  16. Many Is Better Than One: An Integration of Multiple Simple Strategies for Accurate Lung Segmentation in CT Images.

    PubMed

    Shi, Zhenghao; Ma, Jiejue; Zhao, Minghua; Liu, Yonghong; Feng, Yaning; Zhang, Ming; He, Lifeng; Suzuki, Kenji

    2016-01-01

    Accurate lung segmentation is an essential step in developing a computer-aided lung disease diagnosis system. However, because of the high variability of computerized tomography (CT) images, it remains a difficult task to accurately segment lung tissue in CT slices using a simple strategy. Motived by the aforementioned, a novel CT lung segmentation method based on the integration of multiple strategies was proposed in this paper. Firstly, in order to avoid noise, the input CT slice was smoothed using the guided filter. Then, the smoothed slice was transformed into a binary image using an optimized threshold. Next, a region growing strategy was employed to extract thorax regions. Then, lung regions were segmented from the thorax regions using a seed-based random walk algorithm. The segmented lung contour was then smoothed and corrected with a curvature-based correction method on each axis slice. Finally, with the lung masks, the lung region was automatically segmented from a CT slice. The proposed method was validated on a CT database consisting of 23 scans, including a number of 883 2D slices (the number of slices per scan is 38 slices), by comparing it to the commonly used lung segmentation method. Experimental results show that the proposed method accurately segmented lung regions in CT slices. PMID:27635395

  17. Many Is Better Than One: An Integration of Multiple Simple Strategies for Accurate Lung Segmentation in CT Images

    PubMed Central

    Zhao, Minghua; Liu, Yonghong; Feng, Yaning; Zhang, Ming; He, Lifeng; Suzuki, Kenji

    2016-01-01

    Accurate lung segmentation is an essential step in developing a computer-aided lung disease diagnosis system. However, because of the high variability of computerized tomography (CT) images, it remains a difficult task to accurately segment lung tissue in CT slices using a simple strategy. Motived by the aforementioned, a novel CT lung segmentation method based on the integration of multiple strategies was proposed in this paper. Firstly, in order to avoid noise, the input CT slice was smoothed using the guided filter. Then, the smoothed slice was transformed into a binary image using an optimized threshold. Next, a region growing strategy was employed to extract thorax regions. Then, lung regions were segmented from the thorax regions using a seed-based random walk algorithm. The segmented lung contour was then smoothed and corrected with a curvature-based correction method on each axis slice. Finally, with the lung masks, the lung region was automatically segmented from a CT slice. The proposed method was validated on a CT database consisting of 23 scans, including a number of 883 2D slices (the number of slices per scan is 38 slices), by comparing it to the commonly used lung segmentation method. Experimental results show that the proposed method accurately segmented lung regions in CT slices. PMID:27635395

  18. Impact of treatment planning with deformable image registration on dose distribution for carbon-ion beam lung treatment using a fixed irradiation port and rotating couch

    PubMed Central

    Kumagai, M; Yamamoto, N

    2015-01-01

    Objective: When using a fixed irradiation port, treatment couch rotation is necessary to increase beam angle selection. We evaluated dose variations associated with positional morphological changes to organs. Methods: We retrospectively chose the data sets of ten patients with lung cancer who underwent respiratory-gated CT at three different couch rotation angles (0°, 20° and −20°). The respective CT data sets are referred to as CT0, CT20 and CT−20. Three treatment plans were generated as follows: in Plan 1, all compensating bolus designs and dose distributions were calculated using CT0. To evaluate the rotation effect without considering morphology changes, in Plan 2, the compensating boli designed using CT0 were applied to the CT±20 images. Plan 3 involved compensating boli designed using the CT±20 images. The accumulated dose distributions were calculated using deformable image registration (DIR). Results: A sufficient prescribed dose was calculated for the planning target volume (PTV) in Plan 1 [minimum dose received by a volume ≥95% (D95) > 95.8%]. By contrast, Plan 2 showed degraded dose conformation to the PTV (D95 > 90%) owing to mismatch of the bolus design to the morphological positional changes in the respective CT. The dose assessment results of Plan 3 were very close to those of Plan 1. Conclusion: Dose distribution is significantly affected by whether or not positional organ morphology changes are factored into dose planning. Advances in knowledge: In treatment planning using multiple CT scans with different couch positions, it is mandatory to calculate the accumulated dose using DIR. PMID:25811094

  19. Attenuation-based size metric for estimating organ dose to patients undergoing tube current modulated CT exams

    SciTech Connect

    Bostani, Maryam McMillan, Kyle; Lu, Peiyun; Kim, Hyun J.; Cagnon, Chris H.; McNitt-Gray, Michael F.; DeMarco, John J.

    2015-02-15

    Purpose: Task Group 204 introduced effective diameter (ED) as the patient size metric used to correlate size-specific-dose-estimates. However, this size metric fails to account for patient attenuation properties and has been suggested to be replaced by an attenuation-based size metric, water equivalent diameter (D{sub W}). The purpose of this study is to investigate different size metrics, effective diameter, and water equivalent diameter, in combination with regional descriptions of scanner output to establish the most appropriate size metric to be used as a predictor for organ dose in tube current modulated CT exams. Methods: 101 thoracic and 82 abdomen/pelvis scans from clinically indicated CT exams were collected retrospectively from a multidetector row CT (Sensation 64, Siemens Healthcare) with Institutional Review Board approval to generate voxelized patient models. Fully irradiated organs (lung and breasts in thoracic scans and liver, kidneys, and spleen in abdominal scans) were segmented and used as tally regions in Monte Carlo simulations for reporting organ dose. Along with image data, raw projection data were collected to obtain tube current information for simulating tube current modulation scans using Monte Carlo methods. Additionally, previously described patient size metrics [ED, D{sub W}, and approximated water equivalent diameter (D{sub Wa})] were calculated for each patient and reported in three different ways: a single value averaged over the entire scan, a single value averaged over the region of interest, and a single value from a location in the middle of the scan volume. Organ doses were normalized by an appropriate mAs weighted CTDI{sub vol} to reflect regional variation of tube current. Linear regression analysis was used to evaluate the correlations between normalized organ doses and each size metric. Results: For the abdominal organs, the correlations between normalized organ dose and size metric were overall slightly higher for all three

  20. A computer simulation method for low-dose CT images by use of real high-dose images: a phantom study.

    PubMed

    Takenaga, Tomomi; Katsuragawa, Shigehiko; Goto, Makoto; Hatemura, Masahiro; Uchiyama, Yoshikazu; Shiraishi, Junji

    2016-01-01

    Practical simulations of low-dose CT images have a possibility of being helpful means for optimization of the CT exposure dose. Because current methods reported by several researchers are limited to specific vendor platforms and generally rely on raw sinogram data that are difficult to access, we have developed a new computerized scheme for producing simulated low-dose CT images from real high-dose images without use of raw sinogram data or of a particular phantom. Our computerized scheme for low-dose CT simulation was based on the addition of a simulated noise image to a real high-dose CT image reconstructed by the filtered back-projection algorithm. First, a sinogram was generated from the forward projection of a high-dose CT image. Then, an additional noise sinogram resulting from use of a reduced exposure dose was estimated from a predetermined noise model. Finally, a noise CT image was reconstructed with a predetermined filter and was added to the real high-dose CT image to create a simulated low-dose CT image. The noise power spectrum and modulation transfer function of the simulated low-dose images were very close to those of the real low-dose images. In order to confirm the feasibility of our method, we applied this method to clinical cases which were examined with the high dose initially and then followed with a low-dose CT. In conclusion, our proposed method could simulate the low-dose CT images from their real high-dose images with sufficient accuracy and could be used for determining the optimal dose setting for various clinical CT examinations.

  1. Variation of patient imaging doses with scanning parameters for linac-integrated kilovoltage cone beam CT.

    PubMed

    Liao, Xiongfei; Wang, Yunlai; Lang, Jinyi; Wang, Pei; Li, Jie; Ge, Ruigang; Yang, Jack

    2015-01-01

    To evaluate the Elekta kilovoltage CBCT doses and the associated technical protocols with patient dosimetry estimation. Image guidance technique with cone-beam CT (CBCT) in radiation oncology on a daily basis can deliver a significant dose to the patient. To evaluate the patient dose from LINAC-integrated kV cone beam CT imaging in image-guided radiotherapy. CT dose index (CTDI) were measured with PTW TM30009 CT ion chamber in air, in head phantom and body phantom, respectively; with different combinations of tube voltage, current, exposure time per frame, collimator and gantry rotation range. Dose length products (DLP) were subsequently calculated to account for volume integration effects. The CTDI and DLP were also compared to AcQSim™ simulator CT for routine clinical protocols. Both CTDIair and CTDIw depended quadratically on the voltage, while linearly on milliampere x seconds (mAs) settings. It was shown that CTDIw and DLP had very close relationship with the collimator settings and the gantry rotation ranges. Normalized CTDIw for Elekta XVI™ CBCT was lower than that of ACQSim simulator CT owing to its pulsed radiation output characteristics. CTDIw can be used to assess the patient dose in CBCT due to its simplicity for measurement and reproducibility. Regular measurement should be performed in QA & QC program. Optimal image parameters should be chosen to reduce patient dose during CBCT. PMID:26405932

  2. 18FDG PET-CT standardized uptake value for the prediction of radiation pneumonitis in patients with lung cancer receiving radiotherapy

    PubMed Central

    ZHANG, YONG; YU, YONGHUA; YU, JINMING; FU, ZHENG; LIU, TONGHAI; GUO, SHOUFANG

    2015-01-01

    The present study aimed to determine if the standardized uptake value (SUV) determined with 18F-FDG PET-CT can be used to predict radiation pneumonitis (RP) in lung cancer patients who receive radiotherapy. A total of 40 patients with non-small cell lung cancer received 18F-FDG PET-CT examinations prior to and following radiotherapy. The average SUV of lung tissue prior to and following radiation were measured at differing radiation doses. SUV differences between patients with and without RP, and the SUV ratio of the irradiated lung tissues compared with that of non-irradiated lung tissues (L/B) were compared. There were no differences in the mean SUV between the RP and no RP groups prior to radiotherapy. There were also no significant differences in the mean SUV of lung tissue within groups or between the no RP and RP groups with radiation doses of <5 Gy, 5 to ≤14.9 Gy and 15 to ≤34.9 Gy (all P>0.05) following radiotherapy. There were, however, statistically significant differences in the mean SUV of lung tissue within groups or between the no RP and RP groups with doses of ≥60 Gy prior to therapy and 35 to ≤59.9 Gy and ≥60 Gy following therapy (all P<0.05). When the L/B ratio was ≥3, the incidence of RP was 50%, and when the L/B ratio was ≥2.5 the incidence was 40.7%. When the L/B ratio was <2, there were no cases of RP. In conclusion, the present study indicates that 18F-FDG PET-CT can be used to predict RP by L/B ratio. PMID:26722262

  3. Predominant diffuse ground glass opacity in both lung fields: A case of sarcoidosis with atypical CT findings

    PubMed Central

    Ma, Chunmei; Zhao, Yadong; Wu, Taihua

    2016-01-01

    Sarcoidosis can cause fatal diffuse lung fibrosis in the end stage, so its early diagnosis and treatment can prevent the progression of fibrosis. Predominant ground glass opacity on high-resolution CT (HRCT) scans is a rare presentation of sarcoidosis. We report the case of a patient who presented with very few symptoms and signs of sarcoidosis; HRCT revealed large-scale ground glass opacity and minor lymphadenopathy. Bronchoalveolar lavage fluid contained turbid liquid. Sarcoidosis could be confirmed only based on pathological examination of the resected tissue. The patient was administrated prednisone at 40 mg/d orally with tapering of the dose. Lung HRCT scans taken 6 months after the prednisone treatment showed ablation of the ground glass opacity. This case report sheds light on an atypical HRCT presentation of sarcoidosis; the findings here will be useful for the early diagnosis of sarcoidosis and prevention of fatal complications. PMID:27222788

  4. Ultra-low dose comprehensive cardiac CT imaging in a patient with acute myocarditis.

    PubMed

    Tröbs, Monique; Brand, Michael; Achenbach, Stephan; Marwan, Mohamed

    2014-01-01

    The ability of contrast-enhanced CT to detect "late enhancement" in a fashion similar to magnetic resonance imaging has been previously reported. We report a case of acute myocarditis with coronary CT angiography as well as "late enhancement" imaging with ultra-low effective radiation dose. PMID:25439792

  5. SU-E-T-86: Comparison of Two Commercially Available Programs for the Evaluation of Delivered Daily Dose Using Cone Beam CT (CBCT)

    SciTech Connect

    Tuohy, R; Bosse, C; Mavroidis, P; Shi, Z; Crownover, R; Papanikolaou, N; Stathakis, S

    2014-06-01

    Purpose: In this study, two commercially available programs were compared for the evaluation of delivered daily dose using cone beam CT (CBCT). Methods: Thirty (n=30) patients previously treated in our clinic (10 prostate, 10 SBRT lung and 10 abdomen) were used in this study. The patients' plans were optimized and calculated using the Pinnacle treatment planning system. The daily CBCT scans were imported into Velocity and RayStation along with the corresponding planning CTs, structure sets and 3D dose distributions for each patient. The organs at risk (OAR) were contoured on each CBCT by the prescribing physician and were included in the evaluation of the daily delivered dose. Each CBCT was registered to the planning CT, once with rigid registration and then again, separately, with deformable registration. After registering each CBCT, the dose distribution from the planning CT was overlaid and the dose volume histograms (DVH) for the OAR and the planning target volumes (PTV) were calculated. Results: For prostate patients, we observed daily volume changes for the OARs. The DVH analysis for those patients showed variation in the sparing of the OARs while PTV coverage remained virtually unchanged using both Velocity and RayStation systems. Similar results were observed for abdominal patients. In contrast, for SBRT lung patients, the DVH for the OARs and target were comparable to those from the initial treatment plan. Differences in organ volume and organ doses were also observed when comparing the daily fractions using deformable and rigid registrations. Conclusion: By using daily CBCT dose reconstruction, we proved PTV coverage for prostate and abdominal targets is adequate. However, there is significant dosimetric change for the OARs. For lung SBRT patients, the delivered daily dose for both PTV and OAR is comparable to the planned dose with no significant differences.

  6. Influence of radiation therapy on the lung-tissue in breast cancer patients: CT-assessed density changes and associated symptoms

    SciTech Connect

    Rotstein, S.; Lax, I.; Svane, G. )

    1990-01-01

    The relative electron density of lung tissue was measured from computer tomography (CT) slices in 33 breast cancer patients treated by various techniques of adjuvant radiotherapy. The measurements were made before radiotherapy, 3 months and 9 months after completion of radiation therapy. The changes in lung densities at 3 months and 9 months were compared to radiation induced radiological (CT) findings. In addition, subjective symptoms such as cough and dyspnoea were assessed before and after radiotherapy. It was observed that the mean of the relative electron density of lung tissue varied from 0.25 when the whole lung was considered to 0.17 when only the anterior lateral quarter of the lung was taken into account. In patients with positive radiological (CT) findings the mean lung density of the anterior lateral quarter increased 2.1 times 3 months after radiotherapy and was still increased 1.6 times 6 months later. For those patients without findings, in the CT pictures the corresponding values were 1.2 and 1.1, respectively. The standard deviation of the pixel values within the anterior lateral quarter of the lung increased 3.8 times and 3.2 times at 3 months and 9 months, respectively, in the former group, as opposed to 1.2 and 1.1 in the latter group. Thirteen patients had an increase in either cough or dyspnoea as observed 3 months after completion of radiotherapy. In eleven patients these symptoms persisted 6 months later. No significant correlation was found between radiological findings and subjective symptoms. However, when three different treatment techniques were compared among 29 patients the highest rate of radiological findings was observed in patients in which the largest lung volumes received the target dose. A tendency towards an increased rate of subjective symptoms was also found in this group.

  7. Automatic lung tumor segmentation on PET/CT images using fuzzy Markov random field model.

    PubMed

    Guo, Yu; Feng, Yuanming; Sun, Jian; Zhang, Ning; Lin, Wang; Sa, Yu; Wang, Ping

    2014-01-01

    The combination of positron emission tomography (PET) and CT images provides complementary functional and anatomical information of human tissues and it has been used for better tumor volume definition of lung cancer. This paper proposed a robust method for automatic lung tumor segmentation on PET/CT images. The new method is based on fuzzy Markov random field (MRF) model. The combination of PET and CT image information is achieved by using a proper joint posterior probability distribution of observed features in the fuzzy MRF model which performs better than the commonly used Gaussian joint distribution. In this study, the PET and CT simulation images of 7 non-small cell lung cancer (NSCLC) patients were used to evaluate the proposed method. Tumor segmentations with the proposed method and manual method by an experienced radiation oncologist on the fused images were performed, respectively. Segmentation results obtained with the two methods were similar and Dice's similarity coefficient (DSC) was 0.85 ± 0.013. It has been shown that effective and automatic segmentations can be achieved with this method for lung tumors which locate near other organs with similar intensities in PET and CT images, such as when the tumors extend into chest wall or mediastinum.

  8. Normal adrenal glands in small cell lung carcinoma: CT-guided biopsy

    SciTech Connect

    Pagani, J.J.

    1983-05-01

    Twenty-four small cell lung carcinoma patients with morphologically normal adrenal glands by computed tomographic (CT) criteria underwent percutaneous thin-needle biopsy of their adrenal glands. Of 43 glands biopsied, 29 had adequate cellular material for interpretation. Five (17%) of the 29 glands were positive for metastases; the rest had negative biopsies. This series indicates an approximate 17% false-negative diagnosis rate by CT when staging the adrenal glands in patients with small cell lung carcinoma. It also demonstrates the utility of percutaneous needle biopsy as an investigational tool to further evaluate normal-sized adrenal glands in the oncologic patient.

  9. High resolution multidetector CT aided tissue analysis and quantification of lung fibrosis

    NASA Astrophysics Data System (ADS)

    Zavaletta, Vanessa A.; Karwoski, Ronald A.; Bartholmai, Brian; Robb, Richard A.

    2006-03-01

    Idiopathic pulmonary fibrosis (IPF, also known as Idiopathic Usual Interstitial Pneumontis, pathologically) is a progressive diffuse lung disease which has a median survival rate of less than four years with a prevalence of 15-20/100,000 in the United States. Global function changes are measured by pulmonary function tests and the diagnosis and extent of pulmonary structural changes are typically assessed by acquiring two-dimensional high resolution CT (HRCT) images. The acquisition and analysis of volumetric high resolution Multi-Detector CT (MDCT) images with nearly isotropic pixels offers the potential to measure both lung function and structure. This paper presents a new approach to three dimensional lung image analysis and classification of normal and abnormal structures in lungs with IPF.

  10. Patient-specific radiation dose and cancer risk estimation in CT: Part II. Application to patients

    SciTech Connect

    Li Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Toncheva, Greta; Yoshizumi, Terry T.; Frush, Donald P.

    2011-01-15

    Purpose: Current methods for estimating and reporting radiation dose from CT examinations are largely patient-generic; the body size and hence dose variation from patient to patient is not reflected. Furthermore, the current protocol designs rely on dose as a surrogate for the risk of cancer incidence, neglecting the strong dependence of risk on age and gender. The purpose of this study was to develop a method for estimating patient-specific radiation dose and cancer risk from CT examinations. Methods: The study included two patients (a 5-week-old female patient and a 12-year-old male patient), who underwent 64-slice CT examinations (LightSpeed VCT, GE Healthcare) of the chest, abdomen, and pelvis at our institution in 2006. For each patient, a nonuniform rational B-spine (NURBS) based full-body computer model was created based on the patient's clinical CT data. Large organs and structures inside the image volume were individually segmented and modeled. Other organs were created by transforming an existing adult male or female full-body computer model (developed from visible human data) to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. A Monte Carlo program previously developed and validated for dose simulation on the LightSpeed VCT scanner was used to estimate patient-specific organ dose, from which effective dose and risks of cancer incidence were derived. Patient-specific organ dose and effective dose were compared with patient-generic CT dose quantities in current clinical use: the volume-weighted CT dose index (CTDI{sub vol}) and the effective dose derived from the dose-length product (DLP). Results: The effective dose for the CT examination of the newborn patient (5.7 mSv) was higher but comparable to that for the CT examination of the teenager patient (4.9 mSv) due to the size-based clinical CT protocols at our institution, which employ lower scan techniques for smaller

  11. Improving low-dose cardiac CT images using 3D sparse representation based processing

    NASA Astrophysics Data System (ADS)

    Shi, Luyao; Chen, Yang; Luo, Limin

    2015-03-01

    Cardiac computed tomography (CCT) has been widely used in diagnoses of coronary artery diseases due to the continuously improving temporal and spatial resolution. When helical CT with a lower pitch scanning mode is used, the effective radiation dose can be significant when compared to other radiological exams. Many methods have been developed to reduce radiation dose in coronary CT exams including high pitch scans using dual source CT scanners and step-and-shot scanning mode for both single source and dual source CT scanners. Additionally, software methods have also been proposed to reduce noise in the reconstructed CT images and thus offering the opportunity to reduce radiation dose while maintaining the desired diagnostic performance of a certain imaging task. In this paper, we propose that low-dose scans should be considered in order to avoid the harm from accumulating unnecessary X-ray radiation. However, low dose CT (LDCT) images tend to be degraded by quantum noise and streak artifacts. Accordingly, in this paper, a 3D dictionary representation based image processing method is proposed to reduce CT image noise. Information on both spatial and temporal structure continuity is utilized in sparse representation to improve the performance of the image processing method. Clinical cases were used to validate the proposed method.

  12. Classification of patterns for diffuse lung diseases in thoracic CT images by AdaBoost algorithm

    NASA Astrophysics Data System (ADS)

    Kuwahara, Masayuki; Kido, Shoji; Shouno, Hayaru

    2009-02-01

    CT images are considered as effective for differential diagnosis of diffuse lung diseases. However, the diagnosis of diffuse lung diseases is a difficult problem for the radiologists, because they show a variety of patterns on CT images. So, our purpose is to construct a computer-aided diagnosis (CAD) system for classification of patterns for diffuse lung diseases in thoracic CT images, which gives both quantitative and objective information as a second opinion, to decrease the burdens of radiologists. In this article, we propose a CAD system based on the conventional pattern recognition framework, which consists of two sub-systems; one is feature extraction part and the other is classification part. In the feature extraction part, we adopted a Gabor filter, which can extract patterns such like local edges and segments from input textures, as a feature extraction of CT images. In the recognition part, we used a boosting method. Boosting is a kind of voting method by several classifiers to improve decision precision. We applied AdaBoost algorithm for boosting method. At first, we evaluated each boosting component classifier, and we confirmed they had not enough performances in classification of patterns for diffuse lung diseases. Next, we evaluated the performance of boosting method. As a result, by use of our system, we could improve the classification rate of patterns for diffuse lung diseases.

  13. CT Fluoroscopy-Guided Lung Biopsy with Novel Steerable Biopsy Canula: Ex-Vivo Evaluation in Ventilated Porcine Lung Explants

    SciTech Connect

    Schaefer, Philipp J. Fabel, Michael; Bolte, Hendrik; Schaefer, Fritz K. W.; Jahnke, Thomas; Heller, Martin; Lammer, Johannes; Biederer, Juergen

    2010-08-15

    The purpose was to evaluate ex-vivo a prototype of a novel biopsy canula under CT fluoroscopy-guidance in ventilated porcine lung explants in respiratory motion simulations. Using an established chest phantom for porcine lung explants, n = 24 artificial lesions consisting of a fat-wax-Lipiodol mixture (approx. 70HU) were placed adjacent to sensible structures such as aorta, pericardium, diaphragm, bronchus and pulmonary artery. A piston pump connected to a reservoir beneath a flexible silicone reconstruction of a diaphragm simulated respiratory motion by rhythmic inflation and deflation of 1.5 L water. As biopsy device an 18-gauge prototype biopsy canula with a lancet-like, helically bended cutting edge was used. The artificial lesions were punctured under CT fluoroscopy-guidance (SOMATOM Sensation 64, Siemens, Erlangen, Germany; 30mAs/120 kV/5 mm slice thickness) implementing a dedicated protocol for CT fluoroscopy-guided lung biopsy. The mean-diameter of the artificial lesions was 8.3 {+-} 2.6 mm, and the mean-distance of the phantom wall to the lesions was 54.1 {+-} 13.5 mm. The mean-displacement of the lesions by respiratory motion was 14.1 {+-} 4.0 mm. The mean-duration of CT fluoroscopy was 9.6 {+-} 5.1 s. On a 4-point scale (1 = central; 2 = peripheral; 3 = marginal; 4 = off target), the mean-targeted precision was 1.9 {+-} 0.9. No misplacement of the biopsy canula affecting adjacent structures could be detected. The novel steerable biopsy canula proved to be efficient in the ex-vivo set-up. The chest phantom enabling respiratory motion and the steerable biopsy canula offer a feasible ex-vivo system for evaluating and training CT fluoroscopy-guided lung biopsy adapted to respiratory motion.

  14. The MAGIC-5 CAD for nodule detection in low dose and thin slice lung CTs

    NASA Astrophysics Data System (ADS)

    Cerello, Piergiorgio; MAGIC-5 Collaboration

    2010-11-01

    Lung cancer is the leading cause of cancer-related mortality in developed countries. Only 10-15% of all men and women diagnosed with lung cancer live 5 years after the diagnosis. However, the 5-year survival rate for patients diagnosed in the early asymptomatic stage of the disease can reach 70%. Early-stage lung cancers can be diagnosed by detecting non-calcified small pulmonary nodules with computed tomography (CT). Computer-aided detection (CAD) could support radiologists in the analysis of the large amount of noisy images generated in screening programs, where low-dose and thin-slice settings are used. The MAGIC-5 project, funded by the Istituto Nazionale di Fisica Nucleare (INFN, Italy) and Ministero dell'Università e della Ricerca (MUR, Italy), developed a multi-method approach based on three CAD algorithms to be used in parallel with a merging of their results: the Channeler Ant Model (CAM), based on Virtual Ant Colonies, the Dot-Enhancement/Pleura Surface Normals/VBNA (DE-PSN-VBNA), and the Region Growing Volume Plateau (RGVP). Preliminary results show quite good performances, to be improved with the refining of the single algorithm and the added value of the results merging.

