Extended parallel backprojection for standard three-dimensional and phase-correlated four-dimensional axial and spiral cone-beam CT with arbitrary pitch, arbitrary cone-angle, and 100% dose usage

Patient-specific radiation risk-based tube current modulation for diagnostic CT

PURPOSE

Modern CT scanners use automatic exposure control (AEC) techniques, such as tube current modulation (TCM), to reduce dose delivered to patients while maintaining image quality. In contrast to conventional approaches that minimize the tube current time product of the CT scan, referred to as mAsTCM in the following, we herein propose a new method referred to as riskTCM which aims at reducing the radiation risk to the patient by taking into account the specific radiation risk of every dose-sensitive organ.

METHODS

For current mAsTCM implementations, the mAs-product is used as a surrogate for the patient dose. Thus they do not take into account the varying dose sensitivity of different organs. Our riskTCM framework assumes that a coarse CT reconstruction, an organ segmentation and an estimation of the dose distribution can be provided in real time, e.g. by applying machine learning techniques. Using this information riskTCM determines a tube current curve that minimizes a patient risk measure, e.g. the effective dose, while keeping the image quality constant. We retrospectively applied riskTCM to 20 patients covering all relevant anatomical regions and tube voltages from 70 kV to 150 kV. The potential reduction of effective dose at same image noise is evaluated as a figure of merit and compared to mAsTCM and to a situation with a constant tube current referred to as noTCM.

RESULTS

Anatomical regions like the neck, thorax, abdomen and the pelvis benefit from the proposed riskTCM. On average, a reduction of effective dose of about 23 % for the thorax, 31 % for the abdomen, 24 % for the pelvis, and 27% for the neck have been evaluated compared to today's state-of-the-art mAsTCM. For the head, the resulting reduction of effective dose is lower, about 13 % on average compared to mAsTCM.

CONCLUSIONS

With a risk-minimizing tube current modulation, significant higher reduction of effective dose compared to mAs-minimizing tube current modulation is possible. This article is protected by copyright. All rights reserved.

Deep learning-based forward and cross-scatter correction in dual-source CT

PURPOSE

Dual-source computed tomography (DSCT) uses two source-detector pairs offset by about 90°. In addition to the well-known forward scatter, a special issue in DSCT is cross-scattered radiation from X-ray tube A detected in the detector of system B and vice versa. This effect can lead to artifacts and reduction of the contrast-to-noise ratio of the images. The purpose of this work is to present and evaluate different deep learning-based methods for scatter correction in DSCT.

METHODS

We present different neural network-based methods for forward and cross-scatter correction in DSCT. These deep scatter estimation (DSE) methods mainly differ in the input and output information that is provided for training and inference and in whether they operate on two-dimensional (2D) or on three-dimensional (3D) data. The networks are trained and validated with scatter distributions obtained by our in-house Monte Carlo simulation. The simulated geometry is adapted to a realistic clinical setup.

RESULTS

All DSE approaches reduce scatter-induced artifacts and lead to superior results than the measurement-based scatter correction. Forward scatter, under the presence of cross-scatter, is best estimated either by our network that uses the current projection and a couple of neighboring views (fDSE 2D few views) or by our 3D network that processes all projections simultaneously (fDSE 3D). Cross-scatter, under the presence of forward scatter, is best estimated using xSSE XDSE 2D, with xSSE referring to a quick single scatter estimate of cross scatter, or by xDSE 3D that uses all projections simultaneously. By using our proposed networks, the total scatter error in dual could be reduced from about 18 HU to approximately 3 HU.

CONCLUSIONS

Deep learning-based scatter correction can reduce scatter artifacts in DSCT. To achieve more accurate cross-scatter estimations, the use of a cross-scatter approximation improves the results. Also, the ability to leverage across different projection angles improves the precision of the algorithm.

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

PURPOSE

Dual Energy CT (DECT) provides so-called monoenergetic images based on a linear combination of the original polychromatic images. At certain patient-specific energy levels, corresponding to certain patient- and slice-dependent linear combination weights, e.g., E = 160 keV corresponds to α = 1.57, a significant reduction of metal artifacts may be observed. The authors aimed at analyzing the method for its artifact reduction capabilities to identify its limitations. The results are compared with raw data-based processing.

METHODS

Clinical DECT uses a simplified version of monochromatic imaging by linearly combining the low and the high kV images and by assigning an energy to that linear combination. Those pseudo-monochromatic images can be used by radiologists to obtain images with reduced metal artifacts. The authors analyzed the underlying physics and carried out a series expansion of the polychromatic attenuation equations. The resulting nonlinear terms are responsible for the artifacts, but they are not linearly related between the low and the high kV scan: A linear combination of both images cannot eliminate the nonlinearities, it can only reduce their impact. Scattered radiation yields additional noncanceling nonlinearities. This method is compared to raw data-based artifact correction methods. To quantify the artifact reduction potential of pseudo-monochromatic images, they simulated the FORBILD abdomen phantom with metal implants, and they assessed patient data sets of a clinical dual source CT system (100, 140 kV Sn) containing artifacts induced by a highly concentrated contrast agent bolus and by metal. In each case, they manually selected an optimal α and compared it to a raw data-based material decomposition in case of simulation, to raw data-based material decomposition of inconsistent rays in case of the patient data set containing contrast agent, and to the frequency split normalized metal artifact reduction in case of the metal implant. For each case, the contrast-to-noise ratio (CNR) was assessed.

RESULTS

In the simulation, the pseudo-monochromatic images yielded acceptable artifact reduction results. However, the CNR in the artifact-reduced images was more than 60% lower than in the original polychromatic images. In contrast, the raw data-based material decomposition did not significantly reduce the CNR in the virtual monochromatic images. Regarding the patient data with beam hardening artifacts and with metal artifacts from small implants the pseudo-monochromatic method was able to reduce the artifacts, again with the downside of a significant CNR reduction. More intense metal artifacts, e.g., as those caused by an artificial hip joint, could not be suppressed.

