Simulation study of a quasi-monochromatic beam for x-ray computed mammotomography

Breast dosimetry in alternative X-ray-based imaging modalities used in current clinical practices

In X-ray breast imaging, Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT), are the standard and largely used techniques, both for diagnostic and screening purposes. Other techniques, such as dedicated Breast Computed Tomography (BCT) and Contrast Enhanced Mammography (CEM) have been developed as an alternative or a complementary technique to the established ones. The performance of these imaging techniques is being continuously assessed to improve the image quality and to reduce the radiation dose. These imaging modalities are predominantly used in the diagnostic setting to resolve incomplete or indeterminate findings detected with conventional screening examinations and could potentially be used either as an adjunct or as a primary screening tool in select populations, such as for women with dense breasts. The aim of this review is to describe the radiation dosimetry for these imaging techniques, and to compare the mean glandular dose with standard breast imaging modalities, such as DM and DBT.

Cone-beam breast CT using an offset detector: effect of detector offset and image reconstruction algorithm

Objective.A dedicated cone-beam breast computed tomography (BCT) using a high-resolution, low-noise detector operating in offset-detector geometry has been developed. This study investigates the effects of varying detector offsets and image reconstruction algorithms to determine the appropriate combination of detector offset and reconstruction algorithm.Approach.Projection datasets (300 projections in 360°) of 30 breasts containing calcified lesions that were acquired using a prototype cone-beam BCT system comprising a 40 × 30 cm flat-panel detector with 1024 × 768 detector pixels were reconstructed using Feldkamp-Davis-Kress (FDK) algorithm and served as the reference. The projection datasets were retrospectively truncated to emulate cone-beam datasets with sinograms of 768×768 and 640×768 detector pixels, corresponding to 5 cm and 7.5 cm lateral offsets, respectively. These datasets were reconstructed using the FDK algorithm with appropriate weights and an ASD-POCS-based Fast, total variation-Regularized, Iterative, Statistical reconstruction Technique (FRIST), resulting in a total of 4 offset-detector reconstructions (2 detector offsets × 2 reconstruction methods). Signal difference-to-noise ratio (SDNR), variance, and full-width at half-maximum (FWHM) of calcifications in two orthogonal directions were determined from all reconstructions. All quantitative measurements were performed on images in units of linear attenuation coefficient (1/cm).Results.The FWHM of calcifications did not differ (P > 0.262) among reconstruction algorithms and detector formats, implying comparable spatial resolution. For a chosen detector offset, the FRIST algorithm outperformed FDK in terms of variance and SDNR (P < 0.0001). For a given reconstruction method, the 5 cm offset provided better results.Significance.This study indicates the feasibility of using the compressed sensing-based, FRIST algorithm to reconstruct sinograms from offset-detectors. Among the reconstruction methods and detector offsets studied, FRIST reconstructions corresponding to a 30 cm × 30 cm with 5 cm lateral offset, achieved the best performance. A clinical prototype using such an offset geometry has been developed and installed for clinical trials.

A residual dense network assisted sparse view reconstruction for breast computed tomography

To develop and investigate a deep learning approach that uses sparse-view acquisition in dedicated breast computed tomography for radiation dose reduction, we propose a framework that combines 3D sparse-view cone-beam acquisition with a multi-slice residual dense network (MS-RDN) reconstruction. Projection datasets (300 views, full-scan) from 34 women were reconstructed using the FDK algorithm and served as reference. Sparse-view (100 views, full-scan) projection data were reconstructed using the FDK algorithm. The proposed MS-RDN uses the sparse-view and reference FDK reconstructions as input and label, respectively. Our MS-RDN evaluated with respect to fully sampled FDK reference yields superior performance, quantitatively and visually, compared to conventional compressed sensing methods and state-of-the-art deep learning based methods. The proposed deep learning driven framework can potentially enable low dose breast CT imaging.

Effects of kV, filtration, dose, and object size on soft tissue and iodine contrast in dedicated breast CT

PURPOSE

Clinical use of dedicated breast computed tomography (bCT) requires relatively short scan times necessitating systems with high frame rates. This in turn impacts the x-ray tube operating range. We characterize the effects of tube voltage, beam filtration, dose, and object size on contrast and noise properties related to soft tissue and iodine contrast agents as a way to optimize imaging protocols for soft tissue and iodine contrast at high frame rates.

METHODS

This study design uses the signal-difference-to-noise ratio (SDNR), noise-equivalent quanta (NEQ), and detectability (d´) as measures of imaging performance for a prototype breast CT scanner that utilizes a pulsed x-ray tube (with a 4 ms pulse width) at 43.5 fps acquisition rate. We assess a range of kV, filtration, breast phantom size, and mean glandular dose (MGD). Performance measures are estimated from images of adipose-equivalent breast phantoms machined to have a representative size and shape of small, medium, and large breasts. Water (glandular tissue equivalent) and iodine contrast (5 mg/ml) were used to fill two cylindrical wells in the phantoms.

RESULTS

Air kerma levels required for obtaining an MGD of 6 mGy ranged from 7.1 to 9.1 mGy and are reported across all kV, filtration, and breast phantom sizes. However, at 50 kV, the thick filters (0.3 mm of Cu or Gd) exceeded the maximum available mA of the x-ray generator, and hence, these conditions were excluded from subsequent analysis. There was a strong positive association between measurements of SDNR and d' (R²  > 0.97) within the range of parameters investigated in this work. A significant decrease in soft tissue SDNR was observed for increasing phantom size and increasing kV with a maximum SDNR at 50 kV with 0.2 mm Cu or 0.2 mm Gd filtration. For iodine contrast SDNR, a significant decrease was observed with increasing phantom size, but a decrease in SDNR for increasing kV was only observed for 70 kV (50 and 60 kV were not significantly different). Thicker Gd filtration (0.3 mm Gd) resulted in a significant increase in iodine SDNR and decrease in soft tissue SDNR but requires significantly more tube current to deliver the same MGD.

CONCLUSIONS

The choice of 60 kV with 0.2 mm Gd filtration provides a good trade-off for maximizing both soft tissue and iodine contrast. This scanning technique takes advantage of the ~50 keV Gd k-edge to produce contrast and can be achieved within operating range of the x-ray generator used in this work. Imaging at 60 kV allows for a greater range in dose delivered to the large breast sizes when uniform image quality is desired across all breast sizes. While imaging performance metrics (i.e., detectability index and SDNR) were shown to be strongly correlated, the methodologies presented in this work for the estimation of NEQ (and subsequently d') provides a meaningful description of the spatial resolution and noise characteristics of this prototype bCT system across a range of beam quality, dose, and object sizes.

