Application of clinical scanners in rats: experimental carotid imaging using magnetic resonance imaging, spiral computed tomography, and color duplex ultrasound

BACKGROUND AND PURPOSE

Noninvasive small animal imaging allows for reduction of the required numbers of animals in research by providing the possibility of long-term follow-up at various time points. Additionally, correlation to the investigated respective human disease is possible as equivalent equipment is employed. The authors therefore evaluate feasibility and potential of color duplex sonography, computed tomography angiography (CTA), and magnetic resonance angiography (MRA) by the use of clinical scanners for carotid artery imaging in rats.

METHODS

Male Wistar rats (n = 17) were subjected to color duplex sonography, CTA, and MRA of the common carotid artery (CCA) and the carotid bifurcation. Clinical scanners were used for the experiments and optimal parameter settings evaluated accounting for the different size of the animals. The applied imaging methods were analyzed in regard to image quality and practicability in laboratory settings.

RESULTS

The CCA could be clearly displayed by all imaging modalities in all rats. Duplex sonography provided distinct images and reproducible basic functional information. CTA and MRA provided distinct images of the CCA and the carotid bifurcation in both axial and reconstructed 3-dimensional images. The authors further describe different indications for these imaging methods regarding spatial resolution, acquisition times, possible scanning range, and application of contrast agent.

CONCLUSIONS

Color duplex sonography, CTA, and MRA are all feasible methods for imaging of the carotid arteries in rats. Images of sufficient clarity and resolution could be obtained by the use of clinical scanners, yielding information about vessel size, direction of blood flow, and adjacent structures. Further studies need to be performed that address investigations of pathological conditions such as flow disturbances or vessel stenosis.

[A new method of evaluating helical artifact by image subtraction technique]

This paper proposes a new quantitative method of appraising the helical artifact generated by computed tomography (CT) images by helical scan. The quantities-appraisal method of the helical artifact uses as a sample image, the binarization image, which performs the threshold operation. Therefore, results may differ among observers and are lacking in objectivity. We devised a procedure (subtraction technique) that uses the subtraction process as a method of appraising the helical artifact that does not a perform a threshold operation, and evaluated this procedure. As compared with an area technique, a subtraction technique can divide a helical artifact into a plus CT value (Over Level) and a minus CT value (Under Level) and can evaluate them. This provides excellent repeatability and objectivity. Moreover, since CT value data are maintained, the quality of an artifact can also be evaluated, making this a very useful procedure. By using the subtraction technique, new information will be found by evaluating helical artifacts.

Helical cone beam CT with an asymmetrical detector

If a multislice or other area detector is shifted to one side to cover a larger field of view, then the data are truncated on one side. We propose a method to restore the missing data in helical cone-beam acquisitions that uses measured data on the longer side of the asymmetric detector array. The method is based on the idea of complementary rays, which is well known in fan beam geometry; in this paper we extend this concept to the cone-beam case. Different cases of complementary data coverage and dependence on the helical pitch are considered. The proposed method is used in our prototype 16-row CT scanner with an asymmetric detector and a 700 mm field of view. For evaluation we used scanned body phantom data and computer-simulated data. To simulate asymmetric truncation, the full, symmetric datasets were truncated by dropping either 22.5% or 45% from one side of the detector. Reconstructed images from the prototype scanner with the asymmetrical detector show excellent image quality in the extended field of view. The proposed method allows flexible helical pitch selection and can be used with overscan, short-scan, and super-short-scan reconstructions.

A general exact reconstruction for cone-beam CT via backprojection-filtration

In this paper, we prove a generalized backprojection-filtration formula for exact cone-beam image reconstruction with an arbitrary scanning locus. Our proof is independent of the shape of the scanning locus, as long as the object is contained in a region where there is a chord through any interior point. As special cases, this generalized formula can be applied with cone-beam scanning along nonstandard spiral and saddle curves, as well as in an n-PI window setting. The algorithmic implementation and numerical results are described to support the correctness of our general claim.

EnPiT: filtered back-projection algorithm for helical CT using an n-Pi acquisition

In this paper, we formulate a reconstruction algorithm for an n-Pi acquisition, where n can be any positive odd integer. The algorithm is a generalization of the method presented in (Bontus et al. 2003). It is based on the results obtained by Katsevich (2004). For the algorithm, different sets of filter-lines have to be defined. We describe the variation of these lines along the detector in some detail, before we discuss, how the method gives all Radon-plane contributions the correct weighting. The different sets of filter-lines are all contained within the n-Pi window, such that a practical realization is possible. Reconstruction results, which we present in the final section, show convincing image quality.