CONCLUSIONS

Pseudo-monochromatic imaging is able to reduce beam hardening, scatter, and metal artifacts in some cases but it cannot remove them. In all cases, the CNR is significantly reduced, thereby rendering the method questionable, unless special post processing algorithms are implemented to restore the high CNR from the original images (e.g., by using a frequency split technique). Raw data-based dual energy decomposition methods should be preferred, in particular, because the CNR penalty is almost negligible.

Interesting detector shapes for third generation CT scanners

PURPOSE

To discuss options in designing detector shapes in third generation CT and to quantify potential cost savings for compact third generation CT systems, and to extend the work from two-dimensional fan-beam CT to three-dimensional cone-beam CT for circular, sequential, and spiral scan trajectories.

METHODS

Third generation CT scanners typically comprise detectors which are flat or whose shape is the segment of a cylinder or a sphere that is focused onto the focal spot of the x-ray source. There appear to be two design criteria that favor this choice of detector shape. One is the possibility of performing fan-beam and cone-beam filtered backprojection in the native geometry (without rebinning) and the other criterion could be to enable the early use of focused antiscatter grids. It is less known, however, that other detector shapes may also have these properties. While these designs have been evaluated for 2D CT from a theoretical standpoint more than one decade ago the authors revisit and generalize these considerations, extend them to 3D circular, sequential, and spiral cone-beam CT and propose an optimal design in terms of detector costs while keeping image quality constant. Their considerations and conclusions are based on considering the sampling density of the x-rays, including the effects of finite focal spot and finite detector element size. Proposing image reconstruction algorithms or numerically evaluating the results by reconstructing simulated projection data is not within the scope of this work.

RESULTS

If the detector arc is curved to be nearly concentric with the circle describing the edge of the field of measurement significantly less detector area and detector pixels are required compared to today's third generation CT systems where the detector arc is centered about the focal spot. Combined with a detector that just covers the spiral Tam window cost savings of 60% or more are possible in compact CT systems. In terms of practicability the new designs appear to be nearly as easy to realize as today's third generation systems.

CONCLUSIONS

Compact CT systems, which require the focal spot to be mounted close to the edge of the field of measurement, may significantly benefit from using detector shapes other than the typical equiangular detector that is focused onto the focal spot.

Effective and organ doses using helical 4DCT for thoracic and abdominal therapies

The capacity of 4DCT to quantify organ motion is beyond conventional 3DCT capability. Local control could be improved. However we are unaware of any reports of organ dose measurements for helical 4DCT imaging. We therefore quantified the radiation doses for helical 4DCT imaging. Organ and tissue dose was measured for thoracic and abdominal 4DCT in helical mode using an adult anthropomorphic phantom. Radiation doses were measured with thermoluminescence dosimeter chips inserted at various anatomical sites on the phantom. For the helical thoracic 4DCT, organ doses were 57.2 mGy for the lung, 76.7 mGy for the thyroids, 48.1 mGy for the breasts, and 10.86 mGy for the colon. The effective doses for male and female phantoms were very similar, with a mean value of 33.1 mSv. For abdominal 4DCT imaging, organ doses were 14.4 mGy for the lung, 0.78 mGy for the thyroids, 9.83 mGy for breasts, and 58.2 mGy for the colon (all obtained by using ICRP 103). We quantified the radiation exposure for thoracic and abdominal helical 4DCT. The doses for helical 4DCT were approximately 1.5 times higher than those for cine 4DCT, however the stepwise image artifact was reduced. 4DCT imaging should be performed with care in order to minimize radiation exposure, but the advantages of 4DCT imaging mandates its incorporation into routine treatment protocols.

Least-error projection sorting to optimize retrospectively gated cardiac micro-CT of free-breathing mice

PURPOSE

To develop and characterize a technique for optimizing image quality by eliminating streaking artifacts in retrospectively gated microcomputed tomography (micro-CT) images of mice caused by insufficient and irregular angular sampling.

METHODS

A least-error sorting technique was developed to minimize streak artifacts in retrospectively gated cardiac micro-CT images. To ensure complete filling of projection space, for each angular position, the projection acquired closest to the desired cardiac phase is used to reconstruct a volumetric image. An acrylic slanted-edge phantom undergoing cyclic motion was used to characterize the system's resolution. The phantom was scanned using a volumetric micro-CT scanner equipped with a flat-panel detector mounted on a slip-ring gantry. Projection images of the moving phantom were collected over a period of 60 s using a variety of acquisition protocols with the rotation period of the gantry ranging from 1 to 5 s. The modulation transfer function (MTF) of the reconstructed images was measured for many combinations of acquisition and reconstruction parameters. The use of the least-error technique was also demonstrated in vivo.

RESULTS

The motion blurring introduced into the images at physiologically significant velocities of 6 cm∕s agreed well with predicted values; limiting resolution (frequency at 10% MTF) degraded from 2.5 to 1.0 mm(-1) for a velocity of 6 cm∕s and 5 s∕rotation gantry speed. Faster gantry rotation speeds led to improved temporal resolution but the scanner's data storage and transfer rates and field of view limitations made scanning at gantry speeds faster than 2 s∕rotation impractical.

CONCLUSIONS

The least-error technique effectively eliminates streaking artifact caused by missing views and allows for optimization of image quality in retrospectively gated micro-CT.

A robust geometry estimation method for spiral, sequential and circular cone-beam micro-CT

PURPOSE

The authors propose a novel method for misalignment estimation of micro-CT scanners using an adaptive genetic algorithm.

