Accurate technique for complete geometric calibration of cone-beam computed tomography systems

A Simple and Precise Procedure for a Complete Characterization of a Cone-Beam Computed Tomography System

In the calibration of cone-beam computed tomography (CBCT), two factors must be checked: the alignment of the imaging detector of the CBCT system and the effect of the slanted sample platform. Previously, we developed and validated a distinct procedure to accurately calibrate any misalignment of the detector by using a cylindrical phantom with beads in a straight line, parallel to the axis of rotation of the CBCT system. Here, we generalize our earlier procedure to calibrate the CBCT system while also detecting and rectifying a slight slant of the sample platform. We revise and validate our new procedure by calibrating the CBCT system, which also determines the tilt angle between the central axis of the phantom and the axis of rotation, when not 0°. The errors in misaligned angles for our new procedure are within ±0.03°, calibrating the CBCT system more precisely than our earlier work. To confirm this, we have performed a complete, precise calibration of a dental CBCT system with a tilting sample platform. We also reconstruct a HA phantom in this CBCT system to analyze the quality of reconstruction. We present here a validated method for calibrating a CBCT system and rectifying the effect of its tilting sample platform with good accuracy.

Assessing focal spot alignment in clinical linear accelerators: a comprehensive evaluation with triplet phantoms

A fundamental parameter to evaluate the beam delivery precision and stability on a clinical linear accelerator (linac) is the focal spot position (FSP) measured relative to the collimator axis of the radiation head. The aims of this work were to evaluate comprehensive data on FSP acquired on linacs in clinical use and to establish the ability of alternative phantoms to detect effects on patient plan delivery related to FSP. FSP measurements were conducted using a rigid phantom holding two ball-bearings at two different distances from the radiation source. Images of these ball-bearings were acquired using the electronic portal imaging device (EPID) integrated with each linac. Machine QA was assessed using a radiation head-mounted PTW STARCHECK phantom. Patient plan QA was investigated using the SNC ArcCHECK phantom positioned on the treatment couch, irradiated with VMAT plans across a complete 360° gantry rotation and three X-ray energies. This study covered eight Elekta linacs, including those with 6 MV, 18 MV, and 6 MV flattening-filter-free (FFF) beams. The largest range in the FSP was found for 6 MV FFF. The FSP of one linac, retrofitted with 6 MV FFF, displayed substantial differences in FSP compared to 6 MV FFF beams on other linacs, which all had FSP ranges less than 0.50 mm and 0.25 mm in the lateral and longitudinal directions, respectively. The PTW STARCHECK phantom proved effective in characterising the FSP, while the SNC ArcCHECK measurements could not discern FSP-related features. Minor variations in FSP may be attributed to adjustments in linac parameters, component replacements necessary for beam delivery, and the wear and tear of various linac components, including the magnetron and gun filament. Consideration should be given to the ability of any particular phantom to detect a subsequent impact on the accuracy of patient plan delivery.

An interactive task-based method for the avoidance of metal artifacts in CBCT

PURPOSE

Intraoperative cone-beam CT imaging enables 3D validation of implant positioning and fracture reduction for orthopedic and trauma surgeries. However, the emergence of metal artifacts, especially in the vicinity of metallic objects, severely degrades the clinical value of the imaging modality. In previous works, metal artifact avoidance (MAA) methods have been shown to reduce metal artifacts by adapting the scanning trajectory. Yet, these methods fail to translate to clinical practice due to remaining methodological constraints and missing workflow integration.

METHODS

In this work, we propose a method to compute the spatial distribution and calibrated strengths of expected artifacts for a given tilted circular trajectory. By visualizing this as an overlay changing with the C-Arm's tilt, we enable the clinician to interactively choose an optimal trajectory while factoring in the procedural context and clinical task. We then evaluate this method in a realistic human cadaver study and compare the achieved image quality to acquisitions optimized using global metrics.

RESULTS

We assess the effectiveness of the compared methods by evaluation of image quality gradings of depicted pedicle screws. We find that both global metrics as well as the proposed visualization of artifact distribution enable a drastic improvement compared to standard non-tilted scans. Furthermore, the novel interactive visualization yields a significant improvement in subjective image quality compared to the state-of-the-art global metrics. Additionally we show that by formulating an imaging task, the proposed method allows to selectively optimize image quality and avoid artifacts in the region of interest.

CONCLUSION

We propose a method to spatially resolve predicted artifacts and provide a calibrated measure for artifact strength grading. This interactive MAA method proved practical and effective in reducing metal artifacts in the conducted cadaver study. We believe this study serves as a crucial step toward clinical application of an MAA system to improve image quality and enhance the clinical validation of implant placement.

Marker-based C-arm self-calibration with unknown calibration pattern

BACKGROUND

Accurate tomographic reconstructions require the knowledge of the actual acquisition geometry. Many mobile C-arm CT scanners have poorly reproducible acquisition geometries and thus need acquisition-specific calibration procedures. Most of geometric self-calibration methods based on projection data either need prior information or are limited to the estimation of a low number of geometric calibration parameters. Other self-calibration methods generally use a calibration pattern with known geometry and are hardly implementable in practice for clinical applications.

PURPOSE

We present a three-step marker based self-calibration method which does not require the prior knowledge of the calibration pattern and thus enables the use of calibration patterns with arbitrary markers positions.

METHODS

The first step of the method aims at detecting the set of markers of the calibration pattern in each projection of the CT scan and is performed using the YOLO (You Only Look Once) Convolutional Neural Network. The projected marker trajectories are then estimated by a sequential projection-wise marker association scheme based on the Linear Assignment Problem which uses Kalman filters to predict the markers 2D positions in the projections. The acquisition geometry is finally estimated from the marker trajectories using the Bundle-adjustment algorithm.

RESULTS

The calibration method has been tested on realistic simulated images of the ICRP (International Commission on Radiological Protection) phantom, using calibration patterns with 10 and 20 markers. The backprojection error was used to evaluate the self-calibration method and exhibited sub-millimeter errors. Real images of two human knees with 10 and 30 markers calibration patterns were then used to perform a qualitative evaluation of the method, which showed a remarkable artifacts reduction and bone structures visibility improvement.

CONCLUSIONS

The proposed calibration method gave promising results that pave the way to patient-specific geometric self-calibrations in clinics.

Investigating focal spot position drift in a mobile imaging system equipped with a monobloc-based x-ray generator

BACKGROUND

Misalignment or double-contouring artifacts can appear in high-resolution 3D cone beam computed tomography (CBCT) images, potentially indicating geometric accuracy issues in the projection data. Such artifacts may go unnoticed in low-resolution images and could be associated with changes in the focal spot (FS) position.

PURPOSE

High-resolution 3D-CBCT imaging by a mobile imaging device with a large gantry clearance offers more versatility for clinical workflows in image-guided brachytherapy (IGBT), intraoperative radiation therapy (IORT), and spinal, as well as maxillofacial surgery. However, misalignment or double-contouring artifacts hinder workflow advancements in these domains. This paper introduces intrinsic calibration and geometrical correction methods as extensions to a well-established technique for addressing geometrical deviations resulting from factors such as gravity or mechanical inconsistencies. These extensions cover shifts and drifts of the FS depending on FS size selection, temperature, tube current, and tube potential. The proposed methods effectively mitigate artifacts in high-resolution CBCT images stemming from geometrical inaccuracies in projection data, without requiring additional equipment like a pinhole device.

METHODS

Geometrical offsets and drifts of the x-ray tube FS were characterized on a mobile multi-purpose imaging system, the ImagingRing-m. A pinhole-like experiment was simulated by adjusting the movable collimation unit to a small rectangular aperture within the FS size range. The influence of filament selection, that is, FS size, temperature, the relatively low tube currents, as well as tube potential settings have been studied on two different monobloc types sharing the same x-ray tube insert. The Catphan 504 and an Alderson head phantom were used to assess resulting image artifacts.

RESULTS

Switching the FS size to one different from what was used for geometrical (gravitation, mechanical variations) calibration induced the most notable position changes of the x-ray FS, resulting in double-contouring artifacts and blurring of high-resolution 3D-CBCT images. Incorporating these shifts into a geometrical correction method effectively minimized these artifacts. Thermal drifts exhibited the second largest geometrical changes, comparable to FS size shifts across the thermal operating conditions of the x-ray system. The proposed thermal drift compensation markedly reduced thermal drift effects. Tube current and potential had little impact within the range of available tube currents, eliminating the need for compensation in current applications.

CONCLUSIONS

Augmenting the geometrical calibration pipeline with proposed FS drift compensations yielded significant enhancements in image quality for high-resolution reconstructions. While compensation for thermal effects posed challenges, it proved achievable. The roles of tube current and potential were found to be negligible.

Fully automatic online geometric calibration for non-circular cone-beam CT orbits using fiducials with unknown placement

BACKGROUND

Cone-beam CT (CBCT) with non-circular scanning orbits can improve image quality for 3D intraoperative image guidance. However, geometric calibration of such scans can be challenging. Existing methods typically require a prior image, specialized phantoms, presumed repeatable orbits, or long computation time.

PURPOSE

We propose a novel fully automatic online geometric calibration algorithm that does not require prior knowledge of fiducial configuration. The algorithm is fast, accurate, and can accommodate arbitrary scanning orbits and fiducial configurations.

METHODS

The algorithm uses an automatic initialization process to eliminate human intervention in fiducial localization and an iterative refinement process to ensure robustness and accuracy. We provide a detailed explanation and implementation of the proposed algorithm. Physical experiments on a lab test bench and a clinical robotic C-arm scanner were conducted to evaluate spatial resolution performance and robustness under realistic constraints.

RESULTS

Qualitative and quantitative results from the physical experiments demonstrate high accuracy, efficiency, and robustness of the proposed method. The spatial resolution performance matched that of our existing benchmark method, which used a 3D-2D registration-based geometric calibration algorithm.