Performance characterization of megavoltage computed tomography imaging on a helical tomotherapy unit

Helical tomotherapy is an innovative means of delivering IGRT and IMRT using a device that combines features of a linear accelerator and a helical computed tomography (CT) scanner. The HI-ART II can generate CT images from the same megavoltage x-ray beam it uses for treatment. These megavoltage CT (MVCT) images offer verification of the patient position prior to and potentially during radiation therapy. Since the unit uses the actual treatment beam as the x-ray source for image acquisition, no surrogate telemetry systems are required to register image space to treatment space. The disadvantage to using the treatment beam for imaging, however, is that the physics of radiation interactions in the megavoltage energy range may force compromises between the dose delivered and the image quality in comparison to diagnostic CT scanners. The performance of the system is therefore characterized in terms of objective measures of noise, uniformity, contrast, and spatial resolution as a function of the dose delivered by the MVCT beam. The uniformity and spatial resolutions of MVCT images generated by the HI-ART II are comparable to that of diagnostic CT images. Furthermore, the MVCT scan contrast is linear with respect to the electron density of material imaged. MVCT images do not have the same performance characteristics as state-of-the art diagnostic CT scanners when one objectively examines noise and low-contrast resolution. These inferior results may be explained, at least partially, by the low doses delivered by our unit; the dose is 1.1 cGy in a 20 cm diameter cylindrical phantom. In spite of the poorer low-contrast resolution, these relatively low-dose MVCT scans provide sufficient contrast to delineate many soft-tissue structures. Hence, these images are useful not only for verifying the patient's position at the time of therapy, but they are also sufficient for delineating many anatomic structures. In conjunction with the ability to recalculate radiotherapy doses on these images, this enables dose guidance as well as image guidance of radiotherapy treatments.

[Evaluation and comparison of dose profiles and patient doses among X-ray CT scanners]

The increased clinical use of multi-detector-row CT (MDCT) may result in increased radiation doses for patients. The objective of this study was to compare radiation dose profiles between MDCT with 16 data acquisition systems, MDCT with 4 data acquisition systems, and single-detector-row CT (SDCT), and to compare effective doses among them to measure specific organ doses. When comparing radiation dose profiles on the Z-axis, doses outside the scanning range increased, especially when a 20 mm X-ray beam width was used. Effective doses also were higher with MDCT (low helical pitch) than with SDCT (helical pitch 1.0:1), but were not higher with MDCT (high helical pitch) than with SDCT (helical pitch 1.0:1). When a 20 mm X-ray beam width or high helical pitch was used, scanning time was shortened, but doses outside the scanning range were increased. When the standard deviation (SD) is the same, there is not much difference between SDCT and MDCT in terms of effective doses if the helical pitch is 1.0:1. It can be expected that X-ray over-wrap under low helical pitch and incorrect parameter setting cause increased radiation dose to the patient. Therefore, high helical pitch should be used if it is possible to disregard the influence of image noise. It is important to be cautious in regard to patient radiation dose when MDCT is used, and it is necessary to perform high-quality examinations at as low a dose as possible. Optimization of the scan parameters is an important issue for the future.

PI-line-based image reconstruction in helical cone-beam computed tomography with a variable pitch

Current applications of helical cone-beam computed tomography (CT) involve primarily a constant pitch where the translating speed of the table and the rotation speed of the source-detector remain constant. However, situations do exist where it may be more desirable to use a helical scan with a variable translating speed of the table, leading a variable pitch. One of such applications could arise in helical cone-beam CT fluoroscopy for the determination of vascular structures through real-time imaging of contrast bolus arrival. Most of the existing reconstruction algorithms have been developed only for helical cone-beam CT with constant pitch, including the backprojection-filtration (BPF) and filtered-backprojection (FBP) algorithms that we proposed previously. It is possible to generalize some of these algorithms to reconstruct images exactly for helical cone-beam CT with a variable pitch. In this work, we generalize our BPF and FBP algorithms to reconstruct images directly from data acquired in helical cone-beam CT with a variable pitch. We have also performed a preliminary numerical study to demonstrate and verify the generalization of the two algorithms. The results of the study confirm that our generalized BPF and FBP algorithms can yield exact reconstruction in helical cone-beam CT with a variable pitch. It should be pointed out that our generalized BPF algorithm is the only algorithm that is capable of reconstructing exactly region-of-interest image from data containing transverse truncations.