METHODS

The proposed algorithm is able to estimate the rotational geometry, the direction vector of table movement and the displacement between different imaging threads of a dual source or even multisource scanner. The calibration procedure does not rely on dedicated calibration phantoms and a sequence scan of a single metal bead is sufficient to geometrically calibrate the whole imaging system for spiral, sequential, and circular scan protocols. Dual source spiral and sequential scan protocols in micro-computed tomography result in projection data that-besides the source and detector positions and orientations-also require a precise knowledge of the table direction vector to be reconstructed properly. If those geometric parameters are not known accurately severe artifacts and a loss in spatial resolution appear in the reconstructed images as long as no geometry calibration is performed. The table direction vector is further required to ensure that consecutive volumes of a sequence scan can be stitched together and to allow the reconstruction of spiral data at all.

RESULTS

The algorithm's performance is evaluated using simulations of a micro-CT system with known geometry and misalignment. To assess the quality of the algorithm in a real world scenario the calibration of a micro-CT scanner is performed and several reconstructions with and without geometry estimation are presented.

CONCLUSIONS

The results indicate that the algorithm successfully estimates all geometry parameters, misalignment artifacts in the reconstructed volumes vanish, and the spatial resolution is increased as can be shown by the evaluation of modulation transfer function measurements.

Empirical beam hardening correction (EBHC) for CT

PURPOSE

Due to x-ray beam polychromaticity and scattered radiation, attenuation measurements tend to be underestimated. Cupping and beam hardening artifacts become apparent in the reconstructed CT images. If only one material such as water, for example, is present, these artifacts can be reduced by precorrecting the rawdata. Higher order beam hardening artifacts, as they result when a mixture of materials such as water and bone, or water and bone and iodine is present, require an iterative beam hardening correction where the image is segmented into different materials and those are forward projected to obtain new rawdata. Typically, the forward projection must correctly model the beam polychromaticity and account for all physical effects, including the energy dependence of the assumed materials in the patient, the detector response, and others. We propose a new algorithm that does not require any knowledge about spectra or attenuation coefficients and that does not need to be calibrated. The proposed method corrects beam hardening in single energy CT data.

METHODS

The only a priori knowledge entering EBHC is the segmentation of the object into different materials. Materials other than water are segmented from the original image, e.g., by using simple thresholding. Then, a (monochromatic) forward projection of these other materials is performed. The measured rawdata and the forward projected material-specific rawdata are monomially combined (e.g., multiplied or squared) and reconstructed to yield a set of correction volumes. These are then linearly combined and added to the original volume. The combination weights are determined to maximize the flatness of the new and corrected volume. EBHC is evaluated using data acquired with a modern cone-beam dual-source spiral CT scanner (Somatom Definition Flash, Siemens Healthcare, Forchheim, Germany), with a modern dual-source micro-CT scanner (Tomo-Scope Synergy Twin, CT Imaging GmbH, Erlangen, Germany), and with a modern C-arm CT scanner (Axiom Artis dTA, Siemens Healthcare, Forchheim, Germany). A large variety of phantom, small animal, and patient data were used to demonstrate the data and system independence of EBHC.

RESULTS

Although no physics apart from the initial segmentation procedure enter the correction process, beam hardening artifacts were significantly reduced by EBHC. The image quality for clinical CT, micro-CT, and C-arm CT was highly improved. Only in the case of C-arm CT, where high scatter levels and calibration errors occur, the relative improvement was smaller.

CONCLUSIONS

The empirical beam hardening correction is an interesting alternative to conventional iterative higher order beam hardening correction algorithms. It does not tend to over- or undercorrect the data. Apart from the segmentation step, EBHC does not require assumptions on the spectra or on the type of material involved. Potentially, it can therefore be applied to any CT image.

Algorithm for hyperfast cone-beam spiral backprojection

Cone-beam spiral backprojection is computationally highly demanding. At first sight, the backprojection requirements are similar to those of cone-beam backprojection from circular scans such as it is performed in the widely used Feldkamp algorithm. However, there is an additional complication: the illumination of each voxel, i.e. the range of angles the voxel is seen by the X-ray cone is a complex function of the voxel position. The weight function has no analytically closed form and must be numerically determined. Storage of the weights is prohibitive since the amount of memory required equals the number of voxels per spiral rotation times the number of projections a voxel receives contributions and therefore is in the order of 10(9) to 10(11) floating point values for typical spiral scans. We propose a new algorithm that combines the spiral symmetry with the ability of today's 64 bit CPUs to store large amounts of precomputed weights. Using the spiral symmetry in this way allows to exploit data-level parallelism and thereby to achieve a very high level of vectorization. An additional postprocessing step rotates these slices back to normal images. Our new backprojection algorithm achieves up to 24.6 Giga voxel updates per second (GUPS) on our systems that are equipped with two standard Intel X5570 quad core CPUs (Intel Xeon 5500 platform, 2.93 GHz, Intel Corporation). This equals the reconstruction of 410 images per second assuming each slice consists of 512 x 512 pixels, receiving contributions from 512 projections.

Autoadaptive phase-correlated (AAPC) reconstruction for 4D CBCT

PURPOSE

Kilovoltage cone-beam computed tomography (CBCT) is widely used in image-guided radiation therapy for exact patient positioning prior to the treatment. However, producing time series of volumetric images (4D CBCT) of moving anatomical structures remains challenging. The presented work introduces a novel method, combining high temporal resolution inside anatomical regions with strong motion and image quality improvement in regions with little motion.

METHODS

In the proposed method, the projections are divided into regions that are subject to motion and regions at rest. The latter ones will be shared among phase bins, leading thus to an overall reduction in artifacts and noise. An algorithm based on the concept of optical flow was developed to analyze motion-induced changes between projections. The technique was optimized to distinguish patient motion and motion deriving from gantry rotation. The effectiveness of the method is shown in numerical simulations and patient data.

RESULTS

The images reconstructed from the presented method yield an almost the same temporal resolution in the moving volume segments as a conventional phase-correlated reconstruction, while reducing the noise in the motionless regions down to the level of a standard reconstruction without phase correlation. The proposed simple motion segmentation scheme is yet limited to rotation speeds of less than 3 degrees/s.