CONCLUSIONS

We have demonstrated an automatic online geometric calibration method that delivers high spatial resolution and robustness performance. This methodology enables arbitrary scan trajectories and should facilitate translation of such acquisition methods in a clinical setting.

Feasibility of bone marrow edema detection using dual-energy cone-beam computed tomography

BACKGROUND

Dual-energy (DE) detection of bone marrow edema (BME) would be a valuable new diagnostic capability for the emerging orthopedic cone-beam computed tomography (CBCT) systems. However, this imaging task is inherently challenging because of the narrow energy separation between water (edematous fluid) and fat (health yellow marrow), requiring precise artifact correction and dedicated material decomposition approaches.

PURPOSE

We investigate the feasibility of BME assessment using kV-switching DE CBCT with a comprehensive CBCT artifact correction framework and a two-stage projection- and image-domain three-material decomposition algorithm.

METHODS

DE CBCT projections of quantitative BME phantoms (water containers 100-165 mm in size with inserts presenting various degrees of edema) and an animal cadaver model of BME were acquired on a CBCT test bench emulating the standard wrist imaging configuration of a Multitom Rax twin robotic x-ray system. The slow kV-switching scan protocol involved a 60 kV low energy (LE) beam and a 120 kV high energy (HE) beam switched every 0.5° over a 200° angular span. The DE CBCT data preprocessing and artifact correction framework consisted of (i) projection interpolation onto matched LE and HE projections views, (ii) lag and glare deconvolutions, and (iii) efficient Monte Carlo (MC)-based scatter correction. Virtual non-calcium (VNCa) images for BME detection were then generated by projection-domain decomposition into an Aluminium (Al) and polyethylene basis set (to remove beam hardening) followed by three-material image-domain decomposition into water, Ca, and fat. Feasibility of BME detection was quantified in terms of VNCa image contrast and receiver operating characteristic (ROC) curves. Robustness to object size, position in the field of view (FOV) and beam collimation (varied 20-160 mm) was investigated.

RESULTS

The MC-based scatter correction delivered > 69% reduction of cupping artifacts for moderate to wide collimations (> 80 mm beam width), which was essential to achieve accurate DE material decomposition. In a forearm-sized object, a 20% increase in water concentration (edema) of a trabecular bone-mimicking mixture presented as ∼15 HU VNCa contrast using 80-160 mm beam collimations. The variability with respect to object position in the FOV was modest (< 15% coefficient of variation). The areas under the ROC curve were > 0.9. A femur-sized object presented a somewhat more challenging task, resulting in increased sensitivity to object positioning at 160 mm collimation. In animal cadaver specimens, areas of VNCa enhancement consistent with BME were observed in DE CBCT images in regions of MRI-confirmed edema.

CONCLUSION

Our results indicate that the proposed artifact correction and material decomposition pipeline can overcome the challenges of scatter and limited spectral separation to achieve relatively accurate and sensitive BME detection in DE CBCT. This study provides an important baseline for clinical translation of musculoskeletal DE CBCT to quantitative, point-of-care bone health assessment.

Reference-free calibration method for asynchronous rotation in robotic CT

BACKGROUND

Geometry calibration for robotic CT system is necessary for obtaining acceptable images under the asynchrony of two manipulators.

OBJECTIVE

We aim to evaluate the impact of different types of asynchrony on images and propose a reference-free calibration method based on a simplified geometry model.

METHODS

We evaluate the impact of different types of asynchrony on images and propose a novel calibration method focused on asynchronous rotation of robotic CT. The proposed method is initialized with reconstructions under default uncalibrated geometry and uses grid sampling of estimated geometry to determine the direction of optimization. Difference between the re-projections of sampling points and the original projection is used to guide the optimization direction. Images and estimated geometry are optimized alternatively in an iteration, and it stops when the difference of residual projections is close enough, or when the maximum iteration number is reached.

RESULTS

In our simulation experiments, proposed method shows better performance, with the PSNR increasing by 2%, and the SSIM increasing by 13.6% after calibration. The experiments reveal fewer artifacts and higher image quality.

CONCLUSION

We find that asynchronous rotation has a more significant impact on reconstruction, and the proposed method offers a feasible solution for correcting asynchronous rotation.

Surgical navigation for guidewire placement from intraoperative fluoroscopy in orthopaedic surgery

Objective. Surgical guidewires are commonly used in placing fixation implants to stabilize fractures. Accurate positioning of these instruments is challenged by difficulties in 3D reckoning from 2D fluoroscopy. This work aims to enhance the accuracy and reduce exposure times by providing 3D navigation for guidewire placement from as little as two fluoroscopic images.Approach. Our approach combines machine learning-based segmentation with the geometric model of the imager to determine the 3D poses of guidewires. Instrument tips are encoded as individual keypoints, and the segmentation masks are processed to estimate the trajectory. Correspondence between detections in multiple views is established using the pre-calibrated system geometry, and the corresponding features are backprojected to obtain the 3D pose. Guidewire 3D directions were computed using both an analytical and an optimization-based method. The complete approach was evaluated in cadaveric specimens with respect to potential confounding effects from the imaging geometry and radiographic scene clutter due to other instruments.Main results. The detection network identified the guidewire tips within 2.2 mm and guidewire directions within 1.1°, in 2D detector coordinates. Feature correspondence rejected false detections, particularly in images with other instruments, to achieve 83% precision and 90% recall. Estimating the 3D direction via numerical optimization showed added robustness to guidewires aligned with the gantry rotation plane. Guidewire tips and directions were localized in 3D world coordinates with a median accuracy of 1.8 mm and 2.7°, respectively.Significance. The paper reports a new method for automatic 2D detection and 3D localization of guidewires from pairs of fluoroscopic images. Localized guidewires can be virtually overlaid on the patient's pre-operative 3D scan during the intervention. Accurate pose determination for multiple guidewires from two images offers to reduce radiation dose by minimizing the need for repeated imaging and provides quantitative feedback prior to implant placement.

A new system for in-room image guidance in particle therapy at CNAO

This paper describes the design, installation, and commissioning of an in-room imaging device developed at the Centro Nazionale di Adroterapia Oncologica (CNAO, Pavia, Italy). The system is an upgraded version of the one previously installed in 2014, and its design accounted for the experience gained in a decade of clinical practice of patient setup verification and correction through robotic-supported, off-isocenter in-room image guidance. The system's basic feature consists of image-based setup correction through 2D/3D and 3D/3D registration through a dedicated HW/SW platform. The major update with respect to the device already under clinical usage resides in the implementation of a functionality for extending the field of view of the reconstructed Cone Beam CT (CBCT) volume, along with improved overall safety and functional optimization. We report here details on the procedures implemented for system calibration under all imaging modalities and the results of the technical and preclinical commissioning of the device performed on two different phantoms. In the technical commissioning, specific attention was given to the assessment of the accuracy with which the six-degrees-of-freedom correction vector computed at the off-isocenter imaging position was propagated to the planned isocentric irradiation geometry. During the preclinical commissioning, the entire clinical-like procedure for detecting and correcting imposed, known setup deviation was tested on an anthropomorphic radioequivalent phantom. Results showed system performance within the sub-millimeter and sub-degree range according to project specifications under each imaging modality, making it ready for clinical application.

AAPM Task Group Report 238: 3D C-arms with volumetric imaging capability

This report reviews the image acquisition and reconstruction characteristics of C-arm Cone Beam Computed Tomography (C-arm CBCT) systems and provides guidance on quality control of C-arm systems with this volumetric imaging capability. The concepts of 3D image reconstruction, geometric calibration, image quality, and dosimetry covered in this report are also pertinent to CBCT for Image-Guided Radiation Therapy (IGRT). However, IGRT systems introduce a number of additional considerations, such as geometric alignment of the imaging at treatment isocenter, which are beyond the scope of the charge to the task group and the report. Section 1 provides an introduction to C-arm CBCT systems and reviews a variety of clinical applications. Section 2 briefly presents nomenclature specific or unique to these systems. A short review of C-arm fluoroscopy quality control (QC) in relation to 3D C-arm imaging is given in Section 3. Section 4 discusses system calibration, including geometric calibration and uniformity calibration. A review of the unique approaches and challenges to 3D reconstruction of data sets acquired by C-arm CBCT systems is give in Section 5. Sections 6 and 7 go in greater depth to address the performance assessment of C-arm CBCT units. First, Section 6 describes testing approaches and phantoms that may be used to evaluate image quality (spatial resolution and image noise and artifacts) and identifies several factors that affect image quality. Section 7 describes both free-in-air and in-phantom approaches to evaluating radiation dose indices. The methodologies described for assessing image quality and radiation dose may be used for annual constancy assessment and comparisons among different systems to help medical physicists determine when a system is not operating as expected. Baseline measurements taken either at installation or after a full preventative maintenance service call can also provide valuable data to help determine whether the performance of the system is acceptable. Collecting image quality and radiation dose data on existing phantoms used for CT image quality and radiation dose assessment, or on newly developed phantoms, will inform the development of performance criteria and standards. Phantom images are also useful for identifying and evaluating artifacts. In particular, comparing baseline data with those from current phantom images can reveal the need for system calibration before image artifacts are detected in clinical practice. Examples of artifacts are provided in Sections 4, 5, and 6.