Optimization of the energy for Breast monochromatic absorption X-ray Computed Tomography

The limits of mammography have led to an increasing interest on possible alternatives such as the breast Computed Tomography (bCT). The common goal of all X-ray imaging techniques is to achieve the optimal contrast resolution, measured through the Contrast to Noise Ratio (CNR), while minimizing the radiological risks, quantified by the dose. Both dose and CNR depend on the energy and the intensity of the X-rays employed for the specific imaging technique. Some attempts to determine an optimal energy for bCT have suggested the range 22 keV-34 keV, some others instead suggested the range 50 keV-60 keV depending on the parameters considered in the study. Recent experimental works, based on the use of monochromatic radiation and breast specimens, show that energies around 32 keV give better image quality respect to setups based on higher energies. In this paper we report a systematic study aiming at defining the range of energies that maximizes the CNR at fixed dose in bCT. The study evaluates several compositions and diameters of the breast and includes various reconstruction algorithms as well as different dose levels. The results show that a good compromise between CNR and dose is obtained using energies around 28 keV.

Monochromatic breast computed tomography with synchrotron radiation: phase-contrast and phase-retrieved image comparison and full-volume reconstruction

A program devoted to performing the first in vivo synchrotron radiation (SR) breast computed tomography (BCT) is ongoing at the Elettra facility. Using the high spatial coherence of SR, phase-contrast (PhC) imaging techniques can be used. The latest high-resolution BCT acquisitions of breast specimens, obtained with the propagation-based PhC approach, are herein presented as part of the SYRMA-3D collaboration effort toward the clinical exam. Images are acquired with a 60 - μ m   pixel dead-time-free single-photon-counting CdTe detector. The samples are imaged at 32 and 38 keV in a continuous rotating mode, delivering 5 to 20 mGy of mean glandular dose. Contrast-to-noise ratio (CNR) and spatial resolution performances are evaluated for both PhC and phase-retrieved images, showing that by applying the phase-retrieval algorithm a five-time CNR increase can be obtained with a minor loss in spatial resolution across soft tissue interfaces. It is shown that, despite having a poorer CNR, PhC images can provide a sharper visualization of microcalcifications, thus being complementary to phase-retrieved images. Furthermore, the first full-volume scan of a mastectomy sample ( 9 × 9 × 3    cm 3 ) is reported. This investigation into surgical specimens indicates that SR BCT in terms of CNR, spatial resolution, scan duration, and scan volume is feasible.

Investigation of x-ray spectra for iodinated contrast-enhanced dedicated breast CT

Screening for breast cancer with mammography has been very successful, resulting in part to a reduction of breast cancer mortality by approximately 39% since 1990. However, mammography still has limitations in performance, especially for women with dense breast tissue. Iodinated contrast-enhanced, dedicated breast CT (BCT) has been proposed to improve lesion analysis and the accuracy of diagnostic workup for patients suspected of having breast cancer. A mathematical analysis to explore the use of various x-ray filters for iodinated contrast-enhanced BCT is presented. To assess task-based performance, the ideal linear observer signal-to-noise ratio (SNR) is used as a figure-of-merit under the assumptions of a linear, shift-invariant imaging system. To estimate signal and noise propagation through the BCT detector, a parallel-cascade model was used. The lesion model was embedded into a structured background and included a realistic level of iodine uptake. SNR was computed for 84,000 different exposure settings by varying the kV setting, x-ray filter materials and thickness, breast size, and composition and radiation dose. It is shown that some x-ray filter material/thickness combinations can provide up to 75% improvement in the linear ideal observer SNR over a conventionally used x-ray filter for BCT. This improvement in SNR can be traded off for substantial reductions in mean glandular dose.

Radiation doses in volume-of-interest breast computed tomography--A Monte Carlo simulation study

PURPOSE

Cone beam breast computed tomography (breast CT) with true three-dimensional, nearly isotropic spatial resolution has been developed and investigated over the past decade to overcome the problem of lesions overlapping with breast anatomical structures on two-dimensional mammographic images. However, the ability of breast CT to detect small objects, such as tissue structure edges and small calcifications, is limited. To resolve this problem, the authors proposed and developed a volume-of-interest (VOI) breast CT technique to image a small VOI using a higher radiation dose to improve that region's visibility. In this study, the authors performed Monte Carlo simulations to estimate average breast dose and average glandular dose (AGD) for the VOI breast CT technique.

METHODS

Electron-Gamma-Shower system code-based Monte Carlo codes were used to simulate breast CT. The Monte Carlo codes estimated were validated using physical measurements of air kerma ratios and point doses in phantoms with an ion chamber and optically stimulated luminescence dosimeters. The validated full cone x-ray source was then collimated to simulate half cone beam x-rays to image digital pendant-geometry, hemi-ellipsoidal, homogeneous breast phantoms and to estimate breast doses with full field scans. 13-cm in diameter, 10-cm long hemi-ellipsoidal homogeneous phantoms were used to simulate median breasts. Breast compositions of 25% and 50% volumetric glandular fractions (VGFs) were used to investigate the influence on breast dose. The simulated half cone beam x-rays were then collimated to a narrow x-ray beam with an area of 2.5 × 2.5 cm(2) field of view at the isocenter plane and to perform VOI field scans. The Monte Carlo results for the full field scans and the VOI field scans were then used to estimate the AGD for the VOI breast CT technique.

RESULTS

The ratios of air kerma ratios and dose measurement results from the Monte Carlo simulation to those from the physical measurements were 0.97 ± 0.03 and 1.10 ± 0.13, respectively, indicating that the accuracy of the Monte Carlo simulation was adequate. The normalized AGD with VOI field scans was substantially reduced by a factor of about 2 over the VOI region and by a factor of 18 over the entire breast for both 25% and 50% VGF simulated breasts compared with the normalized AGD with full field scans. The normalized AGD for the VOI breast CT technique can be kept the same as or lower than that for a full field scan with the exposure level for the VOI field scan increased by a factor of as much as 12.

CONCLUSIONS

The authors' Monte Carlo estimates of normalized AGDs for the VOI breast CT technique show that this technique can be used to markedly increase the dose to the breast and thus the visibility of the VOI region without increasing the dose to the breast. The results of this investigation should be helpful for those interested in using VOI breast CT technique to image small calcifications with dose concern.

Characterization of scatter magnitude and distribution in dedicated breast computed tomography with bowtie filters

Scatter contamination of projection images in cone-beam computed tomography (CT) degrades the image quality. The use of bowtie filters in dedicated breast CT can decrease this scatter contribution. Three bowtie filter designs that compensate for one or more aspects of the beam-modifying effects due to differences in path length in a projection were studied. These designs have been investigated in terms of their ability to reduce the scatter contamination in projection images acquired in a dedicated breast CT geometry. The scatter magnitude was measured as the scatter-to-primary ratio (SPR) using experimental and Monte Carlo techniques for various breast phantom diameters and tube voltages. The results show that a 55% reduction in the center SPR value could be obtained with the bowtie filter designs. On average, the bowtie filters reduced the center SPR by approximately 18% over all breast diameters. The distribution of the scatter was calculated at a range of different locations to produce scatter distribution maps for all three bowtie filter designs. With the inclusion of the bowtie filters, the scatter distribution was more uniform for all breast diameters. The results of this study will be useful in designing scatter correction methods and understanding the benefits of bowtie filters in dedicated breast CT.