CONCLUSIONS

The method reduces the noise in the reconstruction and increases the image quality. More data are introduced for each phase-correlated reconstruction, and therefore the applied dose is used more efficiently.

3D analytic cone-beam reconstruction for multiaxial CT acquisitions

A conventional 3rd generation Computed Tomography (CT) system with a single circular source trajectory is limited in terms of longitudinal scan coverage since extending the scan coverage beyond 40 mm results in significant cone-beam artifacts. A multiaxial CT acquisition is achieved by combining multiple sequential 3rd generation axial scans or by performing a single axial multisource CT scan with multiple longitudinally offset sources. Data from multiple axial scans or multiple sources provide complementary information. For full-scan acquisitions, we present a window-based 3D analytic cone-beam reconstruction algorithm by tessellating data from neighboring axial datasets. We also show that multi-axial CT acquisition can extend the axial scan coverage while minimizing cone-beam artifacts. For half-scan acquisitions, one cannot take advantage of conjugate rays. We propose a cone-angle dependent weighting approach to combine multi-axial half-scan data. We compute the relative contribution from each axial dataset to each voxel based on the X-ray beam collimation, the respective cone-angles, and the spacing between the axial scans. We present numerical experiments to demonstrate that the proposed techniques successfully reduce cone-beam artifacts at very large volumetric coverage.

Truncation correction for oblique filtering lines

State-of-the-art filtered backprojection (FBP) algorithms often define the filtering operation to be performed along oblique filtering lines in the detector. A limited scan field of view leads to the truncation of those filtering lines, which causes artifacts in the final reconstructed volume. In contrast to the case where filtering is performed solely along the detector rows, no methods are available for the case of oblique filtering lines. In this work, the authors present two novel truncation correction methods which effectively handle data truncation in this case. Method 1 (basic approach) handles data truncation in two successive preprocessing steps by applying a hybrid data extrapolation method, which is a combination of a water cylinder extrapolation and a Gaussian extrapolation. It is independent of any specific reconstruction algorithm. Method 2 (kink approach) uses similar concepts for data extrapolation as the basic approach but needs to be integrated into the reconstruction algorithm. Experiments are presented from simulated data of the FORBILD head phantom, acquired along a partial-circle-plus-arc trajectory. The theoretically exact M-line algorithm is used for reconstruction. Although the discussion is focused on theoretically exact algorithms, the proposed truncation correction methods can be applied to any FBP algorithm that exposes oblique filtering lines.

Improvement of cardiac CT reconstruction using local motion vector fields

The motion of the heart is a major challenge for cardiac imaging using CT. A novel approach to decrease motion blur and to improve the signal to noise ratio is motion compensated reconstruction which takes motion vector fields into account in order to correct motion. The presented work deals with the determination of local motion vector fields from high contrast objects and their utilization within motion compensated filtered back projection reconstruction. Image registration is applied during the quiescent cardiac phases. Temporal interpolation in parameter space is used in order to estimate motion during strong motion phases. The resulting motion vector fields are during image reconstruction. The method is assessed using a software phantom and several clinical cases for calcium scoring. As a criterion for reconstruction quality, calcium volume scores were derived from both, gated cardiac reconstruction and motion compensated reconstruction throughout the cardiac phases using low pitch helical cone beam CT acquisitions. The presented technique is a robust method to determine and utilize local motion vector fields. Motion compensated reconstruction using the derived motion vector fields leads to superior image quality compared to gated reconstruction. As a result, the gating window can be enlarged significantly, resulting in increased SNR, while reliable Hounsfield units are achieved due to the reduced level of motion artefacts. The enlargement of the gating window can be translated into reduced dose requirements.

Motion-compensated iterative cone-beam CT image reconstruction with adapted blobs as basis functions

This paper presents a three-dimensional method to reconstruct moving objects from cone-beam X-ray projections using an iterative reconstruction algorithm and a given motion vector field. For the image representation, adapted blobs are used, which can be implemented efficiently as basis functions. Iterative reconstruction requires the calculation of line integrals (forward projections) through the image volume, which are compared with the actual measurements to update the image volume. In the existence of a divergent motion vector field, a change in the volumes of the blobs has to be taken into account in the forward and backprojections. An efficient method to calculate the line integral through the adapted blobs is proposed. It solves the problem, how to compensate for the divergence in the motion vector field on a grid of basis functions. The method is evaluated on two phantoms, which are subject to three different known motions. Moreover, a motion-compensated filtered back-projection reconstruction method is used, and the reconstructed images are compared. Using the correct motion vector field with the iterative motion-compensated reconstruction, sharp images are obtained, with a quality that is significantly better than gated reconstructions.

Effects of Intrafractional Motion on Water Equivalent Pathlength in Respiratory-Gated Heavy Charged Particle Beam Radiotherapy

PURPOSE

To analyze the water equivalent pathlength (WEL) fluctuations resulting from cardiac motion and display these variations on a beam's-eye-view image; the analysis provides insight into the accuracy of lung tumor irradiation with heavy charged particle beams.

MATERIALS AND METHODS

Volumetric cine computed tomography (CT) images were obtained on 7 lung cancer patients under free-breathing conditions with a 256-multislice CT scanner. Cardiac phase was determined by selecting systole and diastole. A WEL difference image (DeltaWEL) was calculated by subtracting the WEL image at end-systole from that at end-diastole at respiratory exhalation phase. Two calculation regions were defined: Region 1 was limited to the volume defined by planes bounding the heart; Region 2 included the entire body thickness for a given beam's-eye-view angle.

RESULTS

The DeltaWEL values observed in Region 1 showed fluctuations at the periphery of the heart that varied from 20.4 (SD, 5.2) mm WEL to -15.6 (3.2) mm WEL. The areas over which these range perturbation values were observed were 36.8 (32.4) mm(2) and 6.0 (2.8) mm(2) for positive and negative WEL, respectively. The WEL fluctuations in Region 2 increased by approximately 3-4 mm WEL, whereas negative WEL fluctuations changed by approximately -4 to -5 mm WEL, compared with WEL for Region 1; areas over 20 mm WEL changes in Region 2 increased by 9 mm(2) for positive DeltaWEL and 2 mm(2) for negative DeltaWEL.