  15. A technique for multi-dimensional optimization of radiation dose, contrast dose, and image quality in CT imaging

    NASA Astrophysics Data System (ADS)

    Sahbaee, Pooyan; Abadi, Ehsan; Sanders, Jeremiah; Becchetti, Marc; Zhang, Yakun; Agasthya, Greeshma; Segars, Paul; Samei, Ehsan

    2016-03-01

    The purpose of this study was to substantiate the interdependency of image quality, radiation dose, and contrast material dose in CT towards the patient-specific optimization of the imaging protocols. The study deployed two phantom platforms. First, a variable sized phantom containing an iodinated insert was imaged on a representative CT scanner at multiple CTDI values. The contrast and noise were measured from the reconstructed images for each phantom diameter. Linearly related to iodine-concentration, contrast to noise ratio (CNR), was calculated for different iodine-concentration levels. Second, the analysis was extended to a recently developed suit of 58 virtual human models (5D-XCAT) with added contrast dynamics. Emulating a contrast-enhanced abdominal image procedure and targeting a peak-enhancement in aorta, each XCAT phantom was "imaged" using a CT simulation platform. 3D surfaces for each patient/size established the relationship between iodine-concentration, dose, and CNR. The Sensitivity of Ratio (SR), defined as ratio of change in iodine-concentration versus dose to yield a constant change in CNR was calculated and compared at high and low radiation dose for both phantom platforms. The results show that sensitivity of CNR to iodine concentration is larger at high radiation dose (up to 73%). The SR results were highly affected by radiation dose metric; CTDI or organ dose. Furthermore, results showed that the presence of contrast material could have a profound impact on optimization results (up to 45%).

  16. Acquisition, preprocessing, and reconstruction of ultralow dose volumetric CT scout for organ-based CT scan planning

    SciTech Connect

    Yin, Zhye De Man, Bruno; Yao, Yangyang; Wu, Mingye; Montillo, Albert; Edic, Peter M.; Kalra, Mannudeep

    2015-05-15

    Purpose: Traditionally, 2D radiographic preparatory scan images (scout scans) are used to plan diagnostic CT scans. However, a 3D CT volume with a full 3D organ segmentation map could provide superior information for customized scan planning and other purposes. A practical challenge is to design the volumetric scout acquisition and processing steps to provide good image quality (at least good enough to enable 3D organ segmentation) while delivering a radiation dose similar to that of the conventional 2D scout. Methods: The authors explored various acquisition methods, scan parameters, postprocessing methods, and reconstruction methods through simulation and cadaver data studies to achieve an ultralow dose 3D scout while simultaneously reducing the noise and maintaining the edge strength around the target organ. Results: In a simulation study, the 3D scout with the proposed acquisition, preprocessing, and reconstruction strategy provided a similar level of organ segmentation capability as a traditional 240 mAs diagnostic scan, based on noise and normalized edge strength metrics. At the same time, the proposed approach delivers only 1.25% of the dose of a traditional scan. In a cadaver study, the authors’ pictorial-structures based organ localization algorithm successfully located the major abdominal-thoracic organs from the ultralow dose 3D scout obtained with the proposed strategy. Conclusions: The authors demonstrated that images with a similar degree of segmentation capability (interpretability) as conventional dose CT scans can be achieved with an ultralow dose 3D scout acquisition and suitable postprocessing. Furthermore, the authors applied these techniques to real cadaver CT scans with a CTDI dose level of less than 0.1 mGy and successfully generated a 3D organ localization map.

  17. Calculating tumor trajectory and dose-of-the-day using cone-beam CT projections

    SciTech Connect

    Jones, Bernard L. Westerly, David; Miften, Moyed

    2015-02-15

    Purpose: Cone-beam CT (CBCT) projection images provide anatomical data in real-time over several respiratory cycles, forming a comprehensive picture of tumor movement. The authors developed and validated a method which uses these projections to determine the trajectory of and dose to highly mobile tumors during each fraction of treatment. Methods: CBCT images of a respiration phantom were acquired, the trajectory of which mimicked a lung tumor with high amplitude (up to 2.5 cm) and hysteresis. A template-matching algorithm was used to identify the location of a steel BB in each CBCT projection, and a Gaussian probability density function for the absolute BB position was calculated which best fit the observed trajectory of the BB in the imager geometry. Two modifications of the trajectory reconstruction were investigated: first, using respiratory phase information to refine the trajectory estimation (Phase), and second, using the Monte Carlo (MC) method to sample the estimated Gaussian tumor position distribution. The accuracies of the proposed methods were evaluated by comparing the known and calculated BB trajectories in phantom-simulated clinical scenarios using abdominal tumor volumes. Results: With all methods, the mean position of the BB was determined with accuracy better than 0.1 mm, and root-mean-square trajectory errors averaged 3.8% ± 1.1% of the marker amplitude. Dosimetric calculations using Phase methods were more accurate, with mean absolute error less than 0.5%, and with error less than 1% in the highest-noise trajectory. MC-based trajectories prevent the overestimation of dose, but when viewed in an absolute sense, add a small amount of dosimetric error (<0.1%). Conclusions: Marker trajectory and target dose-of-the-day were accurately calculated using CBCT projections. This technique provides a method to evaluate highly mobile tumors using ordinary CBCT data, and could facilitate better strategies to mitigate or compensate for motion during

  18. Clinical value of CT-based preoperative software assisted lung lobe volumetry for predicting postoperative pulmonary function after lung surgery

    NASA Astrophysics Data System (ADS)

    Wormanns, Dag; Beyer, Florian; Hoffknecht, Petra; Dicken, Volker; Kuhnigk, Jan-Martin; Lange, Tobias; Thomas, Michael; Heindel, Walter

    2005-04-01

    This study was aimed to evaluate a morphology-based approach for prediction of postoperative forced expiratory volume in one second (FEV1) after lung resection from preoperative CT scans. Fifteen Patients with surgically treated (lobectomy or pneumonectomy) bronchogenic carcinoma were enrolled in the study. A preoperative chest CT and pulmonary function tests before and after surgery were performed. CT scans were analyzed by prototype software: automated segmentation and volumetry of lung lobes was performed with minimal user interaction. Determined volumes of different lung lobes were used to predict postoperative FEV1 as percentage of the preoperative values. Predicted FEV1 values were compared to the observed postoperative values as standard of reference. Patients underwent lobectomy in twelve cases (6 upper lobes; 1 middle lobe; 5 lower lobes; 6 right side; 6 left side) and pneumonectomy in three cases. Automated calculation of predicted postoperative lung function was successful in all cases. Predicted FEV1 ranged from 54% to 95% (mean 75% +/- 11%) of the preoperative values. Two cases with obviously erroneous LFT were excluded from analysis. Mean error of predicted FEV1 was 20 +/- 160 ml, indicating absence of systematic error; mean absolute error was 7.4 +/- 3.3% respective 137 +/- 77 ml/s. The 200 ml reproducibility criterion for FEV1 was met in 11 of 13 cases (85%). In conclusion, software-assisted prediction of postoperative lung function yielded a clinically acceptable agreement with the observed postoperative values. This method might add useful information for evaluation of functional operability of patients with lung cancer.

  19. Acute Coronary Artery Air Embolism Following CT-Guided Lung Biopsy

    SciTech Connect

    Mansour, Asem AbdelRaouf, Salah; Qandeel, Monther; Swaidan, Maisa

    2005-01-15

    CT-guided needle biopsy is a common procedure for obtaining a tissue diagnosis and consequently correctly managing patients. This procedure has many potential complications, ranging from simple pneumothorax or self-limiting hemoptysis to life-threatening pulmonary hemorrhage and air embolism. Though the latter is a rare complication of CT-guided needle biopsy, it has attracted a lot of interest. We report a case of right coronary air embolism resulting in myocardial infarction after a CT-guided percutaneous needle biopsy of the lung.

  20. CIDI-lung-seg: a single-click annotation tool for automatic delineation of lungs from CT scans.

    PubMed

    Mansoor, Awais; Bagci, Ulas; Foster, Brent; Xu, Ziyue; Douglas, Deborah; Solomon, Jeffrey M; Udupa, Jayaram K; Mollura, Daniel J

    2014-01-01

    Accurate and fast extraction of lung volumes from computed tomography (CT) scans remains in a great demand in the clinical environment because the available methods fail to provide a generic solution due to wide anatomical variations of lungs and existence of pathologies. Manual annotation, current gold standard, is time consuming and often subject to human bias. On the other hand, current state-of-the-art fully automated lung segmentation methods fail to make their way into the clinical practice due to their inability to efficiently incorporate human input for handling misclassifications and praxis. This paper presents a lung annotation tool for CT images that is interactive, efficient, and robust. The proposed annotation tool produces an "as accurate as possible" initial annotation based on the fuzzy-connectedness image segmentation, followed by efficient manual fixation of the initial extraction if deemed necessary by the practitioner. To provide maximum flexibility to the users, our annotation tool is supported in three major operating systems (Windows, Linux, and the Mac OS X). The quantitative results comparing our free software with commercially available lung segmentation tools show higher degree of consistency and precision of our software with a considerable potential to enhance the performance of routine clinical tasks. PMID:25570151

  1. Dosimetric Feasibility of Dose Escalation Using SBRT Boost for Stage III Non-Small Cell Lung Cancer

    PubMed Central

    Hepel, Jaroslaw T.; Peter, Justin; Hiatt, Jessica R.; Patel, Salil; Osibanjo, Oluwademilade; Safran, Howard; Curran, Bruce; DiPetrillo, Thomas

    2012-01-01

    Purpose: Standard chemoradiation therapy for stage III non-small cell lung cancer (NSCLCa) results in suboptimal outcomes with a high rate of local failure and poor overall survival. We hypothesize that dose escalation using stereotactic body radiotherapy (SBRT) boost could improve upon these results. We present here a study evaluating the dosimetric feasibility of such an approach. Methods: Anonymized CT data sets from five randomly selected patients with stage III NSCLCa undergoing definitive chemoradiation therapy in our department with disease volumes appropriate for SBRT boost were selected. Three-dimensional conformal radiation therapy (3D-CRT) plans to 50.4 Gy in 28 fractions were generated follow by SBRT plans to two dose levels, 16 Gy in two fractions and 28 Gy in two fractions. SBRT plans and total composite (3D-CRT and SBRT) were optimized and evaluated for target coverage and dose to critical structures; lung, esophagus, cord, and heart. Results: All five plans met predetermined target coverage and normal tissue dose constraints. PTV V95 was equal to or greater than 95% in all cases. The cumulative lung V20 and V5 of the combined 3D-CRT and SBRT plans were less than or equal to 30 and 55%, respectively. The 5 cc esophageal dose was less than 12 Gy for all low and high dose SBRT plans. The cumulative dose to the esophagus was also acceptable with less than 10% of the esophagus receiving doses in excess of 50 Gy. The cumulative spinal cord dose was less than 33 Gy and heart V25 was less than 5%. Conclusion: The combination of chemoradiation to 50.4 Gy followed by SBRT boost to gross disease at the primary tumor and involved regional lymph nodes is feasible with respect to normal tissue dose constraints in this dosimetric pilot study. A phase I/II trial to evaluate the clinical safety and efficacy of this approach is being undertaken. PMID:23057009

  2. Objective assessment of image quality and dose reduction in CT iterative reconstruction

    SciTech Connect

    Vaishnav, J. Y. Jung, W. C.; Popescu, L. M.; Zeng, R.; Myers, K. J.

    2014-07-15

    Purpose: Iterative reconstruction (IR) algorithms have the potential to reduce radiation dose in CT diagnostic imaging. As these algorithms become available on the market, a standardizable method of quantifying the dose reduction that a particular IR method can achieve would be valuable. Such a method would assist manufacturers in making promotional claims about dose reduction, buyers in comparing different devices, physicists in independently validating the claims, and the United States Food and Drug Administration in regulating the labeling of CT devices. However, the nonlinear nature of commercially available IR algorithms poses challenges to objectively assessing image quality, a necessary step in establishing the amount of dose reduction that a given IR algorithm can achieve without compromising that image quality. This review paper seeks to consolidate information relevant to objectively assessing the quality of CT IR images, and thereby measuring the level of dose reduction that a given IR algorithm can achieve. Methods: The authors discuss task-based methods for assessing the quality of CT IR images and evaluating dose reduction. Results: The authors explain and review recent literature on signal detection and localization tasks in CT IR image quality assessment, the design of an appropriate phantom for these tasks, possible choices of observers (including human and model observers), and methods of evaluating observer performance. Conclusions: Standardizing the measurement of dose reduction is a problem of broad interest to the CT community and to public health. A necessary step in the process is the objective assessment of CT image quality, for which various task-based methods may be suitable. This paper attempts to consolidate recent literature that is relevant to the development and implementation of task-based methods for the assessment of CT IR image quality.

  3. Lung function in silica-exposed workers. A relationship to disease severity assessed by CT scan.

    PubMed

    Bégin, R; Ostiguy, G; Cantin, A; Bergeron, D

    1988-09-01

    To investigate the relationship of lung function, airflow limitation, and lung injury in silica-exposed workers, we analyzed the clinical, functional, and radiologic data of 94 long-term workers exposed in the granite industry or in foundries. The subjects were divided into four subsets based on chest roentgenogram and CT scan of the thorax: group 1 consisted of 21 subjects with category 0 chest roentgenogram and category 0 CT scan; group 2, 28 subjects with category E 1 on both chest roentgenogram and CT scan; group 3, 18 subjects with category E 1 on chest roentgenogram but with coalescence or conglomeration or both seen only on CT scan; and group 4, 27 subjects with category E 1 and coalescence or conglomeration or both on roentgenogram and CT scan. The groups did not differ in terms of age, height, cigarette smoking, or years of exposure. Lung volumes were significantly reduced only in group 4 (p less than 0.05). Lung compliance, diffusion capacity, and the rest-exercise P(A-a)O2 gradient were reduced in groups 3 and 4 (p less than 0.05). Expiratory flow rates were significantly reduced in groups 2, 3, and 4, with the lowest values in group 4. The expiratory flow rates in group 3 were significantly lower in group 3 than in group 2. These results support the concept that airflow in silica-exposed workers is significantly reduced when the disease is detectable on simple chest roentgenogram; coalescence or conglomeration or both on chest roentgenogram or CT scan is associated with significant loss of lung volumes, gas exchange function, and increased airflow obstruction.

  4. Biomechanical deformable image registration of longitudinal lung CT images using vessel information.

    PubMed

    Cazoulat, Guillaume; Owen, Dawn; Matuszak, Martha M; Balter, James M; Brock, Kristy K

    2016-07-01

    Spatial correlation of lung tissue across longitudinal images, as the patient responds to treatment, is a critical step in adaptive radiotherapy. The goal of this work is to expand a biomechanical model-based deformable registration algorithm (Morfeus) to achieve accurate registration in the presence of significant anatomical changes. Six lung cancer patients previously treated with conventionally fractionated radiotherapy were retrospectively evaluated. Exhale CT scans were obtained at treatment planning and following three weeks of treatment. For each patient, the planning CT was registered to the follow-up CT using Morfeus, a biomechanical model-based deformable registration algorithm. To model the complex response of the lung, an extension to Morfeus has been developed: an initial deformation was estimated with Morfeus consisting of boundary conditions on the chest wall and incorporating a sliding interface with the lungs. It was hypothesized that the addition of boundary conditions based on vessel tree matching would provide a robust reduction of the residual registration error. To achieve this, the vessel trees were segmented on the two images by thresholding a vesselness image based on the Hessian matrix's eigenvalues. For each point on the reference vessel tree centerline, the displacement vector was estimated by applying a variant of the Demons registration algorithm between the planning CT and the deformed follow-up CT. An expert independently identified corresponding landmarks well distributed in the lung to compute target registration errors (TRE). The TRE was: [Formula: see text], [Formula: see text] and [Formula: see text] mm after rigid registration, Morfeus and Morfeus with boundary conditions on the vessel tree, respectively. In conclusion, the addition of boundary conditions on the vessels significantly improved the accuracy in modeling the response of the lung and tumor over the course of radiotherapy. Minimizing and modeling these geometrical

  5. Biomechanical deformable image registration of longitudinal lung CT images using vessel information

    NASA Astrophysics Data System (ADS)

    Cazoulat, Guillaume; Owen, Dawn; Matuszak, Martha M.; Balter, James M.; Brock, Kristy K.

    2016-07-01

    Spatial correlation of lung tissue across longitudinal images, as the patient responds to treatment, is a critical step in adaptive radiotherapy. The goal of this work is to expand a biomechanical model-based deformable registration algorithm (Morfeus) to achieve accurate registration in the presence of significant anatomical changes. Six lung cancer patients previously treated with conventionally fractionated radiotherapy were retrospectively evaluated. Exhale CT scans were obtained at treatment planning and following three weeks of treatment. For each patient, the planning CT was registered to the follow-up CT using Morfeus, a biomechanical model-based deformable registration algorithm. To model the complex response of the lung, an extension to Morfeus has been developed: an initial deformation was estimated with Morfeus consisting of boundary conditions on the chest wall and incorporating a sliding interface with the lungs. It was hypothesized that the addition of boundary conditions based on vessel tree matching would provide a robust reduction of the residual registration error. To achieve this, the vessel trees were segmented on the two images by thresholding a vesselness image based on the Hessian matrix’s eigenvalues. For each point on the reference vessel tree centerline, the displacement vector was estimated by applying a variant of the Demons registration algorithm between the planning CT and the deformed follow-up CT. An expert independently identified corresponding landmarks well distributed in the lung to compute target registration errors (TRE). The TRE was: 5.8+/- 2.9 , 3.4+/- 2.3 and 1.6+/- 1.3 mm after rigid registration, Morfeus and Morfeus with boundary conditions on the vessel tree, respectively. In conclusion, the addition of boundary conditions on the vessels significantly improved the accuracy in modeling the response of the lung and tumor over the course of radiotherapy. Minimizing and modeling these geometrical uncertainties will enable

  6. Estimating Radiation Dose Metrics for Patients Undergoing Tube Current Modulation CT Scans

    NASA Astrophysics Data System (ADS)

    McMillan, Kyle Lorin

    Computed tomography (CT) has long been a powerful tool in the diagnosis of disease, identification of tumors and guidance of interventional procedures. With CT examinations comes the concern of radiation exposure and the associated risks. In order to properly understand those risks on a patient-specific level, organ dose must be quantified for each CT scan. Some of the most widely used organ dose estimates are derived from fixed tube current (FTC) scans of a standard sized idealized patient model. However, in current clinical practice, patient size varies from neonates weighing just a few kg to morbidly obese patients weighing over 200 kg, and nearly all CT exams are performed with tube current modulation (TCM), a scanning technique that adjusts scanner output according to changes in patient attenuation. Methods to account for TCM in CT organ dose estimates have been previously demonstrated, but these methods are limited in scope and/or restricted to idealized TCM profiles that are not based on physical observations and not scanner specific (e.g. don't account for tube limits, scanner-specific effects, etc.). The goal of this work was to develop methods to estimate organ doses to patients undergoing CT scans that take into account both the patient size as well as the effects of TCM. This work started with the development and validation of methods to estimate scanner-specific TCM schemes for any voxelized patient model. An approach was developed to generate estimated TCM schemes that match actual TCM schemes that would have been acquired on the scanner for any patient model. Using this approach, TCM schemes were then generated for a variety of body CT protocols for a set of reference voxelized phantoms for which TCM information does not currently exist. These are whole body patient models representing a variety of sizes, ages and genders that have all radiosensitive organs identified. TCM schemes for these models facilitated Monte Carlo-based estimates of fully

  7. Quantification of pulmonary vessel diameter in low-dose CT images

    NASA Astrophysics Data System (ADS)

    Rudyanto, Rina D.; Ortiz de Solórzano, Carlos; Muñoz-Barrutia, Arrate

    2015-03-01

    Accurate quantification of vessel diameter in low-dose Computer Tomography (CT) images is important to study pulmonary diseases, in particular for the diagnosis of vascular diseases and the characterization of morphological vascular remodeling in Chronic Obstructive Pulmonary Disease (COPD). In this study, we objectively compare several vessel diameter estimation methods using a physical phantom. Five solid tubes of differing diameters (from 0.898 to 3.980 mm) were embedded in foam, simulating vessels in the lungs. To measure the diameters, we first extracted the vessels using either of two approaches: vessel enhancement using multi-scale Hessian matrix computation, or explicitly segmenting them using intensity threshold. We implemented six methods to quantify the diameter: three estimating diameter as a function of scale used to calculate the Hessian matrix; two calculating equivalent diameter from the crosssection area obtained by thresholding the intensity and vesselness response, respectively; and finally, estimating the diameter of the object using the Full Width Half Maximum (FWHM). We find that the accuracy of frequently used methods estimating vessel diameter from the multi-scale vesselness filter depends on the range and the number of scales used. Moreover, these methods still yield a significant error margin on the challenging estimation of the smallest diameter (on the order or below the size of the CT point spread function). Obviously, the performance of the thresholding-based methods depends on the value of the threshold. Finally, we observe that a simple adaptive thresholding approach can achieve a robust and accurate estimation of the smallest vessels diameter.

  8. Genome-wide association study of coronary and aortic calcification in lung cancer screening CT

    NASA Astrophysics Data System (ADS)

    de Vos, Bob D.; van Setten, Jessica; de Jong, Pim A.; Mali, Willem P.; Oudkerk, Matthijs; Viergever, Max A.; Išgum, Ivana

    2016-03-01

    Arterial calcification has been related to cardiovascular disease (CVD) and osteoporosis. However, little is known about the role of genetics and exact pathways leading to arterial calcification and its relation to bone density changes indicating osteoporosis. In this study, we conducted a genome-wide association study of arterial calcification burden, followed by a look-up of known single nucleotide polymorphisms (SNPs) for coronary artery disease (CAD) and myocardial infarction (MI), and bone mineral density (BMD) to test for a shared genetic basis between the traits. The study included a subcohort of the Dutch-Belgian lung cancer screening trial comprised of 2,561 participants. Participants underwent baseline CT screening in one of two hospitals participating in the trial. Low-dose chest CT images were acquired without contrast enhancement and without ECG-synchronization. In these images coronary and aortic calcifications were identified automatically. Subsequently, the detected calcifications were quantified using coronary artery calcium Agatston and volume scores. Genotype data was available for these participants. A genome-wide association study was conducted on 10,220,814 SNPs using a linear regression model. To reduce multiple testing burden, known CAD/MI and BMD SNPs were specifically tested (45 SNPs from the CARDIoGRAMplusC4D consortium and 60 SNPS from the GEFOS consortium). No novel significant SNPs were found. Significant enrichment for CAD/MI SNPs was observed in testing Agatston and coronary artery calcium volume scores. Moreover, a significant enrichment of BMD SNPs was shown in aortic calcium volume scores. This may indicate genetic relation of BMD SNPs and arterial calcification burden.

  9. Radiation Dose to the Radiologist's Hand During Continuous CT Fluoroscopy-Guided Interventions

    SciTech Connect

    Stoeckelhuber, Beate M. Leibecke, Thorsten; Schulz, Edda; Melchert, Uwe H.; Bergmann-Koester, Claudia U.; Helmberger, Thomas; Gellissen, Joerg

    2005-06-15

    Computed tomography fluoroscopy (CT fluoroscopy) enables real-time image control over the entire body with high geometric accuracy and, for the most part, without significant interfering artifacts, resulting in increased target accuracy, reduced intervention times, and improved biopsy specimens [1-4]. Depending on the procedure being used, higher radiation doses than in conventional CT-supported interventions might occur. Because the radiologist is present in the CT room during the intervention, he is exposed to additional radiation, which is an important aspect. Initial experience with CT fluoroscopically guided interventions is from the work of Katada et al. in 1994 [5] and only relatively few reports on radiation aspects in CT fluoroscopy are found in the literature [1, 2, 6-11]. To date, there are no reported injuries to patients and radiologists occurring with CT fluoroscopy. The time interval since the wide use of CT fluoroscopy is too short to have data on late effects to the operator using CT fluoroscopy on a daily basis. In addition, the spectrum of CT fluoroscopically guided interventional procedures will expand and more sophisticated procedures requiring longer fluoroscopy times will be performed. Thus, effective exposure reduction is very important. The purpose of our study was to assess the radiation dose to the operator's hand by using data from phantom measurements. In addition, we investigated the effect of a lead drape on the phantom surface adjacent to the scanning plane, the use of thin radiation protective gloves, and the use of different needle holders.

  10. Evaluation of the effective dose of cone beam CT and multislice CT for temporomandibular joint examinations at optimized exposure levels

    PubMed Central

    Kadesjö, N; Benchimol, D; Falahat, B; Näsström, K

    2015-01-01

    Objectives: To compare the effective dose to patients from temporomandibular joint examinations using a dental CBCT device and a multislice CT (MSCT) device, both before and after dose optimization. Methods: A Promax® 3D (Planmeca, Helsinki, Finland) dental CBCT and a LightSpeed VCT® (GE Healthcare, Little Chalfont, UK) multislice CT were used. Organ doses and effective doses were estimated from thermoluminescent dosemeters at 61 positions inside an anthropomorphic phantom at the exposure settings in clinical use. Optimized exposure protocols were obtained through an optimization study using a dry skull phantom, where four observers rated image quality taken at different exposure levels. The optimal exposure level was obtained when all included criteria were rated as acceptable or better by all observers. Results: The effective dose from a bilateral examination was 184 µSv for Promax 3D and 113 µSv for LightSpeed VCT before optimization. Post optimization, the bilateral effective dose was 92 µSv for Promax 3D and 124 µSv for LightSpeed VCT. Conclusions: At optimized exposure levels, the effective dose from CBCT was comparable to MSCT. PMID:26119344

  11. [Examination of Visual Effect in Low-dose Cerebral CT Perfusion Phantom Image Using Iterative Reconstruction].

    PubMed

    Ohmura, Tomomi; Lee, Yongbum; Takahashi, Noriyuki; Sato, Yuichiro; Ishida, Takato; Toyoshima, Hideto

    2015-11-01

    CT perfusion (CTP) is obtained cerebrovascular circulation image for assessment of stroke patients; however, at the expense of increased radiation dose by dynamic scan. Iterative reconstruction (IR) method is possible to decrease image noise, it has the potential to reduce radiation dose. The purpose of this study is to assess the visual effect of IR method by using a digital perfusion phantom. The digital perfusion phantom was created by reconstructed filtered back projection (FBP) method and IR method CT images that had five exposure doses. Various exposure dose cerebral blood flow (CBF) images were derived from deconvolution algorithm. Contrast-to-noise ratio (CNR) and visual assessment were compared among the various exposure dose and each reconstructions. Result of low exposure dose with IR method showed, compared with FBP method, high CNR in severe ischemic area, and visual assessment was significantly improvement. IR method is useful for improving image quality of low-dose CTP. PMID:26596197

  12. [Ultra-low dose chest CT: The end of chest radiograph?].

    PubMed

    Ludes, Claire; Schaal, Marysa; Labani, Aissam; Jeung, Mi-Young; Roy, Catherine; Ohana, Mickaël

    2016-03-01

    Ultra-low dose chest CT (ULD-CT) is acquired at a radiation dose lowered to that of a PA and lateral chest X-ray. Its image quality is degraded, yet remains diagnostic in many clinical indications. Technological improvements, with iterative reconstruction at the foreground, allowed a strong increase in the image quality obtained with this examination, which is achievable on most recent (<5 years) scanner. Established clinical indications of ULD-CT are increasing, and its non-inferiority compared to the reference "full dose" chest CT are currently demonstrated for the detection of solid nodules, for asbestos-related pleural diseases screening and for the monitoring of infectious pneumonia. Its current limitations are the obese patients (BMI>35) and the interstitial pneumonia, situations in which their performances are insufficient. PMID:26830922

  13. Segmentation of the whole breast from low-dose chest CT images

    NASA Astrophysics Data System (ADS)

    Liu, Shuang; Salvatore, Mary; Yankelevitz, David F.; Henschke, Claudia I.; Reeves, Anthony P.

