Ali Bani-Hashemi

Low dose megavoltage cone beam computed tomography with an unflattened 4 MV beam from a carbon target

Megavoltage cone beam computed tomography (MVCBCT) is routinely used for visualizing anatomical structures and implanted fiducials for patient positioning in radiotherapy. MVCBCT using a 6 MV treatment beam with high atomic number (Z) target and flattening filter in the beamline, as done conventionally, has lower image quality than can be achieved with a MV beam due to heavy filtration of the low-energy bremsstrahlung. The unflattened beam of a low Z target has an abundance of diagnostic energy photons, detected with modern flat panel detectors with much higher efficiency given the same dose to the patient. This principle guided the development of a new megavoltage imaging beamline (IBL) for a commercial radiotherapy linear accelerator. A carbon target was placed in one of the electron primary scattering foil slots on the target-foil slide. A PROM on a function controller board was programed to put the carbon target in place for MVCBCT. A low accelerating potential of 4.2 MV was used for the IBL to restrict leakage of primary electrons through the target such that dose from x rays dominated the signal in the monitor chamber and the patient surface dose. Results from phantom and cadaver images demonstrated that the IBL had much improved image quality over the treatment beam. For similar imaging dose, the IBL improved the contrast-to-noise ratio by as much as a factor of 3 in soft tissue over that of the treatment beam. The IBL increased the spatial resolution by about a factor of 2, allowing the visualization of finer anatomical details. Images of the cadaver contained useful information with doses as low as 1 cGy. The IBL may be installed on certain models of linear accelerators without mechanical modification and results in significant improvement in the image quality with the same dose, or images of the same quality with less than one-third of the dose.

Algorithm for X-ray Scatter, Beam-Hardening, and Beam Profile Correction in Diagnostic (Kilovoltage) and Treatment (Megavoltage) Cone Beam CT

Quantitative reconstruction of cone beam X-ray computed tomography (CT) datasets requires accurate modeling of scatter, beam-hardening, beam profile, and detector response. Typically, commercial imaging systems use fast empirical corrections that are designed to reduce visible artifacts due to incomplete modeling of the image formation process. In contrast, Monte Carlo (MC) methods are much more accurate but are relatively slow. Scatter kernel superposition (SKS) methods offer a balance between accuracy and computational practicality. We show how a single SKS algorithm can be employed to correct both kilovoltage (kV) energy (diagnostic) and megavoltage (MV) energy (treatment) X-ray images. Using MC models of kV and MV imaging systems, we map intensities recorded on an amorphous silicon flat panel detector to water-equivalent thicknesses (WETs). Scattergrams are derived from acquired projection images using scatter kernels indexed by the local WET values and are then iteratively refined using a scatter magnitude bounding scheme that allows the algorithm to accommodate the very high scatter-to-primary ratios encountered in kV imaging. The algorithm recovers radiological thicknesses to within 9% of the true value at both kV and megavolt energies. Nonuniformity in CT reconstructions of homogeneous phantoms is reduced by an average of 76% over a wide range of beam energies and phantom geometries.

Fixed gantry tomosynthesis system for radiation therapy image guidance based on a multiple source x-ray tube with carbon nanotube cathodes

The authors present the design and simulation of an imaging system that employs a compact multiple source x-ray tube to produce a tomosynthesisimage from a set of projections obtained at a single tube position. The electron sources within the tube are realized using cold cathodecarbon nanotube technology. The primary intended application is tomosynthesis-based 3D image guidance during external beam radiation therapy. The tube, which is attached to the gantry of a medicallinear accelerator(linac) immediately below the multileaf collimator, operates within the voltage range of 80 – 160 kVp and contains a total of 52 sources that are arranged in a rectilinear array. This configuration allows for the acquisition of tomographic projections from multiple angles without any need to rotate the linac gantry. The x-ray images are captured by the same amorphous silicon flat panel detector employed for portal imaging on contemporary linacs. The field of view (FOV) of the system corresponds to that part of the volume that is sampled by rays from all sources. The present tube and detector configuration provides an 8 × 8 cm 2 FOV in the plane of the linac isocenter when the 40.96 × 40.96 cm 2 imaging detector is placed 40 cm from the isocenter. Since this tomosynthesis application utilizes the extremities of the detector to record image detail relating to structures near the isocenter, simultaneous treatment and imaging is possible for most clinical cases, where the treated target is a small region close to the linac isocenter. The tomosynthesisimages are reconstructed using the simultaneous iterative reconstruction technique, which is accelerated using a graphic processing unit. The authors present details of the system design as well as simulated performance of the imaging system based on reprojections of patient CTimages.