Image reconstruction and image quality evaluation for a 64-slice CT scanner with z-flying focal spot

We present a theoretical overview and a performance evaluation of a novel z-sampling technique for multidetector row CT (MDCT), relying on a periodic motion of the focal spot in the longitudinal direction (z-flying focal spot) to double the number of simultaneously acquired slices. The z-flying focal spot technique has been implemented in a recently introduced MDCT scanner. Using 32 x 0.6 mm collimation, this scanner acquires 64 overlapping 0.6 mm slices per rotation in its spiral (helical) mode of operation, with the goal of improved longitudinal resolution and reduction of spiral artifacts. The longitudinal sampling distance at isocenter is 0.3 mm. We discuss in detail the impact of the z-flying focal spot technique on image reconstruction. We present measurements of spiral slice sensitivity profiles (SSPs) and of longitudinal resolution, both in the isocenter and off-center. We evaluate the pitch dependence of the image noise measured in a centered 20 cm water phantom. To investigate spiral image quality we present images of an anthropomorphic thorax phantom and patient scans. The full width at half maximum (FWHM) of the spiral SSPs shows only minor variations as a function of the pitch, measured values differ by less than 0.15 mm from the nominal values 0.6, 0.75, 1, 1.5, and 2 mm. The measured FWHM of the smallest slice ranges between 0.66 and 0.68 mm at isocenter, except for pitch 0.55 (0.72 mm). In a centered z-resolution phantom, bar patterns up to 15 lp/cm can be visualized independent of the pitch, corresponding to 0.33 mm longitudinal resolution. 100 mm off-center, bar patterns up to 14 lp/cm are visible, corresponding to an object size of 0.36 mm that can be resolved in the z direction. Image noise for constant effective mAs is almost independent of the pitch. Measured values show a variation of less than 7% as a function of the pitch, which demonstrates correct utilization of the applied radiation dose at any pitch. The product of image noise and square root of the slice width (FWHM of the respective SSP) is the same constant for all slices except 0.6 mm. For the thinnest slice, relative image noise is increased by 17%. Spiral windmill-type artifacts are effectively suppressed with the z-flying focal spot technique, which has the potential to maintain a low artifact level up to pitch 1.5, in this way increasing the maximum volume coverage speed that can be clinically used.

[Characteristic of evaluation of new image filter devised for improvement of workflow in CT examination]

In this study, we processed reconstructed images with a new image filter (Siemens Medical Systems, Adaptive Image Filter: AIF). As one of its characteristics, the filter uses low-pass filtering. When an image that emphasizes a high-frequency element is changed to one with a reduced high-frequency element, an image suitable for clinical use can be obtained. For the resolving characteristic and the noise characteristic, we evaluated the degree of transition, using the modulation transfer factor (MTF) and Wiener spectrum (WS). Moreover, we used the signal-to-noise ratio (SNR) to examine the total loss of signal detection capability after use of the AIF. The results showed that, when we changed to images using the AIF and made it the same level as B30 and U40, we had to hold down the kernel level to at least B60 and U80. The use of an image filter did not recognize less of an SNR in comparison with the reconstruction image. In this study, changes in detailed characteristics of the image and SNR could be evaluated objectively using the AIF. As for the effective method by AIF that raw data isn't used for is available for the control of an image (times) using reconstruction and the change of an image on database. Therefore, we consider the AIF useful to improve workflow in CT examinations.