    2015-03-01

    The segmentation of whole breast serves as the first step towards automated breast lesion detection. It is also necessary for automatically assessing the breast density, which is considered to be an important risk factor for breast cancer. In this paper we present a fully automated algorithm to segment the whole breast in low-dose chest CT images (LDCT), which has been recommended as an annual lung cancer screening test. The automated whole breast segmentation and potential breast density readings as well as lesion detection in LDCT will provide useful information for women who have received LDCT screening, especially the ones who have not undergone mammographic screening, by providing them additional risk indicators for breast cancer with no additional radiation exposure. The two main challenges to be addressed are significant range of variations in terms of the shape and location of the breast in LDCT and the separation of pectoral muscles from the glandular tissues. The presented algorithm achieves robust whole breast segmentation using an anatomy directed rule-based method. The evaluation is performed on 20 LDCT scans by comparing the segmentation with ground truth manually annotated by a radiologist on one axial slice and two sagittal slices for each scan. The resulting average Dice coefficient is 0.880 with a standard deviation of 0.058, demonstrating that the automated segmentation algorithm achieves results consistent with manual annotations of a radiologist.

  14. Patient-size-dependent radiation dose optimisation technique for abdominal CT examinations.

    PubMed

    Ngaile, J E; Msaki, P; Kazema, R

    2012-01-01

    Since patient doses from computed tomography (CT) are relatively high, risk-benefit analysis requires dose to patients and image quality be optimised. The aim of this study was to develop a patient-dependent optimisation technique that uses patient diameter to select a combination of CT scanning parameters that minimise dose delivered to patients undergoing abdominal CT examinations. The study was performed using cylindrical phantoms of diameters ranging from 16 to 40 cm in order to establish the relationship between image degradation, CT scanning techniques, patient dose and patient size from two CT scanners. These relationships were established by scanning the phantoms using standard scanning technique followed by selected combinations of scanning parameters. The image noises through phantom images were determined using region of interest software available in both scanners. The energy depositions to the X-ray detector through phantoms were determined from measurements of CT dose index in air corrected for attenuation of the phantom materials. The results demonstrate that exposure settings (milliampere seconds) could be reduced by up to 82 % for smaller phantom relative to standard milliampere seconds, while detector signal could be reduced by up to 93 % for smaller phantom relative to energy depositions required when scanned using standard scanning protocols. It was further revealed that the use of the object-specific scanning parameters on studies performed with phantom of different diameters could reduce the incident radiation to small size object by up to 86 % to obtain the same image quality required for standard adult object. In view of the earlier mentioned fact, substantial dose saving from small-sized adults and children patients undergoing abdomen CT examinations could be achieved through optimal adjustment of CT scanning technique based on the patient transverse diameter.

  15. Development of Monte Carlo simulations to provide scanner-specific organ dose coefficients for contemporary CT

    NASA Astrophysics Data System (ADS)

    Jansen, Jan T. M.; Shrimpton, Paul C.

    2016-07-01

    The ImPACT (imaging performance assessment of CT scanners) CT patient dosimetry calculator is still used world-wide to estimate organ and effective doses (E) for computed tomography (CT) examinations, although the tool is based on Monte Carlo calculations reflecting practice in the early 1990’s. Subsequent developments in CT scanners, definitions of E, anthropomorphic phantoms, computers and radiation transport codes, have all fuelled an urgent need for updated organ dose conversion factors for contemporary CT. A new system for such simulations has been developed and satisfactorily tested. Benchmark comparisons of normalised organ doses presently derived for three old scanners (General Electric 9800, Philips Tomoscan LX and Siemens Somatom DRH) are within 5% of published values. Moreover, calculated normalised values of CT Dose Index for these scanners are in reasonable agreement (within measurement and computational uncertainties of  ±6% and  ±1%, respectively) with reported standard measurements. Organ dose coefficients calculated for a contemporary CT scanner (Siemens Somatom Sensation 16) demonstrate potential deviations by up to around 30% from the surrogate values presently assumed (through a scanner matching process) when using the ImPACT CT Dosimetry tool for newer scanners. Also, illustrative estimates of E for some typical examinations and a range of anthropomorphic phantoms demonstrate the significant differences (by some 10’s of percent) that can arise when changing from the previously adopted stylised mathematical phantom to the voxel phantoms presently recommended by the International Commission on Radiological Protection (ICRP), and when following the 2007 ICRP recommendations (updated from 1990) concerning tissue weighting factors. Further simulations with the validated dosimetry system will provide updated series of dose coefficients for a wide range of contemporary scanners.

  16. Development of Monte Carlo simulations to provide scanner-specific organ dose coefficients for contemporary CT.

    PubMed

    Jansen, Jan T M; Shrimpton, Paul C

    2016-07-21

    The ImPACT (imaging performance assessment of CT scanners) CT patient dosimetry calculator is still used world-wide to estimate organ and effective doses (E) for computed tomography (CT) examinations, although the tool is based on Monte Carlo calculations reflecting practice in the early 1990's. Subsequent developments in CT scanners, definitions of E, anthropomorphic phantoms, computers and radiation transport codes, have all fuelled an urgent need for updated organ dose conversion factors for contemporary CT. A new system for such simulations has been developed and satisfactorily tested. Benchmark comparisons of normalised organ doses presently derived for three old scanners (General Electric 9800, Philips Tomoscan LX and Siemens Somatom DRH) are within 5% of published values. Moreover, calculated normalised values of CT Dose Index for these scanners are in reasonable agreement (within measurement and computational uncertainties of  ±6% and  ±1%, respectively) with reported standard measurements. Organ dose coefficients calculated for a contemporary CT scanner (Siemens Somatom Sensation 16) demonstrate potential deviations by up to around 30% from the surrogate values presently assumed (through a scanner matching process) when using the ImPACT CT Dosimetry tool for newer scanners. Also, illustrative estimates of E for some typical examinations and a range of anthropomorphic phantoms demonstrate the significant differences (by some 10's of percent) that can arise when changing from the previously adopted stylised mathematical phantom to the voxel phantoms presently recommended by the International Commission on Radiological Protection (ICRP), and when following the 2007 ICRP recommendations (updated from 1990) concerning tissue weighting factors. Further simulations with the validated dosimetry system will provide updated series of dose coefficients for a wide range of contemporary scanners. PMID:27362736

  17. Development of Monte Carlo simulations to provide scanner-specific organ dose coefficients for contemporary CT.

    PubMed

    Jansen, Jan T M; Shrimpton, Paul C

    2016-07-21

    The ImPACT (imaging performance assessment of CT scanners) CT patient dosimetry calculator is still used world-wide to estimate organ and effective doses (E) for computed tomography (CT) examinations, although the tool is based on Monte Carlo calculations reflecting practice in the early 1990's. Subsequent developments in CT scanners, definitions of E, anthropomorphic phantoms, computers and radiation transport codes, have all fuelled an urgent need for updated organ dose conversion factors for contemporary CT. A new system for such simulations has been developed and satisfactorily tested. Benchmark comparisons of normalised organ doses presently derived for three old scanners (General Electric 9800, Philips Tomoscan LX and Siemens Somatom DRH) are within 5% of published values. Moreover, calculated normalised values of CT Dose Index for these scanners are in reasonable agreement (within measurement and computational uncertainties of  ±6% and  ±1%, respectively) with reported standard measurements. Organ dose coefficients calculated for a contemporary CT scanner (Siemens Somatom Sensation 16) demonstrate potential deviations by up to around 30% from the surrogate values presently assumed (through a scanner matching process) when using the ImPACT CT Dosimetry tool for newer scanners. Also, illustrative estimates of E for some typical examinations and a range of anthropomorphic phantoms demonstrate the significant differences (by some 10's of percent) that can arise when changing from the previously adopted stylised mathematical phantom to the voxel phantoms presently recommended by the International Commission on Radiological Protection (ICRP), and when following the 2007 ICRP recommendations (updated from 1990) concerning tissue weighting factors. Further simulations with the validated dosimetry system will provide updated series of dose coefficients for a wide range of contemporary scanners.

  18. Operator eye doses during computed tomography fluoroscopic lung biopsy.

    PubMed

    Ekpo, Ernest U; Bakhshi, Suleman; Ryan, Elaine; Hogg, Peter; McEntee, Mark F

    2016-06-01

    The aim of this work was to examine the peak entrance surface air kerma (peak ESAK) to the eyes during CT fluoroscopy lung biopsy, and the impact of lead glasses, exposure parameters, head rotation, and height on peak ESAK to the eyes. Two phantoms simulating the patient and radiologist were used, and 108 exposures were made using a 16-slice Toshiba Alexion CT scanner (Toshiba Medical Systems, Nasu, Japan). ESAK to the phantom radiologist's right eye was measured using an Unfors Xi dosimeter (RaySafe, Billdal, Sweden) with and without lead glasses at two kilovoltages (120 kVp and 135 kVp) and three milliampere settings (10 mA, 20 mA, and 30 mA. A paired t test was used to compare peak ESAK to the eye at different angles, heights, and kVp and mA with and without lead glasses. Peak ESAK was higher without compared to with lead glasses (p  ⩽  0.001). The peak ESAK to the eyes increased as the phantom radiologist rotated toward the gantry without lead glasses, from 2.42 μGy at 120° to 10.54 μGy at 30° (p  =  0.001). No significant difference was noted in peak ESAK with change in phantom radiologist height (p  >  0.05). An increase from 120 kVp to 135 kVp resulted in 23% and 26% increases in peak ESAK with and without lead glasses respectively (p  =  0.001). An increase of tube current from 10 mA to 20 mA almost doubled peak ESAK (p  =  0.005). Findings demonstrate that lead glasses reduce ESAK to the eyes, and that increased kVp, mA, and eye rotation to the gantry increase ESAK to the eyes. PMID:27250649

  19. Novel brachytherapy treatment planning system utilizing dose rate dependent average cell survival, CT-simulator, and dose-volume histogram

    SciTech Connect

    Mayer, R.; Fong, W.; Frankel, T.

    1995-12-31

    This report describes a new brachytherapy planning program that provides an evaluation of a given low or high dose rate treatment taking into account spatial dose heterogeneity and cell response to radiation. This brachytherapy scheme uses the images from a CT-Simulator (AcQSim, Picker International, Cleveland, Ohio) to simultaneously localize the seed positions and to axially scan the patient. This procedure helps to ensure accurate registration of the putative seed positions with the patient tissues and organs. The seed positions are determined by back-projecting positions of seeds or dummy seeds from the CT-Simulator setup scout images. Physicians delineate the tissues of interest on the axial slices. Dose is computed after assigning activity (low dose rate) of dwell times (high dose rate) to the Ir{sup 192} or I{sup 125} seed. The planar isodose distribution is superimposed onto axial cuts of the tissues and onto coronal or sagital views of the tissues following image reconstruction. Areal or volumetric calculations of the dose distribution within a given tissue are computed from the tissue outlines. The treatment plan computes (1) volume differential and cummulative dose histograms of the dose delivered to individual tissues, (2) the average, standard deviation, and coefficient of skewness of the dose distribution delivered to the individual tissues, (3) the average survival probability for a given radiation treatment.

  20. [Diagnostic work-up of pulmonary nodules : Management of pulmonary nodules detected with low‑dose CT screening].

    PubMed

    Wormanns, D

    2016-09-01

    Pulmonary nodules are the most frequent pathological finding in low-dose computed tomography (CT) scanning for early detection of lung cancer. Early stages of lung cancer are often manifested as pulmonary nodules; however, the very commonly occurring small nodules are predominantly benign. These benign nodules are responsible for the high percentage of false positive test results in screening studies. Appropriate diagnostic algorithms are necessary to reduce false positive screening results and to improve the specificity of lung cancer screening. Such algorithms are based on some of the basic principles comprehensively described in this article. Firstly, the diameter of nodules allows a differentiation between large (>8 mm) probably malignant and small (<8 mm) probably benign nodules. Secondly, some morphological features of pulmonary nodules in CT can prove their benign nature. Thirdly, growth of small nodules is the best non-invasive predictor of malignancy and is utilized as a trigger for further diagnostic work-up. Non-invasive testing using positron emission tomography (PET) and contrast enhancement as well as invasive diagnostic tests (e.g. various procedures for cytological and histological diagnostics) are briefly described in this article. Different nodule morphology using CT (e.g. solid and semisolid nodules) is associated with different biological behavior and different algorithms for follow-up are required. Currently, no obligatory algorithm is available in German-speaking countries for the management of pulmonary nodules, which reflects the current state of knowledge. The main features of some international and American recommendations are briefly presented in this article from which conclusions for the daily clinical use are derived. PMID:27495787

  1. 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

  2. Assessing nodule detection on lung cancer screening CT: the effects of tube current modulation and model observer selection on detectability maps

    NASA Astrophysics Data System (ADS)

    Hoffman, J. M.; Noo, F.; McMillan, K.; Young, S.; McNitt-Gray, M.

    2016-03-01

    Lung cancer screening using low dose CT has been shown to reduce lung cancer related mortality and been approved for widespread use in the US. These scans keep radiation doses low while maximizing the detection of suspicious lung lesions. Tube current modulation (TCM) is one technique used to optimize dose, however limited work has been done to assess TCM's effect on detection tasks. In this work the effect of TCM on detection is investigated throughout the lung utilizing several different model observers (MO). 131 lung nodules were simulated at 1mm intervals in each lung of the XCAT phantom. A Sensation 64 TCM profile was generated for the XCAT phantom and 2500 noise realizations were created using both TCM and a fixed TC. All nodules and noise realizations were reconstructed for a total of 262 (left and right lungs) nodule reconstructions and 10 000 XCAT lung reconstructions. Single-slice Hotelling (HO) and channelized Hotelling (CHO) observers, as well as a multislice CHO were used to assess area-under-the-curve (AUC) as a function of nodule location in both the fixed TC and TCM cases. As expected with fixed TC, nodule detectability was lowest through the shoulders and leveled off below mid-lung; with TCM, detectability was unexpectedly highest through the shoulders, dropping sharply near the mid-lung and then increasing into the abdomen. Trends were the same for all model observers. These results suggest that TCM could be further optimized for detection and that detectability maps present exciting new opportunities for TCM optimization on a patient-specific level.

  3. Radiation dose reduction to the breast in thoracic CT: Comparison of bismuth shielding, organ-based tube current modulation, and use of a globally decreased tube current

    SciTech Connect

    Wang Jia; Duan Xinhui; Christner, Jodie A.; Leng Shuai; Yu Lifeng; McCollough, Cynthia H.

    2011-11-15

    Purpose: The purpose of this work was to evaluate dose performance and image quality in thoracic CT using three techniques to reduce dose to the breast: bismuth shielding, organ-based tube current modulation (TCM) and global tube current reduction. Methods: Semi-anthropomorphic thorax phantoms of four different sizes (15, 30, 35, and 40 cm lateral width) were used for dose measurement and image quality assessment. Four scans were performed on each phantom using 100 or 120 kV with a clinical CT scanner: (1) reference scan; (2) scan with bismuth breast shield of an appropriate thickness; (3) scan with organ-based TCM; and (4) scan with a global reduction in tube current chosen to match the dose reduction from bismuth shielding. Dose to the breast was measured with an ion chamber on the surface of the phantom. Image quality was evaluated by measuring the mean and standard deviation of CT numbers within the lung and heart regions. Results: Compared to the reference scan, dose to the breast region was decreased by about 21% for the 15-cm phantom with a pediatric (2-ply) shield and by about 37% for the 30, 35, and 40-cm phantoms with adult (4-ply) shields. Organ-based TCM decreased the dose by 12% for the 15-cm phantom, and 34-39% for the 30, 35, and 40-cm phantoms. Global lowering of the tube current reduced breast dose by 23% for the 15-cm phantom and 39% for the 30, 35, and 40-cm phantoms. In phantoms of all four sizes, image noise was increased in both the lung and heart regions with bismuth shielding. No significant increase in noise was observed with organ-based TCM. Decreasing tube current globally led to similar noise increases as bismuth shielding. Streak and beam hardening artifacts, and a resulting artifactual increase in CT numbers, were observed for scans with bismuth shields, but not for organ-based TCM or global tube current reduction. Conclusions: Organ-based TCM produces dose reduction to the breast similar to that achieved with bismuth shielding for

  4. Registration based super-resolution reconstruction for lung 4D-CT.

    PubMed

    Wu, Xiuxiu; Xiao, Shan; Zhang, Yu

    2014-01-01

    Lung 4D-CT plays an important role in lung cancer radiotherapy for tumor localization and treatment planning. In lung 4D-CT data, the resolution in the slice direction is often much lower than the in-plane resolution. For multi-plane display, isotropic resolution is necessary, but the commonly used interpolation operation will blur the images. In this paper, we present a registration based method for super resolution enhancement of the 4D-CT multi-plane images. Our working premise is that the low-resolution images of different phases at the corresponding position can be regarded as input "frames" to reconstruct high resolution images. First, we employ the Demons registration algorithm to estimate the motion field between different "frames". Then, the projections onto convex sets (POCS) approach is employed to reconstruction high-resolution lung images. We show that our method can get clearer lung images and enhance image structure, compared with the cubic spline interpolation and back projection method. PMID:25570484

  5. Registration based super-resolution reconstruction for lung 4D-CT.

    PubMed

    Wu, Xiuxiu; Xiao, Shan; Zhang, Yu

    2014-01-01

    Lung 4D-CT plays an important role in lung cancer radiotherapy for tumor localization and treatment planning. In lung 4D-CT data, the resolution in the slice direction is often much lower than the in-plane resolution. For multi-plane display, isotropic resolution is necessary, but the commonly used interpolation operation will blur the images. In this paper, we present a registration based method for super resolution enhancement of the 4D-CT multi-plane images. Our working premise is that the low-resolution images of different phases at the corresponding position can be regarded as input "frames" to reconstruct high resolution images. First, we employ the Demons registration algorithm to estimate the motion field between different "frames". Then, the projections onto convex sets (POCS) approach is employed to reconstruction high-resolution lung images. We show that our method can get clearer lung images and enhance image structure, compared with the cubic spline interpolation and back projection method.

  6. Automatic left and right lung separation using free-formed surface fitting on volumetric CT.

    PubMed

    Lee, Youn Joo; Lee, Minho; Kim, Namkug; Seo, Joon Beom; Park, Joo Young

    2014-08-01

    This study presents a completely automated method for separating the left and right lungs using free-formed surface fitting on volumetric computed tomography (CT). The left and right lungs are roughly divided using iterative 3-dimensional morphological operator and a Hessian matrix analysis. A point set traversing between the initial left and right lungs is then detected with a Euclidean distance transform to determine the optimal separating surface, which is then modeled from the point set using a free-formed surface-fitting algorithm. Subsequently, the left and right lung volumes are smoothly and directly separated using the separating surface. The performance of the proposed method was estimated by comparison with that of a human expert on 44 CT examinations. For all data sets, averages of the root mean square surface distance, maximum surface distance, and volumetric overlap error between the results of the automatic and the manual methods were 0.032 mm, 2.418 mm, and 0.017 %, respectively. Our study showed the feasibility of automatically separating the left and right lungs by identifying the 3D continuous separating surface on volumetric chest CT images.

  7. 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

  8. Assessment of the effects of CT dose in averaged x-ray CT images of a dose-sensitive polymer gel

    NASA Astrophysics Data System (ADS)

    Kairn, T.; Kakakhel, M. B.; Johnston, H.; Jirasek, A.; Trapp, J. V.

    2015-01-01

    The signal-to-noise ratio achievable in x-ray computed tomography (CT) images of polymer gels can be increased by averaging over multiple scans of each sample. However, repeated scanning delivers a small additional dose to the gel which may compromise the accuracy of the dose measurement. In this study, a NIPAM-based polymer gel was irradiated and then CT scanned 25 times, with the resulting data used to derive an averaged image and a "zero-scan" image of the gel. Comparison between these two results and the first scan of the gel showed that the averaged and zero-scan images provided better contrast, higher contrast-to- noise and higher signal-to-noise than the initial scan. The pixel values (Hounsfield units, HU) in the averaged image were not noticeably elevated, compared to the zero-scan result and the gradients used in the linear extrapolation of the zero-scan images were small and symmetrically distributed around zero. These results indicate that the averaged image was not artificially lightened by the small, additional dose delivered during CT scanning. This work demonstrates the broader usefulness of the zero-scan method as a means to verify the dosimetric accuracy of gel images derived from averaged x-ray CT data.

  9. IgG4-related lung disease with atypical CT imaging: a case report

    PubMed Central

    Zhou, Jiaxuan; Li, Xian

    2014-01-01

    IgG4-related lung disease is a rare disease, diagnosed when typical pathologic features are seen in the context of increased serum levels of IgG4 and the elevated tissue’s IgG4-positive plasma cells. Here we reported the case of a 24-year-old woman with IgG4-related lung disease. This patient presented with fever, cough and shortness of breath. Thoracic computed tomography (CT) images demonstrated multiple nodules or masses with high density in both lungs, and thickened interlobular septa. The ‘halo sign’ was observed around the high-density lesions of the upper lobes. This range of CT images’ characteristics is atypical, which differs from previous reports of this condition. PMID:25590008

  10. Blinded Validation of Breath Biomarkers of Lung Cancer, a Potential Ancillary to Chest CT Screening

    PubMed Central

    Phillips, Michael; Bauer, Thomas L.; Cataneo, Renee N.; Lebauer, Cassie; Mundada, Mayur; Pass, Harvey I.; Ramakrishna, Naren; Rom, William N.; Vallières, Eric

    2015-01-01

    Background Breath volatile organic compounds (VOCs) have been reported as biomarkers of lung cancer, but it is not known if biomarkers identified in one group can identify disease in a separate independent cohort. Also, it is not known if combining breath biomarkers with chest CT has the potential to improve the sensitivity and specificity of lung cancer screening. Methods Model-building phase (unblinded): Breath VOCs were analyzed with gas chromatography mass spectrometry in 82 asymptomatic smokers having screening chest CT, 84 symptomatic high-risk subjects with a tissue diagnosis, 100 without a tissue diagnosis, and 35 healthy subjects. Multiple Monte Carlo simulations identified breath VOC mass ions with greater than random diagnostic accuracy for lung cancer, and these were combined in a multivariate predictive algorithm. Model-testing phase (blinded validation): We analyzed breath VOCs in an independent cohort of similar subjects (n = 70, 51, 75 and 19 respectively). The algorithm predicted discriminant function (DF) values in blinded replicate breath VOC samples analyzed independently at two laboratories (A and B). Outcome modeling: We modeled the expected effects of combining breath biomarkers with chest CT on the sensitivity and specificity of lung cancer screening. Results Unblinded model-building phase. The algorithm identified lung cancer with sensitivity 74.0%, specificity 70.7% and C-statistic 0.78. Blinded model-testing phase: The algorithm identified lung cancer at Laboratory A with sensitivity 68.0%, specificity 68.4%, C-statistic 0.71; and at Laboratory B with sensitivity 70.1%, specificity 68.0%, C-statistic 0.70, with linear correlation between replicates (r = 0.88). In a projected outcome model, breath biomarkers increased the sensitivity, specificity, and positive and negative predictive values of chest CT for lung cancer when the tests were combined in series or parallel. Conclusions Breath VOC mass ion biomarkers identified lung cancer in a

  11. Effect of CAD on radiologists' detection of lung nodules on thoracic CT scans: observer performance study

    NASA Astrophysics Data System (ADS)

    Sahiner, Berkman; Hadjiiski, Lubomir M.; Chan, Heang-Ping; Shi, Jiazheng; Cascade, Philip N.; Kazerooni, Ella A.; Zhou, Chuan; Wei, Jun; Chughtai, Aamer R.; Poopat, Chad; Song, Thomas; Nojkova, Jadranka S.; Frank, Luba; Attili, Anil

    2007-03-01

    The purpose of this study was to evaluate the effect of computer-aided diagnosis (CAD) on radiologists' performance for the detection of lung nodules on thoracic CT scans. Our computer system was designed using an independent training set of 94 CT scans in our laboratory. The data set for the observer performance study consisted of 48 CT scans. Twenty scans were collected from patient files at the University of Michigan, and 28 scans by the Lung Imaging Database Consortium (LIDC). All scans were read by multiple experienced thoracic radiologists to determine the true nodule locations, defined as any region identified by one or more expert radiologists as containing a nodule larger than 3 mm in diameter. Eighteen CT examinations were nodule-free, while the remaining 30 CT examinations contained a total of 73 nodules having a median size of 5.5 mm (range 3.0-36.4 mm). Four other study radiologists read the CT scans first without and then with CAD, and provided likelihood of nodule ratings for suspicious regions. Two of the study radiologists were fellowship trained in cardiothoracic radiology, and two were cardiothoracic radiology fellows. Freeresponse receiver-operating characteristic (FROC) curves were used to compare the two reading conditions. The computer system had a sensitivity of 79% (58/73) with an average of 4.9 marks per normal scan (88/18). Jackknife alternative FROC (JAFROC) analysis indicated that the improvement with CAD was statistically significant (p=0.03).