Improved spatial resolution and lower-dose pediatric CT imaging: a feasibility study to evaluate narrowing the X-ray photon energy spectrum

This feasibility study has shown that improved spatial resolution and reduced radiation dose can be achieved in pediatric CT by narrowing the X-ray photon energy spectrum. This is done by placing a hafnium filter between the X-ray generator and a pediatric abdominal phantom. A CT system manufactured in 1999 that was in the process of being remanufactured was used as the platform for this study. This system had the advantage of easy access to the X-ray generator for modifications to change the X-ray photon energy spectrum; it also had the disadvantage of not employing the latest post-imaging noise reduction iterative reconstruction technology. Because we observed improvements after changing the X-ray photon energy spectrum, we recommend a future study combining this change with an optimized iterative reconstruction noise reduction technique.

Investigation of energy weighting using an energy discriminating photon counting detector for breast CT

PURPOSE

Breast CT is an emerging imaging technique that can portray the breast in 3D and improve visualization of important diagnostic features. Early clinical studies have suggested that breast CT has sufficient spatial and contrast resolution for accurate detection of masses and microcalcifications in the breast, reducing structural overlap that is often a limiting factor in reading mammographic images. For a number of reasons, image quality in breast CT may be improved by use of an energy resolving photon counting detector. In this study, the authors investigate the improvements in image quality obtained when using energy weighting with an energy resolving photon counting detector as compared to that with a conventional energy integrating detector.

METHODS

Using computer simulation, realistic CT images of multiple breast phantoms were generated. The simulation modeled a prototype breast CT system using an amorphous silicon (a-Si), CsI based energy integrating detector with different x-ray spectra, and a hypothetical, ideal CZT based photon counting detector with capability of energy discrimination. Three biological signals of interest were modeled as spherical lesions and inserted into breast phantoms; hydroxyapatite (HA) to represent microcalcification, infiltrating ductal carcinoma (IDC), and iodine enhanced infiltrating ductal carcinoma (IIDC). Signal-to-noise ratio (SNR) of these three lesions was measured from the CT reconstructions. In addition, a psychophysical study was conducted to evaluate observer performance in detecting microcalcifications embedded into a realistic anthropomorphic breast phantom.

RESULTS

In the energy range tested, improvements in SNR with a photon counting detector using energy weighting was higher (than the energy integrating detector method) by 30%-63% and 4%-34%, for HA and IDC lesions and 12%-30% (with Al filtration) and 32%-38% (with Ce filtration) for the IIDC lesion, respectively. The average area under the receiver operating characteristic curve (AUC) for detection of microcalcifications was higher by greater than 19% (for the different energy weighting methods tested) as compared to the AUC obtained with an energy integrating detector.

CONCLUSIONS

This study showed that breast CT with a CZT photon counting detector using energy weighting can provide improvements in pixel SNR, and detectability of microcalcifications as compared to that with a conventional energy integrating detector. Since a number of degrading physical factors were not modeled into the photon counting detector, this improvement should be considered as an upper bound on achievable performance.

Breast density quantification with cone-beam CT: a post-mortem study

Forty post-mortem breasts were imaged with a flat-panel based cone-beam x-ray CT system at 50 kVp. The feasibility of breast density quantification has been investigated using standard histogram thresholding and an automatic segmentation method based on the fuzzy c-means algorithm (FCM). The breasts were chemically decomposed into water, lipid, and protein immediately after image acquisition was completed. The per cent fibroglandular volume (%FGV) from chemical analysis was used as the gold standard for breast density comparison. Both image-based segmentation techniques showed good precision in breast density quantification with high linear coefficients between the right and left breast of each pair. When comparing with the gold standard using %FGV from chemical analysis, Pearson's r-values were estimated to be 0.983 and 0.968 for the FCM clustering and the histogram thresholding techniques, respectively. The standard error of the estimate was also reduced from 3.92% to 2.45% by applying the automatic clustering technique. The results of the postmortem study suggested that breast tissue can be characterized in terms of water, lipid and protein contents with high accuracy by using chemical analysis, which offers a gold standard for breast density studies comparing different techniques. In the investigated image segmentation techniques, the FCM algorithm had high precision and accuracy in breast density quantification. In comparison to conventional histogram thresholding, it was more efficient and reduced inter-observer variation.

Investigating the effect of characteristic x-rays in cadmium zinc telluride detectors under breast computerized tomography operating conditions

A number of research groups have been investigating the use of dedicated breast computerized tomography (CT). Preliminary results have been encouraging, suggesting an improved visualization of masses on breast CT as compared to conventional mammography. Nonetheless, there are many challenges to overcome before breast CT can become a routine clinical reality. One potential improvement over current breast CT prototypes would be the use of photon counting detectors with cadmium zinc telluride (CZT) (or CdTe) semiconductor material. These detectors can operate at room temperature and provide high detection efficiency and the capability of multi-energy imaging; however, one factor in particular that limits image quality is the emission of characteristic x-rays. In this study, the degradative effects of characteristic x-rays are examined when using a CZT detector under breast CT operating conditions. Monte Carlo simulation software was used to evaluate the effect of characteristic x-rays and the detector element size on spatial and spectral resolution for a CZT detector used under breast CT operating conditions. In particular, lower kVp spectra and thinner CZT thicknesses were studied than that typically used with CZT based conventional CT detectors. In addition, the effect of characteristic x-rays on the accuracy of material decomposition in spectral CT imaging was explored. It was observed that when imaging with 50-60 kVp spectra, the x-ray transmission through CZT was very low for all detector thicknesses studied (0.5-3.0 mm), thus retaining dose efficiency. As expected, characteristic x-ray escape from the detector element of x-ray interaction increased with decreasing detector element size, approaching a 50% escape fraction for a 100 μm size detector element. The detector point spread function was observed to have only minor degradation with detector element size greater than 200 μm and lower kV settings. Characteristic x-rays produced increasing distortion in the spectral response with decreasing detector element size. If not corrected for, this caused a large bias in estimating tissue density parameters for material decomposition. It was also observed that degradation of the spectral response due to characteristic x-rays caused worsening precision in the estimation of tissue density parameters. It was observed that characteristic x-rays do cause some degradation in the spatial and spectral resolution of thin CZT detectors operating under breast CT conditions. These degradations should be manageable with careful selection of the detector element size. Even with the observed spectral distortion from characteristic x-rays, it is still possible to correctly estimate tissue parameters for material decomposition using spectral CT if accurate modeling is used.

Generation of voxelized breast phantoms from surgical mastectomy specimens

PURPOSE

In the research and development of dedicated tomographic breast imaging systems, digital breast object models, also known as digital phantoms, are useful tools. While various digital breast phantoms do exist, the purpose of this study was to develop a realistic high-resolution model suitable for simulating three-dimensional (3D) breast imaging modalities. The primary goal was to design a model capable of producing simulations with realistic breast tissue structure.