Photon counting computed tomography: concept and initial results

A concept of a photon counting cone beam CT is proposed. The system uses a new Multi Slit Multi Slice (MSMS) cone beam acquisition geometry utilizing a linear array photon counting detectors. The MSMS cone beam acquisition is a direct analogy of the scanning multislit acquisition used in projection x-ray imaging. This geometry provides a CT imaging with dose efficient scatter rejection and allows for using available photon counting detectors. The microchannel plate (MCP) detector is proposed as a linear array photon counting detector for MSMS cone beam CT system. Initial testing of the MCP detector for CT application was performed. The field of view of the prototype MCP detector is 60 mm. A delay line position encoding electronics was used. The electronics has a single channel input for evaluation of events from the entire detector field of view. This limits the system count rate at 2 x 10(5) count/s. The spatial resolution of this detector is 80 microm FWHM at 40 kVp and 200 microm FWHM at 90 kVp tube voltages. The detector noise in CT projections is less than 1 count/pixel for the 80 microm pixel size. The CT projections contain quantum-limited and scatter free signal. Images of a contrast phantom and a small animal were acquired at 50 kVp and 80 kVp tube voltages. The CT numbers for different contrast elements were calculated for a given x-ray spectrum and compared with experimental values. The quantum efficiency of the current detector is 56% at 90 kVp, which is suboptimal because of the large channel diameter (25 microm) of these MCPs. The MCPs with smaller channels and higher efficiencies are being tested. The quantum efficiency was measured to be 70% for a new MCP with 5 microm channel diameter. Design parameters of a clinically applicable photon counting MSMS cone beam CT for breast imaging was evaluated. System uses 20 cm field of view MCP detectors based on 5 microm channel MCPs and high count rate ASIC electronics. It was concluded that the MSMS cone beam CT with a photon counting MCP detector is feasible for volume breast imaging.

Urinary calculi: improved detection and characterization with thin-slice multidetector CT

The aim of this study was to assess the effect of reconstructed slice thickness on the detection and characterization of human urinary calculi on a multidetector helical CT scanner. Nineteen human urinary calculi of various chemical composition measuring 1.0-3.7 mm were embedded into agar in a chamber of a nylon body phantom. The phantom was imaged with a four detector-row CT scanner. The number of detected calculi increased as the reconstructed slice thickness decreased. Measured diameters and density of the visible calculi decreased as the slice thickness increased. The results of the present study support the use of thin reconstructed slices to detect and characterize urinary calculi.

Percutaneous radiofrequency treatment of osteoid osteoma using cool-tip electrodes

OBJECTIVES

To report our experience with percutaneous cool-tip radiofrequency ablation of osteoid osteomas and to evaluate clinical outcome.

METHODS AND MATERIAL

Forty-one patients with clinically and radiologically suspected osteoid osteoma were seen over a 48-month period (27 males and 14 females with a mean age of 18.7 years; range 5-43 years). Thirty-eight patients were treated by computed tomography (CT)-guided percutaneous radiofrequency ablation. The procedure was performed under regional or general anaesthesia. After location of the nidus, a 14G-bone biopsy needle is introduced into the nidus. Sampling is performed with a 17G-bone biopsy needle using a coaxial technique. The radiofrequency needle with a 10mm active tip (cool-tip) is inserted through the biopsy needle and is connected to the radiofrequency generator for 6-8 min.

RESULTS

Primary success was obtained in 37 patients (97%) with a 100% secondary success rate. All patients are currently pain-free. No major complications occurred. Patients could resume unrestricted normal activity within 24 h.

CONCLUSIONS

Percutaneous radiofrequency ablation of osteoid osteomas is an efficient and safe method that can be considered the procedure of choice for most cases.

Cone beam volumetric tomography vs. medical CT scanners

This article describes the benefits and dental applications of a three-dimensional imaging technique known as cone beam volumetric tomography (CBVT). When compared to conventional medical CT scanners, CBVT is more accurate, requires less radiation, captures the maxilla and mandible in a single rotation of the X-ray source, and is cost-effective for patients. Here we describe the dental applications of CBVT and its advantages when placing dental implants.

[Diagnostic imaging of lung cancer on multislice CT (MDCT)]

Helical CT, and the newest technological development, multislice CT (multidetector CT: MDCT), have revolutionized the diagnostic approach to diseases of the chest including lung cancer. There are several factors that contribute to the important role of multislice CT scanning of the chest: (1) data acquisition is so rapid that the scanning of the entire lung can be performed during a single breath-hold period; (2) continuous acquisition of thin slices allows the improvement of the image quality of multiplanar reconstruction of thoracic abnormalities; (3) MDCT may help reduce the radiation dose, so that, compared to conventional or single-slice helical CT, the radiation dose is lowered with comparable image quality. The advantages of MDCT include both improved nodule detection and nodule characterization on lung cancer screening programs, because the entire lung can be scanned with thin slice in a single breath-hold without an intersection gap. In the evaluation of lung cancer, MDCT will allow improved detection of pleural dissemination and hilar lymph node adenopathy because of the continuous and narrow scan collimation.