  12. Interactive lung segmentation in abnormal human and animal chest CT scans

    SciTech Connect

    Kockelkorn, Thessa T. J. P. Viergever, Max A.; Schaefer-Prokop, Cornelia M.; Bozovic, Gracijela; Muñoz-Barrutia, Arrate; Rikxoort, Eva M. van; Brown, Matthew S.; Jong, Pim A. de; Ginneken, Bram van

    2014-08-15

    Purpose: Many medical image analysis systems require segmentation of the structures of interest as a first step. For scans with gross pathology, automatic segmentation methods may fail. The authors’ aim is to develop a versatile, fast, and reliable interactive system to segment anatomical structures. In this study, this system was used for segmenting lungs in challenging thoracic computed tomography (CT) scans. Methods: In volumetric thoracic CT scans, the chest is segmented and divided into 3D volumes of interest (VOIs), containing voxels with similar densities. These VOIs are automatically labeled as either lung tissue or nonlung tissue. The automatic labeling results can be corrected using an interactive or a supervised interactive approach. When using the supervised interactive system, the user is shown the classification results per slice, whereupon he/she can adjust incorrect labels. The system is retrained continuously, taking the corrections and approvals of the user into account. In this way, the system learns to make a better distinction between lung tissue and nonlung tissue. When using the interactive framework without supervised learning, the user corrects all incorrectly labeled VOIs manually. Both interactive segmentation tools were tested on 32 volumetric CT scans of pigs, mice and humans, containing pulmonary abnormalities. Results: On average, supervised interactive lung segmentation took under 9 min of user interaction. Algorithm computing time was 2 min on average, but can easily be reduced. On average, 2.0% of all VOIs in a scan had to be relabeled. Lung segmentation using the interactive segmentation method took on average 13 min and involved relabeling 3.0% of all VOIs on average. The resulting segmentations correspond well to manual delineations of eight axial slices per scan, with an average Dice similarity coefficient of 0.933. Conclusions: The authors have developed two fast and reliable methods for interactive lung segmentation in

  13. Reducing the low-dose lung radiation for central lung tumors by restricting the IMRT beams and arc arrangement

    SciTech Connect

    Rosca, Florin

    2012-10-01

    To compare the extent to which 7 different radiotherapy planning techniques for mediastinal lung targets reduces the lung volume receiving low doses of radiation. Thirteen non-small cell lung cancer patients with targets, including the mediastinal nodes, were identified. Treatment plans were generated to both 60- and 74-Gy prescription doses using 7 different planning techniques: conformal, hybrid conformal/intensity-modulated radiation treatment (IMRT), 7 equidistant IMRT beams, 2 restricted beam IMRT plans, a full (360 Degree-Sign ) modulated arc, and a restricted modulated arc plan. All plans were optimized to reduce total lung V5, V10, and V20 volumes, while meeting normal tissue and target coverage constraints. The mean values for the 13 patients are calculated for V5, V10, V20, V{sub ave}, V0-20, and mean lung dose (MLD) lung parameters. For the 74-Gy prescription dose, the mean lung V10 was 42.7, 43.6, 48.2, 56.6, 57, 55.8, and 54.1% for the restricted {+-}36 Degree-Sign IMRT, restricted modulated arc, restricted {+-}45 Degree-Sign IMRT, full modulated arc, hybrid conformal/IMRT, equidistant IMRT, and conformal plans, respectively. A similar lung sparing hierarchy was found for the 60-Gy prescription dose. For the treatment of central lung targets, the {+-}36 Degree-Sign restricted IMRT and restricted modulated arc planning techniques are superior in lowering the lung volume treated to low dose, as well as in minimizing MLD, followed by the {+-}45 Degree-Sign restricted IMRT plan. All planning techniques that allow the use of lateral or lateral/oblique beams result in spreading the low dose over a higher lung volume. The area under the lung dose-volume histogram curve below 20 Gy, V0-20, is proposed as an alternative to individual V{sub dose} parameters, both as a measure of lung sparing and as a parameter to be minimized during IMRT optimization.

  14. Convolution-based estimation of organ dose in tube current modulated CT

    PubMed Central

    Tian, Xiaoyu; Segars, W Paul; Dixon, Robert L; Samei, Ehsan

    2016-01-01

    Estimating organ dose for clinical patients requires accurate modeling of the patient anatomy and the dose field of the CT exam. The modeling of patient anatomy can be achieved using a library of representative computational phantoms (Samei et al 2014 Pediatr. Radiol. 44 460–7). The modeling of the dose field can be challenging for CT exams performed with a tube current modulation (TCM) technique. The purpose of this work was to effectively model the dose field for TCM exams using a convolution-based method. A framework was further proposed for prospective and retrospective organ dose estimation in clinical practice. The study included 60 adult patients (age range: 18–70 years, weight range: 60–180 kg). Patient-specific computational phantoms were generated based on patient CT image datasets. A previously validated Monte Carlo simulation program was used to model a clinical CT scanner (SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). A practical strategy was developed to achieve real-time organ dose estimation for a given clinical patient. CTDIvol-normalized organ dose coefficients (hOrgan) under constant tube current were estimated and modeled as a function of patient size. Each clinical patient in the library was optimally matched to another computational phantom to obtain a representation of organ location/distribution. The patient organ distribution was convolved with a dose distribution profile to generate (CTDIvol)organ, convolution values that quantified the regional dose field for each organ. The organ dose was estimated by multiplying (CTDIvol)organ, convolution with the organ dose coefficients (hOrgan). To validate the accuracy of this dose estimation technique, the organ dose of the original clinical patient was estimated using Monte Carlo program with TCM profiles explicitly modeled. The discrepancy between the estimated organ dose and dose simulated using TCM Monte Carlo program was quantified. We further compared the

  15. Convolution-based estimation of organ dose in tube current modulated CT

    NASA Astrophysics Data System (ADS)

    Tian, Xiaoyu; Segars, W. Paul; Dixon, Robert L.; Samei, Ehsan

    2016-05-01

    Estimating organ dose for clinical patients requires accurate modeling of the patient anatomy and the dose field of the CT exam. The modeling of patient anatomy can be achieved using a library of representative computational phantoms (Samei et al 2014 Pediatr. Radiol. 44 460–7). The modeling of the dose field can be challenging for CT exams performed with a tube current modulation (TCM) technique. The purpose of this work was to effectively model the dose field for TCM exams using a convolution-based method. A framework was further proposed for prospective and retrospective organ dose estimation in clinical practice. The study included 60 adult patients (age range: 18–70 years, weight range: 60–180 kg). Patient-specific computational phantoms were generated based on patient CT image datasets. A previously validated Monte Carlo simulation program was used to model a clinical CT scanner (SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). A practical strategy was developed to achieve real-time organ dose estimation for a given clinical patient. CTDIvol-normalized organ dose coefficients ({{h}\\text{Organ}} ) under constant tube current were estimated and modeled as a function of patient size. Each clinical patient in the library was optimally matched to another computational phantom to obtain a representation of organ location/distribution. The patient organ distribution was convolved with a dose distribution profile to generate {{≤ft(\\text{CTD}{{\\text{I}}\\text{vol}}\\right)}\\text{organ, \\text{convolution}}} values that quantified the regional dose field for each organ. The organ dose was estimated by multiplying {{≤ft(\\text{CTD}{{\\text{I}}\\text{vol}}\\right)}\\text{organ, \\text{convolution}}} with the organ dose coefficients ({{h}\\text{Organ}} ). To validate the accuracy of this dose estimation technique, the organ dose of the original clinical patient was estimated using Monte Carlo program with TCM profiles explicitly modeled

  16. Convolution-based estimation of organ dose in tube current modulated CT

    NASA Astrophysics Data System (ADS)

    Tian, Xiaoyu; Segars, W. Paul; Dixon, Robert L.; Samei, Ehsan

    2016-05-01

    Estimating organ dose for clinical patients requires accurate modeling of the patient anatomy and the dose field of the CT exam. The modeling of patient anatomy can be achieved using a library of representative computational phantoms (Samei et al 2014 Pediatr. Radiol. 44 460-7). The modeling of the dose field can be challenging for CT exams performed with a tube current modulation (TCM) technique. The purpose of this work was to effectively model the dose field for TCM exams using a convolution-based method. A framework was further proposed for prospective and retrospective organ dose estimation in clinical practice. The study included 60 adult patients (age range: 18-70 years, weight range: 60-180 kg). Patient-specific computational phantoms were generated based on patient CT image datasets. A previously validated Monte Carlo simulation program was used to model a clinical CT scanner (SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). A practical strategy was developed to achieve real-time organ dose estimation for a given clinical patient. CTDIvol-normalized organ dose coefficients ({{h}\\text{Organ}} ) under constant tube current were estimated and modeled as a function of patient size. Each clinical patient in the library was optimally matched to another computational phantom to obtain a representation of organ location/distribution. The patient organ distribution was convolved with a dose distribution profile to generate {{≤ft(\\text{CTD}{{\\text{I}}\\text{vol}}\\right)}\\text{organ, \\text{convolution}}} values that quantified the regional dose field for each organ. The organ dose was estimated by multiplying {{≤ft(\\text{CTD}{{\\text{I}}\\text{vol}}\\right)}\\text{organ, \\text{convolution}}} with the organ dose coefficients ({{h}\\text{Organ}} ). To validate the accuracy of this dose estimation technique, the organ dose of the original clinical patient was estimated using Monte Carlo program with TCM profiles explicitly modeled. The

  17. Validity of the size-specific dose estimate in adults undergoing coronary CT angiography: comparison with the volume CT dose index.

    PubMed

    Kidoh, Masafumi; Utsunomiya, Daisuke; Oda, Seitaro; Funama, Yoshinori; Yuki, Hideaki; Nakaura, Takeshi; Kai, Noriyuki; Nozaki, Takeshi; Yamashita, Yasuyuki

    2015-12-01

    Size-specific dose estimate (SSDE) takes into account the patient size but remains to be fully validated for adult coronary computed tomography angiography (CCTA). We investigated the appropriateness of SSDE for accurate estimation of patient dose by comparing the SSDE and the volume CT dose index (CTDIvol) in adult CCTA. This prospective study received institutional review board approval, and informed consent was obtained from each patient. We enrolled 37 adults who underwent CCTA with a 320-row CT. High-sensitivity metal oxide semiconductor field effect transistor dosimeters were placed on the anterior chest. CTDIvol reported by the scanner based on a 32-cm phantom was recorded. We measured chest diameter to convert CTDIvol to SSDE. Using linear regression, we then correlated SSDE with the mean measured skin dose. We also performed linear regression analyses between the skin dose/CTDIvol and the body mass index (BMI), and the skin dose/SSDE and BMI. There was a strong linear correlation (r = 0.93, P < 0.001) between SSDE (mean 37 ± 22 mGy) and mean skin dose (mean 17.7 ± 10 mGy). There was a moderate negative correlation between the skin dose/CTDIvol and BMI (r = 0.45, P < 0.01). The skin dose/SSDE was not affected by BMI (r = 0.06, P > 0.76). SSDE yields a more accurate estimation of the radiation dose without estimation errors attributable to the body size of adult patients undergoing CCTA. PMID:26440660

  18. Automated coronary artery calcification detection on low-dose chest CT images

    NASA Astrophysics Data System (ADS)

    Xie, Yiting; Cham, Matthew D.; Henschke, Claudia; Yankelevitz, David; Reeves, Anthony P.

    2014-03-01

    Coronary artery calcification (CAC) measurement from low-dose CT images can be used to assess the risk of coronary artery disease. A fully automatic algorithm to detect and measure CAC from low-dose non-contrast, non-ECG-gated chest CT scans is presented. Based on the automatically detected CAC, the Agatston score (AS), mass score and volume score were computed. These were compared with scores obtained manually from standard-dose ECG-gated scans and low-dose un-gated scans of the same patient. The automatic algorithm segments the heart region based on other pre-segmented organs to provide a coronary region mask. The mitral valve and aortic valve calcification is identified and excluded. All remaining voxels greater than 180HU within the mask region are considered as CAC candidates. The heart segmentation algorithm was evaluated on 400 non-contrast cases with both low-dose and regular dose CT scans. By visual inspection, 371 (92.8%) of the segmentations were acceptable. The automated CAC detection algorithm was evaluated on 41 low-dose non-contrast CT scans. Manual markings were performed on both low-dose and standard-dose scans for these cases. Using linear regression, the correlation of the automatic AS with the standard-dose manual scores was 0.86; with the low-dose manual scores the correlation was 0.91. Standard risk categories were also computed. The automated method risk category agreed with manual markings of gated scans for 24 cases while 15 cases were 1 category off. For low-dose scans, the automatic method agreed with 33 cases while 7 cases were 1 category off.

  19. Energy deposition in the breast during CT scanning: quantification and implications for dose reduction

    NASA Astrophysics Data System (ADS)

    Rupcich, Franco; Kyprianou, Iacovos; Badal, Andreu; Schmidt, Taly G.

    2011-03-01

    Studies suggest that dose to the breast leads to a higher lifetime attributable cancer incidence risk from a chest CT scan for women compared to men. Numerous methods have been proposed for reducing dose to the breast during CT scanning, including bismuth shielding, tube current modulation, partial-angular scanning, and reduced kVp. These methods differ in how they alter the spectrum and fluence across projection angle. This study used Monte Carlo CT simulations of a voxelized female phantom to investigate the energy (dose) deposition in the breast as a function of both photon energy and projection angle. The resulting dose deposition matrix was then used to investigate several questions regarding dose reduction to the breast: (1) Which photon energies deposit the most dose in the breast, (2) How does increased filtration compare to tube current reduction in reducing breast dose, and (3) Do reduced kVp scans reduce dose to breast, and if so, by what mechanism? The results demonstrate that while high-energy photons deposit more dose per emitted photon, the low-energy photons deposit more dose to the breast for a 120 kVp acquisition. The results also demonstrate that decreasing the tube current for the AP views to match the fluence exiting a shield deposits nearly the same dose to the breast as when using a shield (within ~1%). Finally, results suggest that the dose reduction observed during lower kVp scans is caused by reduced photon fluence rather than the elimination of high-energy photons from the beam. Overall, understanding the mechanisms of dose deposition in the breast as a function of photon energy and projection angle enables comparisons of dose reduction methods and facilitates further development of optimized dose reduction schemes.

  20. PET/CT vs. non-contrast CT alone for surveillance 1-year post lobectomy for stage I non-small-cell lung cancer.

    PubMed

    Dane, Bari; Grechushkin, Vadim; Plank, April; Moore, William; Bilfinger, Thomas

    2013-01-01

    (18)F-FDG PET/CT was compared with non-contrast chest CT in monitoring for recurrence 1-year after lobectomy of stage 1 non-small-cell lung cancer (NSCLC). For surveillance after treatment with curative intent, current (April 2012) National Comprehensive Cancer network guidelines recommend chest CT with or without contrast every 6-12 months for 2 years, then non-contrast chest CT annually. PET/CT is not currently indicated for routine follow-up. One hundred patients receiving surveillance PET/CT 1-year after lobectomy for the treatment of stage 1a or 1b NSCLC were included in the study. Exclusion criteria included the presence or interval diagnosis of a second malignancy, or surgical treatment more radical than single lobectomy. The non-contrast CT obtained from the 1-year PET/CT was interpreted by an experienced chest radiologist blinded to the PET/CT for evidence of recurrence using the following findings: pulmonary nodule, pleural effusion, pleural mass, adenopathy, and extrathoracic mass. The ecision about recurrence was made solely from the non-contrast CT without PET/CT findings. This was compared with the determination made with PET/CT. The reference standard for determination of recurrence was the multi-disciplinary tumor board who had access to all imaging and clinical data. Recurrence at 1 year was documented in 16 of 90 patients. All 16 recurrences were documented with PET/CT and 9 were found with non-contrast CT. Five of the 7 recurrences missed with non-contrast CT were extrathoracic metastases. Sensitivity of CT and PET/CT for recurrence was 56.3% and 100%, respectively (p = 0.015). Specificity of CT and PET/CT for recurrence was 95.9% and 93.2%, respectively (p = 0.62).

  1. MICRO DOSE ASESSMENT OF INHALED PARTICLES IN HUMAN LUNGS: A STEP CLOSER TOWARDS THE TARGET TISSUE DOSE

    EPA Science Inventory

    Rationale: Inhaled particles deposit inhomogeneously in the lung and this may result in excessive deposition dose at local regions of the lung, particularly at the anatomic sites of bifurcations and junctions of the airways, which in turn leads to injuries to the tissues and adve...

  2. Examination using modern low dose Multislice-CT (MS-CT) in otorhinolaryngology in a six-week-old baby.

    PubMed

    Heidelberg, Sokiranski R; Heidelberg, Plinkert M; Istanbul, Yildiz F; Ulm, Pirsig W

    2016-06-01

    A 6-week-old girl suffered from a growing and recurrently bleeding mass of unrecognizable origin, obstructing the left nose. Using low-dose Multislice-CT the exact diagnostic localization could be found within one minute in the sleeping baby without sedation or general anesthesia. The result of this imaging enabled the successful complete microscopic removal of a hemangioma from the left inferior turbinate. Follow-up after 15 months showed normal nasal finds.

  3. Cosolvent-free polymer gel dosimeters with improved dose sensitivity and resolution for x-ray CT dose response

    NASA Astrophysics Data System (ADS)

    Chain, J. N. M.; Jirasek, A.; Schreiner, L. J.; McAuley, K. B.

    2011-04-01

    This study reports new N-isopropylacrylamide (NIPAM) polymer gel recipes with increased dose sensitivity and improved dose resolution for x-ray CT readout. NIPAM can be used to increase the solubility of N, N'-methylenebisacrylamide (Bis) in aqueous solutions from approximately 3% to 5.5% by weight, enabling the manufacture of dosimeters containing up to 19.5%T, which is the total concentration of NIPAM and Bis by weight. Gelatin is shown to have a mild influence on dose sensitivity when gels are imaged using x-ray CT, and a stronger influence when gels are imaged optically. Phantoms that contain only 3% gelatin and 5 mM tetrakis hydroxymethyl phosphonium chloride are sufficiently stiff for dosimetry applications. The best cosolvent-free gel formulation has a dose sensitivity in the linear range (~0.88 H Gy-1) that is a small improvement compared to the best NIPAM-based gels that incorporate isopropanol as a cosolvent (~0.80 H Gy-1). This new gel formulation results in enhanced dose resolution (~0.052 Gy) for x-ray CT readout, making clinical applications of this imaging modality more feasible.

  4. Response of osteosarcoma to preoperative intravenous high-dose methotrexate chemotherapy: CT evaluation

    SciTech Connect

    Mail, J.T.; Cohen, M.D.; Mirkin, L.D.; Provisor, A.J.

    1985-01-01

    The histologic response of an osteosarcoma to preamputation high-dose methotrexate therapy can be used to determine the optimum maintenance chemotherapy regimen to be administered after amputation. This study evaluates computed tomography (CT) as a method of assessing the response of the tumor to the methotrexate therapy. Nine patients with nonmetastatic osteosarcoma of an extremity had a CT scan of the tumor at initial presentation. This was compared with a second CT scan after four courses of high-dose intravenous methotrexate. Each set of scans was evaluated for changes in bony destruction, soft-tissue mass, pattern of calcification, and extent of tumor involvement of the marrow cavity. These findings were correlated with the histologic response of the tumor as measured by the degree of tumor necrosis. The changes seen on CT correlated well with the degree of the histologic response in seven of the nine patients.

  5. Computer-aided diagnosis system for lung cancer based on retrospective helical CT image

    NASA Astrophysics Data System (ADS)

    Ukai, Yuji; Niki, Noboru; Satoh, Hitoshi; Eguchi, Kenji; Mori, Kiyoshi; Ohmatsu, Hironobu; Kakinuma, Ryutaro; Kaneko, Masahiro; Moriyama, Noriyuki

    2000-06-01

    In this paper, we present a computer-aided diagnosis (CAD) system for lung cancer to detect nodule candidates at an early stage from the present and the early helical CT screening of the thorax. We developed an algorithm that can compare automatically the slice images of present and early CT scans for the assistance of comparative reading in retrospect. The algorithm consists of the ROI detection and shape analysis based on comparison of each slice image in the present and the early CT scans. The slice images of present and early CT scans are both displayed in parallel and analyzed quantitatively in order to detect the changes in size and intensity affection. We validated the efficiency of this algorithm by application to image data for mass screening of 50 subjects (total: 150 CT scans). The algorithm could compare the slice images correctly in most combinations with respect to physician's point of view. We validated the efficiency of the algorithm which automatically detect lung nodule candidates using CAD system. The system was applied to the helical CT images of 450 subjects. Currently, we are carrying out the clinical field test program using the CAD system. The results of our CAD system have indicated good performance when compared with physician's diagnosis. The experimental results of the algorithm indicate that our CAD system is useful to increase the efficiency of the mass screening process. CT screening of thorax will be performed by using the CAD system as a counterpart to the double reading technique actually used in herical CT screening program, not by using the film display.

  6. Computer-aided diagnosis system for lung cancer based on retrospective helical CT images

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Ukai, Yuji; Niki, Noboru; Eguchi, Kenji; Mori, Kiyoshi; Ohmatsu, Hironobu; Kakinuma, Ryutaro; Kaneko, Masahiro; Moriyama, Noriyuki

    1999-05-01

    In this paper, we present a computer-aided diagnosis (CAD) system for lung cancer to detect nodule candidates at an early stage from the present and the early helical CT screening of the thorax. We developed an algorithm that can compare automatically the slice images of present and early CT scans for the assistance of comparative reading in retrospect. The algorithm consists of the ROI detection and shape analysis based on comparison of each slice image in the present and the early CT scans. The slice images of present and early CT scans are both displayed in parallel and analyzed quantitatively in order to detect the changes in size and intensity affection. We validated the efficiency of this algorithm by application to image data for mass screening of 50 subjects (total: 150 CT scans). The algorithm could compare the slice images correctly in most combinations with respect to physician's point of view. We validated the efficiency of the algorithm which automatically detect lung nodule candidates using CAD system. The system was applied to the helical CT images of 450 subjects. Currently, we are carrying out the clinical field test program using the CAD system. The results of our CAD system have indicated good performance when compared with physician's diagnosis. The experimental results of the algorithm indicate that our CAD system is useful to increase the efficiency of the mass screening process. CT screening of thorax will be performed by using the CAD system as a counterpart to the double reading technique actually used in herical CT screening program, not by using the film display.

  7. SU-F-BRF-11: Dose Rearrangement in High Dose Locally Advanced Lung Patients Based On Perfusion Imaging

    SciTech Connect

    Matrosic, C; Jarema, D; Kong, F; McShan, D; Stenmark, M; Owen, D; Ten Haken, R; Matuszak, M

    2014-06-15

    Purpose: The use of mean lung dose (MLD) limits allows individualization of lung patient tumor doses at safe levels. However, MLD does not account for local lung function differences between patients, leading to toxicity variability at the same MLD. We investigated dose rearrangement to minimize dose to functional lung, as measured by perfusion SPECT, while maintaining target coverage and conventional MLD limits. Methods: Retrospective plans were optimized for 15 locally advanced NSCLC patients enrolled in a prospective imaging trial. A priority-based optimization system was used. The baseline priorities were (1) meet OAR dose constraints, (2) maximize target gEUD, and (3) minimize physical MLD. As a final step, normal tissue doses were minimized. To determine the benefit of rearranging dose using perfusion SPECT, plans were reoptimized to minimize functional lung gEUD as the 4th priority. Results: When only minimizing physical MLD, the functional lung gEUD was 10.8+/−5.0 Gy (4.3–19.8 Gy). Only 3/15 cases showed a decrease in functional lung gEUD of ≥4% when rearranging dose to minimize functional gEUD in the cost function (10.5+/−5.0 Gy range 4.3−19.7). Although OAR constraints were respected, the dose rearrangement resulted in ≥10% increases in gEUD to an OAR in 4/15 cases. Only slight reductions in functional lung gEUD were noted when omitting the minimization of physical MLD, suggesting that constraining the target gEUD minimizes the potential to redistribute dose. Conclusion: Prioritydriven optimization permits the generation of plans that respect traditional OAR limits and target coverage, but with the ability to rearrange dose based on functional imaging. The latter appears to be limited due to the decreased solution space when constraining target coverage. Since dose rearrangement may increase dose to other OARs, it is also worthwhile to investigate global biomarkers of lung toxicity to further individualize treatment in this population

  8. Automated lung tumor detection and quantification for respiratory gated PET/CT images

    NASA Astrophysics Data System (ADS)

    Wang, Jiali; del Valle, Misael; Franquiz, Juan; McGoron, Anthony

    2008-03-01

    Purpose: To develop and validate an automatic algorithm for the detection and functional assessment of lung tumors on three-dimensional respiratory gated PET/CT images. Method and Materials: First the algorithm will automatically segment lung regions in CT images, then identify and localize focal increases of activity in lung regions of PET images at each gated bin. Once the tumor voxels have been determined, an integration algorithm will include all the tumor counts collected at different bins within the respiratory cycle into one reference bin. Then the total activity (Bq), concentration (Bq/ml), functional volume (ml) and standard uptake values (SUV) are calculated for each tumor on PET images. Validation of the automatic algorithm was demonstrated by conducting experiments with the computerized 4D NCAT phantom and with a dynamic lung-chest phantom imaged using a GE PET/CT System at Baptist Hospital of Miami. Tumor variables to be controlled were: volume, total number of counts (activity), maximum and average number of counts. These values were the gold standard to which the results of the algorithm were compared. The tumor's motion was also controlled with different respiratory periods and amplitudes. Results: Validation, feasibility and robustness of the algorithm were demonstrated. With the algorithm, the best compromise between short PET scan time and reduced image noise can be achieved, while quantification and clinical analysis become faster and more precise.

  9. {sup 18}F-FDG PET-CT Simulation for Non-Small-Cell Lung Cancer: Effect in Patients Already Staged by PET-CT

    SciTech Connect

    Hanna, Gerard G.; McAleese, Jonathan; Carson, Kathryn J.; Stewart, David P.; Cosgrove, Vivian P.; Eakin, Ruth L.; Zatari, Ashraf; Lynch, Tom; Jarritt, Peter H.; Young, V.A. Linda D.C.R.; O'Sullivan, Joe M.

    2010-05-01

    Purpose: Positron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non-small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition. Methods and Materials: A total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTV on the CT scan alone and then on the PET-CT scan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test. Results: PET-CT improved the CI between observers when defining the GTV using the PET-CT images compared with using CT alone for matched cases (median CI, 0.57 for CT and 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTV{sub CT} to GTV{sub FUSED} was -5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001). Conclusion: PET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

  10. CT-guided automated detection of lung tumors on PET images

    NASA Astrophysics Data System (ADS)

    Cui, Yunfeng; Zhao, Binsheng; Akhurst, Timothy J.; Yan, Jiayong; Schwartz, Lawrence H.

    2008-03-01

    The calculation of standardized uptake values (SUVs) in tumors on serial [ 18F]2-fluoro-2-deoxy-D-glucose ( 18F-FDG) positron emission tomography (PET) images is often used for the assessment of therapy response. We present a computerized method that automatically detects lung tumors on 18F-FDG PET/Computed Tomography (CT) images using both anatomic and metabolic information. First, on CT images, relevant organs, including lung, bone, liver and spleen, are automatically identified and segmented based on their locations and intensity distributions. Hot spots (SUV >= 1.5) on 18F-FDG PET images are then labeled using the connected component analysis. The resultant "hot objects" (geometrically connected hot spots in three dimensions) that fall into, reside at the edges or are in the vicinity of the lungs are considered as tumor candidates. To determine true lesions, further analyses are conducted, including reduction of tumor candidates by the masking out of hot objects within CT-determined normal organs, and analysis of candidate tumors' locations, intensity distributions and shapes on both CT and PET. The method was applied to 18F-FDG-PET/CT scans from 9 patients, on which 31 target lesions had been identified by a nuclear medicine radiologist during a Phase II lung cancer clinical trial. Out of 31 target lesions, 30 (97%) were detected by the computer method. However, sensitivity and specificity were not estimated because not all lesions had been marked up in the clinical trial. The method effectively excluded the hot spots caused by mediastinum, liver, spleen, skeletal muscle and bone metastasis.