Motion estimation based on projective information disentanglement for 3D reconstruction of rotational coronary angiography

The 2D projection space-based motion compensation reconstruction (2D-MCR) is a kind of representative method for 3D reconstruction of rotational coronary angiography owing to its high efficiency. However, due to the lack of accurate motion estimation of the overlapping projection pixels, existing 2D-MCR methods may still have a certain level of under-sampling artifacts or lose accuracy for cases with strong cardiac motion. To overcome this, in this study, we proposed a motion estimation approach based on projective information disentanglement (PID-ME) for 3D reconstruction of rotational coronary angiography. The reconstruction method adopts the framework of 2D-MCR, which is referred to as 2D-PID-MCR. The PID-ME consists of two parts: generation of the reference projection sequence based on the fast simplified distance driven projector (FSDDP) algorithm, motion estimation and correction based on the projective average minimal distance measure (PAMD) model. The FSDDP algorithm generates the reference projection sequence faster and accelerates the whole reconstruction greatly. The PAMD model can disentangle the projection information effectively and estimate the motion of both overlapping and non-overlapping projection pixels accurately. The main contribution of this study is the construction of 2D-PID-MCR to overcome the inherent limitations of the existing 2D-MCR method. Simulated and clinical experiments show that the PID-ME, consisting of FSDDP and PAMD, can estimate the motion of the projection sequence data accurately and efficiently. Our 2D-PID-MCR method outperforms the state-of-the-art approaches in terms of accuracy and real-time performance.

A nonconvex model-based combined geometric calibration scheme for micro cone-beam CT with irregular trajectories

BACKGROUND

Many dedicated cone-beam CT (CBCT) systems have irregular scanning trajectories. Compared with the standard CBCT calibration, accurate calibration for CBCT systems with irregular trajectories is a more complex task, since the geometric parameters for each scanning view are variable. Most of the existing calibration methods assume that the intrinsic geometric relationship of the fiducials in the phantom is precisely known, and rarely delve deeper into the issue of whether the phantom accuracy is adapted to the calibration model.

PURPOSE

A high-precision phantom and a highly robust calibration model are interdependent and mutually supportive, and they are both important for calibration accuracy, especially for the high-resolution CBCT. Therefore, we propose a calibration scheme that considers both accurate phantom measurement and robust geometric calibration.

METHODS

Our proposed scheme consists of two parts: (1) introducing a measurement model to acquire the accurate intrinsic geometric relationship of the fiducials in the phantom; (2) developing a highly noise-robust nonconvex model-based calibration method. The measurement model in the first part is achieved by extending our previous high-precision geometric calibration model suitable for CBCT with circular trajectories. In the second part, a novel iterative method with optimization constraints based on a back-projection model is developed to solve the geometric parameters of each view.

RESULTS

The simulations and real experiments show that the measurement errors of the fiducial ball bearings (BBs) are within the subpixel level. With the help of the geometric relationship of the BBs obtained by our measurement method, the classic calibration method can achieve good calibration based on far fewer BBs. All metrics obtained in simulated experiments as well as in real experiments on Micro CT systems with resolutions of 9 and 4.5 μm show that the proposed calibration method has higher calibration accuracy than the competing classic method. It is particularly worth noting that although our measurement model proves to be very accurate, the classic calibration method based on this measurement model can only achieve good calibration results when the resolution of the measurement system is close to that of the system to be calibrated, but our calibration scheme enables high-accuracy calibration even when the resolution of the system to be calibrated is twice that of the measurement system.

CONCLUSIONS

The proposed combined geometrical calibration scheme does not rely on a phantom with an intricate pattern of fiducials, so it is applicable in Micro CT with high resolution. The two parts of the scheme, the "measurement model" and the "calibration model," prove to be of high accuracy. The combination of these two models can effectively improve the calibration accuracy, especially in some extreme cases.

3D Reconstruction of Wrist Bones from C-Arm Fluoroscopy Using Planar Markers

In orthopedic surgeries, such as osteotomy and osteosynthesis, an intraoperative 3D reconstruction of the bone would enable surgeons to quickly assess the fracture reduction procedure with preoperative planning. Scanners equipped with such functionality are often more expensive than a conventional C-arm fluoroscopy device. Moreover, a C-arm fluoroscopy device is commonly available in many orthopedic facilities. Based on the widespread use of such equipment, this paper proposes a method to reconstruct the 3D structure of bone with a conventional C-arm fluoroscopy device. We focus on wrist bones as the target of reconstruction in this research as this will facilitate a flexible imaging scheme. Planar markers are attached to the target object and are tracked in the fluoroscopic image for C-arm pose estimation. The initial calibration of the device is conducted using a checkerboard pattern. In general, reconstruction algorithms are sensitive to geometric calibration errors. To assess the practicality of the method for reconstruction, a simulation study demonstrating the effect of checkerboard thickness and spherical marker size on reconstruction quality was conducted.

Online geometry calibration for retrofit computed tomography from a mouse rotation system and a small-animal imager

BACKGROUND

Computed tomography (CT) generates a three-dimensional rendering that can be used to interrogate a given region or desired structure from any orientation. However, in preclinical research, its deployment remains limited due to relatively high upfront costs. Existing integrated imaging systems that provide merged planar X-ray also dwarfs CT popularity in small laboratories due to their added versatility.

PURPOSE

In this paper, we sought to generate CT-like data using an existing small-animal X-ray imager with a specialized specimen rotation system, or MiSpinner. This setup conforms to the cone-beam CT (CBCT) geometry, which demands high spatial calibration accuracy. Therefore, a simple but robust geometry calibration algorithm is necessary to ensure that the entire imaging system works properly and accurately.

METHODS

Because the rotation system is not permanently affixed, we propose a structure tensor-based two-step online (ST-TSO) geometry calibration algorithm. Specifically, two datasets are needed, namely, calibration and actual measurements. A calibration measurement detects the background of the system forward X-ray projections. A study on the background image reveals the characteristics of the X-ray photon distribution, and thus, provides a reliable estimate of the imaging geometry origin. Actual measurements consisted of an X-ray of the intended object, including possible geometry errors. A comprehensive image processing technique helps to detect spatial misalignment information. Accordingly, the first processing step employs a modified projection matrix-based calibration algorithm to estimate the relevant geometric parameters. Predicted parameters are then fine-tuned in a second processing step by an iterative strategy based on the symmetry property of the sum of projections. Virtual projections calculated from the parameters after two-step processing compensate for the scanning errors and are used for CT reconstruction. Experiments on phantom and mouse imaging data were performed to validate the calibration algorithm.

RESULTS

Once system correction was conducted, CBCT of a CT bar phantom and a cohort of euthanized mice were analyzed. No obvious structure error or spatial artifacts were observed, validating the accuracy of the proposed geometry calibration method. Digital phantom simulation indicated that compared with the preset spatial values, errors in the final estimated parameters could be reduced to 0.05° difference in dominant angle and 0.5-pixel difference in dominant axis bias. The in-plane resolution view of the CT-bar phantom revealed that the resolution approaches 150 μ $\umu$ m.

CONCLUSIONS

A constrained two-step online geometry calibration algorithm has been developed to calibrate an integrated X-ray imaging system, defined by a first-step analytical estimation and a second-step iterative fine-tuning. Test results have validated its accuracy in system correction, thus demonstrating the potential of the described system to be modified and adapted for preclinical research.

An empirical method for geometric calibration of a photon counting detector-based cone beam CT system

BACKGROUND

Geometric calibration is essential in developing a reliable computed tomography (CT) system. It involves estimating the geometry under which the angular projections are acquired. Geometric calibration of cone beam CTs employing small area detectors, such as currently available photon counting detectors (PCDs), is challenging when using traditional-based methods due to detectors' limited areas.

OBJECTIVE

This study presented an empirical method for the geometric calibration of small area PCD-based cone beam CT systems.

METHODS

Unlike the traditional methods, we developed an iterative optimization procedure to determine geometric parameters using the reconstructed images of small metal ball bearings (BBs) embedded in a custom-built phantom. An objective function incorporating the sphericities and symmetries of the embedded BBs was defined to assess performance of the reconstruction algorithm with the given initial estimated set of geometric parameters. The optimal parameter values were those which minimized the objective function. The TIGRE toolbox was employed for fast tomographic reconstruction. To evaluate the proposed method, computer simulations were carried out using various numbers of spheres placed in various locations. Furthermore, efficacy of the method was experimentally assessed using a custom-made benchtop PCD-based cone beam CT.

RESULTS

Computer simulations validated the accuracy and reproducibility of the proposed method. The precise estimation of the geometric parameters of the benchtop revealed high-quality imaging in CT reconstruction of a breast phantom. Within the phantom, the cylindrical holes, fibers, and speck groups were imaged in high fidelity. The CNR analysis further revealed the quantitative improvements of the reconstruction performed with the estimated parameters using the proposed method.

CONCLUSION

Apart from the computational cost, we concluded that the method was easy to implement and robust.

3D-2D image registration in the presence of soft-tissue deformation in image-guided transbronchial interventions

Purpose. Target localization in pulmonary interventions (e.g. transbronchial biopsy of a lung nodule) is challenged by deformable motion and may benefit from fluoroscopic overlay of the target to provide accurate guidance. We present and evaluate a 3D-2D image registration method for fluoroscopic overlay in the presence of tissue deformation using a multi-resolution/multi-scale (MRMS) framework with an objective function that drives registration primarily by soft-tissue image gradients.Methods. The MRMS method registers 3D cone-beam CT to 2D fluoroscopy without gating of respiratory phase by coarse-to-fine resampling and global-to-local rescaling about target regions-of-interest. A variation of the gradient orientation (GO) similarity metric (denotedGO') was developed to downweight bone gradients and drive registration via soft-tissue gradients. Performance was evaluated in terms of projection distance error at isocenter (PDE_iso). Phantom studies determined nominal algorithm parameters and capture range. Preclinical studies used a freshly deceased, ventilated porcine specimen to evaluate performance in the presence of real tissue deformation and a broad range of 3D-2D image mismatch.Results. Nominal algorithm parameters were identified that provided robust performance over a broad range of motion (0-20 mm), including an adaptive parameter selection technique to accommodate unknown mismatch in respiratory phase. TheGO'metric yielded median PDE_iso= 1.2 mm, compared to 6.2 mm for conventionalGO.Preclinical studies with real lung deformation demonstrated median PDE_iso= 1.3 mm with MRMS +GO'registration, compared to 2.2 mm with a conventional transform. Runtime was 26 s and can be reduced to 2.5 s given a prior registration within ∼5 mm as initialization.Conclusions. MRMS registration via soft-tissue gradients achieved accurate fluoroscopic overlay in the presence of deformable lung motion. By driving registration via soft-tissue image gradients, the method avoided false local minima presented by bones and was robust to a wide range of motion magnitude.