METHODS

The methodology for generating an ensemble of digital breast phantoms was based on imaging surgical mastectomy specimens using a benchtop, cone-beam computed tomography system. This approach allowed low-noise, high-resolution projection views of the mastectomy specimens at each angular position. Reconstructions of these projection sets were processed using correction techniques and diffusion filtering prior to segmentation into breast tissue types in order to generate phantoms.

RESULTS

Eight compressed digital phantoms and 20 uncompressed phantoms from which an additional 96 pseudocompressed digital phantoms with voxel dimensions of 0.2 mm(3) were generated. Two distinct tissue classification models were used in forming breast phantoms. The binary model classified each tissue voxel as either adipose or fibroglandular. A multivalue scaled model classified each tissue voxel as percentage of adipose tissue (range 1%-99%). Power spectral analysis was performed to compare simulated reconstructions using the breast phantoms to the original breast specimen reconstruction, and fits were observed to be similar.

CONCLUSIONS

The digital breast phantoms developed herein provide a high-resolution anthropomorphic model of the 3D uncompressed and compressed breast that are suitable for use in evaluating and optimizing tomographic breast imaging modalities. The authors believe that other research groups might find the phantoms useful, and therefore they offer to make them available for wider use.

Analysis of a novel offset cone-beam computed mammotomography system geometry for accomodating various breast sizes

We evaluate a newly developed dedicated cone-beam transmission computed mammotomography (CmT) system configuration using an optimized quasi-monochromatic cone beam technique for attenuation correction of SPECT in a planned dual-modality emission and transmission system for pendant, uncompressed breasts. In this study, we perform initial CmT acquisitions using various sized breast phantoms to evaluate an offset cone-beam geometry. This offset geometry provides conjugate projections through a full 360 degree gantry rotation, and thus yields a greatly increased effective field of view, allowing a much wider range of breast sizes to be imaged without truncation in reconstructed images. Using a tungsten X-ray tube and digital flat-panel X-ray detector in a compact geometry, we obtained initial CmT scans without shift and with the offset geometry, using geometrical frequency/resolution phantoms and two different sizes of breast phantoms. Acquired data were reconstructed using an ordered subsets transmission iterative algorithm. Projection images indicate that the larger, 20 cm wide, breast requires use of a half-cone-beam offset scan to eliminate truncation artifacts. Reconstructed image results illustrate elimination of truncation artifacts, and that the novel quasi-monochromatic beam yields reduced beam hardening. The offset geometry CmT system can indeed potentially be used for structural imaging and accurate attenuation correction for the functional dedicated breast SPECT system.

Spectral optimization for micro-CT

PURPOSE

To optimize micro-CT protocols with respect to x-ray spectra and thereby reduce radiation dose at unimpaired image quality.

METHODS

Simulations were performed to assess image contrast, noise, and radiation dose for different imaging tasks. The figure of merit used to determine the optimal spectrum was the dose-weighted contrast-to-noise ratio (CNRD). Both optimal photon energy and tube voltage were considered. Three different types of filtration were investigated for polychromatic x-ray spectra: 0.5 mm Al, 3.0 mm Al, and 0.2 mm Cu. Phantoms consisted of water cylinders of 20, 32, and 50 mm in diameter with a central insert of 9 mm which was filled with different contrast materials: an iodine-based contrast medium (CM) to mimic contrast-enhanced (CE) imaging, hydroxyapatite to mimic bone structures, and water with reduced density to mimic soft tissue contrast. Validation measurements were conducted on a commercially available micro-CT scanner using phantoms consisting of water-equivalent plastics. Measurements on a mouse cadaver were performed to assess potential artifacts like beam hardening and to further validate simulation results.

RESULTS

The optimal photon energy for CE imaging was found at 34 keV. For bone imaging, optimal energies were 17, 20, and 23 keV for the 20, 32, and 50 mm phantom, respectively. For density differences, optimal energies varied between 18 and 50 keV for the 20 and 50 mm phantom, respectively. For the 32 mm phantom and density differences, CNRD was found to be constant within 2.5% for the energy range of 21-60 keV. For polychromatic spectra and CMs, optimal settings were 50 kV with 0.2 mm Cu filtration, allowing for a dose reduction of 58% compared to the optimal setting for 0.5 mm Al filtration. For bone imaging, optimal tube voltages were below 35 kV. For soft tissue imaging, optimal tube settings strongly depended on phantom size. For 20 mm, low voltages were preferred. For 32 mm, CNRD was found to be almost independent of tube voltage. For 50 mm, voltages larger than 50 kV were preferred. For all three phantom sizes stronger filtration led to notable dose reduction for soft tissue imaging. Validation measurements were found to match simulations well, with deviations being less than 10%. Mouse measurements confirmed simulation results.

CONCLUSIONS

Optimal photon energies and tube settings strongly depend on both phantom size and imaging task at hand. For in vivo CE imaging and density differences, strong filtration and voltages of 50-65 kV showed good overall results. For soft tissue imaging of animals the size of a rat or larger, voltages higher than 65 kV allow to greatly reduce scan times while maintaining dose efficiency. For imaging of bone structures, usage of only minimum filtration and low tube voltages of 40 kV and below allow exploiting the high contrast of bone at very low energies. Therefore, a combination of two filtrations could prove beneficial for micro-CT: a soft filtration allowing for bone imaging at low voltages, and a variable stronger filtration (e.g., 0.2 mm Cu) for soft tissue and contrast-enhanced imaging.

Evaluation of the absorbed dose to the breast using radiochromic film in a dedicated CT mammotomography system employing a quasi-monochromatic x-ray beam

PURPOSE

A dual modality SPECT-CT prototype system dedicated to uncompressed breast imaging (mammotomography) has been developed. The computed tomography subsystem incorporates an ultrathick K-edge filtration technique producing a quasi-monochromatic x-ray cone beam that optimizes the dose efficiency of the system for lesion imaging in an uncompressed breast. Here, the absorbed dose in various geometric phantoms and in an uncompressed and pendant cadaveric breast using a normal tomographic cone beam imaging protocol is characterized using both thermoluminescent dosimeter (TLD) measurements and ionization chamber-calibrated radiochromic film.

METHODS

Initially, two geometric phantoms and an anthropomorphic breast phantom are filled in turn with oil and water to simulate the dose to objects that mimic various breast shapes having effective density bounds of 100% fatty and glandular breast compositions, respectively. Ultimately, an excised human cadaver breast is tomographically scanned using the normal tomographic imaging protocol, and the dose to the breast tissue is evaluated and compared to the earlier phantom-based measurements.

RESULTS

Measured trends in dose distribution across all breast geometric and anthropomorphic phantom volumes indicate lower doses in the medial breast and more proximal to the chest wall, with consequently higher doses near the lateral peripheries and nipple regions. Measured doses to the oil-filled phantoms are consistently lower across all volume shapes due to the reduced mass energy-absorption coefficient of oil relative to water. The mean measured dose to the breast cadaver, composed of adipose and glandular tissues, was measured to be 4.2 mGy compared to a mean whole-breast dose of 3.8 and 4.5 mGy for the oil- and water-filled anthropomorphic breast phantoms, respectively.