  11. Potential of combining iterative reconstruction with noise efficient detector design: aggressive dose reduction in head CT

    PubMed Central

    Bender, B; Schabel, C; Fenchel, M; Ernemann, U; Korn, A

    2015-01-01

    Objective: With further increase of CT numbers and their dominant contribution to medical exposure, there is a recent quest for more effective dose control. While reintroduction of iterative reconstruction (IR) has proved its potential in many applications, a novel focus is placed on more noise efficient detectors. Our purpose was to assess the potential of IR in combination with an integrated circuit detector (ICD) for aggressive dose reduction in head CT. Methods: Non-contrast low-dose head CT [190 mAs; weighted volume CT dose index (CTDIvol), 33.2 mGy] was performed in 50 consecutive patients, using a new noise efficient detector and IR. Images were assessed in terms of quantitative and qualitative image quality and compared with standard dose acquisitions (320 mAs; CTDIvol, 59.7 mGy) using a conventional detector and filtered back projection. Results: By combining ICD and IR in low-dose examinations, the signal to noise was improved by about 13% above the baseline level in the standard-dose control group. Both, contrast-to-noise ratio (2.02 ± 0.6 vs 1.88 ± 0.4; p = 0.18) and objective measurements of image sharpness (695 ± 84 vs 705 ± 151 change in Hounsfield units per pixel; p = 0.79) were fully preserved in the low-dose group. Likewise, there was no significant difference in the grading of several subjective image quality parameters when both noise-reducing strategies were used in low-dose examinations. Conclusion: Combination of noise efficient detector with IR allows for meaningful dose reduction in head CT without compromise of standard image quality. Advances in knowledge: Our study demonstrates the feasibility of almost 50% dose reduction in head CT dose (1.1 mSv per scan) through combination of novel dose-reducing strategies. PMID:25827204

  12. Multi-stage learning for robust lung segmentation in challenging CT volumes.

    PubMed

    Sofka, Michal; Wetzl, Jens; Birkbeck, Neil; Zhang, Jingdan; Kohlberger, Timo; Kaftan, Jens; Declerck, Jérôme; Zhou, S Kevin

    2011-01-01

    Simple algorithms for segmenting healthy lung parenchyma in CT are unable to deal with high density tissue common in pulmonary diseases. To overcome this problem, we propose a multi-stage learning-based approach that combines anatomical information to predict an initialization of a statistical shape model of the lungs. The initialization first detects the carina of the trachea, and uses this to detect a set of automatically selected stable landmarks on regions near the lung (e.g., ribs, spine). These landmarks are used to align the shape model, which is then refined through boundary detection to obtain fine-grained segmentation. Robustness is obtained through hierarchical use of discriminative classifiers that are trained on a range of manually annotated data of diseased and healthy lungs. We demonstrate fast detection (35s per volume on average) and segmentation of 2 mm accuracy on challenging data.

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

    SciTech Connect

    Landry, Guillaume; Nijhuis, Reinoud; Thieke, Christian; Reiner, Michael; Ganswindt, Ute; Belka, Claus; Dedes, George; Handrack, Josefine; Parodi, Katia; Janssens, Guillaume; Orban de Xivry, Jonathan; Kamp, Florian; Wilkens, Jan J.; Paganelli, Chiara; Riboldi, Marco; Baroni, Guido

    2015-03-15

    Purpose: Intensity modulated proton therapy (IMPT) of head and neck (H and N) cancer patients may be improved by plan adaptation. The decision to adapt the treatment plan based on a dose recalculation on the current anatomy requires a diagnostic quality computed tomography (CT) scan of the patient. As gantry-mounted cone beam CT (CBCT) scanners are currently being offered by vendors, they may offer daily or weekly updates of patient anatomy. CBCT image quality may not be sufficient for accurate proton dose calculation and it is likely necessary to perform CBCT CT number correction. In this work, the authors investigated deformable image registration (DIR) of the planning CT (pCT) to the CBCT to generate a virtual CT (vCT) to be used for proton dose recalculation. Methods: Datasets of six H and N cancer patients undergoing photon intensity modulated radiation therapy were used in this study to validate the vCT approach. Each dataset contained a CBCT acquired within 3 days of a replanning CT (rpCT), in addition to a pCT. The pCT and rpCT were delineated by a physician. A Morphons algorithm was employed in this work to perform DIR of the pCT to CBCT following a rigid registration of the two images. The contours from the pCT were deformed using the vector field resulting from DIR to yield a contoured vCT. The DIR accuracy was evaluated with a scale invariant feature transform (SIFT) algorithm comparing automatically identified matching features between vCT and CBCT. The rpCT was used as reference for evaluation of the vCT. The vCT and rpCT CT numbers were converted to stopping power ratio and the water equivalent thickness (WET) was calculated. IMPT dose distributions from treatment plans optimized on the pCT were recalculated with a Monte Carlo algorithm on the rpCT and vCT for comparison in terms of gamma index, dose volume histogram (DVH) statistics as well as proton range. The DIR generated contours on the vCT were compared to physician-drawn contours on the rpCT

  14. SU-E-J-267: Change in Mean CT Intensity of Lung Tumors During Radiation Treatment

    SciTech Connect

    Mahon, R; Tennyson, N; Weiss, E; Hugo, G

    2015-06-15

    Purpose: To evaluate CT intensity change of lung tumors during radiation therapy. Methods: Repeated 4D CT images were acquired on a CT simulator during the course of therapy for 27 lung cancer patients on IRB approved protocols. All subjects received definitive radiation treatment ± chemotherapy. CT scans were completed prior to treatment, and 2–7 times during the treatment course. Primary tumor was delineated by an experienced Radiation Oncologist. Contours were thresholded between −100 HU and 200 HU to remove airways and bone. Correlations between the change in the mean tumor intensity and initial tumor intensity, SUVmax, and tumor volume change rate were investigated. Reproducibility was assessed by evaluating the variation in mean intensity over all phases in 4DCT, for a subgroup of 19 subjects. Results: Reproducibility of tumor intensity between phases as characterized by the root mean square of standard deviation across 19 subjects was 1.8 HU. Subjects had a mean initial tumor intensity of 16.5 ± 11.6 HU and an overall reduction in HU by 10.3 ± 8.5 HU. Evaluation of the changes in tumor intensity during treatment showed a decrease of 0.3 ± 0.3 HU/day for all subjects, except three. No significant correlation was found between change in HU/day and initial HU intensity (p=0.53), initial PET SUVmax (p=0.69), or initial tumor volume (p=0.70). The rate of tumor volume change was weakly correlated (R{sup 2}=0.05) with HU change (p=0.01). Conclusion: Most lung cancer subjects showed a marked trend of decreasing mean tumor CT intensity throughout radiotherapy, including early in the treatment course. Change in HU/day is not correlated with other potential early predictors for response, such as SUV and tumor volume change. This Result supports future studies to evaluate change in tumor intensity on CT as an early predictor of response.

  15. Deep convolutional neural networks for automatic coronary calcium scoring in a screening study with low-dose chest CT

    NASA Astrophysics Data System (ADS)

    Lessmann, Nikolas; Išgum, Ivana; Setio, Arnaud A. A.; de Vos, Bob D.; Ciompi, Francesco; de Jong, Pim A.; Oudkerk, Matthjis; Mali, Willem P. Th. M.; Viergever, Max A.; van Ginneken, Bram

    2016-03-01

    The amount of calcifications in the coronary arteries is a powerful and independent predictor of cardiovascular events and is used to identify subjects at high risk who might benefit from preventive treatment. Routine quantification of coronary calcium scores can complement screening programs using low-dose chest CT, such as lung cancer screening. We present a system for automatic coronary calcium scoring based on deep convolutional neural networks (CNNs). The system uses three independently trained CNNs to estimate a bounding box around the heart. In this region of interest, connected components above 130 HU are considered candidates for coronary artery calcifications. To separate them from other high intensity lesions, classification of all extracted voxels is performed by feeding two-dimensional 50 mm × 50 mm patches from three orthogonal planes into three concurrent CNNs. The networks consist of three convolutional layers and one fully-connected layer with 256 neurons. In the experiments, 1028 non-contrast-enhanced and non-ECG-triggered low-dose chest CT scans were used. The network was trained on 797 scans. In the remaining 231 test scans, the method detected on average 194.3 mm3 of 199.8 mm3 coronary calcifications per scan (sensitivity 97.2 %) with an average false-positive volume of 10.3 mm3 . Subjects were assigned to one of five standard cardiovascular risk categories based on the Agatston score. Accuracy of risk category assignment was 84.4 % with a linearly weighted κ of 0.89. The proposed system can perform automatic coronary artery calcium scoring to identify subjects undergoing low-dose chest CT screening who are at risk of cardiovascular events with high accuracy.

  16. SU-E-T-161: Evaluation of Dose Calculation Based On Cone-Beam CT

    SciTech Connect

    Abe, T; Nakazawa, T; Saitou, Y; Nakata, A; Yano, M; Tateoka, K; Fujimoto, K; Sakata, K

    2014-06-01

    Purpose: The purpose of this study is to convert pixel values in cone-beam CT (CBCT) using histograms of pixel values in the simulation CT (sim-CT) and the CBCT images and to evaluate the accuracy of dose calculation based on the CBCT. Methods: The sim-CT and CBCT images immediately before the treatment of 10 prostate cancer patients were acquired. Because of insufficient calibration of the pixel values in the CBCT, it is difficult to be directly used for dose calculation. The pixel values in the CBCT images were converted using an in-house program. A 7 fields treatment plans (original plan) created on the sim-CT images were applied to the CBCT images and the dose distributions were re-calculated with same monitor units (MUs). These prescription doses were compared with those of original plans. Results: In the results of the pixel values conversion in the CBCT images,the mean differences of pixel values for the prostate,subcutaneous adipose, muscle and right-femur were −10.78±34.60, 11.78±41.06, 29.49±36.99 and 0.14±31.15 respectively. In the results of the calculated doses, the mean differences of prescription doses for 7 fields were 4.13±0.95%, 0.34±0.86%, −0.05±0.55%, 1.35±0.98%, 1.77±0.56%, 0.89±0.69% and 1.69±0.71% respectively and as a whole, the difference of prescription dose was 1.54±0.4%. Conclusion: The dose calculation on the CBCT images achieve an accuracy of <2% by using this pixel values conversion program. This may enable implementation of efficient adaptive radiotherapy.

  17. Automated lung field segmentation in CT images using mean shift clustering and geometrical features

    NASA Astrophysics Data System (ADS)

    Chama, Chanukya Krishna; Mukhopadhyay, Sudipta; Biswas, Prabir Kumar; Dhara, Ashis Kumar; Madaiah, Mahendra Kasuvinahally; Khandelwal, Niranjan

    2013-02-01

    Lung field segmentation is a prerequisite for development of automated computer aided diagnosis system from chest computed tomography (CT) scans. Intensity based algorithm such as mean shift (MS) segmentation on CT images for delineation of lung field is reported as the best technique in terms of accuracy and speed in the literature. However, in presence of high dense abnormalities, accurate and automated delineation of lung field becomes difficult. So an improved lung field segmentation using mean shift clustering followed by geometric property based techniques such as lung region of interest (ROI) created from symmetric centroid map of two normal subjects, false positives (FP) reduction module (using eccentricity, solidity, area, centroid features) and false negatives (FN) reduction module (using overlap feature between clusters from MS label map and convex hull of costal lung) is proposed. The performance of the proposed algorithm is validated on images obtained from Lung Image Database Consortium (LIDC) - Image Database Resource Initiative (IDRI) public database of 17 subjects containing nodular patterns and from local database of 26 subjects containing interstitial lung disease (ILD) patterns. The proposed algorithm has achieved mean Modified Hausdorff Distance (MHD) in mm of 1.47 +/- 4.31, Dice Similarity Coefficient (DSC) of 0.9854 +/- 0.0288, sensitivity of 0.9771 +/- 0.0433, specificity of 0.9991 +/- 0.0014 for 133 normal images from 32 subjects and MHD in mm of 6.23 +/- 9.00, DSC of 0.8954 +/- 0.1498, sensitivity of 0.8468 +/- 0.1908, specificity of 0.9969 +/- 0.0061 for 296 abnormal images from 43 subjects.

  18. Large scale validation of the M5L lung CAD on heterogeneous CT datasets

    SciTech Connect

    Lopez Torres, E. E-mail: cerello@to.infn.it; Fiorina, E.; Pennazio, F.; Peroni, C.; Saletta, M.; Cerello, P. E-mail: cerello@to.infn.it; Camarlinghi, N.; Fantacci, M. E.

    2015-04-15

    Purpose: M5L, a fully automated computer-aided detection (CAD) system for the detection and segmentation of lung nodules in thoracic computed tomography (CT), is presented and validated on several image datasets. Methods: M5L is the combination of two independent subsystems, based on the Channeler Ant Model as a segmentation tool [lung channeler ant model (lungCAM)] and on the voxel-based neural approach. The lungCAM was upgraded with a scan equalization module and a new procedure to recover the nodules connected to other lung structures; its classification module, which makes use of a feed-forward neural network, is based of a small number of features (13), so as to minimize the risk of lacking generalization, which could be possible given the large difference between the size of the training and testing datasets, which contain 94 and 1019 CTs, respectively. The lungCAM (standalone) and M5L (combined) performance was extensively tested on 1043 CT scans from three independent datasets, including a detailed analysis of the full Lung Image Database Consortium/Image Database Resource Initiative database, which is not yet found in literature. Results: The lungCAM and M5L performance is consistent across the databases, with a sensitivity of about 70% and 80%, respectively, at eight false positive findings per scan, despite the variable annotation criteria and acquisition and reconstruction conditions. A reduced sensitivity is found for subtle nodules and ground glass opacities (GGO) structures. A comparison with other CAD systems is also presented. Conclusions: The M5L performance on a large and heterogeneous dataset is stable and satisfactory, although the development of a dedicated module for GGOs detection could further improve it, as well as an iterative optimization of the training procedure. The main aim of the present study was accomplished: M5L results do not deteriorate when increasing the dataset size, making it a candidate for supporting radiologists on large

  19. Creation of a CT Image Library for the Lung Screening Study of the National Lung Screening Trial.

    PubMed

    Clark, K W; Gierada, D S; Moore, S M; Maffitt, D R; Koppel, P; Phillips, S R; Prior, F W

    2007-03-01

    The CT Image Library (CTIL) of the Lung Screening Study (LSS) network of the National Lung Screening Trial (NLST) consists of up to three annual screens using CT imaging from each of 17,308 participants with a significant history of smoking but no evidence of cancer at trial enrollment (Fall 2002-Spring 2004). Screens performed at numerous medical centers associated with 10 LSS-NLST screening centers are deidentified of protected health information and delivered to the CTIL via DVD, external hard disk, or Internet/Virtual Private Network transmission. The collection will be completed in late 2006. The CTIL is of potential interest to clinical researchers and software developers of nodule detection algorithms. Its attractiveness lies in its very specific, well-defined patient population, scanned via a common CT protocol, and in its collection of evenly spaced serial screens. In this work, we describe the technical details of the CTIL collection process from screening center retrieval through library storage. PMID:16783598

  20. Development of a Radiation Dose Reporting Software for X-ray Computed Tomography (CT)

    NASA Astrophysics Data System (ADS)

    Ding, Aiping

    X-ray computed tomography (CT) has experienced tremendous technological advances in recent years and has established itself as one of the most popular diagnostic imaging tools. While CT imaging clearly plays an invaluable role in modern medicine, its rapid adoption has resulted in a dramatic increase in the average medical radiation exposure to the worldwide and United States populations. Existing software tools for CT dose estimation and reporting are mostly based on patient phantoms that contain overly simplified anatomies insufficient in meeting the current and future needs. This dissertation describes the development of an easy-to-use software platform, “VirtualDose”, as a service to estimate and report the organ dose and effective dose values for patients undergoing the CT examinations. “VirtualDose” incorporates advanced models for the adult male and female, pregnant women, and children. To cover a large portion of the ignored obese patients that frequents the radiology clinics, a new set of obese male and female phantoms are also developed and applied to study the effects of the fat tissues on the CT radiation dose. Multi-detector CT scanners (MDCT) and clinical protocols, as well as the most recent effective dose algorithms from the International Commission on Radiological Protection (ICRP) Publication 103 are adopted in “VirtualDose” to keep pace with the MDCT development and regulatory requirements. A new MDCT scanner model with both body and head bowtie filter is developed to cover both the head and body scanning modes. This model was validated through the clinical measurements. A comprehensive slice-by-slice database is established by deriving the data from a larger number of single axial scans simulated on the patient phantoms using different CT bowtie filters, beam thicknesses, and different tube voltages in the Monte Carlo N-Particle Extended (MCNPX) code. When compared to the existing CT dose software packages, organ dose data in this

  1. Radiation dose calculations for CT scans with tube current modulation using the approach to equilibrium function

    SciTech Connect

    Li, Xinhua; Zhang, Da; Liu, Bob

    2014-11-01

    Purpose: The approach to equilibrium function has been used previously to calculate the radiation dose to a shift-invariant medium undergoing CT scans with constant tube current [Li, Zhang, and Liu, Med. Phys. 39, 5347–5352 (2012)]. The authors have adapted this method to CT scans with tube current modulation (TCM). Methods: For a scan with variable tube current, the scan range was divided into multiple subscan ranges, each with a nearly constant tube current. Then the dose calculation algorithm presented previously was applied. For a clinical CT scan series that presented tube current per slice, the authors adopted an efficient approach that computed the longitudinal dose distribution for one scan length equal to the slice thickness, which center was at z = 0. The cumulative dose at a specific point was a summation of the contributions from all slices and the overscan. Results: The dose calculations performed for a total of four constant and variable tube current distributions agreed with the published results of Dixon and Boone [Med. Phys. 40, 111920 (14pp.) (2013)]. For an abdomen/pelvis scan of an anthropomorphic phantom (model ATOM 701-B, CIRS, Inc., VA) on a GE Lightspeed Pro 16 scanner with 120 kV, N × T = 20 mm, pitch = 1.375, z axis current modulation (auto mA), and angular current modulation (smart mA), dose measurements were performed using two lines of optically stimulated luminescence dosimeters, one of which was placed near the phantom center and the other on the surface. Dose calculations were performed on the central and peripheral axes of a cylinder containing water, whose cross-sectional mass was about equal to that of the ATOM phantom in its abdominal region, and the results agreed with the measurements within 28.4%. Conclusions: The described method provides an effective approach that takes into account subject size, scan length, and constant or variable tube current to evaluate CT dose to a shift-invariant medium. For a clinical CT scan

  2. Nonlinear histogram binning for quantitative analysis of lung tissue fibrosis in high-resolution CT data

    NASA Astrophysics Data System (ADS)

    Zavaletta, Vanessa A.; Bartholmai, Brian J.; Robb, Richard A.

    2007-03-01

    Diffuse lung diseases, such as idiopathic pulmonary fibrosis (IPF), can be characterized and quantified by analysis of volumetric high resolution CT scans of the lungs. These data sets typically have dimensions of 512 x 512 x 400. It is too subjective and labor intensive for a radiologist to analyze each slice and quantify regional abnormalities manually. Thus, computer aided techniques are necessary, particularly texture analysis techniques which classify various lung tissue types. Second and higher order statistics which relate the spatial variation of the intensity values are good discriminatory features for various textures. The intensity values in lung CT scans range between [-1024, 1024]. Calculation of second order statistics on this range is too computationally intensive so the data is typically binned between 16 or 32 gray levels. There are more effective ways of binning the gray level range to improve classification. An optimal and very efficient way to nonlinearly bin the histogram is to use a dynamic programming algorithm. The objective of this paper is to show that nonlinear binning using dynamic programming is computationally efficient and improves the discriminatory power of the second and higher order statistics for more accurate quantification of diffuse lung disease.

  3. Automated Measurement of Heterogeneity in CT Images of Healthy and Diseased Rat Lungs using Variogram Analysis of an Octree Decomposition

    SciTech Connect

    Jacob, Rick E.; Carson, James P.

    2014-01-01

    Elastase dosed mice, whole lung and single lobe groups. Combines octree image decomposition with variogram-based analysis Results in promising novel approach for characterizing and measuring lung disease at different stages

  4. Improving the channeler ant model for lung CT analysis

    NASA Astrophysics Data System (ADS)

    Cerello, Piergiorgio; Lopez Torres, Ernesto; Fiorina, Elisa; Oppedisano, Chiara; Peroni, Cristiana; Arteche Diaz, Raul; Bellotti, Roberto; Bosco, Paolo; Camarlinghi, Niccolo; Massafra, Andrea

    2011-03-01

    The Channeler Ant Model (CAM) is an algorithm based on virtual ant colonies, conceived for the segmentation of complex structures with different shapes and intensity in a 3D environment. It exploits the natural capabilities of virtual ant colonies to modify the environment and communicate with each other by pheromone deposition. When applied to lung CTs, the CAM can be turned into a Computer Aided Detection (CAD) method for the identification of pulmonary nodules and the support to radiologists in the identification of early-stage pathological objects. The CAM has been validated with the segmentation of 3D artificial objects and it has already been successfully applied to the lung nodules detection in Computed Tomography images within the ANODE09 challenge. The model improvements for the segmentation of nodules attached to the pleura and to the vessel tree are discussed, as well as a method to enhance the detection of low-intensity nodules. The results on five datasets annotated with different criteria show that the analytical modules (i.e. up to the filtering stage) provide a sensitivity in the 80 - 90% range with a number of FP/scan of the order of 20. The classification module, although not yet optimised, keeps the sensitivity in the 70 - 85% range at about 10 FP/scan, in spite of the fact that the annotation criteria for the training and the validation samples are different.

  5. Lung dose analysis in loco-regional hypofractionated radiotherapy of breast cancer

    PubMed Central

    Attar, Mohammad A.; Bahadur, Yasir A.; Constantinescu, Camelia T.; Eltaher, Maha M.

    2016-01-01

    Objectives: To report the ipsilateral lung dosimetry data of breast cancer (BC) patients treated with loco-regional hypofractionated radiotherapy (HFRT). Methods: Treatment plans of 150 patients treated in the Radiotherapy Unit, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia between January 2012 and March 2015 by HFRT for BC were retrospectively reviewed. All patients received 42.4 Gy in 16 fractions by tangential and supra-clavicular fields with 6 MV, 18 MV, or mixed energies. Ipsilateral lung dosimetric data V20Gy and mean lung dose (MLD) were recorded. Correlations between lung dose, patient characteristics, and treatment delivery parameters were assessed by a logistic regression test. Results: The mean ipsilateral lung V20Gy was 24.6% and mean MLD was 11.9 Gy. A weak, but statistically significant correlation was found between lung dose and lung volume (p=0.043). The lung dose was significantly decreasing with patient separation and depth of axillary lymph node (ALN) and supra-claviculary lymph nodes (SCLN) (p<0.0001), and increasing with ALN (p=0.001) and SCLN (p=0.003) dose coverage. Lung dose significantly decreased with beam energy (p<0.0001): mean V20Gy was 27.8%, 25.4% for 6 MV, mixed energy, and 21.2% for 18 MV. The use of a low breast-board angle correlates with low lung dose. Conclusion: Our data suggest that the use of high energy photon beams and low breast-board angulation can reduce the lung dose. PMID:27279508

  6. Towards a comprehensive CT image segmentation for thoracic organ radiation dose estimation and reporting

    NASA Astrophysics Data System (ADS)

    Lorenz, Cristian; Ruppertshofen, Heike; Vik, Torbjörn; Prinsen, Peter; Wiegert, Jens

    2014-03-01

    Administered dose of ionizing radiation during medical imaging is an issue of increasing concern for the patient, for the clinical community, and for respective regulatory bodies. CT radiation dose is currently estimated based on a set of very simplifying assumptions which do not take the actual body geometry and organ specific doses into account. This makes it very difficult to accurately report imaging related administered dose and to track it for different organs over the life of the patient. In this paper this deficit is addressed in a two-fold way. In a first step, the absorbed radiation dose in each image voxel is estimated based on a Monte-Carlo simulation of X-ray absorption and scattering. In a second step, the image is segmented into tissue types with different radio sensitivity. In combination this allows to calculate the effective dose as a weighted sum of the individual organ doses. The main purpose of this paper is to assess the feasibility of automatic organ specific dose estimation. With respect to a commercially applicable solution and respective robustness and efficiency requirements, we investigated the effect of dose sampling rather than integration over the organ volume. We focused on the thoracic anatomy as the exemplary body region, imaged frequently by CT. For image segmentation we applied a set of available approaches which allowed us to cover the main thoracic radio-sensitive tissue types. We applied the dose estimation approach to 10 thoracic CT datasets and evaluated segmentation accuracy and administered dose and could show that organ specific dose estimation can be achieved.

  7. Accuracy and Utility of Deformable Image Registration in {sup 68}Ga 4D PET/CT Assessment of Pulmonary Perfusion Changes During and After Lung Radiation Therapy

    SciTech Connect

    Hardcastle, Nicholas; Hofman, Michael S.; Hicks, Rodney J.; Callahan, Jason; Kron, Tomas; MacManus, Michael P.; Ball, David L.; Jackson, Price; Siva, Shankar

    2015-09-01

    Purpose: Measuring changes in lung perfusion resulting from radiation therapy dose requires registration of the functional imaging to the radiation therapy treatment planning scan. This study investigates registration accuracy and utility for positron emission tomography (PET)/computed tomography (CT) perfusion imaging in radiation therapy for non–small cell lung cancer. Methods: {sup 68}Ga 4-dimensional PET/CT ventilation-perfusion imaging was performed before, during, and after radiation therapy for 5 patients. Rigid registration and deformable image registration (DIR) using B-splines and Demons algorithms was performed with the CT data to obtain a deformation map between the functional images and planning CT. Contour propagation accuracy and correspondence of anatomic features were used to assess registration accuracy. Wilcoxon signed-rank test was used to determine statistical significance. Changes in lung perfusion resulting from radiation therapy dose were calculated for each registration method for each patient and averaged over all patients. Results: With B-splines/Demons DIR, median distance to agreement between lung contours reduced modestly by 0.9/1.1 mm, 1.3/1.6 mm, and 1.3/1.6 mm for pretreatment, midtreatment, and posttreatment (P<.01 for all), and median Dice score between lung contours improved by 0.04/0.04, 0.05/0.05, and 0.05/0.05 for pretreatment, midtreatment, and posttreatment (P<.001 for all). Distance between anatomic features reduced with DIR by median 2.5 mm and 2.8 for pretreatment and midtreatment time points, respectively (P=.001) and 1.4 mm for posttreatment (P>.2). Poorer posttreatment results were likely caused by posttreatment pneumonitis and tumor regression. Up to 80% standardized uptake value loss in perfusion scans was observed. There was limited change in the loss in lung perfusion between registration methods; however, Demons resulted in larger interpatient variation compared with rigid and B-splines registration

  8. Simulated and measured dose response characteristics of detectors used for CT dosimetry

    NASA Astrophysics Data System (ADS)

    Hakanen, Arvi

    2012-08-01

    A CT-SD16 semiconductor detector was calibrated in terms of the computed tomography (CT) air kerma index for the integration length L = 100 mm, CK,PMMA,100, in the cylindrical CT head and body dosimetry phantoms using a DCT10 pencil ionization chamber as a reference instrument. Using IEC RQT 9 120-kV x-ray radiation quality and 25-62.5 mm nominal beam widths free in air, a CK,PMMA,100(DCT10)/CK,PMMA,100(CT-SD16) ratio of 0.97 was observed, while in the centre of 300 mm long CT head and body dosimetry phantoms, CK,PMMA,100(DCT10)/CK,PMMA,100(CT-SD16) ratios ranged from 1.02 to 1.09. Using IEC RQT 8-10 radiation qualities free in air, Monte Carlo simulated dose response characteristics of CT-SD16 and DCT10 were comparable with those obtained from the measurements. Simulations were also used to determine CK,PMMA,100(DCT10) in the centre of the CT head and body phantoms. At IEC RQT 9 and 25-62.5 mm nominal beam widths, the relative values of the simulated dose agreed with the measured values within 2-10% for the head and body phantoms, respectively. A kq correction factor between dose measurements in the phantom and free in air was determined for the model of DCT10 and for the real detectors using measured CK,PMMA,100 data. Simulations were performed using the EGSnrc CAVRZ code.