Online Calibration of a Linear Micro Tomosynthesis Scanner

In a linear tomosynthesis scanner designed for imaging histologic samples of several centimeters size at 10 µm resolution, the mechanical instability of the scanning stage (±10 µm) exceeded the resolution of the image system, making it necessary to determine the trajectory of the stage for each scan to avoid blurring and artifacts in the images that would arise from the errors in the geometric information used in 3D reconstruction. We present a method for online calibration by attaching a layer of randomly dispersed micro glass beads or calcium particles to the bottom of the sample stage. The method was based on a parametric representation of the rigid body motion of the sample stage-marker layer assembly. The marker layer was easy to produce and proven effective in the calibration procedure.

Online Geometric Calibration of a Hybrid CT System for Ultrahigh-Resolution Imaging

A hybrid imaging system consisting of a standard computed tomography (CT) scanner and a low-profile photon-counting detector insert in contact with the patient's body has been used to produce ultrahigh-resolution images in a limited volume in chest scans of patients. The detector insert is placed on the patient bed as needed and not attached. Thus, its position and orientation in the scanner is dependent on the patient's position and scan settings. To allow accurate image reconstruction, we devised a method of determining the relative geometry of the detector insert and the CT scanner for each scan using fiducial markers. This method uses an iterative registration algorithm to align the markers in the reconstructed volume from the detector insert to that of the concurrent CT scan. After obtaining precise geometric information of the detector insert relative to the CT scanner, the two complementary sets of images are summed together to create a detailed image with reduced artifacts.

Drift Artifacts Correction for Laboratory Cone-Beam Nanoscale X-ray Computed Tomography by Fitting the Partial Trajectory of Projection Centroid

A self-correction method for the drift artifacts of laboratory cone-beam nanoscale X-ray computed tomography (nano-CT) based on the trajectory of projection centroid (TPC) is proposed. This method does not require additional correction phantoms, simplifying the correction process. The whole TPC is estimated by the partial TPC in the optimal projection set. The projection drift is calculated by the measured TPC and the estimated TPC. The interval search method is used so that the proposed method can adapt to the case of a truncated projection due to drift. The fixed-angle scanning experiment of the Siemens star and the partial derivative analysis of the projection position show the necessity of correcting drift artifacts. Further, the Shepp–Logan phantoms with different drift levels are simulated. The results show that the proposed method can effectively estimate the horizontal and vertical drifts within the projection drift range of ±2 mm (27 pixels) with high accuracy. Experiments were conducted on tomato seed and bamboo stick to validate the feasibility of the proposed method for samples with different textures. The correction effect on different reconstructed slices indicates that the proposed method provides performance superior to the reference scanning method (RSM) and global fitting. In addition, the proposed method requires no extra scanning, which improves the acquisition efficiency, as well as radiation utilization.

Angle prediction model when the imaging plane is tilted about z-axis

Computer Tomography (CT) is a complicated imaging system, requiring highly geometric positioning. We found a special artifact caused by detection plane tilted around z-axis. In short scan cone-beam reconstruction, this kind of geometric deviation result in half circle shaped fuzzy around highlighted particles in reconstructed slices. This artifact is distinct near the slice periphery, but deficient around the slice center. We generated mathematical models, and InceptionV3-R deep network to study the slice artifact features to estimate the detector z-axis tilt angle. The testing results are: mean absolute error of 0.08819 degree, the Root mean square error of 0.15221 degree and R-square of 0.99944. A geometric deviation recover formula was deduced, which can eliminate this artifact efficiently. This research enlarges the CT artifact knowledge hierarchy, and verifies the capability of machine learning in CT geometric deviation artifact recoveries.

Technical assessment of 2D and 3D imaging performance of an IGZO-based flat-panel X-ray detector

BACKGROUND

Indirect detection flat-panel detectors (FPDs) consisting of hydrogenated amorphous silicon (a-Si:H) thin-film transistors (TFTs) are a prevalent technology for digital x-ray imaging. However, their performance is challenged in applications requiring low exposure levels, high spatial resolution, and high frame rate. Emerging FPD designs using metal oxide TFTs may offer potential performance improvements compared to FPDs based on a-Si:H TFTs.

PURPOSE

This work investigates the imaging performance of a new indium gallium zinc oxide (IGZO) TFT-based detector in 2D fluoroscopy and 3D cone-beam CT (CBCT).

METHODS

The new FPD consists of a sensor array combining IGZO TFTs with a-Si:H photodiodes and a 0.7-mm thick CsI:Tl scintillator. The FPD was implemented on an x-ray imaging bench with system geometry emulating intraoperative CBCT. A conventional FPD with a-Si:H TFTs and a 0.6-mm thick CsI:Tl scintillator was similarly implemented as a basis of comparison. 2D imaging performance was characterized in terms of electronic noise, sensitivity, linearity, lag, spatial resolution (modulation transfer function, MTF), image noise (noise-power spectrum, NPS), and detective quantum efficiency (DQE) with entrance air kerma (EAK) ranging from 0.3 to 1.2 μGy. 3D imaging performance was evaluated in terms of the 3D MTF and noise-equivalent quanta (NEQ), soft-tissue contrast-to-noise ratio (CNR), and image quality evident in anthropomorphic phantoms for a range of anatomical sites and dose, with weighted air kerma, K w ${K_w}$ , ranging from 0.8 to 4.9 mGy.

RESULTS

The 2D imaging performance of the IGZO-based FPD exhibited up to ∼1.7× lower electronic noise than the a-Si:H FPD at matched pixel pitch. Furthermore, the IGZO FPD exhibited ∼27% increase in mid-frequency DQE (1 mm^-1 ) at matched pixel size and dose (EAK ≈ 1.0 μGy) and ∼11% increase after adjusting for differences in scintillator thickness. 2D spatial resolution was limited by the scintillator for each FPD. The IGZO-based FPD demonstrated improved 3D NEQ at all spatial frequencies in both head (≥25% increase for all dose levels) and body (≥10% increase for K w ${K_w}$ ≤2 mGy) imaging scenarios. These characteristics translated to improved low-contrast visualization in anthropomorphic phantoms, demonstrating ≥10% improvement in CNR and extension of the low-dose range for which the detector is input-quantum limited.

CONCLUSION

The IGZO-based FPD demonstrated improvements in electronic noise, image lag, and NEQ that translated to measurable improvements in 2D and 3D imaging performance compared to a conventional FPD based on a-Si:H TFTs. The improvements are most beneficial for 2D or 3D imaging scenarios involving low-dose and/or high-frame rate.

Review of high energy x-ray computed tomography for non-destructive dimensional metrology of large metallic advanced manufactured components

Advanced manufacturing technologies, led by additive manufacturing, have undergone significant growth in recent years. These technologies enable engineers to design parts with reduced weight while maintaining structural and functional integrity. In particular, metal additive manufacturing parts are increasingly used in application areas such as aerospace, where a failure of a mission-critical part can have dire safety consequences. Therefore, the quality of these components is extremely important. A critical aspect of quality control is dimensional evaluation, where measurements provide quantitative results that are traceable to the standard unit of length, the metre. Dimensional measurements allow designers, manufacturers and users to check product conformity against engineering drawings and enable the same quality standard to be used across the supply chain nationally and internationally. However, there is a lack of development of measurement techniques that provide non-destructive dimensional measurements beyond common non-destructive evaluation focused on defect detection. X-ray computed tomography (XCT) technology has great potential to be used as a non-destructive dimensional evaluation technology. However, technology development is behind the demand and growth for advanced manufactured parts. Both the size and the value of advanced manufactured parts have grown significantly in recent years, leading to new requirements of dimensional measurement technologies. This paper is a cross-disciplinary review of state-of-the-art non-destructive dimensional measuring techniques relevant to advanced manufacturing of metallic parts at larger length scales, especially the use of high energy XCT with source energy of greater than 400 kV to address the need in measuring large advanced manufactured parts. Technologies considered as potential high energy x-ray generators include both conventional x-ray tubes, linear accelerators, and alternative technologies such as inverse Compton scattering sources, synchrotron sources and laser-driven plasma sources. Their technology advances and challenges are elaborated on. The paper also outlines the development of XCT for dimensional metrology and future needs.

Technical evaluation of the cone-beam computed tomography imaging performance of a novel, mobile, gantry-based X-ray system for brachytherapy

Purpose

A novel, mobile cone‐beam computed tomography (CBCT) system for image‐guided adaptive brachytherapy was recently deployed at our hospital as worldwide first site. Prior to the device's clinical operation, a profound characterization of its imaging performance was conducted. This was essential to optimize both the imaging workflow and image quality for achieving the best possible clinical outcomes. We present the results of our investigations.

Methods

The novel CBCT‐system features a ring gantry with 121 cm clearance as well as a 43.2 × 43.2 cm² flat‐panel detector, and is controlled via a tablet‐personal computer (PC). For evaluating its imaging performance, the geometric reproducibility as well as imaging fidelity, computed tomography (CT)‐number accuracy, uniformity, contrast‐noise‐ratio (CNR), noise characteristics, and spatial resolution as fundamental image quality parameters were assessed. As dose metric the weighted cone‐beam dose index (CBDI_w) was measured. Image quality was evaluated using standard quality assurance (QA) as well as anthropomorphic upper torso and breast phantoms. Both in‐house and manufacturer protocols for abdomen, pelvis, and breast imaging were examined.