CONCLUSIONS

Assuming rotational symmetry due to the tomographic acquisition exposures, these results characterize the 3D dose distributions in an uncompressed human breast tissue volume for this dedicated breast imaging device and illustrate advantages of using the novel ultrathick K-edge filtered beam to minimize the dose to the breast during fully-3D imaging.

Compact x-ray sources for mammographic applications: Monte Carlo simulations of image quality

Thomson scattering x-ray sources can provide spectral distributions that are ideally suited for mammography with sufficient fluence rates. In this article, the authors investigate the effects of different spectral distributions on the image quality in simulated images of a breast mammographic phantom containing details of different compositions and thicknesses. They simulated monochromatic, quasimonochromatic, and polychromatic x-ray sources in order to define the energy for maximum figure of merit (signal-difference-to-noise ratio squared/mean glandular dose), the effect of an energy spread, and the effect of the presence of higher-order harmonics. The advantages of these sources with respect to conventional polychromatic sources as a function of phantom and detail thickness were also investigated. The results show that the energy for the figure of merit peak is between 16 and 27.4 keV, depending on the phantom thickness and detail composition and thickness. An energy spread of about 1 keV standard deviation, easily achievable with compact x-ray sources, does not appreciably affect the image quality.

Design and characterization of a spatially distributed multibeam field emission x-ray source for stationary digital breast tomosynthesis

Digital breast tomosynthesis (DBT) is a limited angle computed tomography technique that can distinguish tumors from its overlying breast tissues and has potentials for detection of cancers at a smaller size and earlier stage. Current prototype DBT scanners are based on the regular full-field digital mammography systems and require partial isocentric motion of an x-ray tube over certain angular range to record the projection views. This prolongs the scanning time and, in turn, degrades the imaging quality due to motion blur. To mitigate the above limitations, the concept of a stationary DBT (s-DBT) scanner has been recently proposed based on the newly developed spatially distributed multibeam field emission x-ray (MBFEX) source technique using the carbon nanotube. The purpose of this article is to evaluate the performance of the 25-beam MBFEX source array that has been designed and fabricated for the s-DBT system. The s-DBT system records all the projection images by electronically activating the multiple x-ray beams from different viewing angles without any mechanical motion. The configuration of the MBFEX source is close to the published values from the Siemens Mammomat system. The key issues including the x-ray flux, focal spot size, spatial resolution, scanning time, beam-to-beam consistency, and reliability are evaluated using the standard procedures. In this article, the authors describe the design and performance of a distributed x-ray source array specifically designed for the s-DBT system. They evaluate the emission current, current variation, lifetime, and focal spot sizes of the source array. An emission current of up to 18 mA was obtained at 0.5 x 0.3 mm effective focal spot size. The experimentally measured focal spot sizes are comparable to that of a typical commercial mammography tube without motion blurring. Trade-off between the system spatial resolution, x-ray flux, and scanning time are also discussed. Projection images of a breast phantom were collected using the x-ray source array from 25 different viewing angles without motion. These preliminary results demonstrate the feasibility of the proposed s-DBT scanner. The technology has the potential to increase the resolution and reduce the imaging time for DBT. With the present design of 25 views, they demonstrated experimentally the feasibility of achieving 11 s scanning time at full detector resolution with 0.5 x 0.3 mm source resolution without motion blur. The flexibility in configuration of the x-ray source array will also allow system designers to consider imaging geometries that are difficult to achieve with the conventional single-source rotating approach.

Methodology for generating a 3D computerized breast phantom from empirical data

The initial process for creating a flexible three-dimensional computer-generated breast phantom based on empirical data is described. Dedicated breast computed-tomography data were processed to suppress noise and scatter artifacts in the reconstructed image set. An automated algorithm was developed to classify the breast into its primary components. A preliminary phantom defined using subdivision surfaces was generated from the segmented data. To demonstrate potential applications of the phantom, simulated mammographic image data were acquired of the phantom using a simplistic compression model and an analytic projection algorithm directly on the surface model. The simulated image was generated using a model for a polyenergetic cone-beam projection of the compressed phantom. The methods used to create the breast phantom generate resulting images that have a high level of tissue structure detail available and appear similar to actual mammograms. Fractal dimension measurements of simulated images of the phantom are comparatively similar to measurements from images of real human subjects. A realistic and geometrically defined breast phantom that can accurately simulate imaging data may have many applications in breast imaging research.

Evaluation of tilted cone-beam CT orbits in the development of a dedicated hybrid mammotomograph

A compact dedicated 3D breast SPECT-CT (mammotomography) system is currently under development. In its initial prototype, the cone-beam CT sub-system is restricted to a fixed-tilt circular rotation around the patient's pendant breast. This study evaluated stationary-tilt angles for the CT sub-system that will enable maximal volumetric sampling and viewing of the breast and chest wall. Images of geometric/anthropomorphic phantoms were acquired using various fixed-tilt circular and 3D sinusoidal trajectories. The iteratively reconstructed images showed more distortion and attenuation coefficient inaccuracy from tilted cone-beam orbits than from the complex trajectory. Additionally, line profiles illustrated cupping artifacts in planes distal to the central plane of the tilted cone-beam, otherwise not apparent for images acquired with complex trajectories. This indicates that undersampled cone-beam data may be an additional cause of cupping artifacts. High-frequency objects could be distinguished for all trajectories, but their shapes and locations were corrupted by out-of-plane frequency information. Although more acrylic balls were visualized with a fixed-tilt and nearly flat cone-beam at the posterior of the breast, 3D complex trajectories have less distortion and more complete sampling throughout the reconstruction volume. While complex trajectories would ideally be preferred, negatively fixed-tilt source-detector configuration demonstrates minimally distorted patient images.

Breast cancer imaging: a perspective for the next decade

Breast imaging is largely indicated for detection, diagnosis, and clinical management of breast cancer and for evaluation of the integrity of breast implants. In this work, a prospective view of techniques for breast cancer detection and diagnosis is provided based on an assessment of current trends. The potential role of emerging techniques that are under various stages of research and development is also addressed. It appears that the primary imaging tool for breast cancer screening in the next decade will be high-resolution, high-contrast, anatomical x-ray imaging with or without depth information. MRI and ultrasonography will have an increasingly important adjunctive role for imaging high-risk patients and women with dense breasts. Pilot studies with dedicated breast CT have demonstrated high-resolution three-dimensional imaging capabilities, but several technological barriers must be overcome before clinical adoption. Radionuclide based imaging techniques and x-ray imaging with intravenously injected contrast offer substantial potential as a diagnostic tools and for evaluation of suspicious lesions. Developing optical and electromagnetic imaging techniques hold significant potential for physiologic information and they are likely to be of most value when integrated with or adjunctively used with techniques that provide anatomic information. Experimental studies with breast specimens suggest that phase-sensitive x-ray imaging techniques can provide edge enhancement and contrast improvement but more research is needed to evaluate their potential role in clinical breast imaging. From the technological perspective, in addition to improvements within each modality, there is likely to be a trend towards multi-modality systems that combine anatomic with physiologic information. We are also likely to transition from a standardized screening, where all women undergo the same imaging exam (mammography), to selection of a screening modality or modalities based an individual-risk or other classification.