  9. In vivo dosimetry for estimation of effective doses in multislice CT coronary angiography

    SciTech Connect

    De Denaro, M.; Bregant, P.; Severgnini, M.; De Guarrini, F.

    2007-10-15

    In vivo dosimetry represents a technique that has been widely employed to evaluate the dose to the patient mainly in radiotherapy. Considering the increment in dose to the population due to new high-dose multislice CT examinations, such as coronary angiography, it is becoming important to more accurately know the dose to the patient. The desire to know patient dose extends even to radiological examinations. Thermoluminescent dosimeters are considered the gold standard for in vivo dosimetry, but their use is time consuming. A rapid, less labor-intensive method has been developed to perform in vivo dosimetry using radiochromic film positioned next to the patient's skin. Multislice CT scanners allow the estimation of the effective dose to the patient from the dose length product (DLP) parameter, the value of which is displayed on the acquisition console, simply multiplying the DLP by published conversion factors. The method represents only an approximation based on standard size circular phantoms and neglects the actual size of the patient. More accurate evaluations can be carried out using software-based Monte Carlo simulations. However, these methods do not consider possible dose reduction techniques, such as automatic tube-current modulation. For 22 patients effective doses measured by in vivo dosimetry and calculated by software were compared. The technique of using in vivo dosimetry measured with radiochromic film appears a promising procedure for improving the assessment of the effective dose to the patient.

  10. Image texture and radiation dose properties in CT.

    PubMed

    Mozejko, David; Kjernlie Andersen, Hilde; Pedersen, Marius; Waaler, Dag; Trægde Martinsen, Anne Catrine

    2016-01-01

    The aim of this study was to compare image noise properties of GE Discovery HD 750 and Toshiba Aquilion ONE. The uniformity section of a Catphan 600 image quality assurance phantom was scanned with both scanners, at different dose levels and with extension rings simulating patients of different sizes. 36 datasets were obtained and analyzed in terms of noise power spectrum. All the results prove that introduction of extension rings significantly altered the image quality with respect to noise properties. Without extension rings, the Toshiba scanner had lower total visible noise than GE (with GE as reference: FC18 had 82% and FC08 had 80% for 10 mGy, FC18 had 77% and FC08 74% for 15 mGy, FC18 had 80% and FC08 77% for 20 mGy). The total visible noise (TVN) for 20 and 15 mGy were similar for the phantom with the smallest additional extension ring, while Toshiba had higher TVN than GE for the 10 mGy dose level (120% FC18, 110% FC08). For the second and third ring, the GE images had lower TVN than Toshiba images for all dose levels (Toshiba TVN is greater than 155% for all cases). The results indi-cate that GE potentially has less image noise than Toshiba for larger patients. The Toshiba FC18 kernel had higher TVN than the Toshiba FC08 kernel with additional beam hardening correction for all dose levels and phantom sizes (120%, 107%, and 106% for FC18 compared to 110%, 98%, and 97%, for FC08, for 10, 15 and 20 mGy doses, respectively). PMID:27167260

  11. Enlarged longitudinal dose profiles in cone-beam CT and the need for modified dosimetry

    SciTech Connect

    Mori, Shinichiro; Endo, Masahiro; Nishizawa, Kanae; Tsunoo, Takanori; Aoyama, Takahiko; Fujiwara, Hideaki; Murase, Kenya

    2005-04-01

    In order to examine phantom length necessary to assess radiation dose delivered to patients in cone-beam CT with an enlarged beamwidth, we measured dose profiles in cylindrical phantoms of sufficient length using a prototype 256-slice CT-scanner developed at our institute. Dose profiles parallel to the rotation axis were measured at the central and peripheral positions in PMMA (polymethylmethacrylate) phantoms of 160 or 320 mm diameter and 900 mm length. For practical application, we joined unit cylinders (150 mm long) together to provide phantoms of 900 mm length. Dose profiles were measured with a pin photodiode sensor having a sensitive region of approximately 2.8x2.8 mm{sup 2} and 2.7 mm thickness. Beamwidths of the scanner were varied from 20 to 138 mm. Dose profile integrals (DPI) were calculated using the measured dose profiles for various beamwidths and integration ranges. For the body phantom (320-mm-diam phantom), 76% of the DPI was represented for a 20 mm beamwidth and 60% was represented for a 138 mm beamwidth if dose profiles were integrated over a 100 mm range, while more than 90% of the DPI was represented for beamwidths between 20 and 138 mm if integration was carried out over a 300 mm range. The phantom length and integration range for dosimetry of cone-beam CT needed to be more than 300 mm to represent more than 90% of the DPI for the body phantom with the beamwidth of more than 20 mm. Although we reached this conclusion using the prototype 256-slice CT-scanner, it may be applied to other multislice CT-scanners as well.

  12. Designing a phantom for dose evaluation in multi-slice CT

    NASA Astrophysics Data System (ADS)

    Abboud, Samir; Badal, Andreu; Stern, Stanley H.; Kyprianou, Iacovos S.

    2010-04-01

    Accurately representing radiation dose delivered in MSCT is becoming a concern as the maximum beam width of some modern CT scanners tends to become wider than the 100 mm charge-collection length of the pencil ionization chamber generally used in CT dosimetry. We investigate two alternative methods of dose evaluation in CT scanners. We investigate two alternative approaches for better characterization of CT dose than conventional evaluation of CTDI100. First, we simulate dose profiles and energy deposition in phantoms longer than the typically used 14-15 cm length right-circular cylinders. Second we explore the accuracy and practicality of applying mathematical convolution to a scatter kernel in order to generate dose profiles. A basic requirement for any newly designed phantom is that it be able to capture approximately the same dose as would an infinitely long cylinder, but yet be of a size and weight that a person could easily carry and position. Using the PENELOPE Monte Carlo package, we simulated dose profiles in cylindrical polymethyl methacrylate (PMMA) phantoms of 10, 16, 20, 24 and 32 cm diameter and 15, 30 and 300 cm length. Beam widths were varied from 1 cm to 60 cm. Lengths necessary to include within the dose integrals values associated with the scatter tails as well as with the primary radiation of the profile were then calculated as the full width at five percent of maximum dose. The resulting lengths suggest that to accommodate wide beam widths, phantoms longer than those currently used are necessary. The results also suggest that using a longer phantom is a relatively more accurate approach, while using mathematical convolution is simpler and more practical to implement than using the long phantoms designed according to direct Monte Carlo simulations.

  13. Profile of CT scan output dose in axial and helical modes using convolution

    NASA Astrophysics Data System (ADS)

    Anam, C.; Haryanto, F.; Widita, R.; Arif, I.; Dougherty, G.

    2016-03-01

    The profile of the CT scan output dose is crucial for establishing the patient dose profile. The purpose of this study is to investigate the profile of the CT scan output dose in both axial and helical modes using convolution. A single scan output dose profile (SSDP) in the center of a head phantom was measured using a solid-state detector. The multiple scan output dose profile (MSDP) in the axial mode was calculated using convolution between SSDP and delta function, whereas for the helical mode MSDP was calculated using convolution between SSDP and the rectangular function. MSDPs were calculated for a number of scans (5, 10, 15, 20 and 25). The multiple scan average dose (MSAD) for differing numbers of scans was compared to the value of CT dose index (CTDI). Finally, the edge values of MSDP for every scan number were compared to the corresponding MSAD values. MSDPs were successfully generated by using convolution between a SSDP and the appropriate function. We found that CTDI only accurately estimates MSAD when the number of scans was more than 10. We also found that the edge values of the profiles were 42% to 93% lower than that the corresponding MSADs.

  14. Influence of z overscanning on normalized effective doses calculated for pediatric patients undergoing multidetector CT examinations

    SciTech Connect

    Tzedakis, Antonis; Damilakis, John; Perisinakis, Kostas; Karantanas, Apostolos; Karabekios, Spiros; Gourtsoyiannis, Nicholas

    2007-04-15

    The purpose of this study was to evaluate the effect of z overscanning on normalized effective dose for pediatric patients undergoing multidetector-computed tomography (CT) examinations. Five commercially available mathematical anthropomorphic phantoms representing newborn, 1-, 5-, 10-, and 15-year-old patients and the Monte Carlo N-Particle (MCNP, version 4C2) radiation transport code were employed in the current study to simulate pediatric CT exposures. For all phantoms, axial and helical examinations at 120 kV tube voltage were simulated. Scans performed at 80 kV were also simulated. Sex-specific normalized effective doses were estimated for four standard CT examinations i.e., head-neck, chest, abdomen-pelvis, and trunk, for all pediatric phantoms. Data for both axial and helical mode acquisition were obtained. In the helical mode, z overscanning was taken into account. The validity of the Monte Carlo results was verified by comparison with dose data obtained using thermoluminescence dosimetry and a physical pediatric anthropomorphic phantom simulating a 10-year-old child. In all cases normalized effective dose values were found to increase with increasing z overscanning. The percentage differences in normalized data between axial and helical scans may reach 43%, 70%, 36%, and 26% for head-neck, chest, abdomen-pelvis, and trunk studies, respectively. Normalized data for female pediatric patients was in general higher compared to male patients for all ages, examined regions, and z overscanning values. For both male and female children, the normalized effective dose values were reduced as the age was increased. For the same typical exposure conditions, dose values decreased when lower tube voltage was used; for a 1-year-old child, for example, the effective dose was 3.8 times lower when 80 kV instead of 120 kV was used. Normalized data for the estimation of effective dose to pediatric patients undergoing standard axial and helical CT examinations on an

  15. The effects of gantry tilt on breast dose and image noise in cardiac CT

    SciTech Connect

    Hoppe, Michael E.; Gandhi, Diksha; Schmidt, Taly Gilat; Stevens, Grant M.; Foley, W. Dennis

    2013-12-15

    Purpose: This study investigated the effects of tilted-gantry acquisition on image noise and glandular breast dose in females during cardiac computed tomography (CT) scans. Reducing the dose to glandular breast tissue is important due to its high radiosensitivity and limited diagnostic significance in cardiac CT scans.Methods: Tilted-gantry acquisition was investigated through computer simulations and experimental measurements. Upon IRB approval, eight voxelized phantoms were constructed from previously acquired cardiac CT datasets. Monte Carlo simulations quantified the dose deposited in glandular breast tissue over a range of tilt angles. The effects of tilted-gantry acquisition on breast dose were measured on a clinical CT scanner (CT750HD, GE Healthcare) using an anthropomorphic phantom with MOSFET dosimeters in the breast regions. In both simulations and experiments, scans were performed at gantry tilt angles of 0°–30°, in 5° increments. The percent change in breast dose was calculated relative to the nontilted scan for all tilt angles. The percent change in noise standard deviation due to gantry tilt was calculated in all reconstructed simulated and experimental images.Results: Tilting the gantry reduced the breast dose in all simulated and experimental phantoms, with generally greater dose reduction at increased gantry tilts. For example, at 30° gantry tilt, the dosimeters located in the superior, middle, and inferior breast regions measured dose reductions of 74%, 61%, and 9%, respectively. The simulations estimated 0%–30% total breast dose reduction across the eight phantoms and range of tilt angles. However, tilted-gantry acquisition also increased the noise standard deviation in the simulated phantoms by 2%–50% due to increased pathlength through the iodine-filled heart. The experimental phantom, which did not contain iodine in the blood, demonstrated decreased breast dose and decreased noise at all gantry tilt angles.Conclusions: Tilting the

  16. Tissue decomposition from dual energy CT data for MC based dose calculation in particle therapy

    SciTech Connect

    Hünemohr, Nora Greilich, Steffen; Paganetti, Harald; Seco, Joao; Jäkel, Oliver

    2014-06-15

    Purpose: The authors describe a novel method of predicting mass density and elemental mass fractions of tissues from dual energy CT (DECT) data for Monte Carlo (MC) based dose planning. Methods: The relative electron density ϱ{sub e} and effective atomic number Z{sub eff} are calculated for 71 tabulated tissue compositions. For MC simulations, the mass density is derived via one linear fit in the ϱ{sub e} that covers the entire range of tissue compositions (except lung tissue). Elemental mass fractions are predicted from the ϱ{sub e} and the Z{sub eff} in combination. Since particle therapy dose planning and verification is especially sensitive to accurate material assignment, differences to the ground truth are further analyzed for mass density, I-value predictions, and stopping power ratios (SPR) for ions. Dose studies with monoenergetic proton and carbon ions in 12 tissues which showed the largest differences of single energy CT (SECT) to DECT are presented with respect to range uncertainties. The standard approach (SECT) and the new DECT approach are compared to reference Bragg peak positions. Results: Mean deviations to ground truth in mass density predictions could be reduced for soft tissue from (0.5±0.6)% (SECT) to (0.2±0.2)% with the DECT method. Maximum SPR deviations could be reduced significantly for soft tissue from 3.1% (SECT) to 0.7% (DECT) and for bone tissue from 0.8% to 0.1%. MeanI-value deviations could be reduced for soft tissue from (1.1±1.4%, SECT) to (0.4±0.3%) with the presented method. Predictions of elemental composition were improved for every element. Mean and maximum deviations from ground truth of all elemental mass fractions could be reduced by at least a half with DECT compared to SECT (except soft tissue hydrogen and nitrogen where the reduction was slightly smaller). The carbon and oxygen mass fraction predictions profit especially from the DECT information. Dose studies showed that most of the 12 selected tissues would

  17. Correction of CT artifacts and its influence on Monte Carlo dose calculations

    SciTech Connect

    Bazalova, Magdalena; Beaulieu, Luc; Palefsky, Steven; Verhaegen, Frank

    2007-06-15

    Computed tomography (CT) images of patients having metallic implants or dental fillings exhibit severe streaking artifacts. These artifacts may disallow tumor and organ delineation and compromise dose calculation outcomes in radiotherapy. We used a sinogram interpolation metal streaking artifact correction algorithm on several phantoms of exact-known compositions and on a prostate patient with two hip prostheses. We compared original CT images and artifact-corrected images of both. To evaluate the effect of the artifact correction on dose calculations, we performed Monte Carlo dose calculation in the EGSnrc/DOSXYZnrc code. For the phantoms, we performed calculations in the exact geometry, in the original CT geometry and in the artifact-corrected geometry for photon and electron beams. The maximum errors in 6 MV photon beam dose calculation were found to exceed 25% in original CT images when the standard DOSXYZnrc/CTCREATE calibration is used but less than 2% in artifact-corrected images when an extended calibration is used. The extended calibration includes an extra calibration point for a metal. The patient dose volume histograms of a hypothetical target irradiated by five 18 MV photon beams in a hypothetical treatment differ significantly in the original CT geometry and in the artifact-corrected geometry. This was found to be mostly due to miss-assignment of tissue voxels to air due to metal artifacts. We also developed a simple Monte Carlo model for a CT scanner and we simulated the contribution of scatter and beam hardening to metal streaking artifacts. We found that whereas beam hardening has a minor effect on metal artifacts, scatter is an important cause of these artifacts.

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

    SciTech Connect

    Yu, S; Sehgal, V; Kuo, J; Daroui, P; Ramsinghani, N; Al-Ghazi, M

    2014-06-01

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

  19. Effect of shaped filter design on dose and image quality in breast CT.

    PubMed

    Lück, Ferdinand; Kolditz, Daniel; Hupfer, Martin; Kalender, Willi A

    2013-06-21

    The purpose of this study was to investigate the effect of shaped filters specifically designed for dedicated breast computed tomography (CT) scanners on dose and image quality. Optimization of filter shape and material in fan direction was performed using two different design methods, one aiming at homogeneous noise distributions in the CT images and the other aiming at a uniform dose distribution in the breast. The optimal filter thickness as a function of fan angle was determined iteratively to fulfil the above mentioned criteria for each breast diameter. Different filter materials (aluminium, copper, carbon, polytetrafluoroethylene) and breast phantoms with diameters between 80-180 mm were investigated. Noise uniformity in the reconstructed images, obtained from CT simulations based on ray-tracing methods, and dose in the breast, calculated with a Monte Carlo software tool, were used as figure of merit. Furthermore, CT-value homogeneity, the distribution of noise in cone direction, spatial resolution from centre to periphery and the contrast-to-noise ratio weighted by dose (CNRD) were evaluated. In addition, the decrease of scatter due to shaped filters was investigated. Since only few or one filter are practical in clinical CT systems, the effects of one shaped filter for different breast diameters were also investigated. In this case the filter, designed for the largest breast diameter, was simulated at variable source-to-filter distances depending on breast diameter. With the filter design method aiming at uniform noise distribution best results were obtained for aluminium as the filter material. Noise uniformity improved from 20} down to 5} and dose was reduced by about 30-40} for all breast diameters. No decrease of noise uniformity in cone direction, CT-value homogeneity, spatial resolution and the CNRD was detected with the shaped filter. However, a small improvement of CNRD was observed. Furthermore, a scatter reduction of about 20-30} and a more

  20. Technique factors and their relationship to radiation dose in pendant geometry breast CT

    SciTech Connect

    Boone, John M.; Kwan, Alexander L. C.; Seibert, J. Anthony; Shah, Nikula; Lindfors, Karen K.; Nelson, Thomas R.

    2005-12-15

    The use of breast computed tomography (CT) as an alternative to mammography in some patients is being studied at several institutions. However, the radiation dosimetry issues associated with breast CT are markedly different than in the case of mammography. In this study, the spectral properties of an operational breast CT scanner were characterized both by physical measurement and computer modeling of the kVp-dependent spectra, from 40 to 110 kVp (Be window W anode with 0.30 mm added Cu filtration). Previously reported conversion factors, normalized glandular dose for CT-DgN(ct), derived from Monte Carlo methods, were used in concert with the output spectra of the breast scanner to compute the mean glandular dose to the breast based upon different combinations of x-ray technique factors (kVp and mAs). The mean glandular dose (MGD) was measured as a function of the compressed breast thickness (2-8 cm) and three different breast compositions (0%, 50%, and 100% glandular fractions) in four clinical mammography systems in our institution. The average MGD from these four systems was used to compute the technique factors for breast CT systems that would match the two-view mammographic dose levels. For a 14 cm diameter breast (equivalent to a 5 cm thick compressed breast in mammography), air kerma levels at the breast CT scanner's isocenter (468 mm from the source) of 4.4, 6.4, and 9.0 mGy were found to deliver equivalent mammography doses for 0%, 50%, and 100% glandular breasts (respectively) at 80 kVp. At 80 kVp (where air kerma was 11.3 mGy/100 mAs at the isocenter), 57 mAs (integrated over the entire scan) was required to match the mammography dose for a 14 cm 50% glandular breast. At 50 kVp, 360 mAs is required to match mammographic dose levels. Tables are provided for both air kerma at the isocenter and mAs for 0%, 50%, and 100% glandular breasts. Other issues that impact breast CT technique factors are also discussed.

  1. Effect of shaped filter design on dose and image quality in breast CT

    NASA Astrophysics Data System (ADS)

    Lück, Ferdinand; Kolditz, Daniel; Hupfer, Martin; Kalender, Willi A.

    2013-06-01

    The purpose of this study was to investigate the effect of shaped filters specifically designed for dedicated breast computed tomography (CT) scanners on dose and image quality. Optimization of filter shape and material in fan direction was performed using two different design methods, one aiming at homogeneous noise distributions in the CT images and the other aiming at a uniform dose distribution in the breast. The optimal filter thickness as a function of fan angle was determined iteratively to fulfil the above mentioned criteria for each breast diameter. Different filter materials (aluminium, copper, carbon, polytetrafluoroethylene) and breast phantoms with diameters between 80-180 mm were investigated. Noise uniformity in the reconstructed images, obtained from CT simulations based on ray-tracing methods, and dose in the breast, calculated with a Monte Carlo software tool, were used as figure of merit. Furthermore, CT-value homogeneity, the distribution of noise in cone direction, spatial resolution from centre to periphery and the contrast-to-noise ratio weighted by dose (CNRD) were evaluated. In addition, the decrease of scatter due to shaped filters was investigated. Since only few or one filter are practical in clinical CT systems, the effects of one shaped filter for different breast diameters were also investigated. In this case the filter, designed for the largest breast diameter, was simulated at variable source-to-filter distances depending on breast diameter. With the filter design method aiming at uniform noise distribution best results were obtained for aluminium as the filter material. Noise uniformity improved from 20} down to 5} and dose was reduced by about 30-40} for all breast diameters. No decrease of noise uniformity in cone direction, CT-value homogeneity, spatial resolution and the CNRD was detected with the shaped filter. However, a small improvement of CNRD was observed. Furthermore, a scatter reduction of about 20-30} and a more

  2. Automatic detection of lung vessel bifurcation in thoracic CT images

    NASA Astrophysics Data System (ADS)

    Maduskar, Pragnya; Vikal, Siddharth; Devarakota, Pandu

    2011-03-01

    Computer-aided diagnosis (CAD) systems for detection of lung nodules have been an active topic of research for last few years. It is desirable that a CAD system should generate very low false positives (FPs) while maintaining high sensitivity. This work aims to reduce the number of false positives occurring at vessel bifurcation point. FPs occur quite frequently on vessel branching point due to its shape which can appear locally spherical due to the intrinsic geometry of intersecting tubular vessel structures combined with partial volume effects and soft tissue attenuation appearance surrounded by parenchyma. We propose a model-based technique for detection of vessel branching points using skeletonization, followed by branch-point analysis. First we perform vessel structure enhancement using a multi-scale Hessian filter to accurately segment tubular structures of various sizes followed by thresholding to get binary vessel structure segmentation [6]. A modified Reebgraph [7] is applied next to extract the critical points of structure and these are joined by a nearest neighbor criterion to obtain complete skeletal model of vessel structure. Finally, the skeletal model is traversed to identify branch points, and extract metrics including individual branch length, number of branches and angle between various branches. Results on 80 sub-volumes consisting of 60 actual vessel-branching and 20 solitary solid nodules show that the algorithm identified correctly vessel branching points for 57 sub-volumes (95% sensitivity) and misclassified 2 nodules as vessel branch. Thus, this technique has potential in explicit identification of vessel branching points for general vessel analysis, and could be useful in false positive reduction in a lung CAD system.

  3. Diagnostic accuracy at several reduced radiation dose levels for CT imaging in the diagnosis of appendicitis

    NASA Astrophysics Data System (ADS)

    Zhang, Di; Khatonabadi, Maryam; Kim, Hyun; Jude, Matilda; Zaragoza, Edward; Lee, Margaret; Patel, Maitraya; Poon, Cheryce; Douek, Michael; Andrews-Tang, Denise; Doepke, Laura; McNitt-Gray, Shawn; Cagnon, Chris; DeMarco, John; McNitt-Gray, Michael

    2012-03-01

    Purpose: While several studies have investigated the tradeoffs between radiation dose and image quality (noise) in CT imaging, the purpose of this study was to take this analysis a step further by investigating the tradeoffs between patient radiation dose (including organ dose) and diagnostic accuracy in diagnosis of appendicitis using CT. Methods: This study was IRB approved and utilized data from 20 patients who underwent clinical CT exams for indications of appendicitis. Medical record review established true diagnosis of appendicitis, with 10 positives and 10 negatives. A validated software tool used raw projection data from each scan to create simulated images at lower dose levels (70%, 50%, 30%, 20% of original). An observer study was performed with 6 radiologists reviewing each case at each dose level in random order over several sessions. Readers assessed image quality and provided confidence in their diagnosis of appendicitis, each on a 5 point scale. Liver doses at each case and each dose level were estimated using Monte Carlo simulation based methods. Results: Overall diagnostic accuracy varies across dose levels: 92%, 93%, 91%, 90% and 90% across the 100%, 70%, 50%, 30% and 20% dose levels respectively. And it is 93%, 95%, 88%, 90% and 90% across the 13.5-22mGy, 9.6-13.5mGy, 6.4-9.6mGy, 4-6.4mGy, and 2-4mGy liver dose ranges respectively. Only 4 out of 600 observations were rated "unacceptable" for image quality. Conclusion: The results from this pilot study indicate that the diagnostic accuracy does not change dramatically even at significantly reduced radiation dose.

  4. Effect of tube current modulation for dose estimation using a simulation tool on body CT examination.

    PubMed

    Kawaguchi, Ai; Matsunaga, Yuta; Kobayashi, Masanao; Suzuki, Shoichi; Matsubara, Kosuke; Chida, Koichi

    2015-12-01

    The purpose of this study was to evaluate the effect of tube current modulation for dose estimation of a body computed tomography (CT) examination using a simulation tool. The authors also compared longitudinal variations in tube current values between iterative reconstruction (IR) and filtered back-projection (FBP) reconstruction algorithms. One hundred patients underwent body CT examinations. The tube current values around 10 organ regions were recorded longitudinally from tube current information. The organ and effective doses were simulated by average tube current values and longitudinal modulated tube current values. The organ doses for the bladder and breast estimated by longitudinal modulated tube current values were 20 % higher and 25 % lower than those estimated using the average tube current values, respectively. The differences in effective doses were small (mean, 0.7 mSv). The longitudinal variations in tube current values were almost the same for the IR and FBP algorithms.

  5. Prospective estimation of organ dose in CT under tube current modulation

    SciTech Connect

    Tian, Xiaoyu; Li, Xiang; Segars, W. Paul; Frush, Donald P.; Samei, Ehsan

    2015-04-15

    Purpose: Computed tomography (CT) has been widely used worldwide as a tool for medical diagnosis and imaging. However, despite its significant clinical benefits, CT radiation dose at the population level has become a subject of public attention and concern. In this light, optimizing radiation dose has become a core responsibility for the CT community. As a fundamental step to manage and optimize dose, it may be beneficial to have accurate and prospective knowledge about the radiation dose for an individual patient. In this study, the authors developed a framework to prospectively estimate organ dose for chest and abdominopelvic CT exams under tube current modulation (TCM). Methods: The organ dose is mainly dependent on two key factors: patient anatomy and irradiation field. A prediction process was developed to accurately model both factors. To model the anatomical diversity and complexity in the patient population, the authors used a previously developed library of computational phantoms with broad distributions of sizes, ages, and genders. A selected clinical patient, represented by a computational phantom in the study, was optimally matched with another computational phantom in the library to obtain a representation of the patient’s anatomy. To model the irradiation field, a previously validated Monte Carlo program was used to model CT scanner systems. The tube current profiles were modeled using a ray-tracing program as previously reported that theoretically emulated the variability of modulation profiles from major CT machine manufacturers Li et al., [Phys. Med. Biol. 59, 4525–4548 (2014)]. The prediction of organ dose was achieved using the following process: (1) CTDI{sub vol}-normalized-organ dose coefficients (h{sub organ}) for fixed tube current were first estimated as the prediction basis for the computational phantoms; (2) each computation phantom, regarded as a clinical patient, was optimally matched with one computational phantom in the library; (3

  6. Three-dimensional display of the heart, aorta, lungs, and airway using CT

    SciTech Connect

    Fram, E.K.; Godwin, J.D.; Putman, C.E.