Intraoperative imaging of zygomaticomaxillary complex fractures using a 3D C-arm system

After preclinical studies and evaluation of radiation exposures, intraoperative three-dimensional (3D) C-arm based imaging is now available for the facial skeleton. Fourteen patients admitted for surgical treatment of zygomaticomaxillary complex (ZMC) fractures were included in the study. Preoperative diagnostics and surgical treatment were performed as usual. Intraoperatively, after open reduction, a cone-beam computed tomography (CBCT) dataset was generated using the SIREMOBIL Iso-C3D (Siemens Medical Solutions, Erlangen, Germany). After DICOM-import in eFilm Workstation axial, coronal and sagittal reconstructions were evaluated by five examiners with the help of six defined criteria. In our study, secondary reconstructions were available after 6 min, excluding the time needed for the evaluation of the images. Especially the positioning of the isocentre of the SIREMOBIL Iso-C3D proved to be uncomplicated. Because of the size of the datasets, assessment of the symmetry of the malar projection proved difficult. Best scoring results were found regarding the visualization of the fragment position, bony anchorage of the screws and the fitting of the plates. Remarkable was the low level of metal artefacts in primary and secondary reconstructions. In conclusion, our results demonstrate intraoperative CBCT using the SIREMOBIL Iso-C3D suitable for assessment of postoperative results following ZMC reduction.

The effect of z overscanning on patient effective dose from multidetector helical computed tomography examinations

z overscanning in multidetector (MD) helical CT scanning is prerequisite for the interpolation of acquired data required during image reconstruction and refers to the exposure of tissues beyond the boundaries of the volume to be imaged. The aim of the present study was to evaluate the effect of z overscanning on the patient effective dose from helical MD CT examinations. The Monte Carlo N-particle radiation transport code was employed in the current study to simulate CT exposure. The validity of the Monte Carlo simulation was verified by (a) a comparison of calculated and measured standard computed tomography dose index (CTDI) dosimetric data, and (b) a comparison of calculated and measured dose profiles along the z axis. CTDI was measured using a pencil ionization chamber and head and body CT phantoms. Dose profiles along the z axis were obtained using thermoluminescence dosimeters. A commercially available mathematical anthropomorphic phantom was used for the estimation of effective doses from four standard CT examinations, i.e., head and neck, chest, abdomen and pelvis, and trunk studies. Data for both axial and helical modes of operation were obtained. In the helical mode, z overscanning was taken into account. The calculated effective dose from a CT exposure was normalized to CTDI(free in air). The percentage differences in the normalized effective dose between contiguous axial and helical scans with pitch = 1, may reach 13.1%, 35.8%, 29.0%, and 21.5%, for head and neck, chest, abdomen and pelvis, and trunk studies, respectively. Given that the same kilovoltage and tube load per rotation were used in both axial and helical scans, the above differences may be attributed to z overscanning. For helical scans with pitch = 1, broader beam collimation is associated with increased z overscanning and consequently higher normalized effective dose value, when other scanning parameters are held constant. For a given beam collimation, the selection of a higher value of reconstructed image slice width increases the normalized effective dose. In conclusion, z overscanning may significantly affect the patient effective dose from CT examinations performed on MD CT scanners. Therefore, an estimation of the patient effective dose from MD helical CT examinations should always take into consideration the effect of z overscanning.

An approximate short scan helical FDK cone beam algorithm based on nutating curved surfaces satisfying the Tuy's condition