Generalized subtraction methods in digital mammography

Digital mammography can greatly facilitate new applications, with the potential of further improving early diagnosis of breast cancer. Indeed, early manifestations of breast cancer are often very subtle and are displayed on the variable pattern of normal anatomy that may either obscure or simulate disease. This is particularly important in dense breasts, because of the complexity of overlying fibroglandular structures. The requirement of improved lesion conspicuity has brought to the application of a number of subtraction methods such as the tomographic technique to exploit depth-dependent information or the digital angiography where subtraction in the temporal domain is applied in conjuction with administration of contrast medium. Since there are various parameters that might be used for subtraction, such techniques have to be intended in generalized form. Generalized subtraction methods in mammography are here presented and compared.

Anniversary paper. Development of x-ray computed tomography: the role of medical physics and AAPM from the 1970s to present

The AAPM, through its members, meetings, and its flagship journal Medical Physics, has played an important role in the development and growth of x-ray tomography in the last 50 years. From a spate of early articles in the 1970s characterizing the first commercial computed tomography (CT) scanners through the "slice wars" of the 1990s and 2000s, the history of CT and related techniques such as tomosynthesis can readily be traced through the pages of Medical Physics and the annals of the AAPM and RSNA/AAPM Annual Meetings. In this article, the authors intend to give a brief review of the role of Medical Physics and the AAPM in CT and tomosynthesis imaging over the last few decades.

Technological development and advances in single-photon emission computed tomography/computed tomography

Single-photon emission computed tomography/computed tomography (SPECT/CT) has emerged during the past decade as a means of correlating anatomical information from CT with functional information from SPECT. The integration of SPECT and CT in a single imaging device facilitates anatomical localization of the radiopharmaceutical to differentiate physiological uptake from that associated with disease and patient-specific attenuation correction to improve the visual quality and quantitative accuracy of the SPECT image. The first clinically available SPECT/CT systems performed emission-transmission imaging using a dual-headed SPECT camera and a low-power x-ray CT subsystem. Newer SPECT/CT systems are available with high-power CT subsystems suitable for detailed anatomical diagnosis, including CT coronary angiography and coronary calcification that can be correlated with myocardial perfusion measurements. The high-performance CT capabilities also offer the potential to improve compensation of partial volume errors for more accurate quantitation of radionuclide measurement of myocardial blood flow and other physiological processes and for radiation dosimetry for radionuclide therapy. In addition, new SPECT technologies are being developed that significantly improve the detection efficiency and spatial resolution for radionuclide imaging of small organs including the heart, brain, and breast, and therefore may provide new capabilities for SPECT/CT imaging in these important clinical applications.

Dedicated breast computed tomography: volume image denoising via a partial-diffusion equation based technique

Dedicated breast computed tomography (CT) imaging possesses the potential for improved lesion detection over conventional mammograms, especially for women with dense breasts. The breast CT images are acquired with a glandular dose comparable to that of standard two-view mammography for a single breast. Due to dose constraints, the reconstructed volume has a non-negligible quantum noise when thin section CT slices are visualized. It is thus desirable to reduce noise in the reconstructed breast volume without loss of spatial resolution. In this study, partial diffusion equation (PDE) based denoising techniques specifically for breast CT were applied at different steps along the reconstruction process and it was found that denoising performed better when applied to the projection data rather than reconstructed data. Simulation results from the contrast detail phantom show that the PDE technique outperforms Wiener denoising as well as adaptive trimmed mean filter. The PDE technique increases its performance advantage relative to Wiener techniques when the photon fluence is reduced. With the PDE technique, the sensitivity for lesion detection using the contrast detail phantom drops by less than 7% when the dose is cut down to 40% of the two-view mammography. For subjective evaluation, the PDE technique was applied to two human subject breast data sets acquired on a prototype breast CT system. The denoised images had appealing visual characteristics with much lower noise levels and improved tissue textures while maintaining sharpness of the original reconstructed volume.

Breast CT

Breast cancer is a serious disease that accounts for approximately 40,000 deaths per year in the United States. Unfortunately, there is no known cause of breast cancer, and therefore the best way to prevent mortality is early detection. In the past 15 years, breast cancer mortality has been reduced significantly, which is in part due to screening with film-screen mammography. Nonetheless, conventional mammography lacks sensitivity, especially for certain subgroups of women such as those with dense breast tissue, those under 50 years old, and pre- or perimenopausal women. In addition, mammography has a very poor positive predictive value for biopsy, with 70%-90% of biopsies performed turning out negative. By improving visualization of breast tissue, X-ray computerized tomography (CT) of the breast can potentially provide improvements in diagnostic accuracy over conventional mammography. Owing to recent technological developments in digital detector technology, flat-panel CT imagers dedicated to imaging of the breast are now feasible. A number of academic groups are currently researching dedicated breast CT and prototype systems are currently being evaluated in the clinical setting.

Evaluating the impact of X-ray spectral shape on image quality in flat-panel CT breast imaging

In recent years, there has been an increasing interest in exploring the feasibility of dedicated computed tomography (CT) breast imaging using a flat-panel digital detector in a truncated cone-beam imaging geometry. Preliminary results are promising and it appears as if three-dimensional tomographic imaging of the breast has great potential for reducing the masking effect of superimposed parenchymal structure typically observed with conventional mammography. In this study, a mathematical framework used for determining optimal design and acquisition parameters for such a CT breast imaging system is described. The ideal observer signal-to-noise ratio (SNR) is used as a figure of merit, under the assumptions that the imaging system is linear and shift invariant. Computation of the ideal observer SNR used a parallel-cascade model to predict signal and noise propagation through the detector, as well as a realistic model of the lesion detection task in breast imaging. For all evaluations, the total mean glandular dose for a CT breast imaging study was constrained to be approximately equivalent to that of a two-view conventional mammography study. The framework presented was used to explore the effect of x-ray spectral shape across an extensive range of kVp settings, filter material types, and filter thicknesses. The results give an indication of how spectral shape can affect image quality in flat-panel CT breast imaging.

