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Cauley KA, Hu Y, Fielden SW. Head CT: Toward Making Full Use of the Information the X-Rays Give. AJNR Am J Neuroradiol 2021; 42:1362-1369. [PMID: 34140278 DOI: 10.3174/ajnr.a7153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 12/13/2022]
Abstract
Although clinical head CT images are typically interpreted qualitatively, automated methods applied to routine clinical head CTs enable quantitative assessment of brain volume, brain parenchymal fraction, brain radiodensity, and brain radiomass. These metrics gain clinical meaning when viewed relative to a reference database and expressed as quantile regression values. Quantitative imaging data can aid in objective reporting and in the identification of outliers, with possible diagnostic implications. The comparison to a reference database necessitates standardization of head CT imaging parameters and protocols. Future research is needed to learn the effects of virtual monochromatic imaging on the quantitative characteristics of head CT images.
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Affiliation(s)
- K A Cauley
- From the Department of Radiology (K.A.C.), Geisinger Medical Center, Danville, Pennsylvania
| | - Y Hu
- Department of Biomedical & Translational Informatics (Y.H.), Geisinger Medical Center, Danville, Pennsylvania
| | - S W Fielden
- Geisinger Autism & Developmental Medicine Institute (S.W.F.), Lewisburg, Pennsylvania
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Cauley KA, Yorks PJ, Flora S, Fielden SW. The effects of the skull on CT imaging of the brain: a skull and brain phantom study. Br J Radiol 2021; 94:20200714. [PMID: 33533635 DOI: 10.1259/bjr.20200714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the effects of beam hardening by the skull on the measured radiodensity of the brain. To test a hypothesis that these effects of beam hardening are decreased using a monochromatic energy source. METHODS Selected clinical cases were reviewed in illustration. An anthropomorphic skull and brain phantom was created and scanned in a clinical CT scanner with skull, without skull, and with hemicraniectomy. The effects of beam hardening were illustrated by scanning the phantom with mono- and poly-chromatic X-ray sources. RESULTS In clinical cases, the HU values of the brain were consistently lower when the X-ray beam traversed the skull than when it did not. An anthropomorphic skull-and-brain phantom further demonstrated these effects, which were evident with a polychromatic energy source and absent with a virtual monochromatic energy source. CONCLUSIONS Beam hardening by the skull lowers the measured HU values of the brain. The effects, which can impact quantitative imaging, may be mitigated by a virtual monochromatic energy source. ADVANCES IN KNOWLEDGE Beam hardening by the skull lowers the measured radiodensity of the brain. The effects may be mitigated by a virtual monochromatic energy source.
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Affiliation(s)
- Keith A Cauley
- Department of Radiology, Geisinger Medical Center, Danville, PA, USA
| | - Patrick J Yorks
- Department of Medical Health Physics, Geisinger Medical Center, Danville, PA, USA
| | - Sarah Flora
- Department of Radiology, Geisinger Medical Center, Danville, PA, USA
| | - Samuel W Fielden
- Geisinger Autism & Developmental Medicine Institute, Lewisburg, PA, USA
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Zhu Y, Pi Z, Zhou H, Li Z, Lei F, Hui J, Zhang X, Xie J, Liang Y. Imaging pediatric acute head trauma using 100-kVp low dose CT with adaptive statistical iterative reconstruction (ASIR-V) in single rotation on a 16 cm wide-detector CT. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2021; 29:517-527. [PMID: 33814483 DOI: 10.3233/xst-210856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To demonstrate the ability of achieving low dose and high-quality head CT images for children with acute head trauma using 100 kVp and adaptive statistical iterative reconstruction (ASIR-V) algorithm in single rotation on a 16 cm wide-detector system. MATERIALS AND METHODS We retrospectively analyzed the CT dose index (CTDI) and image quality of 104 children aged 0-6 years with acute head trauma (1 hour -3 days) in two groups: Group 1(n = 50) on a 256-row CT with single rotation at a reduced-dose of 100 kVp/240 mA and reconstructed using ASIR-V at 70%level; Group 2(n = 54) on a 64-row CT with multiple rotations at a standard dose of 120 kVp/ 180mA and reconstructed using a conventional filtered back-projection (FBP). Both groups used the 0.5 s/r axial scan mode. CT dose index (CTDI) and quantitative image quality measurements were compared using the Student t test; qualitative image quality comparison was carried out using Mann-Whitney rank test and the inter-reviewer agreement was evaluated using Kappa test. RESULTS The exposure time was 0.5 s for Group 1 and 3.27±0.29 s for Group 2. The CTDI in Group 1 was 9.74±0.86mGy, 36.38%lower than the 15.31mGy in Group 2 (p < 0.001). Group 1 and Group 2 had similar artifact index (2.06±1.06 vs. 2.37±1.18) in the cerebellar hemispheres, and similar contrast-to-noise ratio (2.32±0.83 vs. 1.69±0.68), (1.47±0.72 vs. 1.10±0.43) respectively for cerebellum and thalamus (p > 0.05). Image quality was acceptable for diagnosis, and motion artifacts were reduced in Group 1 (p < 0.001). CONCLUSION Single rotation CT with 100 kVp and 70%ASIR-V on 16 cm wide-detector CT reduces radiation dose and motion artifacts for children with acute head trauma without compromising diagnostic quality as compared with standard dose protocol. Thus, it provides a novel imaging method in management of pediatric acute head trauma.