    1982-12-01

    In previous studies of human anatomy, three-dimensional display of CT data has required laborious manual boundary tracking, except for high-contrast structures such as the spine. Automated boundary tracking techniques have been extended so that they can function well for both high-contrast and soft-tissue interfaces. These methods have been applied to the in vivo study of human lungs, heart, aorta, and larynx in this paper.

  7. SU-E-I-32: Benchmarking Head CT Doses: A Pooled Vs. Protocol Specific Analysis of Radiation Doses in Adult Head CT Examinations

    SciTech Connect

    Fujii, K; Bostani, M; Cagnon, C; McNitt-Gray, M

    2015-06-15

    Purpose: The aim of this study was to collect CT dose index data from adult head exams to establish benchmarks based on either: (a) values pooled from all head exams or (b) values for specific protocols. One part of this was to investigate differences in scan frequency and CT dose index data for inpatients versus outpatients. Methods: We collected CT dose index data (CTDIvol) from adult head CT examinations performed at our medical facilities from Jan 1st to Dec 31th, 2014. Four of these scanners were used for inpatients, the other five were used for outpatients. All scanners used Tube Current Modulation. We used X-ray dose management software to mine dose index data and evaluate CTDIvol for 15807 inpatients and 4263 outpatients undergoing Routine Brain, Sinus, Facial/Mandible, Temporal Bone, CTA Brain and CTA Brain-Neck protocols, and combined across all protocols. Results: For inpatients, Routine Brain series represented 84% of total scans performed. For outpatients, Sinus scans represented the largest fraction (36%). The CTDIvol (mean ± SD) across all head protocols was 39 ± 30 mGy (min-max: 3.3–540 mGy). The CTDIvol for Routine Brain was 51 ± 6.2 mGy (min-max: 36–84 mGy). The values for Sinus were 24 ± 3.2 mGy (min-max: 13–44 mGy) and for Facial/Mandible were 22 ± 4.3 mGy (min-max: 14–46 mGy). The mean CTDIvol for inpatients and outpatients was similar across protocols with one exception (CTA Brain-Neck). Conclusion: There is substantial dose variation when results from all protocols are pooled together; this is primarily a function of the differences in technical factors of the protocols themselves. When protocols are analyzed separately, there is much less variability. While analyzing pooled data affords some utility, reviewing protocols segregated by clinical indication provides greater opportunity for optimization and establishing useful benchmarks.

  8. CT angiography - chest

    MedlinePlus

    Computed tomography angiography - thorax; CTA - lungs; Pulmonary embolism - CTA chest; Thoracic aortic aneurysm - CTA chest; Venous thromboembolism - CTA lung; Blood clot - CTA lung; Embolus - CTA lung; CT ...

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

    SciTech Connect

    Rong Yi

    2010-10-01

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

  10. Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis.

    PubMed

    Platon, Alexandra; Jlassi, Helmi; Rutschmann, Olivier T; Becker, Christoph D; Verdun, Francis R; Gervaz, Pascal; Poletti, Pierre-Alexandre

    2009-02-01

    The aim of this study was to evaluate a low-dose CT with oral contrast medium (LDCT) for the diagnosis of acute appendicitis and compare its performance with standard-dose i.v. contrast-enhanced CT (standard CT) according to patients' BMIs. Eighty-six consecutive patients admitted with suspicion of acute appendicitis underwent LDCT (30 mAs), followed by standard CT (180 mAs). Both examinations were reviewed by two experienced radiologists for direct and indirect signs of appendicitis. Clinical and surgical follow-up was considered as the reference standard. Appendicitis was confirmed by surgery in 37 (43%) of the 86 patients. Twenty-nine (34%) patients eventually had an alternative discharge diagnosis to explain their abdominal pain. Clinical and biological follow-up was uneventful in 20 (23%) patients. LDCT and standard CT had the same sensitivity (100%, 33/33) and specificity (98%, 45/46) to diagnose appendicitis in patients with a body mass index (BMI) >or= 18.5. In slim patients (BMI<18.5), sensitivity to diagnose appendicitis was 50% (2/4) for LDCT and 100% (4/4) for standard CT, while specificity was identical for both techniques (67%, 2/3). LDCT may play a role in the diagnostic workup of patients with a BMI >or= 18.5.

  11. Lung texture in serial thoracic CT scans: correlation with radiologist-defined severity of acute changes following radiation therapy

    NASA Astrophysics Data System (ADS)

    Cunliffe, Alexandra R.; Armato, Samuel G., III; Straus, Christopher; Malik, Renuka; Al-Hallaq, Hania A.

    2014-09-01

    This study examines the correlation between the radiologist-defined severity of normal tissue damage following radiation therapy (RT) for lung cancer treatment and a set of mathematical descriptors of computed tomography (CT) scan texture (‘texture features’). A pre-therapy CT scan and a post-therapy CT scan were retrospectively collected under IRB approval for each of the 25 patients who underwent definitive RT (median dose: 66 Gy). Sixty regions of interest (ROIs) were automatically identified in the non-cancerous lung tissue of each post-therapy scan. A radiologist compared post-therapy scan ROIs with pre-therapy scans and categorized each as containing no abnormality, mild abnormality, moderate abnormality, or severe abnormality. Twenty texture features that characterize gray-level intensity, region morphology, and gray-level distribution were calculated in post-therapy scan ROIs and compared with anatomically matched ROIs in the pre-therapy scan. Linear regression and receiver operating characteristic (ROC) analysis were used to compare the percent feature value change (ΔFV) between ROIs at each category of visible radiation damage. Most ROIs contained no (65%) or mild abnormality (30%). ROIs with moderate (3%) or severe (2%) abnormalities were observed in 9 patients. For 19 of 20 features, ΔFV was significantly different among severity levels. For 12 features, significant differences were observed at every level. Compared with regions with no abnormalities, ΔFV for these 12 features increased, on average, by 1.5%, 12%, and 30%, respectively, for mild, moderate, and severe abnormalitites. Area under the ROC curve was largest when comparing ΔFV in the highest severity level with the remaining three categories (mean AUC across features: 0.84). In conclusion, 19 features that characterized the severity of radiologic changes from pre-therapy scans were identified. These features may be used in future studies to quantify acute normal lung tissue damage

  12. Automated characterization of normal and pathologic lung tissue by topological texture analysis of multidetector CT

    NASA Astrophysics Data System (ADS)

    Boehm, H. F.; Fink, C.; Becker, C.; Reiser, M.

    2007-03-01

    Reliable and accurate methods for objective quantitative assessment of parenchymal alterations in the lung are necessary for diagnosis, treatment and follow-up of pulmonary diseases. Two major types of alterations are pulmonary emphysema and fibrosis, emphysema being characterized by abnormal enlargement of the air spaces distal to the terminal, nonrespiratory bronchiole, accompanied by destructive changes of the alveolar walls. The main characteristic of fibrosis is coursening of the interstitial fibers and compaction of the pulmonary tissue. With the ability to display anatomy free from superimposing structures and greater visual clarity, Multi-Detector-CT has shown to be more sensitive than the chest radiograph in identifying alterations of lung parenchyma. In automated evaluation of pulmonary CT-scans, quantitative image processing techniques are applied for objective evaluation of the data. A number of methods have been proposed in the past, most of which utilize simple densitometric tissue features based on the mean X-ray attenuation coefficients expressed in terms of Hounsfield Units [HU]. Due to partial volume effects, most of the density-based methodologies tend to fail, namely in cases, where emphysema and fibrosis occur within narrow spatial limits. In this study, we propose a methodology based upon the topological assessment of graylevel distribution in the 3D image data of lung tissue which provides a way of improving quantitative CT evaluation. Results are compared to the more established density-based methods.

  13. Assessing Tumor Response to Treatment in Patients with Lung Cancer Using Dynamic Contrast-Enhanced CT

    PubMed Central

    Strauch, Louise S.; Eriksen, Rie Ø.; Sandgaard, Michael; Kristensen, Thomas S.; Nielsen, Michael B.; Lauridsen, Carsten A.

    2016-01-01

    The aim of this study was to provide an overview of the literature available on dynamic contrast-enhanced computed tomography (DCE-CT) as a tool to evaluate treatment response in patients with lung cancer. This systematic review was compiled according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only original research articles concerning treatment response in patients with lung cancer assessed with DCE-CT were included. To assess the validity of each study we implemented Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). The initial search yielded 651 publications, and 16 articles were included in this study. The articles were divided into groups of treatment. In studies where patients were treated with systemic chemotherapy with or without anti-angiogenic drugs, four out of the seven studies found a significant decrease in permeability after treatment. Four out of five studies that measured blood flow post anti-angiogenic treatments found that blood flow was significantly decreased. DCE-CT may be a useful tool in assessing treatment response in patients with lung cancer. It seems that particularly permeability and blood flow are important perfusion values for predicting treatment outcome. However, the heterogeneity in scan protocols, scan parameters, and time between scans makes it difficult to compare the included studies. PMID:27455330

  14. Development of a minipig model for lung injury induced by a single high-dose radiation exposure and evaluation with thoracic computed tomography

    PubMed Central

    Lee, Jong-Geol; Park, Sunhoo; Bae, Chang-Hwan; Jang, Won-Suk; Lee, Sun-Joo; Lee, Dal Nim; Myung, Jae Kyung; Kim, Cheol Hyeon; Jin, Young-Woo; Lee, Seung-Sook; Shim, Sehwan

    2016-01-01

    Radiation-induced lung injury (RILI) due to nuclear or radiological exposure remains difficult to treat because of insufficient clinical data. The goal of this study was to establish an appropriate and efficient minipig model and introduce a thoracic computed tomography (CT)-based method to measure the progression of RILI. Göttingen minipigs were allocated to control and irradiation groups. The most obvious changes in the CT images after irradiation were peribronchial opacification, interlobular septal thickening, and lung volume loss. Hounsfield units (HU) in the irradiation group reached a maximum level at 6 weeks and decreased thereafter, but remained higher than those of the control group. Both lung area and cardiac right lateral shift showed significant changes at 22 weeks post irradiation. The white blood cell (WBC) count, a marker of pneumonitis, increased and reached a maximum at 6 weeks in both peripheral blood and bronchial alveolar lavage fluid. Microscopic findings at 22 weeks post irradiation were characterized by widening of the interlobular septum, with dense fibrosis and an increase in the radiation dose–dependent fibrotic score. Our results also showed that WBC counts and microscopic findings were positively correlated with the three CT parameters. In conclusion, the minipig model can provide useful clinical data regarding RILI caused by the adverse effects of high-dose radiotherapy. Peribronchial opacification, interlobular septal thickening, and lung volume loss are three quantifiable CT parameters that can be used as a simple method for monitoring the progression of RILI. PMID:26712795

  15. Low dose dynamic CT myocardial perfusion imaging using a statistical iterative reconstruction method

    SciTech Connect

    Tao, Yinghua; Chen, Guang-Hong; Hacker, Timothy A.; Raval, Amish N.; Van Lysel, Michael S.; Speidel, Michael A.

    2014-07-15

    Purpose: Dynamic CT myocardial perfusion imaging has the potential to provide both functional and anatomical information regarding coronary artery stenosis. However, radiation dose can be potentially high due to repeated scanning of the same region. The purpose of this study is to investigate the use of statistical iterative reconstruction to improve parametric maps of myocardial perfusion derived from a low tube current dynamic CT acquisition. Methods: Four pigs underwent high (500 mA) and low (25 mA) dose dynamic CT myocardial perfusion scans with and without coronary occlusion. To delineate the affected myocardial territory, an N-13 ammonia PET perfusion scan was performed for each animal in each occlusion state. Filtered backprojection (FBP) reconstruction was first applied to all CT data sets. Then, a statistical iterative reconstruction (SIR) method was applied to data sets acquired at low dose. Image voxel noise was matched between the low dose SIR and high dose FBP reconstructions. CT perfusion maps were compared among the low dose FBP, low dose SIR and high dose FBP reconstructions. Numerical simulations of a dynamic CT scan at high and low dose (20:1 ratio) were performed to quantitatively evaluate SIR and FBP performance in terms of flow map accuracy, precision, dose efficiency, and spatial resolution. Results: Forin vivo studies, the 500 mA FBP maps gave −88.4%, −96.0%, −76.7%, and −65.8% flow change in the occluded anterior region compared to the open-coronary scans (four animals). The percent changes in the 25 mA SIR maps were in good agreement, measuring −94.7%, −81.6%, −84.0%, and −72.2%. The 25 mA FBP maps gave unreliable flow measurements due to streaks caused by photon starvation (percent changes of +137.4%, +71.0%, −11.8%, and −3.5%). Agreement between 25 mA SIR and 500 mA FBP global flow was −9.7%, 8.8%, −3.1%, and 26.4%. The average variability of flow measurements in a nonoccluded region was 16.3%, 24.1%, and 937

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

    SciTech Connect

    Moteabbed, M. Sharp, G. C.; Wang, Y.; Trofimov, A.; Efstathiou, J. A.; Lu, H.-M.

    2015-01-15

    Purpose: As radiation therapy evolves toward more adaptive techniques, image guidance plays an increasingly important role, not only in patient setup but also in monitoring the delivered dose and adapting the treatment to patient changes. This study aimed to validate a method for evaluation of delivered intensity modulated radiotherapy (IMRT) dose based on multimodal deformable image registration (DIR) for prostate treatments. Methods: A pelvic phantom was scanned with CT and cone-beam computed tomography (CBCT). Both images were digitally deformed using two realistic patient-based deformation fields. The original CT was then registered to the deformed CBCT resulting in a secondary deformed CT. The registration quality was assessed as the ability of the DIR method to recover the artificially induced deformations. The primary and secondary deformed CT images as well as vector fields were compared to evaluate the efficacy of the registration method and it’s suitability to be used for dose calculation. PLASTIMATCH, a free and open source software was used for deformable image registration. A B-spline algorithm with optimized parameters was used to achieve the best registration quality. Geometric image evaluation was performed through voxel-based Hounsfield unit (HU) and vector field comparison. For dosimetric evaluation, IMRT treatment plans were created and optimized on the original CT image and recomputed on the two warped images to be compared. The dose volume histograms were compared for the warped structures that were identical in both warped images. This procedure was repeated for the phantom with full, half full, and empty bladder. Results: The results indicated mean HU differences of up to 120 between registered and ground-truth deformed CT images. However, when the CBCT intensities were calibrated using a region of interest (ROI)-based calibration curve, these differences were reduced by up to 60%. Similarly, the mean differences in average vector field

  17. Dose conversion coefficients for paediatric CT examinations with automatic tube current modulation

    NASA Astrophysics Data System (ADS)

    Schlattl, H.; Zankl, M.; Becker, J.; Hoeschen, C.

    2012-10-01

    A common dose-saving technique used in modern CT devices is automatic tube current modulation (TCM), which was originally designed to also reduce the dose in paediatric CT patients. In order to be able to deduce detailed organ doses of paediatric models, dose conversion coefficients normalized to CTDIvol for an eight-week-old baby and seven- and eight-year-old children have been computed accounting for TCM. The relative difference in organ dose conversion coefficients with and without TCM is for many organs and examinations less than 10%, but can in some cases amount up to 30%, e.g., for the thyroid in the chest CT of the seven-year-old child. Overall, the impact of TCM on the conversion coefficients increases with increasing age. Besides TCM, also the effect of collimation and tube voltage on organ dose conversion coefficients has been investigated. It could be shown that the normalization to CTDIvol leads to conversion coefficients that can in most cases be considered to be independent of collimation and tube voltage.

  18. Development of age-specific Japanese head phantoms for dose evaluation in paediatric head CT examinations.

    PubMed

    Yamauchi-Kawaura, C; Fujii, K; Akahane, K; Yamauchi, M; Narai, K; Aoyama, T; Katsu, T; Obara, S; Imai, K; Ikeda, M

    2015-02-01

    In this study, the authors developed age-specific physical head phantoms simulating the physique of Japanese children for dose evaluation in paediatric head computed tomography (CT) examinations. Anatomical structures at 99 places in 0-, 0.5-, 1- and 3-y-old Japanese patients were measured using DICOM viewer software from CT images, and the head phantom of each age was designed. For trial manufacture, a 3-y-old head phantom consisting of acrylic resin and gypsum was produced by machine processing. Radiation doses for the head phantom were measured with radiophotoluminescence glass dosemeters and Si-pin photodiode dosemeters. To investigate whether the phantom shape was suitable for dose evaluation, organ doses in the same scan protocol were compared between the 3-y-old head and commercially available anthropomorphic phantoms having approximately the same head size. The doses of organs in both phantoms were equivalent. The authors' designed paediatric head phantom will be useful for dose evaluation in paediatric head CT examinations.

  19. Absorbed doses of lungs from radon retained in airway lumens of mice and rats.

    PubMed

    Sakoda, Akihiro; Ishimori, Yuu; Yamaoka, Kiyonori; Kataoka, Takahiro; Mitsunobu, Fumihiro

    2013-08-01

    This paper provides absorbed doses arising from radon gas in air retained in lung airway lumens. Because radon gas exposure experiments often use small animals, the calculation was performed for mice and rats. For reference, the corresponding computations were also done for humans. Assuming that radon concentration in airway lumens is the same as that in the environment, its progeny's production in and clearance from airways were simulated. Absorbed dose rates were obtained for three lung regions and the whole lung, considering that secretory and basal cells are sensitive to radiation. The results showed that absorbed dose rates for all lung regions and whole lung generally increase from mice to rats to humans. For example, the dose rates for the whole lung were 25.4 in mice, 41.7 in rats, and 59.9 pGy (Bq m⁻³)⁻¹ h⁻¹ in humans. Furthermore, these values were also compared with lung dose rates from two other types of exposures, that is, due to inhalation of radon or its progeny, which were already reported. It was confirmed that the direct inhalation of radon progeny in the natural environment, which is known as a cause of lung cancer, results in the highest dose rates for all species. Based on the present calculations, absorbed dose rates of the whole lung from radon gas were lower by a factor of about 550 (mice), 200 (rats), or 70 (humans) than those from radon progeny inhalation. The calculated dose rate values are comparatively small. Nevertheless, the present study is considered to contribute to our understanding of doses from inhalation of radon and its progeny.

  20. Experimentally studied dynamic dose interplay does not meaningfully affect target dose in VMAT SBRT lung treatments

    SciTech Connect

    Stambaugh, Cassandra; Nelms, Benjamin E.; Dilling, Thomas; Stevens, Craig; Latifi, Kujtim; Zhang, Geoffrey; Moros, Eduardo; Feygelman, Vladimir

    2013-09-15

    Purpose: The effects of respiratory motion on the tumor dose can be divided into the gradient and interplay effects. While the interplay effect is likely to average out over a large number of fractions, it may play a role in hypofractionated [stereotactic body radiation therapy (SBRT)] treatments. This subject has been extensively studied for intensity modulated radiation therapy but less so for volumetric modulated arc therapy (VMAT), particularly in application to hypofractionated regimens. Also, no experimental study has provided full four-dimensional (4D) dose reconstruction in this scenario. The authors demonstrate how a recently described motion perturbation method, with full 4D dose reconstruction, is applied to describe the gradient and interplay effects during VMAT lung SBRT treatments.Methods: VMAT dose delivered to a moving target in a patient can be reconstructed by applying perturbations to the treatment planning system-calculated static 3D dose. Ten SBRT patients treated with 6 MV VMAT beams in five fractions were selected. The target motion (motion kernel) was approximated by 3D rigid body translation, with the tumor centroids defined on the ten phases of the 4DCT. The motion was assumed to be periodic, with the period T being an average from the empirical 4DCT respiratory trace. The real observed tumor motion (total displacement ≤8 mm) was evaluated first. Then, the motion range was artificially increased to 2 or 3 cm. Finally, T was increased to 60 s. While not realistic, making T comparable to the delivery time elucidates if the interplay effect can be observed. For a single fraction, the authors quantified the interplay effect as the maximum difference in the target dosimetric indices, most importantly the near-minimum dose (D{sub 99%}), between all possible starting phases. For the three- and five-fractions, statistical simulations were performed when substantial interplay was found.Results: For the motion amplitudes and periods obtained from

  1. Patient-specific dose estimation for pediatric abdomen-pelvis CT

    NASA Astrophysics Data System (ADS)

    Li, Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P.

    2009-02-01

    The purpose of this study is to develop a method for estimating patient-specific dose from abdomen-pelvis CT examinations and to investigate dose variation across patients in the same weight group. Our study consisted of seven pediatric patients in the same weight/protocol group, for whom full-body computer models were previously created based on the patients' CT data obtained for clinical indications. Organ and effective dose of these patients from an abdomen-pelvis scan protocol (LightSpeed VCT scanner, 120-kVp, 85-90 mA, 0.4-s gantry rotation period, 1.375-pitch, 40-mm beam collimation, and small body scan field-of-view) was calculated using a Monte Carlo program previously developed and validated for the same CT system. The seven patients had effective dose of 2.4-2.8 mSv, corresponding to normalized effective dose of 6.6-8.3 mSv/100mAs (coefficient of variation: 7.6%). Dose variations across the patients were small for large organs in the scan coverage (mean: 6.6%; range: 4.9%-9.2%), larger for small organs in the scan coverage (mean: 10.3%; range: 1.4%-15.6%), and the largest for organs partially or completely outside the scan coverage (mean: 14.8%; range: 5.7%-27.7%). Normalized effective dose correlated strongly with body weight (correlation coefficient: r = -0.94). Normalized dose to the kidney and the adrenal gland correlated strongly with mid-liver equivalent diameter (kidney: r = -0.97; adrenal glands: r = -0.98). Normalized dose to the small intestine correlated strongly with mid-intestine equivalent diameter (r = -0.97). These strong correlations suggest that patient-specific dose may be estimated for any other child in the same size group who undergoes the abdomen-pelvis scan.

  2. Evaluation of a low-dose/slow-rotating SPECT-CT system

    NASA Astrophysics Data System (ADS)

    Hamann, M.; Aldridge, M.; Dickson, J.; Endozo, R.; Lozhkin, K.; Hutton, B. F.

    2008-05-01

    The 4-slice CT that forms part of the GE Infinia Hawkeye-4 SPECT-CT scanner (Hawkeye) is evaluated against the diagnostic 16-slice CT that is incorporated in the GE Discovery ST PET-CT system (DST). The x-ray tube of the slow-rotating Hawkeye system (23 s/rotation) operates at approximately a third of the dose of diagnostic systems as used for conventional diagnostic imaging. Image reconstruction is optimized for low noise. High-contrast spatial resolution significantly falls behind diagnostic figures: the average of MTF50 and MTF10 (resolution where the MTF has fallen to 50% and 10%) is 2.8 ± 0.1 cm-1 for Hawkeye and 5.3 ± 0.1 cm-1 for the DST (standard reconstruction filters). Resolution in the direction of the couch movement (z coordinate) is governed by the fixed Hawkeye slice width of 5 mm. Reconstruction accuracy is found to be increased by reducing the default z increment from 4.4 mm to 2.2 mm. Low-contrast object detectability is superior compared with diagnostic systems operating in the Hawkeye dose range. In the diagnostic dose regime, however, small low-contrast details remain visible in DST that are not detectable with Hawkeye. Although not of diagnostic quality, the low-dose Hawkeye provides appropriate data for SPECT attenuation correction and anatomical localization capability. For more information on this article, see medicalphysicsweb.org

  3. A method to evaluate the dose increase in CT with iodinated contrast medium

    SciTech Connect

    Amato, Ernesto; Lizio, Domenico; Settineri, Nicola; Di Pasquale, Andrea; Salamone, Ignazio; Pandolfo, Ignazio

    2010-08-15

    Purpose: The objective of this study is to develop a method to calculate the relative dose increase when a computerized tomography scan (CT) is carried out after administration of iodinated contrast medium, with respect to the same CT scan in absence of contrast medium. Methods: A Monte Carlo simulation in GEANT4 of anthropomorphic neck and abdomen phantoms exposed to a simplified model of CT scanner was set up in order to calculate the increase of dose to thyroid, liver, spleen, kidneys, and pancreas as a function of the quantity of iodine accumulated; a series of experimental measurements of Hounsfield unit (HU) increment for known concentrations of iodinated contrast medium was carried out on a Siemens Sensation 16 CT scanner in order to obtain a relationship between the increment in HU and the relative dose increase in the organs studied. The authors applied such a method to calculate the average dose increase in three patients who underwent standard CT protocols consisting of one native scan in absence of contrast, followed by a contrast-enhanced scan in venous phase. Results: The authors validated their GEANT4 Monte Carlo simulation by comparing the resulting dose increases for iodine solutions in water with the ones presented in literature and with their experimental data obtained through a Roentgen therapy unit. The relative dose increases as a function of the iodine mass fraction accumulated and as a function of the Hounsfield unit increment between the contrast-enhanced scan and the native scan are presented. The data shown for the three patients exhibit an average relative dose increase between 22% for liver and 74% for kidneys; also, spleen (34%), pancreas (28%), and thyroid (48%) show a remarkable average increase. Conclusions: The method developed allows a simple evaluation of the dose increase when iodinated contrast medium is used in CT scans, basing on the increment in Hounsfield units observed on the patients' organs. Since many clinical protocols

  4. A database for estimating organ dose for coronary angiography and brain perfusion CT scans for arbitrary spectra and angular tube current modulation

    SciTech Connect

    Rupcich, Franco; Badal, Andreu; Kyprianou, Iacovos; Schmidt, Taly Gilat

    2012-09-15

    Purpose: The purpose of this study was to develop a database for estimating organ dose in a voxelized patient model for coronary angiography and brain perfusion CT acquisitions with any spectra and angular tube current modulation setting. The database enables organ dose estimation for existing and novel acquisition techniques without requiring Monte Carlo simulations. Methods: The study simulated transport of monoenergetic photons between 5 and 150 keV for 1000 projections over 360 Degree-Sign through anthropomorphic voxelized female chest and head (0 Degree-Sign and 30 Degree-Sign tilt) phantoms and standard head and body CTDI dosimetry cylinders. The simulations resulted in tables of normalized dose deposition for several radiosensitive organs quantifying the organ dose per emitted photon for each incident photon energy and projection angle for coronary angiography and brain perfusion acquisitions. The values in a table can be multiplied by an incident spectrum and number of photons at each projection angle and then summed across all energies and angles to estimate total organ dose. Scanner-specific organ dose may be approximated by normalizing the database-estimated organ dose by the database-estimated CTDI{sub vol} and multiplying by a physical CTDI{sub vol} measurement. Two examples are provided demonstrating how to use the tables to estimate relative organ dose. In the first, the change in breast and lung dose during coronary angiography CT scans is calculated for reduced kVp, angular tube current modulation, and partial angle scanning protocols relative to a reference protocol. In the second example, the change in dose to the eye lens is calculated for a brain perfusion CT acquisition in which the gantry is tilted 30 Degree-Sign relative to a nontilted scan. Results: Our database provides tables of normalized dose deposition for several radiosensitive organs irradiated during coronary angiography and brain perfusion CT scans. Validation results indicate

  5. Validation of calculation algorithms for organ doses in CT by measurements on a 5 year old paediatric phantom

    NASA Astrophysics Data System (ADS)

    Dabin, Jérémie; Mencarelli, Alessandra; McMillan, Dayton; Romanyukha, Anna; Struelens, Lara; Lee, Choonsik

    2016-06-01

    Many organ dose calculation tools for computed tomography (CT) scans rely on the assumptions: (1) organ doses estimated for one CT scanner can be converted into organ doses for another CT scanner using the ratio of the Computed Tomography Dose Index (CTDI) between two CT scanners; and (2) helical scans can be approximated as the summation of axial slices covering the same scan range. The current study aims to validate experimentally these two assumptions. We performed organ dose measurements in a 5 year-old physical anthropomorphic phantom for five different CT scanners from four manufacturers. Absorbed doses to 22 organs were measured using thermoluminescent dosimeters for head-to-torso scans. We then compared the measured organ doses with the values calculated from the National Cancer Institute dosimetry system for CT (NCICT) computer program, developed at the National Cancer Institute. Whereas the measured organ doses showed significant variability (coefficient of variation (CoV) up to 53% at 80 kV) across different scanner models, the CoV of organ doses normalised to CTDIvol substantially decreased (12% CoV on average at 80 kV). For most organs, the difference between measured and simulated organ doses was within  ±20% except for the bone marrow, breasts and ovaries. The discrepancies were further explained by additional Monte Carlo calculations of organ doses using a voxel phantom developed from CT images of the physical phantom. The results demonstrate that organ doses calculated for one CT scanner can be used to assess organ doses from other CT scanners with 20% uncertainty (k  =  1), for the scan settings considered in the study.