CONCLUSIONS

Cine CT with a 256-multislice CT scanner captures both volumetric cardiac and respiratory motion with a temporal resolution sufficient to estimate range fluctuations by these motions. This information can be used to assess the range perturbations that charged particle beams may experience in irradiation of lung or esophageal tumors adjacent to the heart.

Effective doses in subjects undergoing computed tomography cardiac imaging with the 256-multislice CT scanner

BACKGROUND

The 256-multislice CT (256MSCT) obtains volumetric data with 128-mm coverage in a single rotation. This coverage allows satisfactory visualization of the whole heart, allowing the 256MSCT to visualize the cardiac chambers and coronary arteries by cine scan without ECG gating. These characteristics provide a solution to the problems of MSCT. Although a wider beam width provides more efficient imaging over a wider coverage area, patient doses with the 256MSCT are of considerable concern.

OBJECTIVE

We assessed potential radiation exposure with the 256MSCT in a cardiac CT protocol and compared the results to those with 16- and 64MSCT (collimated 64x0.5mm using 256MSCT).

METHODS

Organ or tissue doses were measured in an anthropomorphic phantom under a coronary artery imaging protocol with the 256MSCT in cine scan mode without ECG gating, and with the 16- and 64MSCT in helical scan mode with ECG gating.

RESULTS

Average effective doses were 22.8mSv for the 16MSCT, 27.8mSv for the 64MSCT and 14.1mSv for the 256MSCT. The 16- and 64MSCT doses were thus approximately 1.6- and 2.0-fold higher than those of the 256MSCT.

CONCLUSIONS

Use of the 256MSCT in cardiac volumetric cine imaging offers lower radiation exposure than 16- and 64MSCT, and suggests the potential of this equipment in single-beat cardiac imaging without ECG gating. This effective dose is acceptable for routine cardiac imaging.

Evaluation of the spatial resolution characteristics of a cone-beam breast CT scanner

The purpose of this study was to examine the spatial resolution of a prototype pendant-geometry cone-beam breast computed tomography (CT) system. Modulation transfer functions (MTFs) of the reconstructed image in the coronal (x and y) plane were computed as a function of the cone angle, the radial distance from the axis of rotation, the size of the reconstruction matrix, the back-projection filter used, and the number of projections acquired for the reconstruction. The results show that the cone angle and size of the reconstruction matrix have minimal impact on the MTF, while the MTF degraded radially from the axis of rotation (from 0.76 at 2.6 mm from axis of rotation down to 0.37 at 76.9 mm from axis of rotation at f=0.5 mm(-1)). The Ramp reconstruction filter increases the MTF near the axis of rotation relative to the Shepp-Logan filter, while an increase in the number of projections from 500 to 1000 increased the MTF near the periphery of the reconstructed image. The MTF in the z direction (anterior-posterior direction) was also evaluated. The z-direction MTF values tend to be higher when compared to the coronal MTF (0.85 at f =0.5 mm(-1)), and tend to be very constant throughout the coronal plane direction. The results suggest that an increase in the MTF for the prototype breast CT system is possible by optimizing various scanning and reconstruction parameters.

Tilted cone-beam reconstruction with row-wise fan-to-parallel rebinning

Reconstruction algorithms for cone-beam CT have been the focus of many studies. Several exact and approximate reconstruction algorithms were proposed for step-and-shoot and helical scanning trajectories to combat cone-beam related artefacts. In this paper, we present a new closed-form cone-beam reconstruction formula for tilted gantry data acquisition. Although several algorithms were proposed in the past to combat errors induced by the gantry tilt, none of the algorithms addresses the scenario in which the cone-beam geometry is first rebinned to a set of parallel beams prior to the filtered backprojection. We show that the image quality advantages of the rebinned parallel-beam reconstruction are significant, which makes the development of such an algorithm necessary. Because of the rebinning process, the reconstruction algorithm becomes more complex and the amount of iso-centre adjustment depends not only on the projection and tilt angles, but also on the reconstructed pixel location. In this paper, we first demonstrate the advantages of the row-wise fan-to-parallel rebinning and derive a closed-form solution for the reconstruction algorithm for the step-and-shoot and constant-pitch helical scans. The proposed algorithm requires the 'warping' of the reconstruction matrix on a view-by-view basis prior to the backprojection step. We further extend the algorithm to the variable-pitch helical scans in which the patient table travels at non-constant speeds. The algorithm was tested extensively on both the 16- and 64-slice CT scanners. The efficacy of the algorithm is clearly demonstrated by multiple experiments.

Aperture weighted cardiac reconstruction for cone-beam CT

Multi-row detectors together with fast rotating gantries made cardiac imaging possible for CT. Due to the cardiac motion, ECG gating has to be integrated into the reconstruction of the data measured on a low pitch helical trajectory. Since the first multi-row scanners were introduced, it has been shown that approximative true cone-beam reconstruction methods are most suitable for the task of retrospectively gated cardiac volume CT. In this paper, we present the aperture weighted cardiac reconstruction (AWCR), which is a three-dimensional reconstruction algorithm of the filtered back-projection type. It is capable of handling all illumination intervals of an object point, which occur as a consequence of a low pitch helical cone-beam acquisition. Therefore, this method is able to use as much redundant data as possible, resulting in an improvement of the image homogeneity, the signal to noise ratio and the temporal resolution. Different optimization techniques like the heart rate adaptive cardiac weighting or the automatic phase determination can be adopted to AWCR. The excellent image quality achieved by AWCR is presented for medical datasets acquired with both a 40-slice and a 64-slice cone-beam CT scanner.