Traditionally, short scan helical FDK algorithms have been implemented based on horizontal transaxial slices. However, not every point on the horizontal transaxial slice satisfies Tuy's condition for the corresponding (pi+fan angle) segment of helix, which means that some points on the horizontal slices are incompletely sampled and are impossible to be exactly reconstructed. In this paper, we propose and implement an improved but still approximate short scan helical cone beam FDK algorithm based on nutating curved surfaces satisfying the Tuy's condition. This surface is defined by averaging PI surfaces emanating the initial and final source points of a (pi+fan angle) segment of helix. One of the key characteristics of the surface is that every point on it satisfies the Tuy's condition for the corresponding (pi+fan angle) segment of helix, which means that we can potentially reconstruct every point on the surface exactly. This difference makes the proposed algorithm deliver a better-reconstructed image quality while requiring a smaller detector area than that of traditional FDK methods based on horizontal transaxial slices. Another characteristic of the proposed surface is that every point within the helix belongs to one and only one such surface. Therefore, the location of the short scan segment for the reconstruction of a point in Cartesian coordinate could be precalculated and stored in a look-up table. This enables us to perform reconstruction directly on rectangular grids. We compare the performance of the improved FDK algorithm with that of a quasi-exact algorithm based on data combination technique. The simulation results show that the reconstructed image quality of these two methods is similar.

Application of limited cone beam computed tomography to clinical assessment of alveolar bone grafting: a preliminary report

OBJECTIVES

The aim of this study was to demonstrate the clinical applicability of limited cone beam computed tomography (Dental 3D-CT) for assessment of bone-grafted alveolar cleft.

PATIENTS AND METHODS

Seventeen bone bridges were examined after alveolar bone grafting in 13 patients with cleft lip and palate. All bone bridges, including cleft-adjacent teeth, were examined by plain radiography and the Dental 3D-CT imaging system.

RESULTS

The plain radiographs showed the approximate condition of the bone bridge and cleft-adjacent teeth. The Dental 3D-CT images clearly showed precise three-dimensional (3D) morphology of the bone bridge, 3D relationships between the bone bridge and the roots of cleft-adjacent teeth, and their periodontal condition. In addition, the conditions surrounding dental implants installed in the bone bridge could be observed three-dimensionally.

CONCLUSIONS

The results indicate that the Dental 3D-CT imaging system is suitable for clinical assessment of alveolar bone grafting before and after installation of dental implants or orthodontic treatment of the cleft-adjacent teeth.

Multislice CT: 64 slices and beyond

Since the first introduction of 4-slice multislice computed tomography (MSCT) more than 6 years ago, MSCT imaging has achieved widespread acceptance and became a standard of care in routine clinical practice by offering high-speed, non-invasive, thin-slice diagnostic scanning for a wide range of clinical applications in radiology and cardiology. In the past year, the industry has witnessed an explosive increase in the amount of data obtained by MSCT and in the number at acquired slices to 32 and 64. While some experts have argued that a 16-slice system is sufficient from a practical standpoint, a closer examination of 32- and 64-slice systems offers new and superior clinical benefits over and above 16-slice technology, especially in imaging of the coronary arteries and in multiphase and functional studies. With the introduction of 32-slice computed tomography (CT) systems, the routinely acquired slice thicknesses have been reduced to 0.5 mm and 1 mm. At these slice thickness levels, it is possible to acquire isotropic volume data sets in all CT scans. Recently, diagnosis based on isotropic volume data has become the standard in CT imaging as it offers far greater clinical benefits than previous 16-slice CT technology. While many of the clinical benefits of a 64-slice CT system center around imaging the heart, there are several distinct areas in the radiology practice that benefit as well. One key area is in the field of interventional neuroradiology and the ability to separate venous from arterial flow using computed tomography angiography (CTA). The evolution of MSCT has opened up new frontiers in diagnostic imaging that were unimaginable just a few years ago.

Measuring Coronary Calcium on CT Images Adjusted for Attenuation Differences

PURPOSE

To quantify scanner and participant variability in attenuation values for computed tomographic (CT) images assessed for coronary calcium and define a method for standardizing attenuation values and calibrating calcium measurements.

MATERIALS AND METHODS

Institutional review board approval and participant informed consent were obtained at all study sites. An image attenuation adjustment method involving the use of available calibration phantom data to define standard attenuation values was developed. The method was applied to images from two population-based multicenter studies: the Coronary Artery Risk Development in Young Adults study (3041 participants) and the Multi-Ethnic Study of Atherosclerosis (6814 participants). To quantify the variability in attenuation, analysis of variance techniques were used to compare the CT numbers of standardized torso phantom regions across study sites, and multivariate linear regression models of participant-specific calibration phantom attenuation values that included participant age, race, sex, body mass index (BMI), smoking status, and site as covariates were developed. To assess the effect of the calibration method on calcium measurements, Pearson correlation coefficients between unadjusted and attenuation-adjusted calcium measurements were computed. Multivariate models were used to examine the effect of sex, race, BMI, smoking status, unadjusted score, and site on Agatston score adjustments.