  6. Dose and image quality for a cone-beam C-arm CT system

    SciTech Connect

    Fahrig, Rebecca; Dixon, Robert; Payne, Thomas; Morin, Richard L.; Ganguly, Arundhuti; Strobel, Norbert

    2006-12-15

    We assess dose and image quality of a state-of-the-art angiographic C-arm system (Axiom Artis dTA, Siemens Medical Solutions, Forchheim, Germany) for three-dimensional neuro-imaging at various dose levels and tube voltages and an associated measurement method. Unlike conventional CT, the beam length covers the entire phantom, hence, the concept of computed tomography dose index (CTDI) is not the metric of choice, and one can revert to conventional dosimetry methods by directly measuring the dose at various points using a small ion chamber. This method allows us to define and compute a new dose metric that is appropriate for a direct comparison with the familiar CTDI{sub W} of conventional CT. A perception study involving the CATPHAN 600 indicates that one can expect to see at least the 9 mm inset with 0.5% nominal contrast at the recommended head-scan dose (60 mGy) when using tube voltages ranging from 70 kVp to 125 kVp. When analyzing the impact of tube voltage on image quality at a fixed dose, we found that lower tube voltages gave improved low contrast detectability for small-diameter objects. The relationships between kVp, image noise, dose, and contrast perception are discussed.

  7. HDRMC, an accelerated Monte Carlo dose calculator for high dose rate brachytherapy with CT-compatible applicators

    SciTech Connect

    Chibani, Omar C-M Ma, Charlie

    2014-05-15

    Purpose: To present a new accelerated Monte Carlo code for CT-based dose calculations in high dose rate (HDR) brachytherapy. The new code (HDRMC) accounts for both tissue and nontissue heterogeneities (applicator and contrast medium). Methods: HDRMC uses a fast ray-tracing technique and detailed physics algorithms to transport photons through a 3D mesh of voxels representing the patient anatomy with applicator and contrast medium included. A precalculated phase space file for the{sup 192}Ir source is used as source term. HDRM is calibrated to calculated absolute dose for real plans. A postprocessing technique is used to include the exact density and composition of nontissue heterogeneities in the 3D phantom. Dwell positions and angular orientations of the source are reconstructed using data from the treatment planning system (TPS). Structure contours are also imported from the TPS to recalculate dose-volume histograms. Results: HDRMC was first benchmarked against the MCNP5 code for a single source in homogenous water and for a loaded gynecologic applicator in water. The accuracy of the voxel-based applicator model used in HDRMC was also verified by comparing 3D dose distributions and dose-volume parameters obtained using 1-mm{sup 3} versus 2-mm{sup 3} phantom resolutions. HDRMC can calculate the 3D dose distribution for a typical HDR cervix case with 2-mm resolution in 5 min on a single CPU. Examples of heterogeneity effects for two clinical cases (cervix and esophagus) were demonstrated using HDRMC. The neglect of tissue heterogeneity for the esophageal case leads to the overestimate of CTV D90, CTV D100, and spinal cord maximum dose by 3.2%, 3.9%, and 3.6%, respectively. Conclusions: A fast Monte Carlo code for CT-based dose calculations which does not require a prebuilt applicator model is developed for those HDR brachytherapy treatments that use CT-compatible applicators. Tissue and nontissue heterogeneities should be taken into account in modern HDR

  8. Characterizing Functional Lung Heterogeneity in COPD Using Reference Equations for CT Scan-Measured Lobar Volumes

    PubMed Central

    Diaz, Alejandro A.; Curran-Everett, Douglas; Muralidhar, Nivedita; Hersh, Craig P.; Zach, Jordan A.; Schroeder, Joyce; Lynch, David A.; Celli, Bartolome; Washko, George R.

    2013-01-01

    Background: CT scanning is increasingly used to characterize COPD. Although it is possible to obtain CT scan-measured lung lobe volumes, normal ranges remain unknown. Using COPDGene data, we developed reference equations for lobar volumes at maximal inflation (total lung capacity [TLC]) and relaxed exhalation (approximating functional residual capacity [FRC]). Methods: Linear regression was used to develop race-specific (non-Hispanic white [NHW], African American) reference equations for lobar volumes. Covariates included height and sex. Models were developed in a derivation cohort of 469 subjects with normal pulmonary function and validated in 546 similar subjects. These cohorts were combined to produce final prediction equations, which were applied to 2,191 subjects with old GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage II to IV COPD. Results: In the derivation cohort, women had smaller lobar volumes than men. Height positively correlated with lobar volumes. Adjusting for height, NHWs had larger total lung and lobar volumes at TLC than African Americans; at FRC, NHWs only had larger lower lobes. Age and weight had no effect on lobar volumes at TLC but had small effects at FRC. In subjects with COPD at TLC, upper lobes exceeded 100% of predicted values in GOLD II disease; lower lobes were only inflated to this degree in subjects with GOLD IV disease. At FRC, gas trapping was severe irrespective of disease severity and appeared uniform across the lobes. Conclusions: Reference equations for lobar volumes may be useful in assessing regional lung dysfunction and how it changes in response to pharmacologic therapies and surgical or endoscopic lung volume reduction. PMID:23699785

  9. 3D segmentation of lung CT data with graph-cuts: analysis of parameter sensitivities

    NASA Astrophysics Data System (ADS)

    Cha, Jung won; Dunlap, Neal; Wang, Brian; Amini, Amir

    2016-03-01

    Lung boundary image segmentation is important for many tasks including for example in development of radiation treatment plans for subjects with thoracic malignancies. In this paper, we describe a method and parameter settings for accurate 3D lung boundary segmentation based on graph-cuts from X-ray CT data1. Even though previously several researchers have used graph-cuts for image segmentation, to date, no systematic studies have been performed regarding the range of parameter that give accurate results. The energy function in the graph-cuts algorithm requires 3 suitable parameter settings: K, a large constant for assigning seed points, c, the similarity coefficient for n-links, and λ, the terminal coefficient for t-links. We analyzed the parameter sensitivity with four lung data sets from subjects with lung cancer using error metrics. Large values of K created artifacts on segmented images, and relatively much larger value of c than the value of λ influenced the balance between the boundary term and the data term in the energy function, leading to unacceptable segmentation results. For a range of parameter settings, we performed 3D image segmentation, and in each case compared the results with the expert-delineated lung boundaries. We used simple 6-neighborhood systems for n-link in 3D. The 3D image segmentation took 10 minutes for a 512x512x118 ~ 512x512x190 lung CT image volume. Our results indicate that the graph-cuts algorithm was more sensitive to the K and λ parameter settings than to the C parameter and furthermore that amongst the range of parameters tested, K=5 and λ=0.5 yielded good results.

  10. MO-PIS-Exhibit Hall-01: Imaging: CT Dose Optimization Technologies I

    SciTech Connect

    Denison, K; Smith, S

    2014-06-15

    Partners in Solutions is an exciting new program in which AAPM partners with our vendors to present practical “hands-on” information about the equipment and software systems that we use in our clinics. The imaging topic this year is CT scanner dose optimization capabilities. Note that the sessions are being held in a special purpose room built on the Exhibit Hall Floor, to encourage further interaction with the vendors. Dose Optimization Capabilities of GE Computed Tomography Scanners Presentation Time: 11:15 – 11:45 AM GE Healthcare is dedicated to the delivery of high quality clinical images through the development of technologies, which optimize the application of ionizing radiation. In computed tomography, dose management solutions fall into four categories: employs projection data and statistical modeling to decrease noise in the reconstructed image - creating an opportunity for mA reduction in the acquisition of diagnostic images. Veo represents true Model Based Iterative Reconstruction (MBiR). Using high-level algorithms in tandem with advanced computing power, Veo enables lower pixel noise standard deviation and improved spatial resolution within a single image. Advanced Adaptive Image Filters allow for maintenance of spatial resolution while reducing image noise. Examples of adaptive image space filters include Neuro 3-D filters and Cardiac Noise Reduction Filters. AutomA adjusts mA along the z-axis and is the CT equivalent of auto exposure control in conventional x-ray systems. Dynamic Z-axis Tracking offers an additional opportunity for dose reduction in helical acquisitions while SmartTrack Z-axis Tracking serves to ensure beam, collimator and detector alignment during tube rotation. SmartmA provides angular mA modulation. ECG Helical Modulation reduces mA during the systolic phase of the heart cycle. SmartBeam optimization uses bowtie beam-shaping hardware and software to filter off-axis x-rays - minimizing dose and reducing x-ray scatter. The

  11. Low-Dose X-ray CT Reconstruction via Dictionary Learning

    PubMed Central

    Xu, Qiong; Zhang, Lei; Hsieh, Jiang; Wang, Ge

    2013-01-01

    Although diagnostic medical imaging provides enormous benefits in the early detection and accuracy diagnosis of various diseases, there are growing concerns on the potential side effect of radiation induced genetic, cancerous and other diseases. How to reduce radiation dose while maintaining the diagnostic performance is a major challenge in the computed tomography (CT) field. Inspired by the compressive sensing theory, the sparse constraint in terms of total variation (TV) minimization has already led to promising results for low-dose CT reconstruction. Compared to the discrete gradient transform used in the TV method, dictionary learning is proven to be an effective way for sparse representation. On the other hand, it is important to consider the statistical property of projection data in the low-dose CT case. Recently, we have developed a dictionary learning based approach for low-dose X-ray CT. In this paper, we present this method in detail and evaluate it in experiments. In our method, the sparse constraint in terms of a redundant dictionary is incorporated into an objective function in a statistical iterative reconstruction framework. The dictionary can be either predetermined before an image reconstruction task or adaptively defined during the reconstruction process. An alternating minimization scheme is developed to minimize the objective function. Our approach is evaluated with low-dose X-ray projections collected in animal and human CT studies, and the improvement associated with dictionary learning is quantified relative to filtered backprojection and TV-based reconstructions. The results show that the proposed approach might produce better images with lower noise and more detailed structural features in our selected cases. However, there is no proof that this is true for all kinds of structures. PMID:22542666

  12. Low-dose X-ray CT reconstruction via dictionary learning.

    PubMed

    Xu, Qiong; Yu, Hengyong; Mou, Xuanqin; Zhang, Lei; Hsieh, Jiang; Wang, Ge

    2012-09-01

    Although diagnostic medical imaging provides enormous benefits in the early detection and accuracy diagnosis of various diseases, there are growing concerns on the potential side effect of radiation induced genetic, cancerous and other diseases. How to reduce radiation dose while maintaining the diagnostic performance is a major challenge in the computed tomography (CT) field. Inspired by the compressive sensing theory, the sparse constraint in terms of total variation (TV) minimization has already led to promising results for low-dose CT reconstruction. Compared to the discrete gradient transform used in the TV method, dictionary learning is proven to be an effective way for sparse representation. On the other hand, it is important to consider the statistical property of projection data in the low-dose CT case. Recently, we have developed a dictionary learning based approach for low-dose X-ray CT. In this paper, we present this method in detail and evaluate it in experiments. In our method, the sparse constraint in terms of a redundant dictionary is incorporated into an objective function in a statistical iterative reconstruction framework. The dictionary can be either predetermined before an image reconstruction task or adaptively defined during the reconstruction process. An alternating minimization scheme is developed to minimize the objective function. Our approach is evaluated with low-dose X-ray projections collected in animal and human CT studies, and the improvement associated with dictionary learning is quantified relative to filtered backprojection and TV-based reconstructions. The results show that the proposed approach might produce better images with lower noise and more detailed structural features in our selected cases. However, there is no proof that this is true for all kinds of structures. PMID:22542666

  13. Dose reduction and image quality optimizations in CT of pediatric and adult patients: phantom studies

    NASA Astrophysics Data System (ADS)

    Jeon, P.-H.; Lee, C.-L.; Kim, D.-H.; Lee, Y.-J.; Jeon, S.-S.; Kim, H.-J.

    2014-03-01

    Multi-detector computed tomography (MDCT) can be used to easily and rapidly perform numerous acquisitions, possibly leading to a marked increase in the radiation dose to individual patients. Technical options dedicated to automatically adjusting the acquisition parameters according to the patient's size are of specific interest in pediatric radiology. A constant tube potential reduction can be achieved for adults and children, while maintaining a constant detector energy fluence. To evaluate radiation dose, the weighted CT dose index (CTDIw) was calculated based on the CT dose index (CTDI) measured using an ion chamber, and image noise and image contrast were measured from a scanned image to evaluate image quality. The dose-weighted contrast-to-noise ratio (CNRD) was calculated from the radiation dose, image noise, and image contrast measured from a scanned image. The noise derivative (ND) is a quality index for dose efficiency. X-ray spectra with tube voltages ranging from 80 to 140 kVp were used to compute the average photon energy. Image contrast and the corresponding contrast-to-noise ratio (CNR) were determined for lesions of soft tissue, muscle, bone, and iodine relative to a uniform water background, as the iodine contrast increases at lower energy (i.e., k-edge of iodine is 33 keV closer to the beam energy) using mixed water-iodine contrast normalization (water 0, iodine 25, 100, 200, and 1000 HU, respectively). The proposed values correspond to high quality images and can be reduced if only high-contrast organs are assessed. The potential benefit of lowering the tube voltage is an improved CNRD, resulting in a lower radiation dose and optimization of image quality. Adjusting the tube potential in abdominal CT would be useful in current pediatric radiography, where the choice of X-ray techniques generally takes into account the size of the patient as well as the need to balance the conflicting requirements of diagnostic image quality and radiation dose

  14. Image Quality and Radiation Dose for Prospectively Triggered Coronary CT Angiography: 128-Slice Single-Source CT versus First-Generation 64-Slice Dual-Source CT

    PubMed Central

    Gu, Jin; Shi, He-shui; Han, Ping; Yu, Jie; Ma, Gui-na; Wu, Sheng

    2016-01-01

    This study sought to compare the image quality and radiation dose of coronary computed tomography angiography (CCTA) from prospectively triggered 128-slice CT (128-MSCT) versus dual-source 64-slice CT (DSCT). The study was approved by the Medical Ethics Committee at Tongji Medical College of Huazhong University of Science and Technology. Eighty consecutive patients with stable heart rates lower than 70 bpm were enrolled. Forty patients were scanned with 128-MSCT, and the other 40 patients were scanned with DSCT. Two radiologists independently assessed the image quality in segments (diameter >1 mm) according to a three-point scale (1: excellent; 2: moderate; 3: insufficient). The CCTA radiation dose was calculated. Eighty patients with 526 segments in the 128-MSCT group and 544 segments in the DSCT group were evaluated. The image quality 1, 2 and 3 scores were 91.6%, 6.9% and 1.5%, respectively, for the 128-MSCT group and 97.6%, 1.7% and 0.7%, respectively, for the DSCT group, and there was a statistically significant inter-group difference (P ≤ 0.001). The effective doses were 3.0 mSv in the 128-MSCT group and 4.5 mSv in the DSCT group (P ≤ 0.001). Compared with DSCT, CCTA with prospectively triggered 128-MSCT had adequate image quality and a 33.3% lower radiation dose. PMID:27752040

  15. Value of Combined PET/CT for Radiation Planning in CT-Guided Percutaneous Interstitial High-Dose-Rate Single-Fraction Brachytherapy for Colorectal Liver Metastases

    SciTech Connect

    Steffen, Ingo G.; Wust, Peter; Ruehl, Ricarda

    2010-07-15

    Purpose: To determine the additional value of fluorodeoxyglucose-positron emission tomography (PET) for clinical target volume definition in the planning of computed tomography (CT)-guided interstitial brachytherapy for liver metastases. Patients and Methods: A total of 19 patients with liver metastases from colorectal cancer treated in 25 sessions were included in the present study. All patients had undergone fluorodeoxyglucose-PET for patient evaluation before interstitial CT-guided brachytherapy. A contrast-enhanced CT scan of the upper abdomen was obtained for radiation planning. The clinical target volume (CTV) was defined by a radiation oncologist and radiologist. After registration of the CT scan with the PET data set, the target volume was defined again using the fusion images. Results: PET revealed one additional liver lesion that was not visible on CT. The median CT-CTV (defined using CT and magnetic resonance imaging) was 68 cm{sup 3} (range 4-260). The PET/CT-CTV (median, 78 cm{sup 3}; range, 4-273) was significantly larger, with a median gain of 24.5% (interquartile range, 2.1-71.5%; p = .022). An increased CTV was observed in 15 cases and a decrease in 6; in 4 cases, the CT-CTV and PET/CT-CTV were equal. Incomplete dose coverage of PET/CT-CTVs was indicative of early local progression (p = .004); however, CT-based radiation plans did not show significant differences in the local control rates when stratified by dose coverage. Conclusion: Retrospective implementation of fluorodeoxyglucose-PET for CTV specification for CT-guided brachytherapy for colorectal liver metastases revealed a significant change in the CTVs. Additional PET-positive tumor regions with incomplete dose coverage could explain unexpected early local progression.

  16. CT dose equilibration and energy absorption in polyethylene cylinders with diameters from 6 to 55 cm

    SciTech Connect

    Li, Xinhua; Zhang, Da; Liu, Bob

    2015-06-15

    Purpose: ICRU Report No. 87 Committee and AAPM Task Group 200 designed a three-sectional polyethylene phantom of 30 cm in diameter and 60 cm in length for evaluating the midpoint dose D{sub L}(0) and its rise-to-the-equilibrium curve H(L) = D{sub L}(0)/D{sub eq} from computed tomography (CT) scanning, where D{sub eq} is the equilibrium dose. To aid the use of the phantom in radiation dose assessment and to gain an understanding of dose equilibration and energy absorption in polyethylene, the authors evaluated the short (20 cm) to long (60 cm) phantom dose ratio with a polyethylene diameter of 30 cm, assessed H(L) in polyethylene cylinders of 6–55 cm in diameters, and examined energy absorption in these cylinders. Methods: A GEANT4-based Monte Carlo program was used to simulate the single axial scans of polyethylene cylinders (diameters 6–55 cm and length 90 cm, as well as diameter 30 cm and lengths 20 and 60 cm) on a clinical CT scanner (Somatom Definition dual source CT, Siemens Healthcare). Axial dose distributions were computed on the phantom central and peripheral axes. An average dose over the central 23 or 100 mm region was evaluated for modeling dose measurement using a 0.6 cm{sup 3} thimble chamber or a 10 cm long pencil ion chamber, respectively. The short (20 cm) to long (90 cm) phantom dose ratios were calculated for the 30 cm diameter polyethylene phantoms scanned at four tube voltages (80–140 kV) and a range of beam apertures (1–25 cm). H(L) was evaluated using the dose integrals computed with the 90 cm long phantoms. The resultant H(L) data were subsequently used to compute the fraction of the total energy absorbed inside or outside the scan range (E{sub in}/E or E{sub out}/E) on the phantom central and peripheral axes, where E = LD{sub eq} was the total energy absorbed along the z axis. Results: The midpoint dose in the 60 cm long polyethylene phantom was equal to that in the 90 cm long polyethylene phantom. The short-to-long phantom dose

  17. A model of CT dose profiles in Banach space; with applications to CT dosimetry

    NASA Astrophysics Data System (ADS)

    Weir, Victor J.

    2016-07-01

    In this paper the scatter component of computed tomography dose profiles is modeled using the solution to a nonlinear ordinary differential equation. This scatter function is summed with a modeled primary function of approximate trapezoidal shape. The primary dose profile is modeled to include the analytic continuation of the Heaviside step function. A mathematical theory is developed in a Banach space. The modeled function is used to accurately fit data from a 256-slice GE Revolution scanner. A 60 cm long body phantom is assembled and used for data collection with both a pencil chamber and a Farmer-type chamber.

  18. Organ dose conversion coefficients for tube current modulated CT protocols for an adult population

    NASA Astrophysics Data System (ADS)

    Fu, Wanyi; Tian, Xiaoyu; Sahbaee, Pooyan; Zhang, Yakun; Segars, William Paul; Samei, Ehsan

    2016-03-01

    In computed tomography (CT), patient-specific organ dose can be estimated using pre-calculated organ dose conversion coefficients (organ dose normalized by CTDIvol, h factor) database, taking into account patient size and scan coverage. The conversion coefficients have been previously estimated for routine body protocol classes, grouped by scan coverage, across an adult population for fixed tube current modulated CT. The coefficients, however, do not include the widely utilized tube current (mA) modulation scheme, which significantly impacts organ dose. This study aims to extend the h factors and the corresponding dose length product (DLP) to create effective dose conversion coefficients (k factor) database incorporating various tube current modulation strengths. Fifty-eight extended cardiac-torso (XCAT) phantoms were included in this study representing population anatomy variation in clinical practice. Four mA profiles, representing weak to strong mA dependency on body attenuation, were generated for each phantom and protocol class. A validated Monte Carlo program was used to simulate the organ dose. The organ dose and effective dose was further normalized by CTDIvol and DLP to derive the h factors and k factors, respectively. The h factors and k factors were summarized in an exponential regression model as a function of body size. Such a population-based mathematical model can provide a comprehensive organ dose estimation given body size and CTDIvol. The model was integrated into an iPhone app XCATdose version 2, enhancing the 1st version based upon fixed tube current modulation. With the organ dose calculator, physicists, physicians, and patients can conveniently estimate organ dose.

  19. SU-F-18C-12: On the Relationship of the Weighted Dose to the Surface Dose In Abdominal CT - Patient Size Dependency

    SciTech Connect

    Zhou, Y; Scott, A; Allahverdian, J

    2014-06-15

    Purpose: It is possible to measure the patient surface dose non-invasively using radiolucent dosimeters. However, the patient size specific weighted dose remains unknown. We attempted to study the weighted dose to surface dose relationship as the patient size varies in abdominal CT. Methods: Seven abdomen phantoms (CIRS TE series) simulating patients from an infant to a large adult were used. Size specific doses were measured with a 100 mm CT chamber under axial scans using a Siemens Sensation 64 (mCT) and a GE 750 HD. The scanner settings were 120 kVp, 200 mAs with fully opened collimations. Additional kVps (80, 100, 140) were added depending on the phantom sizes. The ratios (r) of the weighted CT dose (Dw) to the surface dose (Ds) were related to the phantom size (L) defined as the diameter resulting the equivalent cross-sectional area. Results: The Dw versus Ds ratio (r) was fitted to a linear relationship: r = 1.083 − 0.007L (R square = 0.995), and r = 1.064 − 0.007L (R square = 0.953), for Siemens Sensation 64 and GE 750 HD, respectively. The relationship appears to be independent of the scanner specifics. Conclusion: The surface dose to the weighted dose ratio decreases linearly as the patient size increases. The result is independent of the scanner specifics. The result can be used to obtain in vivo CT dosimetry in abdominal CT.

  20. Calculation of dose profiles in stereotactic synchrotron microplanar beam radiotherapy in a tissue-lung phantom.

    PubMed

    Company, F Z

    2007-03-01

    Synchrotron x-ray beams with high fluence rate and highly collimated may be used in stereotactic radiotherapy of lung tumours. A bundle of converging monochromatic x-ray beams having uniform microscopic thickness i.e. (microplanar beams) are directed to the center of the tumour, delivering lethal dose to the target volume while sparing normal cells. The proposed technique takes advantage of the hypothesised repair mechanism of capillary cells between alternate microbeam zones, which regenerate the lethally irradiated endothelial cells. The sharply dropping lateral dose of a microbeam provides low scattered dose to the off-target interbeam volume. In the target volume the converging bundle of beams are closely spaced, and relatively high primary and secondary electron doses overlap and produce a high dose region between the beams. This higher and lower dose margins in the target volume allows precise targeting. The advantages of stereotactic microbeam radiotherapy will be lost as the dose between microbeams exceeds the tolerance dose of the dose limiting tissues. Therefore, it is essential to optimize the interbeam doses in off-target volume. The lateral and depth doses of 100 keV microplanar beams are investigated for a single beam and an array of converging microplanar beams in a tissue, lung and tissue-lung phantoms. The EGS5 Monte Carlo code is used to calculate dose profiles at different depths and bundles of beams. The maximum dose on the beam axis (peak) and the minimum interbeam dose (valley) are compared at different energies, depths, bundle sizes, heights, widths and beam spacings. The interbeam dose is calculated at different depths and an isodose map of the phantom is obtained. An acceptable energy region is found for tissue and lung microbeam radiotherapy and a stereotactic microbeam radiotherapy model is proposed for a 4 cm diameter and 1 cm thick tumour on the lung phantom.

  1. HOSVD-Based 3D Active Appearance Model: Segmentation of Lung Fields in CT Images.

    PubMed

    Wang, Qingzhu; Kang, Wanjun; Hu, Haihui; Wang, Bin

    2016-07-01

    An Active Appearance Model (AAM) is a computer vision model which can be used to effectively segment lung fields in CT images. However, the fitting result is often inadequate when the lungs are affected by high-density pathologies. To overcome this problem, we propose a Higher-order Singular Value Decomposition (HOSVD)-based Three-dimensional (3D) AAM. An evaluation was performed on 310 diseased lungs form the Lung Image Database Consortium Image Collection. Other contemporary AAMs operate directly on patterns represented by vectors, i.e., before applying the AAM to a 3D lung volume,it has to be vectorized first into a vector pattern by some technique like concatenation. However, some implicit structural or local contextual information may be lost in th