Experimental spectral measurements of heavy K-edge filtered beams for x-ray computed mammotomography

A dual modality computed mammotomography (CmT) and single photon emission computed tomography (SPECT) system for dedicated 3D breast imaging is in development. Using heavy K-edge filtration, the CmT component narrows the energy spectrum of the cone-shaped x-ray beam incident on the patient's pendant, uncompressed breast. This quasi-monochromatic beam is expected to improve discrimination of tissue with similar attenuation coefficients while restraining absorbed dose to below that of dual view mammography. Previous simulation studies showed the optimal energy that maximizes dose efficiency for a 50/50% adipose/glandular breast is between 30 and 40 keV. This study experimentally validates these results using pre-breast and post-breast spectral measurements made under tungsten tube voltages between 40 and 100 kVp using filter materials with K-edge values ranging from 15 to 70 keV. Different filter material thicknesses are used, approximately equivalent to the 200th and 500th attenuating value layer (VL) thickness. Cerium (K = 40.4 keV) filtered post-breast spectra for 8-18 cm breasts are measured for a range of breast compositions. Figures of merit include mean beam energy, spectral full-width at tenth-maximum, beam hardening and dose for the range of breast sizes. Measurements corroborate simulation results, indicating that for a given dose, a 200th VL of cerium filtration may have optimal performance in the dedicated mammotomography paradigm.

Optimized radiographic spectra for small animal digital subtraction angiography

The increasing use of small animals in basic research has spurred interest in new imaging methodologies. Digital subtraction angiography (DSA) offers a particularly appealing approach to functional imaging in the small animal. This study examines the optimal x-ray, molybdenum (Mo) or tungsten (W) target sources, and technique to produce the highest quality small animal functional subtraction angiograms in terms of contrast and signal-difference-to-noise ratio squared (SdNR2). Two limiting conditions were considered-normalization with respect to dose and normalization against tube loading. Image contrast and SdNR2 were simulated using an established x-ray model. DSA images of live rats were taken at two representative tube potentials for the W and Mo sources. Results show that for small animal DSA, the Mo source provides better contrast. However, with digital detectors, SdNR2 is the more relevant figure of merit. The W source operated at kVps >60 achieved a higher SdNR2. The highest SdNR2 was obtained at voltages above 90 kVp. However, operation at the higher potential results in significantly greater dose and tube load and reduced contrast quantization. A reasonable tradeoff can be achieved at tube potentials at the beginning of the performance plateau, around 70 kVp, where the relative gain in SdNR2 is the greatest.

Imaging properties of digital magnification radiography

Flat panel detectors exhibit improved signal-to-noise ratio (SNR) and display capabilities compared to film. This improvement necessitates a new evaluation of optimal geometry for conventional projection imaging applications such as digital projection mammography as well as for advanced x-ray imaging applications including cone-beam computed tomography (CT), tomosynthesis, and mammotomography. Such an evaluation was undertaken in this study to examine the effects of x-ray source distribution, inherent detector resolution, magnification, scatter rejection, and noise characteristics including noise aliasing. A model for x-ray image acquisition was used to develop generic results applicable to flat panel detectors with similar x-ray absorption characteristics. The model assumed a Gaussian distribution for the focal spot and a rectangular distribution for a pixel. A generic model for the modulated transfer function (MTF) of indirect flat panel detectors was derived by a nonlinear fit of empirical receptor data to the Burgess model for phosphor MTFs. Noise characteristics were investigated using a generic noise power spectrum (NPS) model for indirect phosphor-based detectors. The detective quantum efficiency (DQE) was then calculated from the MTF and NPS models. The results were examined as a function of focal spot size (0.1, 0.3, and 0.6 mm) and pixel size (50, 100, 150, and 200 microm) for magnification ranges 1 to 3. Mammography, general radiography (also applicable to mammotomography), and chest radiography applications were explored using x-ray energies of 28, 74, and 120 kVp, respectively. Nodule detection was examined using the effective point source scatter model, effective DQE, and the Hotelling SNR2 efficiency. Results indicate that magnification can potentially improve the signal and noise performance of digital images. Results also show that a cross over point occurs in the spatial frequency above and below which the effects of magnification differ indicating that there are task dependent tradeoffs associated with magnification. The cross over point varies depending upon focal spot size, pixel size, x-ray energy, and source-to-image-distance (SID). For mammography, the cross over point occurs for a 0.3 mm focal spot while a 0.6 mm focal spot indicates that magnification does not improve image quality due to focal spot blurring. Thus, the benefit of magnification may be limited. For general radiography (as well as mammotomography), and chest radiography, the cross over point changes with SID. For a system with a 0.3 mm focal spot, 100 microm pixel size, a 2 m SID, and the applicable tissue thickness and scatter components, optimal magnification improved SNR2 by approximately 1.2 times for mammography and 1.5 times for general radiography (and mammotomography). These results indicate that the optimal geometry can improve image quality without changing patient dose or otherwise reduce dose without compromising image quality.

Breast CT: potential for breast cancer screening and diagnosis

Although screening mammography has been shown to be effective in reducing breast cancer mortality, a new technique called breast computed tomography (CT) is being studied in the hope that breast cancer can be detected even earlier. A prototype unit has been designed, fabricated and tested at the University of California, Davis, USA, and is currently being used in a Phase II clinical trial to study the feasibility of breast CT for breast cancer detection and diagnosis. A total of 46 volunteers and patients have been imaged, and the breast CT images show impressive anatomical detail of the breast that is not appreciated in mammography. The radiation dose levels needed to produce excellent image quality are equal to two-view mammography. Further study of breast CT is needed to better understand its potential role in breast cancer screening and diagnosis.

Computed tomography for imaging the breast

Despite the success of screening mammography contributing to the reduction of cancer mortality, a number of other imaging techniques are being studied for breast cancer screening. In our laboratory, a dedicated breast computed tomography (CT) system has been developed and is currently undergoing patient testing. The breast CT system is capable of scanning the breast with the woman lying prone on a tabletop, with the breast in the pendant position. A 360 degrees scan currently requires 16.6 s, and a second scanner with a 9-second scan time is nearly operational. Extensive effort was placed on computing the radiation dose to the breast under CT geometry, and the scan parameters are selected to utilize the same radiation dose levels as two-view mammography. A total of 55 women have been scanned, ten healthy volunteers in a Phase I trial, and 45 women with a high likelihood of having breast cancer in a Phase II trial. The breast CT process leads to the production of approximately three hundred 512 x 512 images for each breast. Subjective evaluation of the breast CT images reveals excellent anatomical detail, good depiction of microcalcifications, and exquisite visualization of the soft tissue components of the tumor when contrasted against adipose tissues. The use of iodine contrast injection dramatically enhances the visualization of tumors. While a thorough scientific investigation based upon observer performance studies is in progress, initial breast CT images do appear promising and it is likely that breast CT will play some role in breast cancer imaging.