Results

Using the in‐house protocols, the QA phantom scans showed altogether a high image quality, with high CT‐number accuracy (R² > 0.97) and uniformity (<12 Hounsfield Unit (HU) cupping), reasonable noise and imaging fidelity, and good CNR at bone–tissue transitions of up to 28:1. Spatial resolution was strongly limited by geometric instabilities of the device. The breast phantom scans fulfilled clinical requirements, whereas the abdomen and pelvis scans showed severe artifacts, particularly at air/bone–tissue transitions.

Conclusion

With the novel CBCT‐system, achieving a high image quality appears possible in principle. However, adaptations of the standard protocols, performance enhancements in image reconstruction referring to artifact reductions, as well as the extinction of geometric instabilities are imperative.

Improving dose calculation accuracy in preclinical radiation experiments using multi-energy element resolved cone beam CT

Cone-beam CT (CBCT) in modern pre-clinical small-animal radiation research platforms provides volumetric images for image guidance and experiment planning purposes. In this work, we implemented multi-energy element-resolved (MEER) CBCT using three scans with different kVps on a SmART platform (Precision X-ray Inc.) We performed comprehensive calibration tasks achieve sufficient accuracy for this quantitative imaging purpose. For geometry calibration, we scanned a ball bearing phantom and used an analytical method together with an optimization approach to derive gantry-angle specific geometry parameters. Intensity calibration and correction included the corrections for detector lag, glare, and beam hardening. The corrected CBCT projection images acquired at 30, 40 and 60 kVp in multiple scans were used to reconstruct CBCT images using the Feldkamp-Davis-Kress reconstruction algorithm. After that, an optimization problem was solved to determine images of relative electron density (rED) and elemental composition (EC) that are needed for Monte Carlo-based radiation dose calculation. We demonstrated effectiveness of our CBCT calibration steps by showing improvements in image quality and successful material decomposition in cases with a small animal CT calibration phantom and a plastinated mouse phantom. It was found that artifacts induced by geometry inaccuracy, detector lag, glare and beam hardening were visually reduced. CT number mean errors were reduced from 19\% to 5\%. In the CT calibration phantom case, median errors in H, O, and Ca fractions for all the inserts were below 1\%, 2\%, and 4\% respectively, and median error in rED was less than 5\%. Compared to standard approach deriving material type and rED via CT number conversion, our approach improved Monte Carlo simulation-based dose calculation accuracy in bone regions. Mean dose error was reduced from 47.5\% to 10.9\%.

Spectral CT using a fine grid structure and varying x-ray incidence angle

PURPOSE

Interest in spectral computed tomography (CT) for diagnostics and therapy evaluation has been growing. Data acquisitions with distinct spectral sensitivities provide the ability to discriminate multiple materials, quantitative density estimates, and reduced artifacts due to energy dependencies. We introduce a novel spectral CT concept that includes a fine-pitch grid structure for prefiltration of the x-ray beam.

METHODS

We develop physical models for grid designs and illustrate the basic operating principles wherein small angulations of the incident x rays results significant filtration and spectral shaping of the beam. We fabricate a prototype grid with tungsten lamellae. We compare x-ray spectra induced by this filter as a function of incidence angle in both simulation students and in physical measurements. The grid is also integrated onto a CT test bench where we scanned an iodinated phantom with clinically relevant concentrations (5, 10, 20, and 50 mgI/mL) to demonstrate the ability to perform spectral CT acquisitions and material decomposition.

RESULTS

X-ray spectrometer measurements reveal diverse and controllable spectral shaping with small angle changes that are in agreement with simulation studies. Critical angles where the characteristics of the induced spectrum changes dramatically are identified. Reconstructions of projection data for two angulations separated by 2° was reconstructed and material decomposition into iodine and water images shows good agreement with the known iodine concentrations.

CONCLUSIONS

This work demonstrates the feasibility of the grid-based approach to enable spectral CT data acquisitions and accurate material decompositions. On-going and future studies will investigate the potential of this novel concept as a relatively simple upgrade to standard energy-integrating CT.

High-resolution model-based material decomposition in dual-layer flat-panel CBCT

PURPOSE

Spectral CT uses energy-dependent measurements that enable material discrimination in addition to reconstruction of structural information. Flat-panel detectors (FPDs) have been widely used in dedicated and interventional systems to deliver high spatial resolution, volumetric cone-beam CT (CBCT) in compact and OR-friendly designs. In this work, we derive a model-based method that facilitates high-resolution material decomposition in a spectral CBCT system equipped with a prototype dual-layer FPD. Through high-fidelity modeling of multilayer detector, we seek to avoid resolution loss that is present in more traditional processing and decomposition approaches.

METHOD

A physical model for spectral measurements in dual-layer flat-panel CBCT is developed including layer-dependent differences in system geometry, spectral sensitivities, and detector blur (e.g., due to varied scintillator thicknesses). This forward model is integrated into a model-based material decomposition (MBMD) method based on minimization of a penalized weighted least-squared (PWLS) objective function. The noise and resolution performance of this approach was compared with traditional projection-domain decomposition (PDD) and image-domain decomposition (IDD) approaches as well as one-step MBMD with lower-fidelity models that use approximated geometry, projection interpolation, or an idealized system geometry without system blur model. Physical studies using high-resolution three-dimensional (3D)-printed water-iodine phantoms were conducted to demonstrate the high-resolution imaging performance of the compared decomposition methods in iodine basis images and synthetic monoenergetic images.

RESULTS

Physical experiments demonstrate that the MBMD methods incorporating an accurate geometry model can yield higher spatial resolution iodine basis images and synthetic monoenergetic images than PDD and IDD results at the same noise level. MBMD with blur modeling can further improve the spatial-resolution compared with the decomposition results obtained with IDD, PDD, and MBMD methods with lower-fidelity models. Using the MBMD without or with blur model can increase the absolute modulation at 1.75 lp/mm by 10% and 22% compared with IDD at the same noise level.

CONCLUSION

The proposed model-based material decomposition method for a dual-layer flat-panel CBCT system has demonstrated an ability to extend high-resolution performance through sophisticated detector modeling including the layer-dependent blur. The proposed work has the potential to not only facilitate high-resolution spectral CT in interventional and dedicated CBCT systems, but may also provide the opportunity to evaluate different flat-panel design trade-offs including multilayer FPDs with mismatched geometries, scintillator thicknesses, and spectral sensitivities.

Development of a fluoroscopically guided robotic assistant for instrument placement in pelvic trauma surgery

Purpose: A method for fluoroscopic guidance of a robotic assistant is presented for instrument placement in pelvic trauma surgery. The solution uses fluoroscopic images acquired in standard clinical workflow and helps avoid repeat fluoroscopy commonly performed during implant guidance. Approach: Images acquired from a mobile C-arm are used to perform 3D-2D registration of both the patient (via patient CT) and the robot (via CAD model of a surgical instrument attached to its end effector, e.g; a drill guide), guiding the robot to target trajectories defined in the patient CT. The proposed approach avoids C-arm gantry motion, instead manipulating the robot to acquire disparate views of the instrument. Phantom and cadaver studies were performed to determine operating parameters and assess the accuracy of the proposed approach in aligning a standard drill guide instrument. Results: The proposed approach achieved average drill guide tip placement accuracy of 1.57 ± 0.47    mm and angular alignment of 0.35 ± 0.32    deg in phantom studies. The errors remained within 2 mm and 1 deg in cadaver experiments, comparable to the margins of errors provided by surgical trackers (but operating without the need for external tracking). Conclusions: By operating at a fixed fluoroscopic perspective and eliminating the need for encoded C-arm gantry movement, the proposed approach simplifies and expedites the registration of image-guided robotic assistants and can be used with simple, non-calibrated, non-encoded, and non-isocentric C-arm systems to accurately guide a robotic device in a manner that is compatible with the surgical workflow.

Auto-calibration of cone beam geometries from arbitrary rotating markers using a vector geometry formulation of projection matrices

An efficient method for the determination of the projection geometry of cone beam micro computed tomography systems based on two or more fiducial markers of unknown position within the field of view is derived. By employing the projection matrix formalism commonly used in computer graphics, a very clear presentation of the resulting self consistent calibration problem can be given relating the sought-for matrix to observable parameters of the markers' projections. Both an easy to implement solution procedure for both the unknown projection matrix and the marker assembly as well as the mapping from projection matrices to real space positions and orientations of source and detector relative to the rotational axis are provided. The separate treatment of the calibration problem in terms of projection matrices on the one hand and the independent transformation to a more intuitive geometry representation on the other hand proves to be very helpful with respect to the discussion of the ambiguities occurring in reference-free calibration. In particular, a link between methods based on knowledge on the sample and those based on knowledge solely on the detector geometry can be drawn. This further provides another intuitive view on the often reported difficulty in the estimation of the detector tilt towards the rotational axis. A simulation study considering 10⁶randomly generated cone beam imaging configurations and fiducial marker distributions within a range of typical scenarios is performed in order to assess the stability of the proposed technique. An experimental example supports the simulation results.

Geometry Calibration of a Modular Stereo Cone-Beam X-ray CT System

Compared to single source systems, stereo X-ray CT systems allow acquiring projection data within a reduced amount of time, for an extended field-of-view, or for dual X-ray energies. To exploit the benefit of a dual X-ray system, its acquisition geometry needs to be calibrated. Unfortunately, in modular stereo X-ray CT setups, geometry misalignment occurs each time the setup is changed, which calls for an efficient calibration procedure. Although many studies have been dealing with geometry calibration of an X-ray CT system, little research targets the calibration of a dual cone-beam X-ray CT system. In this work, we present a phantom-based calibration procedure to accurately estimate the geometry of a stereo cone-beam X-ray CT system. With simulated as well as real experiments, it is shown that the calibration procedure can be used to accurately estimate the geometry of a modular stereo X-ray CT system thereby reducing the misalignment artifacts in the reconstruction volumes.