3D Reconstruction from Projection Matrices in a C-Arm Based 3D-Angiography System

3D reconstruction of arterial vessels from planar radiographs obtained at several angles around the object has gained increasing interest. The motivating application has been interventional angiography. In order to obtain a three-dimensional reconstruction from a C-arm mounted X-Ray Image Intensifier (XRII) traditionally the trajectory of the source and the detector system is characterized and the pixel size is estimated. The main use of the imaging geometry characterization is to provide a correct 3D-2D mapping between the 3D voxels to be reconstructed and the 2D pixels on the radiographic images.

Steering a robot with vanishing points

The paper analyzes the use of vanishing points for steering a robot. Parallel lines in the environment of the robot are used to compute vanishing points which serve as a reference for guiding the robot. To accomplish the steering task, three subtasks are performed: detection of straight lines, computation of vanishing points, and robot steering using vanishing points. Straight lines are detected by employing a high precision edge detector and a line-fitting algorithm. The cross product method introduced by Magee and Aggarwal (1984) is modified to make the detection of vanishing points appropriate for an indoor environment. Properties of vanishing points under camera rotation and translation are derived. Using these properties, the location of the vanishing points can serve as a reference for steering the robot. A model of the robot environment is defined, summarizing the minimum number of constraints necessary for the method to work. Finally, the limitations as well as the advantages of using vanishing points in robot navigation are discussed. >

Clinical evaluation of the iterative metal artifact reduction algorithm for CT simulation in radiotherapy

PURPOSE To clinically evaluate an iterative metal artifact reduction (IMAR) algorithm prototype in the radiation oncology clinic setting by testing for accuracy in CT number retrieval, relative dosimetric changes in regions affected by artifacts, and improvements in anatomical and shape conspicuity of corrected images. METHODS A phantom with known material inserts was scanned in the presence/absence of metal with different configurations of placement and sizes. The relative change in CT numbers from the reference data (CT with no metal) was analyzed. The CT studies were also used for dosimetric tests where dose distributions from both photon and proton beams were calculated. Dose differences and gamma analysis were calculated to quantify the relative changes between doses calculated on the different CT studies. Data from eight patients (all different treatment sites) were also used to quantify the differences between dose distributions before and after correction with IMAR, with no reference standard. A ranking experiment was also conducted to analyze the relative confidence of physicians delineating anatomy in the near vicinity of the metal implants. RESULTS IMAR corrected images proved to accurately retrieve CT numbers in the phantom study, independent of metal insert configuration, size of the metal, and acquisition energy. For plastic water, the mean difference between corrected images and reference images was -1.3 HU across all scenarios (N = 37) with a 90% confidence interval of [-2.4, -0.2] HU. While deviations were relatively higher in images with more metal content, IMAR was able to effectively correct the CT numbers independent of the quantity of metal. Residual errors in the CT numbers as well as some induced by the correction algorithm were found in the IMAR corrected images. However, the dose distributions calculated on IMAR corrected images were closer to the reference data in phantom studies. Relative spatial difference in the dose distributions in the regions affected by the metal artifacts was also observed in patient data. However, in absence of a reference ground truth (CT set without metal inserts), these differences should not be interpreted as improvement/deterioration of the accuracy of calculated dose. With limited data presented, it was observed that proton dosimetry was affected more than photons as expected. Physicians were significantly more confident contouring anatomy in the regions affected by artifacts. While site specific preferences were detected, all indicated that they would consistently use IMAR corrected images. CONCLUSIONS IMAR correction algorithm could be readily implemented in an existing clinical workflow upon commercial release. While residual errors still exist in IMAR corrected images, these images present with better overall conspicuity of the patient/phantom geometry and offer more accurate CT numbers for improved local dosimetry. The variety of different scenarios included herein attest to the utility of the evaluated IMAR for a wide range of radiotherapy clinical scenarios.