The radon-split method for helical cone-beam CT and its application to nongated reconstruction

The mathematical analysis of exact filtered back-projection algorithms is strictly related to Radon inversion. We show how filter-lines can be defined for the helical trajectory, which serve for the extraction of contributions of particular kinds of Radon-planes. Due to the Fourier-slice theorem, Radon-planes with few intersections with the helix are associated with low-frequency contributions to transversal slices. This insight leads to different applications of the new method. The application presented here enables the incorporation of an arbitrary amount of redundant data in an approximate way. This means that the back-projection is not restricted to an n-Pi interval. A detailed mathematical analysis, in which we demonstrate how the defined filter-lines work, concludes this paper.

Multithreaded cardiac CT

Phase-correlated CT, as it is used for cardiac imaging, is the most popular and the most important but also the most demanding special CT application in the clinical routine, today. Basically, it fulfills the four-dimensional imaging task of depicting a quasiperiodically moving object at any desired motion phase with significantly reduced motion artifacts. Although image quality with phase-correlated reconstruction is far better than with standard reconstruction, there are motion artifacts remaining and improvements of temporal resolution are required. As a well-known alternative to simply decreasing rotation time, we consider a spiral cone-beam CT scanner that has G x-ray guns and detectors mounted. We call this a multisource or a multithreaded CT scanner. Aiming for improved temporal resolution the relative temporal resolution tau, which measures the fraction of a motion period that enters the image, is studied as a function of the motion rate (heart rate) and the degree of scan overlap (pitch value) for various configurations. The parameters to optimize are the number of threads G and the interthread parameters delta alpha and delta z, which are the angular and the longitudinal separation between adjacent threads, respectively. To demonstrate the improvements approximate image reconstruction of multithreaded raw data is performed by using a generalization of the extended parallel back projection cone-beam reconstruction algorithm [Med. Phys. 31(6), 1623-1641 (2004)] to the case of multithreaded CT. Reconstructions of a simulated cardiac motion phantom and of simulated semi-antropomorphic phantoms are presented for two and three threads and compared to the single-threaded case to demonstrate the potential of multithreaded cardiac CT. Patient data were acquired using a clinical double-threaded CT scanner to validate the theoretical results. The optimum angle delta alpha between the tubes is 90 degrees for a double-threaded system, and for triple-threaded scanners it is 60 degrees or 120 degrees. In all cases, delta z = 0 results as an optimum, which means that the threads should be mounted in the same transversal plane. However, the dependency of the temporal resolution on delta z is very weak and a longitudinal separation delta z not = 0 would not deteriorate image quality. The mean temporal resolution achievable with an optimized multithreaded CT scanner is a factor of G better than the mean temporal resolution obtained with a single-threaded scanner. The standard reconstructions showed decreased cone-beam artifacts with multithreaded CT compared to the single-threaded case. Our phase-correlated reconstructions demonstrate that temporal resolution is significantly improved with multithreaded CT. The clinical patient data confirm our results.

Improved motion compensation in 3D-CT using respiratory-correlated segment reconstruction: diagnostic and radiotherapy applications

Conventional respiratory-gated CT and four-dimensional CT (4DCT) are disadvantaged by their low temporal resolution, which results in the inclusion of anatomic motion-induced artefacts. These represent a significant source of error both in radiotherapy treatment planning for the thorax and upper abdomen and in diagnostic procedures. In particular, temporal resolution and image quality are vitally important to accurate diagnosis and the minimization of planning target volume margin due to respiratory motion. To improve both temporal resolution and signal-to-noise ratio (SNR), we developed a respiratory-correlated segment reconstruction method (RS) and adapted it to the Feldkamp-Davis-Kress algorithm (FDK) with a 256 multidetector row CT (256MDCT). The 256MDCT scans approximately 100 mm in the craniocaudal direction with a 0.5 mm slice thickness in one rotation. Data acquisition for the RS-FDK relies on the assistance of a respiratory sensing system operating in cine scan mode (continuous axial scan with the table stationary). We evaluated the RS-FDK for volume accuracy and image noise in a phantom study with the 256MDCT and compared results with those for a full scan (FS-FDK), which is usually employed in conventional 4DCT and in half scan (HS-FDK). Results showed that the RS-FDK gave a more accurate volume than the others and had the same SNR as the FS-FDK. In a subsequent animal study, we demonstrated a practical sorting process for projection data which was unaffected by variations in respiratory period, and found that the RS-FDK gave the clearest visualization among the three algorithms of the margins of the liver and pulmonary vessels. In summary, the RS-FDK algorithm provides multi-phase images with higher temporal resolution and better SNR. This method should prove useful when combined with new radiotherapeutic and diagnostic techniques.

Direct cone-beam cardiac reconstruction algorithm with cardiac banding artifact correction

Multislice helical computed tomography (CT) is a promising noninvasive technique for coronary artery imaging. Various factors can cause inconsistencies in cardiac CT data, which can result in degraded image quality. These inconsistencies may be the result of the patient physiology (e.g., heart rate variations), the nature of the data (e.g., cone-angle), or the reconstruction algorithm itself. An algorithm which provides the best temporal resolution for each slice, for example, often provides suboptimal image quality for the entire volume since the cardiac temporal resolution (TRc) changes from slice to slice. Such variations in TRc can generate strong banding artifacts in multiplanar reconstruction images or three-dimensional images. Discontinuous heart walls and coronary arteries may compromise the accuracy of the diagnosis. A beta-blocker is often used to reduce and stabilize patients' heart rate but cannot eliminate the variation. In order to obtain robust and optimal image quality, a software solution that increases the temporal resolution and decreases the effect of heart rate is highly desirable. This paper proposes an ECG-correlated direct cone-beam reconstruction algorithm (TCOT-EGR) with cardiac banding artifact correction (CBC) and disconnected projections redundancy compensation technique (DIRECT). First the theory and analytical model of the cardiac temporal resolution is outlined. Next, the performance of the proposed algorithms is evaluated by using computer simulations as well as patient data. It will be shown that the proposed algorithms enhance the robustness of the image quality against inconsistencies by guaranteeing smooth transition of heart cycles used in reconstruction.

