Hepatic dual-contrast CT imaging: slow triple kVp switching CT with CNN-based sinogram completion and material decomposition

Purpose: Dual-contrast protocols are a promising clinical multienergy computed tomography (CT) application for focal liver lesion detection and characterization. One avenue to enable multienergy CT is the introduction of photon-counting detectors (PCD). Although clinical translation is highly desired because of the diagnostic benefits of PCDs, it will still be a decade or more before they are broadly available. In our work, we investigated an alternative solution that can be implemented on widely used conventional CT systems (single source and integrating detector) to perform multimaterial spectral decomposition for dual-contrast imaging. Approach: We propose to slowly alternate the x-ray tube voltage between 3 kVp levels so each kVp level covers a few degrees of gantry rotation. This leads to the challenge of sparsely sampled projection data in each energy level. Performing the material decomposition (MD) in the sinogram domain is not directly possible as the projection images of the three energy levels are not angularly aligned. In order to overcome this challenge, we developed a convolutional neural network (CNN) framework for sparse sinogram completion (SC) and MD. To evaluate the feasibility of the slow kVp switching scheme, simulation studies of an abdominal phantom, which included liver lesions, were conducted. Results: The line-integral SC network yielded sinograms with a pixel-wise RMSE < 0.05 of the line-integrals compared to the ground truth. This provided acceptable image quality up to a switching angle of 9 deg per kVp. The MD network we developed allowed us to differentiate iodine and gadolinium in the sinogram domain. The average relative quantification errors for iodine and gadolinium were below 10%. Conclusions: We developed a slow triple kVp switching data acquisition scheme and a CNN-based data processing pipeline. Results from a digital phantom validation illustrate the potential for future applications of dual-contrast agent protocols on practically available single-energy CT systems.

Evaluation of a preclinical photon-counting CT prototype for pulmonary imaging

The purpose of this study was to investigate a preclinical spectral photon-counting CT (SPCCT) prototype compared to conventional CT for pulmonary imaging. A custom-made lung phantom, including nodules of different sizes and shapes, was scanned with a preclinical SPCCT and a conventional CT in standard and high-resolution (HR-CT) mode. Volume estimation was evaluated by linear regression. Shape similarity was evaluated with the Dice similarity coefficient. Spatial resolution was investigated via MTF for each imaging system. In-vivo rabbit lung images from the SPCCT system were subjectively reviewed. Evaluating the volume estimation, linear regression showed best results for the SPCCT compared to CT and HR-CT with a root mean squared error of 21.3 mm³, 28.5 mm³ and 26.4 mm³ for SPCCT, CT and HR-CT, respectively. The Dice similarity coefficient was superior for SPCCT throughout nodule shapes and all nodule sizes (mean, SPCCT: 0.90; CT: 0.85; HR-CT: 0.85). 10% MTF improved from 10.1 LP/cm for HR-CT to 21.7 LP/cm for SPCCT. Visual investigation of small pulmonary structures was superior for SPCCT in the animal study. In conclusion, the SPCCT prototype has the potential to improve the assessment of lung structures due to higher resolution compared to conventional CT.

Experimental feasibility of spectral photon-counting computed tomography with two contrast agents for the detection of endoleaks following endovascular aortic repair

Objectives

After endovascular aortic repair (EVAR), discrimination of endoleaks and intra-aneurysmatic calcifications within the aneurysm often requires multiphase computed tomography (CT). Spectral photon-counting CT (SPCCT) in combination with a two-contrast agent injection protocol may provide reliable detection of endoleaks with a single CT acquisition.

Methods

To evaluate the feasibility of SPCCT, the stent-lined compartment of an abdominal aortic aneurysm phantom was filled with a mixture of iodine and gadolinium mimicking enhanced blood. To represent endoleaks of different flow rates, the adjacent compartments contained either one of the contrast agents or calcium chloride to mimic intra-aneurysmatic calcifications. After data acquisition with a SPCCT prototype scanner with multi-energy bins, material decomposition was performed to generate iodine, gadolinium and calcium maps.

Results

In a conventional CT slice, Hounsfield units (HU) of the compartments were similar ranging from 147 to 168 HU. Material-specific maps differentiate the distributions within the compartments filled with iodine, gadolinium or calcium.

Conclusion

SPCCT may replace multiphase CT to detect endoleaks without sacrificing diagnostic accuracy. It is a unique feature of our method to capture endoleak dynamics and allow reliable distinction from intra-aneurysmatic calcifications in a single scan, thereby enabling a significant reduction of radiation exposure.

Key Points

• SPCCT might enable advanced endoleak detection.

• Material maps derived from SPCCT can differentiate iodine, gadolinium and calcium.

• SPCCT may potentially reduce radiation burden for EVAR patients under post-interventional surveillance.

Simultaneous dual-contrast multi-phase liver imaging using spectral photon-counting computed tomography: a proof-of-concept study

Background

To assess the feasibility of dual-contrast spectral photon-counting computed tomography (SPCCT) for liver imaging.