Guidelines for Micro-Computed Tomography Analysis of Rodent Dentoalveolar Tissues

Micro–computed tomography (μCT) has become essential for analysis of mineralized as well as nonmineralized tissues and is therefore widely applicable in the life sciences. However, lack of standardized approaches and protocols for scanning, analyzing, and reporting data often makes it difficult to understand exactly how analyses were performed, how to interpret results, and if findings can be broadly compared with other models and studies. This problem is compounded in analysis of the dentoalveolar complex by the presence of four distinct mineralized tissues: enamel, dentin, cementum, and alveolar bone. Furthermore, these hard tissues interface with adjacent soft tissues, the dental pulp and periodontal ligament (PDL), making for a complex organ. Drawing on others' and our own experience analyzing rodent dentoalveolar tissues by μCT, we introduce techniques to successfully analyze dentoalveolar tissues with similar or disparate compositions, densities, and morphological characteristics. Our goal is to provide practical guidelines for μCT analysis of rodent dentoalveolar tissues, including approaches to optimize scan parameters (filters, voltage, voxel size, and integration time), reproducibly orient samples, define regions and volumes of interest, segment and subdivide tissues, interpret findings, and report methods and results. We include illustrative examples of analyses performed on genetically engineered mouse models with phenotypes in enamel, dentin, cementum, and alveolar bone. The recommendations are designed to increase transparency and reproducibility, promote best practices, and provide a basic framework to apply μCT analysis to the dentoalveolar complex that can also be extrapolated to a variety of other tissues of the body. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.

Correction of geometric artifact in cone-beam computed tomography through a deep neural network

Cone-beam computed tomography is a noninvasive detection system that can obtain the three-dimensional structure of objects in a way that does not damage the object. It is widely applied in precision instruments, medical detection, and other fields. However, in the actual process, if a geometric artifact appears in the results, it will affect the quality of reconstructed images, including detail loss and decreased spatial resolution, which leads to inaccurate distinction of defects in detection. We propose a method for correcting a geometric artifact by means of data-driven projection and neural networks. The network designed is a deep neural network with six convolutional layers and six deconvolutional layers that can correct a geometric artifact by training a large number of labeled data and unlabeled data. Compared with other networks that require prior information for reconstructed images, the proposed method uses a projection data-driven approach that can avoid the requirement for prior information. The simulation data have been tested under varying degrees of noise, and satisfactory geometric artifact correction results have been obtained. Meanwhile, we use the actual data of line pairs and ball grid array solder joints to conduct experiments. The results obtained by our method are compared with two other phantom-based method and the U-net method, respectively. The results of similarity and spatial resolution show that the proposed method can achieve the comparable results as the two types of methods. At the same time, we apply a projection data-driven approach to avoid the requirement for prior information, which is more conducive to the correction of the geometric artifact in practical situations where prior information is lacking.

Drill-mounted video guidance for orthopaedic trauma surgery

Purpose: Percutaneous fracture fixation is a challenging procedure that requires accurate interpretation of fluoroscopic images to insert guidewires through narrow bone corridors. We present a guidance system with a video camera mounted onboard the surgical drill to achieve real-time augmentation of the drill trajectory in fluoroscopy and/or CT. Approach: The camera was mounted on the drill and calibrated with respect to the drill axis. Markers identifiable in both video and fluoroscopy are placed about the surgical field and co-registered by feature correspondences. If available, a preoperative CT can also be co-registered by 3D-2D image registration. Real-time guidance is achieved by virtual overlay of the registered drill axis on fluoroscopy or in CT. Performance was evaluated in terms of target registration error (TRE), conformance within clinically relevant pelvic bone corridors, and runtime. Results: Registration of the drill axis to fluoroscopy demonstrated median TRE of 0.9 mm and 2.0 deg when solved with two views (e.g., anteroposterior and lateral) and five markers visible in both video and fluoroscopy-more than sufficient to provide Kirschner wire (K-wire) conformance within common pelvic bone corridors. Registration accuracy was reduced when solved with a single fluoroscopic view ( TRE = 3.4    mm and 2.7 deg) but was also sufficient for K-wire conformance within pelvic bone corridors. Registration was robust with as few as four markers visible within the field of view. Runtime of the initial implementation allowed fluoroscopy overlay and/or 3D CT navigation with freehand manipulation of the drill up to 10    frames / s . Conclusions: A drill-mounted video guidance system was developed to assist with K-wire placement. Overall workflow is compatible with fluoroscopically guided orthopaedic trauma surgery and does not require markers to be placed in preoperative CT. The initial prototype demonstrates accuracy and runtime that could improve the accuracy of K-wire placement, motivating future work for translation to clinical studies.

Fluoroscopic Guidance of a Surgical Robot: Pre-clinical Evaluation in Pelvic Guidewire Placement

PURPOSE

A method and prototype for a fluoroscopically-guided surgical robot is reported for assisting pelvic fracture fixation. The approach extends the compatibility of existing guidance methods with C-arms that are in mainstream use (without prior geometric calibration) using an online calibration of the C-arm geometry automated via registration to patient anatomy. We report the first preclinical studies of this method in cadaver for evaluation of geometric accuracy.

METHODS

The robot is placed over the patient within the imaging field-of-view and radiographs are acquired as the robot rotates an attached instrument. The radiographs are then used to perform an online geometric calibration via 3D-2D image registration, which solves for the intrinsic and extrinsic parameters of the C-arm imaging system with respect to the patient. The solved projective geometry is then be used to register the robot to the patient and drive the robot to planned trajectories. This method is applied to a robotic system consisting of a drill guide instrument for guidewire placement and evaluated in experiments using a cadaver specimen.

RESULTS

Robotic drill guide alignment to trajectories defined in the cadaver pelvis were accurate within 2 mm and 1° (on average) using the calibration-free approach. Conformance of trajectories within bone corridors was confirmed in cadaver by extrapolating the aligned drill guide trajectory into the cadaver pelvis.

CONCLUSION

This study demonstrates the accuracy of image-guided robotic positioning without prior calibration of the C-arm gantry, facilitating the use of surgical robots with simpler imaging devices that cannot establish or maintain an offline calibration. Future work includes testing of the system in a clinical setting with trained orthopaedic surgeons and residents.

C-arm orbits for metal artifact avoidance (MAA) in cone-beam CT

Metal artifacts present a challenge to cone-beam CT (CBCT) image-guided surgery, obscuring visualization of metal instruments and adjacent anatomy-often in the very region of interest pertinent to the imaging/surgical tasks. We present a method to reduce the influence of metal artifacts by prospectively defining an image acquisition protocol-viz., the C-arm source-detector orbit-that mitigates metal-induced biases in the projection data. The metal artifact avoidance (MAA) method is compatible with simple mobile C-arms, does not require exact prior information on the patient or metal implants, and is consistent with 3D filtered backprojection (FBP), more advanced (e.g. polyenergetic) model-based image reconstruction (MBIR), and metal artifact reduction (MAR) post-processing methods. The MAA method consists of: (i) coarse localization of metal objects in the field-of-view (FOV) via two or more low-dose scout projection views and segmentation (e.g. a simple U-Net) in coarse backprojection; (ii) model-based prediction of metal-induced x-ray spectral shift for all source-detector vertices accessible by the imaging system (e.g. gantry rotation and tilt angles); and (iii) identification of a circular or non-circular orbit that reduces the variation in spectral shift. The method was developed, tested, and evaluated in a series of studies presenting increasing levels of complexity and realism, including digital simulations, phantom experiment, and cadaver experiment in the context of image-guided spine surgery (pedicle screw implants). The MAA method accurately predicted tilted circular and non-circular orbits that reduced the magnitude of metal artifacts in CBCT reconstructions. Realistic distributions of metal instrumentation were successfully localized (0.71 median Dice coefficient) from 2-6 low-dose scout views even in complex anatomical scenes. The MAA-predicted tilted circular orbits reduced root-mean-square error (RMSE) in 3D image reconstructions by 46%-70% and 'blooming' artifacts (apparent width of the screw shaft) by 20-45%. Non-circular orbits defined by MAA achieved a further ∼46% reduction in RMSE compared to the best (tilted) circular orbit. The MAA method presents a practical means to predict C-arm orbits that minimize spectral bias from metal instrumentation. Resulting orbits-either simple tilted circular orbits or more complex non-circular orbits that can be executed with a motorized multi-axis C-arm-exhibited substantial reduction of metal artifacts in raw CBCT reconstructions by virtue of higher fidelity projection data, which are in turn compatible with subsequent MAR post-processing and/or polyenergetic MBIR to further reduce artifacts.

Cone-beam imaging with tilted rotation axis: Method and performance evaluation

PURPOSE

The recently introduced robotic x-ray systems provide the flexibility to acquire cone-beam computed tomography (CBCT) data using customized, application-specific source-detector trajectories. We exploit this capability to mitigate the effects of x-ray scatter and noise in CBCT imaging of weight-bearing foot and cervical spine (C-spine) using scan orbits with a tilted rotation axis.