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Affiliation(s)
- Yanan Zhu
- Medical Imaging Centre, Affiliated Hospital of Ankang University (Ankang Central Hospital), Ankang, China
| | - Zhian Pi
- Medical Imaging Centre, Affiliated Hospital of Ankang University (Ankang Central Hospital), Ankang, China
| | - Heping Zhou
- Medical Imaging Centre, Affiliated Hospital of Ankang University (Ankang Central Hospital), Ankang, China
| | - Zhengjun Li
- Medical Imaging Centre, Affiliated Hospital of Ankang University (Ankang Central Hospital), Ankang, China
| | - Faqing Lei
- Medical Imaging Centre, Affiliated Hospital of Ankang University (Ankang Central Hospital), Ankang, China
| | - Jianjun Hui
- Emergency Department, Affiliated Hospital of Ankang University (Ankang Central Hospital), Ankang, China
| | - Ximeng Zhang
- Medical Imaging Centre, Affiliated Hospital of Ankang University (Ankang Central Hospital), Ankang, China
| | - Juanping Xie
- School of Medicine, Ankang University, Ankang, China
| | - Yukun Liang
- Medical Imaging Centre, Affiliated Hospital of Ankang University (Ankang Central Hospital), Ankang, China
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Irimia A, Maher AS, Rostowsky KA, Chowdhury NF, Hwang DH, Law EM. Brain Segmentation From Computed Tomography of Healthy Aging and Geriatric Concussion at Variable Spatial Resolutions. Front Neuroinform 2019; 13:9. [PMID: 30936828 PMCID: PMC6431646 DOI: 10.3389/fninf.2019.00009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 02/05/2019] [Indexed: 12/21/2022] Open
Abstract
When properly implemented and processed, anatomic T 1-weighted magnetic resonance imaging (MRI) can be ideal for the noninvasive quantification of white matter (WM) and gray matter (GM) in the living human brain. Although MRI is more suitable for distinguishing GM from WM than computed tomography (CT), the growing clinical use of the latter technique has renewed interest in head CT segmentation. Such interest is particularly strong in settings where MRI is unavailable, logistically unfeasible or prohibitively expensive. Nevertheless, whereas MRI segmentation is a sophisticated and technically-mature research field, the task of automatically classifying soft brain tissues from CT remains largely unexplored. Furthermore, brain segmentation methods for MRI hold considerable potential for adaptation and application to CT image processing. Here we demonstrate this by combining probabilistic, atlas-based classification with topologically-constrained tissue boundary refinement to delineate WM, GM and cerebrospinal fluid (CSF) from head CT images. The feasibility and utility of this approach are revealed by comparison of MRI-only vs. CT-only segmentations in geriatric concussion victims with both MRI and CT scans. Comparison of the two segmentations yields mean Sørensen-Dice coefficients of 85.5 ± 4.6% (WM), 86.7 ± 5.6% (GM) and 91.3 ± 2.8% (CSF), as well as average Hausdorff distances of 3.76 ± 1.85 mm (WM), 3.43 ± 1.53 mm (GM) and 2.46 ± 1.27 mm (CSF). Bootstrapping results suggest that the segmentation approach is sensitive enough to yield WM, GM and CSF volume estimates within ~5%, ~4%, and ~3% of their MRI-based estimates, respectively. To our knowledge, this is the first 3D segmentation approach for CT to undergo rigorous within-subject comparison with high-resolution MRI. Results suggest that (1) standard-quality CT allows WM/GM/CSF segmentation with reasonable accuracy, and that (2) the task of soft brain tissue classification from CT merits further attention from neuroimaging researchers.