Methods

We present an SPCCT in-silico study for simultaneous mapping of the complementary distribution in the liver of two contrast agents (CAs) subsequently intravenously injected: a gadolinium-based contrast agent and an iodine-based contrast agent. Four types of simulated liver lesions with a characteristic arterial and portal venous pattern (haemangioma, hepatocellular carcinoma, cyst, and metastasis) are presented. A material decomposition was performed to reconstruct quantitative iodine and gadolinium maps. Finally, a multi-dimensional classification algorithm for automatic lesion detection is presented.

Results

Our simulations showed that with a single-scan SPCCT and an adapted contrast injection protocol, it was possible to reconstruct contrast-enhanced images of the liver with arterial distribution of the iodine-based CA and portal venous phase of the gadolinium-based CA. The characteristic patterns of contrast enhancement were visible in all liver lesions. The approach allowed for an automatic detection and classification of liver lesions using a multi-dimensional analysis.

Conclusions

Dual-contrast SPCCT should be able to visualise the characteristic arterial and portal venous enhancement with a single scan, allowing for an automatic lesion detection and characterisation, with a reduced radiation exposure.

A Fourier approach to pulse pile-up in photon-counting x-ray detectors

PURPOSE

An analytic Fourier approach to predict the expected number of counts registered in a photon-counting detector subject to pulse pile-up for arbitrary photon flux, detector response function, and pulse-shape is presented. The analysis provides a complete forward model for energy-sensitive, photon-counting x-ray detectors for spectral computed tomography.

METHODS

The formalism of the stochastic theory of the expected frequency of level crossings of shot noise processes is applied to the pulse pile-up effect and build on a recently published analytic Fourier representation of the level crossing frequency of shot noise processes with piece-wise continuous kernels with jumps.

RESULTS

The general analytic result is validated by a Monte Carlo simulation for pulses of the form g(t) = e(-t/τ) (t > 0) and a Gaussian detector response function. The Monte Carlo simulations are in excellent agreement with the analytic predictions of photon counts within the numerical accuracy of the calculations.

CONCLUSIONS

The phenomenon of pulse pile-up is identified with the level-crossing problem of shot noise processes and an exact, analytic formula for the expected number of counts in energy-sensitive, photon-counting x-ray detectors for arbitrary photon flux, response function, and pulse-shapes is derived. The framework serves as a theoretical foundation for future works on pulse pile-up.

Clinical boundary conditions for grating-based differential phase-contrast mammography

Research in grating-based differential phase-contrast imaging (DPCI) has gained increasing momentum in the past couple of years. The first results on the potential clinical benefits of the technique for X-ray mammography are becoming available and indicate improvements in terms of general image quality, the delineation of lesions versus the background tissue and the visibility of microcalcifications. In this paper, we investigate some aspects related to the technical feasibility of DPCI for human X-ray mammography. After a short introduction to state-of-the-art full-field digital mammography in terms of technical aspects as well as clinical aspects, we put together boundary conditions for DPCI. We then discuss the implications for system design in a comparative manner for systems with two-dimensional detectors versus slit-scanning systems, stating advantages and disadvantages of the two designs. Finally, focusing on a slit-scanning system, we outline a possible concept for phase acquisition.

Gold nanocrystal labeling allows low-density lipoprotein imaging from the subcellular to macroscopic level

Low-density lipoprotein (LDL) plays a critical role in cholesterol transport and is closely linked to the progression of several diseases. This motivates the development of methods to study LDL behavior from the microscopic to whole-body level. We have developed an approach to efficiently load LDL with a range of diagnostically active nanocrystals or hydrophobic agents. We performed focused experiments on LDL labeled with gold nanocrystals (Au-LDL). The labeling procedure had minimal effect on LDL size, morphology, or composition. Biological function was found to be maintained from both in vitro and in vivo experiments. Tumor-bearing mice were injected intravenously with LDL, DiR-LDL, Au-LDL, or a gold-loaded nanoemulsion. LDL accumulation in the tumors was detected with whole-body imaging methods, such as computed tomography (CT), spectral CT, and fluorescence imaging. Cellular localization was studied with transmission electron microscopy and fluorescence techniques. This LDL labeling procedure should permit the study of lipoprotein biointeractions in unprecedented detail.

A novel vacuum ultra violet lamp for metastable rare gas experiments

We report on a new design of a vacuum ultra violet (VUV) lamp for direct optical excitation of high laying atomic states, e.g., for excitation of metastable rare gas atoms. The lamp can be directly mounted to ultra-high vacuum vessels (p ≤ 10(-10)mbar). It is driven by a 2.45 GHz microwave source. For optimum operation, it requires powers of ~20 W. The VUV light is transmitted through a magnesium fluoride window, which is known to have a decreasing transmittance for VUV photons with time. In our special setup, after a run-time of the VUV lamp of 550 h the detected signal continuously decreased to 25% of its initial value. This corresponds to a lifetime increase of two orders of magnitude compared to previous setups or commercial lamps.