METHODS

We used an advanced CBCT simulator implementing accurate models of x-ray scatter, primary attenuation, and noise to investigate the effects of the orbital tilt angle in upright foot and C-spine imaging. The system model was parameterized using a laboratory version of a three-dimensional (3D) robotic x-ray system (Multitom RAX, Siemens Healthineers). We considered a generalized tilted axis scan configuration, where the detector remained parallel to patient's long body axis during the acquisition, but the elevation of source and detector was changing. A modified Feldkamp-Davis-Kress (FDK) algorithm was developed for reconstruction in this configuration, which departs from the FDK assumption of a detector that is perpendicular to the scan plane. The simulated foot scans involved source-detector distance (SDD) of 1386 mm, orbital tilt angles ranging 10° to 40°, and 400 views at 1 mAs/view and 0.5° increment; the C-spine scans involved -25° to -45° tilt angles, SDD of 1090 mm, and 202 views at 1.3 mAs and 1° increment The imaging performance was assessed by projection-domain measurements of the scatter-to-primary ratio (SPR) and by reconstruction-domain measurements of contrast, noise and generalized contrast-to-noise ratio (gCNR, accounting for both image noise and background nonuniformity) of the metatarsals (foot imaging) and cervical vertebrae (spine imaging). The effects of scatter correction were also compared for horizontal and tilted scans using an ideal Monte Carlo (MC)-based scatter correction and a frame-by-frame mean scatter correction.

RESULTS

The proposed modified FDK, involving projection resampling, mitigated streak artifacts caused by the misalignment between the filtering direction and the detector rows. For foot imaging (no grids), an optimized 20° tilted orbit reduced the maximum SPR from ~1.5 in a horizontal scan to <0.5. The gCNR of the second metatarsal was enhanced twofold compared to a horizontal orbit. For the C-spine (with vertical grids), imaging with a tilted orbit avoided highly attenuating x-ray paths through the lower cervical vertebrae and shoulders. A -35° tilted orbit yielded improved image quality and visualization of the lower cervical spine: the SPR of lower cervical vertebrae was reduced from ~10 (horizontal orbit) to <6 (tilted orbit), and the gCNR for C5-C7 increased by a factor of 2. Furthermore, tilted orbits showed potential benefits over horizontal orbits by enabling scatter correction with a simple frame-by-frame mean correction without substantial increase in noise-induced artifacts after the correction.

CONCLUSIONS

Tilted scan trajectories, enabled by the emerging robotic x-ray system technology, were optimized for CBCT imaging of foot and cervical spine using an advanced simulation framework. The results demonstrated the potential advantages of tilted axis orbits in mitigation of scatter artifacts and improving contrast-to-noise ratio in CBCT reconstructions.

Data sustained misalignment correction in microscopic cone beam CT via optimization under the Grangeat Epipolar consistency condition

PURPOSE

The misalignment correction in cone beam computed tomography (CBCT), which is usually carried out in an offline manner, is a difficult and tedious process. It becomes even more challenging in microscopic CBCT due to the much higher requirements on spatial resolution. In practice, however, an offline approach for misalignment correction may not be readily implementable, especially in the situations where either time is of the essence or the process needs to be carried out repetitively. Thus, an online self-calibration (i.e., data sustained misalignment correction without the involvement of specific alignment phantom) would be more practical. In this work, we investigate the data sustained misalignment correction in microscopic CBCT via optimization under the Grangeat Epipolar Consistence Condition and evaluate its performance via phantom and specimen studies.

METHODS

With the cost function defined according to the Grangeat Epipolar Consistency Condition (G-ECC) and by minimizing the cost function using the simplex-simulated annealing algorithm (SIMPSA), we evaluate and verify the G-ECC optimization-based online self-calibration method's performance. Performance is measured in sensitivity, robustness, and accuracy using the projection data of phantoms generated by computer simulation and botanical specimens acquired by a prototype microscopic CBCT.

RESULTS

The online data sustained misalignment correction in microscopic CBCT via G-ECC optimization works very well in sensitivity and robustness, in addition to its accuracy of 0.27%, 0.48%, and 0.34% relative errors, respectively, in obtaining the three geometric parameters that are the most critical to image reconstruction in CBCT. Quantitatively, the performance in meeting the requirements on spatial resolution is comparable to, if not better than, that of the offline misalignment correction method, in which a specific alignment phantom has to be used.

CONCLUSIONS

The G-ECC optimization-based online self-calibration approach provides a practical solution (as long as no latitudinal (lateral) data truncation occurs) for misalignment correction in microscopic CBCT, an application that demands high accuracy in geometric alignment for biological (cellular) imaging at super high spatial resolutions in the order of micrometers (2.1 µm).

Set-up error validation with EPID images: Measurements vs Egs_cbct simulation

Aim

In this study, the egs_cbct code's ability to replicate an electronic portal imaging device (EPID) is explored.

Background

We have investigated head and neck (H&N) setup verification on an Elekta Precise linear accelerator. It is equipped with an electronic portal imaging device (EPID) that can capture a set of projection images over different gantry angles.

Methods and materials

Cone-beam computed tomography (CBCT) images were reconstructed from projection images of two different setup scenarios. Projections of an Anthropomorphic Rando head phantom were also simulated by using the egs_cbct Monte Carlo code for comparison with the measured projections.Afterwards, CBCT images were reconstructed from this data. Image quality was evaluated against a metric defined as the image acquisition interval (IAI). It determines the number of projection images to be used for CBCT image reconstruction.

Results

From this results it was established that phantom shifts could be determined within 2 mm and rotations within one degree accuracy using only 20 projection images (IAI = 10 degrees). Similar results were obtained with the simulated data.

Conclusion

In this study it is demonstrated that a head and neck setup can be verified using substantially fewer projection images. Bony landmarks and air cavities could still be observed in the reconstructed Rando head phantom. The egs_cbct code can be used as a tool to investigate setup errors without tedious measurements with an EPID system.

A simulation-based method for evaluating geometric tests of a linac c-arm in quality control in radiotherapy

Purpose

Assessment of the accuracy of geometric tests of a linac used in external beam therapy is crucial for ensuring precise dose delivery. In this paper, a new simulation‐based method for assessing accuracy of such geometric tests is proposed and evaluated on a set of testing procedures.

Methods

Linac geometry testing methods used in this study are based on an established design of a two‐module phantom. Electronic portal imaging device (EPID) images of fiducial balls contained in these modules can be used to automatically reconstruct linac geometry. The projection of the phantom modules fiducial balls onto the EPID detector plane is simulated for assumed nominal geometry of a linac. Then, random errors are added to the coordinates of the projections of the centers of the fiducial balls and the linac geometry is reconstructed from these data.

Results

Reconstruction is performed for a set of geometric test designs and it is shown how the dispersion of the reconstructed values of geometric parameters depends on the design of a geometric test. Assuming realistic accuracy of EPID image analysis, it is shown that for selected testing plans the reconstruction accuracy of geometric parameters can be significantly better than commonly used action thresholds for these parameters.

Conclusions

Proposed solution has the potential to improve geometric testing design and practice. It is an important part of a fully automated geometric testing solution.

Known-component metal artifact reduction (KC-MAR) for cone-beam CT

Intraoperative cone-beam CT (CBCT) is increasingly used for surgical navigation and validation of device placement. In spinal deformity correction, CBCT provides visualization of pedicle screws and fixation rods in relation to adjacent anatomy. This work reports and evaluates a method that uses prior information regarding such surgical instrumentation for improved metal artifact reduction (MAR). The known-component MAR (KC-MAR) approach achieves precise localization of instrumentation in projection images using rigid or deformable 3D-2D registration of component models, thereby overcoming residual errors associated with segmentation-based methods. Projection data containing metal components are processed via 2D inpainting of the detector signal, followed by 3D filtered back-projection (FBP). Phantom studies were performed to identify nominal algorithm parameters and quantitatively investigate performance over a range of component material composition and size. A cadaver study emulating screw and rod placement in spinal deformity correction was conducted to evaluate performance under realistic clinical imaging conditions. KC-MAR demonstrated reduction in artifacts (standard deviation in voxel values) across a range of component types and dose levels, reducing the artifact to 5-10 HU. Accurate component delineation was demonstrated for rigid (screw) and deformable (rod) models with sub-mm registration errors, and a single-pixel dilation of the projected components was found to compensate for partial-volume effects. Artifacts associated with spine screws and rods were reduced by 40%-80% in cadaver studies, and the resulting images demonstrated markedly improved visualization of instrumentation (e.g. screw threads) within cortical margins. The KC-MAR algorithm combines knowledge of surgical instrumentation with 3D image reconstruction in a manner that overcomes potential pitfalls of segmentation. The approach is compatible with FBP-thereby maintaining simplicity in a manner that is consistent with surgical workflow-or more sophisticated model-based reconstruction methods that could further improve image quality and/or help reduce radiation dose.

A method of determining geometry of cone beam CT scanner

The task of determining the geometry of a cone-beam CT scanner with flat panel detector and circular/spiral source trajectory is considered. Accomplishing this task implies analyzing projections of a set of points referred to as calibrating set or calibrating phantom. We take advantage of the fact that observed coordinates of a point’s projection are rational functions of the point’s location. Unknown coefficients of these functions can be recovered exactly from six projections of the point. Location of the source as well as position and orientation of the detector are determined in the scanner reference frame, which is constituted by rotation axis and central plane of the scanner. Two different projections of a calibrating set are enough to solve the task if the source trajectory is a circle. In applications where a shift of an object transversally to the central plane is required, two additional projections have to be collected in order to identify the direction of the shift. The developed formalism becomes especially simple when the detector is aligned with the rotation axis. In this case four projections of a single calibrating point rotated successfully about the rotation axis are sufficient. The error analysis carried out in the paper shows that the magnitude of deviation from the true values is of the order of the magnitude of measurement errors.