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Affiliation(s)
- Andrei Irimia
- USC Leonard Davis School of Gerontology, Ethel Percy Andrus Gerontology Center, University of Southern California, Los Angeles, CA, United States
| | - Alexander S Maher
- USC Leonard Davis School of Gerontology, Ethel Percy Andrus Gerontology Center, University of Southern California, Los Angeles, CA, United States
| | - Kenneth A Rostowsky
- USC Leonard Davis School of Gerontology, Ethel Percy Andrus Gerontology Center, University of Southern California, Los Angeles, CA, United States
| | - Nahian F Chowdhury
- USC Leonard Davis School of Gerontology, Ethel Percy Andrus Gerontology Center, University of Southern California, Los Angeles, CA, United States
| | - Darryl H Hwang
- Department of Radiology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - E Meng Law
- Department of Radiology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States.,Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States.,Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia
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Abstract
OBJECTIVE The aim of this study was to investigate the use of one magnetic resonance image-processing tool, FSL, in its ability to perform automated segmentation of computed tomographic images of the brain. METHODS Head computed tomography (CT) images were brain extracted and segmented using the FSL tools BET and FAST, respectively. The products of segmentation were analyzed by histogram. The impact of image intensity inhomogeneity correction was investigated using simulated bias fields, 14 routine head CT scans, and selected illustrative clinical cases. RESULTS FSL FAST performs direct segmentation of head CT images, permitting quantitation of gray and white matter densities and volumes, achieving a more complete segmentation than masking methods. "Bias field correction" reduced the covariance of image signal intensities of the total brain and gray matter images (P < 0.01). Correction is larger when the effects of beam hardening and radiation scatter are larger, resulting in improved segmentation. CONCLUSIONS FSL FAST enables direct segmentation of head CT images.
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Radiation dose reduction using 100-kVp and a sinogram-affirmed iterative reconstruction algorithm in adolescent head CT: Impact on grey-white matter contrast and image noise. Eur Radiol 2016; 27:2717-2725. [PMID: 27966043 DOI: 10.1007/s00330-016-4679-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/13/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To retrospectively evaluate the image quality and radiation dose of 100-kVp scans with sinogram-affirmed iterative reconstruction (IR) for unenhanced head CT in adolescents. METHODS Sixty-nine patients aged 12-17 years underwent head CT under 120- (n = 34) or 100-kVp (n = 35) protocols. The 120-kVp images were reconstructed with filtered back-projection (FBP), 100-kVp images with FBP (100-kVp-F) and sinogram-affirmed IR (100-kVp-S). We compared the effective dose (ED), grey-white matter (GM-WM) contrast, image noise, and contrast-to-noise ratio (CNR) between protocols in supratentorial (ST) and posterior fossa (PS). We also assessed GM-WM contrast, image noise, sharpness, artifacts, and overall image quality on a four-point scale. RESULTS ED was 46% lower with 100- than 120-kVp (p < 0.001). GM-WM contrast was higher, and image noise was lower, on 100-kVp-S than 120-kVp at ST (p < 0.001). CNR of 100-kVp-S was higher than of 120-kVp (p < 0.001). GM-WM contrast of 100-kVp-S was subjectively rated as better than of 120-kVp (p < 0.001). There were no significant differences in the other criteria between 100-kVp-S and 120-kVp (p = 0.072-0.966). CONCLUSIONS The 100-kVp with sinogram-affirmed IR facilitated dramatic radiation reduction and better GM-WM contrast without increasing image noise in adolescent head CT. KEY POINTS • 100-kVp head CT provides 46% radiation dose reduction compared with 120-kVp. • 100-kVp scanning improves subjective and objective GM-WM contrast. • Sinogram-affirmed IR decreases head CT image noise, especially in supratentorial region. • 100-kVp protocol with sinogram-affirmed IR is suited for adolescent head CT.
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Grams AE, Rehwald R, Schmittnägel C, Schmidt T, Tanislav C, Berghoff M, Krombach GA, Moritz R, Obert M, Gizewski ER, Glodny B. Factors influencing intracranial vessel densities on unenhanced computed tomography: differences between hemispheres. Clin Imaging 2016; 40:1081-1085. [DOI: 10.1016/j.clinimag.2016.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 06/18/2016] [Accepted: 06/21/2016] [Indexed: 01/17/2023]
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Enhanced gray-white matter differentiation on non-enhanced CT using a frequency selective non-linear blending. Neuroradiology 2016; 58:649-55. [DOI: 10.1007/s00234-016-1674-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/03/2016] [Indexed: 11/25/2022]
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