RESULTS

Mean attenuation values (CT numbers) of a standard calibration phantom scanned beneath participants varied significantly according to scanner and participant BMI (P < .001 for both). Values were lowest for Siemens multi-detector row CT scanners (110.0 HU), followed by GE-Imatron electron-beam (116.0 HU) and GE LightSpeed multi-detector row scanners (121.5 HU). Values were also lower for morbidly obese (BMI, > or =40.0 kg/m(2)) participants (108.9 HU), followed by obese (BMI, 30.0-39.9 kg/m(2)) (114.8 HU), overweight (BMI, 25.0-29.9 kg/m(2)) (118.5 HU), and normal-weight or underweight (BMI, <25.0 kg/m(2)) (120.1 HU) participants. Agatston score calibration adjustments ranged from -650 to 1071 (mean, -8 +/- 50 [standard deviation]) and increased with Agatston score (P < .001). The direction and magnitude of adjustment varied significantly according to scanner and BMI (P < .001 for both) and were consistent with phantom attenuation results in that calibration resulted in score decreases for images with higher phantom attenuation values.

CONCLUSION

Image attenuation values vary by scanner and participant body size, producing calcium score differences that are not due to true calcium burden disparities. Use of calibration phantoms to adjust attenuation values and calibrate calcium measurements in research studies and clinical practice may improve the comparability of such measurements between persons scanned with different scanners and within persons over time.

Geometric misalignment and calibration in cone-beam tomography

We present a new high-precision method for the geometric calibration in cone-beam computed tomography. It is based on a Fourier analysis of the projection-orbit data, recorded with a flat-panel area detector, of individual point-like objects. For circular scan trajectories the complete set of misalignment parameters which determine the deviation of the detector alignment from the ideal scan geometry are obtained from explicit analytic expressions. To derive these expressions we show how to disentangle the problems of calculating misalignment parameters and point coordinates. The calculation of the coordinates of the point objects inside the scanned volume, in units of the distance from the focal spot to the center of rotation, is then possible analytically likewise. We simulate point-projection data on a misaligned detector with various amounts of randomness added to mimic measurement uncertainties. This data is then employed in our calibration to validate the method by comparing the resulting misalignment parameters and point coordinates to the known true ones. We also present our implementation and results for the geometric calibration of micro-CT systems. The effectiveness of the corresponding misalignment correction in reducing image artifacts is exemplified by reconstructed micro-CT images.

The influence of antiscatter grids on soft-tissue detectability in cone-beam computed tomography with flat-panel detectors

The influence of antiscatter x-ray grids on image quality in cone-beam computed tomography (CT) is evaluated through broad experimental investigation for various anatomical sites (head and body), scatter conditions (scatter-to-primary ratio (SPR) ranging from approximately 10% to 150%), patient dose, and spatial resolution in three-dimensional reconstructions. Studies involved linear grids in combination with a flat-panel imager on a system for kilovoltage cone-beam CT imaging and guidance of radiation therapy. Grids were found to be effective in reducing x-ray scatter "cupping" artifacts, with heavier grids providing increased image uniformity. The system was highly robust against ring artifacts that might arise in CT reconstructions as a result of gridline shadows in the projection data. The influence of grids on soft-tissue detectability was evaluated quantitatively in terms of absolute contrast, voxel noise, and contrast-to-noise ratio (CNR) in cone-beam CT reconstructions of 16 cm "head" and 32 cm "body" cylindrical phantoms. Imaging performance was investigated qualitatively in observer preference tests based on patient images (pelvis, abdomen, and head-and-neck sites) acquired with and without antiscatter grids. The results suggest that although grids reduce scatter artifacts and improve subject contrast, there is little strong motivation for the use of grids in cone-beam CT in terms of CNR and overall image quality under most circumstances. The results highlight the tradeoffs in contrast and noise imparted by grids, showing improved image quality with grids only under specific conditions of high x-ray scatter (SPR> 100%), high imaging dose (Dcenter> 2 cGy), and low spatial resolution (voxel size > or = 1 mm).