Task-driven source-detector trajectories in cone-beam computed tomography: II. Application to neuroradiology

We apply the methodology detailed in "Task-driven source-detector trajectories in cone-beam computed tomography: I. Theory and methods" by Stayman et al. for task-driven optimization of source-detector orbits in cone-beam computed tomography (CBCT) to scenarios emulating imaging tasks in interventional neuroradiology. The task-driven imaging framework is used to optimize the CBCT source-detector trajectory by maximizing the detectability index, d ' . The approach was applied to simulated cases of endovascular embolization of an aneurysm and arteriovenous malformation and was translated to real data first using a CBCT test bench followed by implementation on an interventional robotic C-arm. Task-driven trajectories were found to generally favor higher fidelity (i.e., less noisy) views, with an average increase in d ' ranging from 7% to 28%. Visually, this resulted in improved conspicuity of particular stimuli by reducing the noise and altering the noise correlation to a form distinct from the spatial frequencies associated with the imaging task. The improvements in detectability and the demonstration of the task-driven workflow using a real interventional imaging system show the potential of the task-driven imaging framework to improve imaging performance on motorized, multiaxis C-arms in neuroradiology.

Evaluation of the Impact of the Linac MLC and Gantry Sag in volumetric modulated arc therapy

PURPOSE

Mechanical sag in the radiotherapy linear accelerator gantry and multi-leaf collimator (MLC) carriage effectively causes systematic deviations in the isocenter with respect to gantry angle. To minimize the impact of this error on treatment, a tolerance value of a 1-mm mechanical isocenter shift is commonly accepted for intensity-modulated radiation therapy quality assurance (QA). However, this tolerance value has not been firmly established for volumetric modulated arc therapy (VMAT) treatments. The purpose of this study is therefore to evaluate the impact of gantry and MLC carriage sag on VMAT clinical performance.

METHODS

A published dataset of Elekta and Varian sag measurements served as a starting point for the investigation. Typical sag profiles were chosen and modeled as continuous isocenter deviations in three dimensions. The data were then incorporated into existing Digital Imaging and Communications in Medicine protocol, extended for radiotherapy plans via a "beam-splitting" algorithm. Three treatment sites were investigated in parallel: head and neck, prostate, and prostate with surrounding lymph nodes. Monte Carlo-simulated dose distributions were obtained for varying magnifications of the modeled sag. The resulting dose distributions, including that for no error, were compared qualitatively and quantitatively, against multiple metrics.

RESULTS

The dose-volume histograms (DVHs) for all plans exhibited a decrease in planning target volume (PTV) dose uniformity with increasing sag magnification, whereas dose to organs at risk exhibited no coherent trend. The prostate plan was shown to be the most vulnerable to mechanical sag across all considered metrics. However, all plans with peak isocenter deviation less than 1 mm were well within typical cutoff points for each metric.

CONCLUSIONS

All avenues of investigation presented substantiate the commonly accepted tolerance value of a 1-mm peak isocenter shift in annual linac QA.

A geometric calibration method for the digital chest tomosynthesis with dual-axis scanning geometry

The aim of this study was to develop a geometric calibration method capable of eliminating the reconstruction artifacts of geometric misalignments in a tomosynthesis prototype with dual-axis scanning geometry. The potential scenarios of geometric misalignments were demonstrated, and their effects on reconstructed images were also evaluated. This method was a phantom-based approach with iterative optimization, and the calibration phantom was designed for specific tomosynthesis scanning geometry. The phantom was used to calculate a set of geometric parameters from each projection, and these parameters were then used to evaluate the geometric misalignments of the dual-axis scanning-geometry prototype. The simulated results revealed that the extracted geometric parameters were similar to the input values and that the artifacts of reconstructed images were minimized due to geometric calibration. Additionally, experimental chest phantom imaging results also indicated that the artifacts of the reconstructed images were suppressed and that object structures were preserved through calibration. And the quantitative analysis result also indicated that the MTF can be further improved with the geometric calibration. All the simulated and experimental results demonstrated that this method is effective for tomosynthesis with dual-axis scanning geometry. Furthermore, this geometric calibration method can also be applied to other tomography imaging systems to reduce geometric misalignments and be used for different geometric calibration phantom configurations.

Technical Note: Intrinsic raw data-based CT misalignment correction without redundant data

PURPOSE

CT image reconstruction requires accurate knowledge of the used geometry or image quality might be degraded by misalignment artifacts. To overcome this issue, an intrinsic method, that is, a method not requiring a dedicated calibration phantom, to perform a raw data-based misalignment correction for CT is proposed herein that does not require redundant data and hence is applicable to measurements with less than 180 ∘ plus fan-angle of data.

METHODS

The forward projection of a volume reconstructed from a misaligned geometry resembles the acquired raw data if no redundant data are used, that is, if less than 180 ∘ plus fan-angle are used for image reconstruction. Hence, geometric parameters cannot be deduced from such data by an optimization of the geometry-dependent raw data fidelity. We propose to use a nonlinear transform applied to the reconstructed volume to introduce inconsistencies in the raw data that can be employed to estimate geometric parameters using less than 180 ∘ plus fan-angle of data. The proposed method is evaluated using simulations of the FORBILD head phantom and using actual measurements of a contrast-enhanced scan of a mouse acquired using a micro-CT.

RESULTS

Noisy simulations and actual measurements demonstrate that the proposed method is capable of correcting for artifacts arising from a misaligned geometry without redundant data while ensuring raw data fidelity.

CONCLUSIONS

The proposed method extends intrinsic raw data-based misalignment correction methods to an angular range of 180 ∘ or less and is thus applicable to systems with a limited scan range.

Image quality and dose characteristics for an O-arm intraoperative imaging system with model-based image reconstruction

PURPOSE

To assess the imaging performance and radiation dose characteristics of the O-arm CBCT imaging system (Medtronic Inc., Littleton MA) and demonstrate the potential for improved image quality and reduced dose via model-based image reconstruction (MBIR).

METHODS

Two main studies were performed to investigate previously unreported characteristics of the O-arm system. First is an investigation of dose and 3D image quality achieved with filtered back-projection (FBP) - including enhancements in geometric calibration, handling of lateral truncation and detector saturation, and incorporation of an isotropic apodization filter. Second is implementation of an MBIR algorithm based on Huber-penalized likelihood estimation (PLH) and investigation of image quality improvement at reduced dose. Each study involved measurements in quantitative phantoms as a basis for analysis of contrast-to-noise ratio and spatial resolution as well as imaging of a human cadaver to test the findings under realistic imaging conditions.

RESULTS

View-dependent calibration of system geometry improved the accuracy of reconstruction as quantified by the full-width at half maximum of the point-spread function - from 0.80 to 0.65 mm - and yielded subtle but perceptible improvement in high-contrast detail of bone (e.g., temporal bone). Standard technique protocols for the head and body imparted absorbed dose of 16 and 18 mGy, respectively. For low-to-medium contrast (<100 HU) imaging at fixed spatial resolution (1.3 mm edge-spread function) and fixed dose (6.7 mGy), PLH improved CNR over FBP by +48% in the head and +35% in the body. Evaluation at different dose levels demonstrated 30% increase in CNR at 62% of the dose in the head and 90% increase in CNR at 50% dose in the body.

CONCLUSIONS

A variety of improvements in FBP implementation (geometric calibration, truncation and saturation effects, and isotropic apodization) offer the potential for improved image quality and reduced radiation dose on the O-arm system. Further gains are possible with MBIR, including improved soft-tissue visualization, low-dose imaging protocols, and extension to methods that naturally incorporate prior information of patient anatomy and/or surgical instrumentation.

An EPID-based method to determine mechanical deformations in a linear accelerator

PURPOSE

Medical linear accelerators (linac) are delivering increasingly complex treatments using modern techniques in radiation therapy. Complete and precise mechanical QA of the linac is therefore necessary to ensure that there is no unexpected deviation from the gantry's planned course. However, state-of-the-art EPID-based mechanical QA procedures often neglect some degrees of freedom (DOF) like the in-plane rotations of the gantry and imager or the source movements inside the gantry head. Therefore, the purpose of this work is to characterize a 14 DOF method for the mechanical QA of linacs. This method seeks to measure every mechanical deformation in a linac, including source movements, in addition to relevant clinical parameters like mechanical and radiation isocenters.

METHODS

A widely available commercial phantom and a custom-made accessory inserted in the linac's interface mount are imaged using the electronic portal imaging device (EPID) at multiple gantry angles. Then, simulated images are generated using the nominal geometry of the linac and digitized models of the phantoms. The nominal geometry used to generate these images can be modified using 14 DOF (3 rigid rotations and 3 translations for the imager and the gantry, and 2 in-plane translations of the source) and any change will modify the simulated image. The set of mechanical deformations that minimizes the differences between the simulated and measured image is found using a genetic algorithm coupled with a gradient-descent optimizer. Phantom mispositioning and gantry angular offset were subsequently calculated and extracted from the results. Simulations of the performances of the method for different levels of noise in the phantom models were performed to calculate the absolute uncertainty of the measured mechanical deformations. The measured source positions and the center of collimation were used to define the beam central axis and calculate the radiation isocenter position and radius.

RESULTS

After the simultaneous optimization of the 14 DOF, the average distance between the center of the measured and simulated ball bearings on the imager was 0.086 mm. Over the course of a full counter-clockwise gantry rotation, all mechanical deformations were measured, showing sub-millimeter translations and rotations smaller than 1° along every axis. The average absolute uncertainty of the 14 DOF (1 SD) was 0.15 mm or degree. Phantom positioning errors were determined with more than 0.1 mm precision. Errors introduced in the experimental setup like phantom positioning errors, source movements or gantry angular offsets were all successfully detected by our QA method. The mechanical deformations measured are shown to be reproducible over the course of a few weeks and are not sensitive to the experimental setup.

CONCLUSION

This work presents of new method for an accurate mechanical QA of the linacs. It features a 14 DOF model of the mechanical deformations that is both more complete and precise than other available methods. It has demonstrated sub-millimeter accuracy through simulation and experimentation. Introduced errors were successfully detected with high precision.