Properties of the prototype 256-row (cone beam) CT scanner

We evaluated Feldkamp artifacts, which are specific to cone-beam computed tomography (CT), in phantom and clinical studies using the 256-multidetector-row CT (256MDCT), and compared the reconstruction accuracy of axial and helical scans. Image noise, slice sensitivity profile (SSP) and artifacts with the 256MDCT were evaluated using a phantom, and the results were compared to those of a 64MDCT. We also examined chest and abdomen scans produced with the 256MDCT in volunteers. For the axial scan, Feldkamp artifacts were visualized as high-frequency streak-like artifacts that are oriented horizontally at the edge of the scan region in the phantom study. Similar results were obtained with the volunteers in soft-tissue regions near either bony structures or air pockets. Feldkamp artifacts with the 256MDCT can lead to misdiagnosis if not correctly identified and minimized via helical scanning. Image noise was less for axial than helical scans, while SSP was better with helical than axial scans. Feldkamp artifacts observed in the 256MDCT images, however, did not generally affect the interpretation of images. The 256MDCT promises more accurate diagnosis, and will provide volumetric cine images of wider cranio-caudal coverage, enabling new applications of CT.

A three-dimensional-weighted cone beam filtered backprojection (CB-FBP) algorithm for image reconstruction in volumetric CT—helical scanning

Based on the structure of the original helical FDK algorithm, a three-dimensional (3D)-weighted cone beam filtered backprojection (CB-FBP) algorithm is proposed for image reconstruction in volumetric CT under helical source trajectory. In addition to its dependence on view and fan angles, the 3D weighting utilizes the cone angle dependency of a ray to improve reconstruction accuracy. The 3D weighting is ray-dependent and the underlying mechanism is to give a favourable weight to the ray with the smaller cone angle out of a pair of conjugate rays but an unfavourable weight to the ray with the larger cone angle out of the conjugate ray pair. The proposed 3D-weighted helical CB-FBP reconstruction algorithm is implemented in the cone-parallel geometry that can improve noise uniformity and image generation speed significantly. Under the cone-parallel geometry, the filtering is naturally carried out along the tangential direction of the helical source trajectory. By exploring the 3D weighting's dependence on cone angle, the proposed helical 3D-weighted CB-FBP reconstruction algorithm can provide significantly improved reconstruction accuracy at moderate cone angle and high helical pitches. The 3D-weighted CB-FBP algorithm is experimentally evaluated by computer-simulated phantoms and phantoms scanned by a diagnostic volumetric CT system with a detector dimension of 64 x 0.625 mm over various helical pitches. The computer simulation study shows that the 3D weighting enables the proposed algorithm to reach reconstruction accuracy comparable to that of exact CB reconstruction algorithms, such as the Katsevich algorithm, under a moderate cone angle (4 degrees) and various helical pitches. Meanwhile, the experimental evaluation using the phantoms scanned by a volumetric CT system shows that the spatial resolution along the z-direction and noise characteristics of the proposed 3D-weighted helical CB-FBP reconstruction algorithm are maintained very well in comparison to the FDK-type algorithms. Moreover, the experimental evaluation by clinical data verifies that the proposed 3D-weighted CB-FBP algorithm for image reconstruction in volumetric CT under helical source trajectory meets the challenges posed by diagnostic applications of volumetric CT imaging.

An Approximate Cone Beam Reconstruction Algorithm for Gantry-Tilted CT Using Tangential Filtering

FDK algorithm is a well-known 3D (three-dimensional) approximate algorithm for CT (computed tomography) image reconstruction and is also known to suffer from considerable artifacts when the scanning cone angle is large. Recently, it has been improved by performing the ramp filtering along the tangential direction of the X-ray source helix for dealing with the large cone angle problem. In this paper, we present an FDK-type approximate reconstruction algorithm for gantry-tilted CT imaging. The proposed method improves the image reconstruction by filtering the projection data along a proper direction which is determined by CT parameters and gantry-tilted angle. As a result, the proposed algorithm for gantry-tilted CT reconstruction can provide more scanning flexibilities in clinical CT scanning and is efficient in computation. The performance of the proposed algorithm is evaluated with turbell clock phantom and thorax phantom and compared with FDK algorithm and a popular 2D (two-dimensional) approximate algorithm. The results show that the proposed algorithm can achieve better image quality for gantry-tilted CT image reconstruction.

Tilted plane Feldkamp type reconstruction algorithm for spiral cone beam CT

An approximate image reconstruction method for spiral cone beam computed tomography (CT), called tilted plane Feldkamp type reconstruction algorithm (TPFR), is presented in this paper, which extends Feldkamp cone beam reconstruction algorithm to deal with its inaccuracy and artifact problems caused by large cone angle. This is done by tilting the reconstructing planes to minimize the cone angle and optimally fit the spiral segment of the source. The tilted plane image reconstruction requires reforming the three-dimensional projection data set for the tilted plane and application of Feldkamp algorithm to the reformed data set. Analytical and computational results can show that the image reconstruction performance of the proposed TPFR algorithm is superior to that of the Feldkamp reconstruction algorithm in the image quality, volume coverage speed, maximum achievable pitch value, and slice sensitivity profiles. Moreover, it provides more accurate image reconstruction than the existing two-dimensional reconstruction algorithms.