A computer simulation study comparing lesion detection accuracy with digital mammography, breast tomosynthesis, and cone-beam CT breast imaging

Although conventional mammography is currently the best modality to detect early breast cancer, it is limited in that the recorded image represents the superposition of a three-dimensional (3D) object onto a 2D plane. Recently, two promising approaches for 3D volumetric breast imaging have been proposed, breast tomosynthesis (BT) and CT breast imaging (CTBI). To investigate possible improvements in lesion detection accuracy with either breast tomosynthesis or CT breast imaging as compared to digital mammography (DM), a computer simulation study was conducted using simulated lesions embedded into a structured 3D breast model. The computer simulation realistically modeled x-ray transport through a breast model, as well as the signal and noise propagation through a CsI based flat-panel imager. Polyenergetic x-ray spectra of Mo/Mo 28 kVp for digital mammography, Mo/Rh 28 kVp for BT, and W/Ce 50 kVp for CTBI were modeled. For the CTBI simulation, the intensity of the x-ray spectra for each projection view was determined so as to provide a total average glandular dose of 4 mGy, which is approximately equivalent to that given in conventional two-view screening mammography. The same total dose was modeled for both the DM and BT simulations. Irregular lesions were simulated by using a stochastic growth algorithm providing lesions with an effective diameter of 5 mm. Breast tissue was simulated by generating an ensemble of backgrounds with a power law spectrum, with the composition of 50% fibroglandular and 50% adipose tissue. To evaluate lesion detection accuracy, a receiver operating characteristic (ROC) study was performed with five observers reading an ensemble of images for each case. The average area under the ROC curves (Az) was 0.76 for DM, 0.93 for BT, and 0.94 for CTBI. Results indicated that for the same dose, a 5 mm lesion embedded in a structured breast phantom was detected by the two volumetric breast imaging systems, BT and CTBI, with statistically significant higher confidence than with planar digital mammography, while the difference in lesion detection between BT and CTBI was not statistically significant.

Physical characterization of a prototype selenium-based full field digital mammography detector

The purpose of this study was to measure experimentally the physical performance of a prototype mammographic imager based on a direct detection, flat-panel array design employing an amorphous selenium converter with 70 microm pixels. The system was characterized for two different anode types, a molybdenum target with molybdenum filtration (Mo/Mo) and a tungsten target with rhodium filtration (W/Rh), at two different energies, 28 and 35 kVp, with approximately 2 mm added aluminum filtration. To measure the resolution, the presampled modulation transfer function (MTF) was measured using an edge method. The normalized noise power spectrum (NNPS) was measured by two-dimensional Fourier analysis of uniformly exposed mammograms. The detective quantum efficiencies (DQEs) were computed from the MTFs, the NNPSs, and theoretical ideal signal to noise ratios. The MTF was found to be close to its ideal limit and reached 0.2 at 11.8 mm(-1) and 0.1 at 14.1 mm(-1) for images acquired at an RQA-M2 technique (Mo/Mo anode, 28 kVp, 2 mm Al). Using a tungsten technique (MW2; W/Rh anode, 28 kVp, 2 mm Al), the MTF went to 0.2 at 11.2 mm(-1) and to 0.1 at 13.3 mm(-1). The DQE reached a maximum value of 54% at 1.35 mm(-1) for the RQA-M2 technique at 1.6 microC/kg and achieved a peak value of 64% at 1.75 mm(-1) for the tungsten technique (MW2) at 1.9 microC/kg. Nevertheless, the DQE showed strong exposure and frequency dependencies. The results indicated that the detector offered high MTFs and DQEs, but structured noise effects may require improved calibration before clinical implementation.

A framework for optimising the radiographic technique in digital X-ray imaging

The transition to digital radiology has provided new opportunities for improved image quality, made possible by the superior detective quantum efficiency and post-processing capabilities of new imaging systems, and advanced imaging applications, made possible by rapid digital image acquisition. However, this transition has taken place largely without optimising the radiographic technique used to acquire the images. This paper proposes a framework for optimising the acquisition of digital X-ray images. The proposed approach is based on the signal and noise characteristics of the digital images and the applied exposure. Signal is defined, based on the clinical task involved in an imaging application, as the difference between the detector signal with and without a target present against a representative background. Noise is determined from the noise properties of uniformly acquired images of the background, taking into consideration the absorption properties of the detector. Incident exposure is estimated or otherwise measured free in air, and converted to dose. The main figure of merit (FOM) for optimisation is defined as the signal-difference-to-noise ratio (SdNR) squared per unit exposure or (more preferably) dose. This paper highlights three specific technique optimisation studies that used this approach to optimise the radiographic technique for digital chest and breast applications. In the first study, which was focused on chest radiography with a CsI flat-panel detector, a range of kV(p) (50-150) and filtration (Z = 13-82) were examined in terms of their associated FOM as well as soft tissue to bone contrast, a factor of importance in digital chest radiography. The results indicated that additive Cu filtration can improve image quality. A second study in digital mammography using a selenium direct flat-panel detector indicated improved SdNR per unit exposure with the use of a tungsten target and a rhodium filter than conventional molybdenum target/molybdenum filter techniques. Finally, a third study focusing on cone-beam computed tomography of the breast using a CsI flat-panel detector indicated that high Z filtration of a tungsten target X-ray beam can notably improve the signal and noise characteristics of the image. The general findings highlight the fact that the techniques that are conventionally assumed to be optimum may need to be revisited for digital radiography.

Quasimonochromatic x-ray computed tomography by the balanced filter method using a conventional x-ray source

A quasimonochromatic x-ray computed tomography (CT) system utilizing balanced filters has recently been developed for acquiring quantitative CT images. This system consisted of basic components such as a conventional x-ray generator for radiography, a stage for mounting and rotating objects, and an x-ray line sensor camera. Metallic sheets of Er and Yb were used as the balanced filters for obtaining quasimonochromatic incident x rays that include the characteristic lines of the W Kalpha doublet from a tungsten target. The mean energy and energy width of the quasimonochromatic x rays were determined to be 59.0 and 1.9 keV, respectively, from x-ray spectroscopic measurements using a high-purity Ge detector. The usefulness of the present x-ray CT system was demonstrated by obtaining spatial distributions of the linear attenuation coefficients of three selected samples--a 20 cm diameter cylindrical water phantom, a 3.5 cm diameter aluminum rod, and a human head phantom. The results clearly indicate that this apparatus is surprisingly effective for estimating the distribution of the linear attenuation coefficients without any correction of the beam-hardening effect. Thus, implementing the balanced filter method on an x-ray CT scanner has promise in producing highly quantitative CT images.

Spektr: A computational tool for x-ray spectral analysis and imaging system optimization

A set of computational tools are presented that allow convenient calculation of x-ray spectra, selection of elemental and compound filters, and calculation of beam quality characteristics, such as half-value layer, mR/mAs, and fluence per unit exposure. The TASMIP model of Boone and Seibert is adapted to a library of high-level language (Matlab) functions and shown to agree with experimental measurements across a wide range of kVp and beam filtration. Modeling of beam filtration is facilitated by a convenient, extensible database of mass and mass-energy attenuation coefficients compiled from the National Institute of Standards and Technology. The functions and database were integrated in a graphical user interface and made available online at http:// www.aip.org/epaps/epaps.html. The functionality of the toolset and potential for investigation of imaging system optimization was illustrated in theoretical calculations of imaging performance across a broad range of kVp, filter material type, and filter thickness for direct and indirect-detection flat-panel imagers. The calculations reveal a number of nontrivial effects in the energy response of such detectors that may not have been guessed from simple K-edge filter techniques, and point to a variety of compelling hypotheses regarding choice of beam filtration that warrant future investigation.