Evaluation of x-ray scatter properties in a dedicated cone-beam breast CT scanner

The magnitude of scatter contamination on a first-generation prototype breast computed tomography (CT) scanner was evaluated using the scatter-to-primary ratio (SPR) metric. The SPR was measured and characterized over a wide range of parameters relevant to breast CT imaging, including x-ray beam energy, breast diameter, breast composition, isocenter-to-detector distance, collimated slot thickness, and grid ratio. The results demonstrated that in the absence of scatter reduction techniques, the SPR levels for the average breast (e.g., 14 cm diameter 50/50 composition cylindrical phantom) are quite high (approximately 0.5 at the center of the phantom for 80 kVp in true cone-beam CT geometry), and increases as the diameter of the phantom is increased (to approximately 1.0 at the center of a 18 cm diameter 50/50 phantom). The x-ray beam energy and the phantom compositions had only minimal impact on the measured SPR. When an ideal bowtie filter was used, the SPRs at the central axis of the 14 and 18 cm cylindrical phantoms were reduced while the SPRs at the edge of the phantoms were increased. Lastly, collimation in the vertical direction had a significant impact on the SPRs at the central axis of the phantoms. These high SPR levels might lead to cupping artifacts and increased noise in the reconstructed CT images, and this suggests that efficient scatter rejection and/or correction techniques may be required to improve the quality and accuracy of cone beam CT images.

Cardiac cone-beam CT volume reconstruction using ART

Modern computed tomography systems allow volume imaging of the heart. Up to now, approximately two-dimensional (2D) and 3D algorithms based on filtered backprojection are used for the reconstruction. These algorithms become more sensitive to artifacts when the cone angle of the x-ray beam increases as it is the current trend of computed tomography (CT) technology. In this paper, we investigate the potential of iterative reconstruction based on the algebraic reconstruction technique (ART) for helical cardiac cone-beam CT. Iterative reconstruction has the advantages that it takes the cone angle into account exactly and that it can be combined with retrospective cardiac gating fairly easily. We introduce a modified ART algorithm for cardiac CT reconstruction. We apply it to clinical cardiac data from a 16-slice CT scanner and compare the images to those obtained with a current analytical reconstruction method. In a second part, we investigate the potential of iterative reconstruction for a large area detector with 256 slices. For the clinical cases, iterative reconstruction produces excellent images of diagnostic quality. For the large area detector, iterative reconstruction produces images superior to analytical reconstruction in terms of cone-beam artifacts.

Enlarged longitudinal dose profiles in cone-beam CT and the need for modified dosimetry

In order to examine phantom length necessary to assess radiation dose delivered to patients in cone-beam CT with an enlarged beamwidth, we measured dose profiles in cylindrical phantoms of sufficient length using a prototype 256-slice CT-scanner developed at our institute. Dose profiles parallel to the rotation axis were measured at the central and peripheral positions in PMMA (polymethylmethacrylate) phantoms of 160 or 320 mm diameter and 900 mm length. For practical application, we joined unit cylinders (150 mm long) together to provide phantoms of 900 mm length. Dose profiles were measured with a pin photodiode sensor having a sensitive region of approximately 2.8 x 2.8 mm2 and 2.7 mm thickness. Beamwidths of the scanner were varied from 20 to 138 mm. Dose profile integrals (DPI) were calculated using the measured dose profiles for various beamwidths and integration ranges. For the body phantom (320-mm-diam phantom), 76% of the DPI was represented for a 20 mm beamwidth and 60% was represented for a 138 mm beamwidth if dose profiles were integrated over a 100 mm range, while more than 90% of the DPI was represented for beamwidths between 20 and 138 mm if integration was carried out over a 300 mm range. The phantom length and integration range for dosimetry of cone-beam CT needed to be more than 300 mm to represent more than 90% of the DPI for the body phantom with the beamwidth of more than 20 mm. Although we reached this conclusion using the prototype 256-slice CT-scanner, it may be applied to other multislice CT-scanners as well.

Helical cardiac cone beam CT reconstruction with large area detectors: a simulation study

Retrospectively gated cardiac volume CT imaging has become feasible with the introduction of heart rate adaptive cardiac CT reconstruction algorithms. The development in detector technology and the rapid introduction of multi-row detectors has demanded reconstruction schemes which account for the cone geometry. With the extended cardiac reconstruction (ECR) framework, the idea of approximate helical cone beam CT has been extended to be used with retrospective gating, enabling heart rate adaptive cardiac cone beam reconstruction. In this contribution, the ECR technique is evaluated for systems with an increased number of detector rows, which leads to larger cone angles. A simulation study has been carried out based on a 4D cardiac phantom consisting of a thorax model and a dynamic heart insert. Images have been reconstructed for different detector set-ups. Reconstruction assessment functions have been calculated for the detector set-ups employing different rotation times, relative pitches and heart rates. With the increased volume coverage of large area detector systems, low-pitch scans become feasible without resulting in extensive scan times, inhibiting single breath hold acquisitions. ECR delivers promising image results when being applied to systems with larger cone angles.

Clinical potentials of the prototype 256-detector row CT-scanner

RATIONALE AND OBJECTIVES

To evaluate clinical potentials of the 256-detector row computed tomography (CT) in healthy volunteers.

MATERIALS AND METHODS

Eight healthy males (22-63 years) participated in the present study. They underwent a noncontrast-enhanced examination with a contiguous axial scan mode either for head, chest, abdomen, or pelvis. Dose was the same as routinely used for multislice CT examinations. Image quality was interpreted by three board-certified radiologists.

RESULTS

With the 256-detector row CT, 0.5-0.8 mm isotropic volumetric data could be acquired in one rotation. Main promising findings are as follows. Three-dimensional structures were visualized clearly in the multiple planes without secondary reconstruction, whereas the axial images had nearly the same image quality as conventional CT. Shading or streak artifacts were observed at the edge of the scan region. The latter are also known as Feldkamp artifacts. Coronal chest images showed a motion artifact from the heart beating.

CONCLUSION

The 256-detector row CT promises to be useful in clinical applications with its ability to provide three-dimensional visualization of fine structures. The Feldkamp artifacts observed did not generally affect interpretation of images. Investigations are now continuing on image correction along the craniocaudal direction to improve the overall image quality.