Focused beam-stop array for the measurement of scatter in megavoltage portal and cone beam CT imaging

We describe a focused beam-stop array (BSA) for the measurement of object scatter in imaging systems that utilize x-ray beams in the megavoltage (MV) energy range. The BSA consists of 64 doubly truncated tungsten cone elements of 0.5 cm maximum diameter that are arranged in a regular array on an acrylic slab. The BSA is placed in the accessory tray of a medical linear accelerator at a distance of approximately 50 cm from the focal spot. We derive an expression that allows us to estimate the scatter in an image taken without the array present, given image values in a second image with the array in place. The presence of the array reduces fluence incident on the imaged object. This leads to an object-dependent underestimation bias in the scatter measurements. We apply corrections in order to address this issue. We compare estimates of the flat panel detector response to scatter obtained using the BSA to those derived from Monte Carlo simulations. We find that the two estimates agree to within 10% in terms of RMS error for 30 cm x 30 cm water slabs in the thickness range of 10-30 cm. Larger errors in the scatter estimates are encountered for thinner objects, probably owing to extrafocal radiation sources. However, RMS errors in the estimates of primary images are no more than 5% for water slab thicknesses in the range of 1-30 cm. The BSA scatter estimates are also used to correct cone beam tomographic projections. Maximum deviations of central profiles of uniform water phantoms are reduced from 193 to 19 HU after application of corrections for scatter, beam hardening, and lateral truncation that are based on the BSA-derived scatter estimate. The same corrections remove the typical cupping artifact from both phantom and patient images. The BSA proves to be a useful tool for quantifying and removing image scatter, as well as for validating models of MV imaging systems.

Image quality & dosimetric property of an investigational Imaging Beam Line MV-CBCT

To measure and compare the contrast to noise ratio (CNR) as a function of dose for the CBCTs produced by the mega‐voltage (MV) imaging beam line (IBL) and the treatment beam line (TBL), and to compare the dose to target and various critical structures of pediatric patients for the IBL CBCT versus standard TBL orthogonal port films. Two Siemens Oncor linear accelerators were modified at our institution such that the MV‐CBCT would operate under an investigational IBL rather than the standard 6MV TBL. Prior to the modification, several CBCTs of an electron density phantom were acquired with the TBL at various dose values. After the modification, another set of CBCTs of the electron density phantom were acquired for various doses using the IBL. The contrast to noise ratio (CNR) for each tissue equivalent insert was calculated. In addition, a dosimetric study of pediatric patients was conducted comparing the 1 cGy IBL CBCT and conventional TBL orthogonal pair port films. The CNR for eight tissue equivalent inserts at five different dose settings for each type of CBCT was measured. The CNR of the muscle insert was 0.8 for a 5 cGy TBL CBCT, 1.1 for a 1.5 cGy IBL CBCT, and 2.8 for a conventional CT. The CNR of the trabecular bone insert was 2.9 for a 5 cGy TBL CBCT, 5.5 for a 1.5 cGy IBL CBCT, and 14.8 for a conventional CT. The IBL CBCT delivered approximately one‐fourth the dose to the target and critical structures of the patients as compared to the TBL orthogonal pair port films. The IBL CBCT improves image quality while simultaneously reducing the dose to the patient as compared to the TBL CBCT. A 1 cGy IBL CBCT, which is used for bony anatomy localization, delivers one‐fourth the dose as compared to conventional ortho‐pair films. PACS number: 87.57.Q, 87.57.cj, 87.53.Jw

CT Truncation artifact removal using water-equivalent thicknesses derived from truncated projection data

Large patient anatomies and limited imaging fleld-of-view (FOV) lead to truncation of CT projections. Truncation introduces serious artifacts into reconstructed images, including central cupping and bright external rings. FOV may be increased using laterally offset detectors, but this requires sophisticated imaging hardware and full angular scanning. We propose a novel method to complete truncated projections based on the observation that the thickness of the patient may be estimated along the projection rays by calculating water-equivalent thicknesses (WET). These values are not at all affected by truncation and thus constitute valuable auxiliary information. We parameterize pairs of points along each ray that intersects the unknown object boundary. These points are separated by the measured WET value (obtained from projections that have been corrected for scatter and beam-hardening). We assume, for all large body parts, that the patient outline may be roughly approximated as an ellipse. Using a deterministic optimization algorithm, we simultaneously estimate the point positions and ellipse parameters by minimizing the distance between point sets and the ellipse boundary. The optimal ellipse is used to complete the truncated projections. Reconstruction then ensues. We apply the algorithm to a severely truncated CT dataset of a typical abdomen. The RMS error between complete data and truncated reconstructions (corrected using an empirical extrapolation approach) is 20.4% for an abdominal dataset. The new algorithm reduces this error to 1.0%. Even thought the algorithm assumes an elliptical patient cross-section, truly impressive increases in quantitative image quality are observed. The presence of pelvic bone in the image does not appreciably bias the ellipse position even though it does bias the thickness estimates for some rays. The algorithm incurs low computational cost and is suitable for on-line clinical workflows.

Comparison of patient megavoltage cone beam CT images acquired with an unflattened beam from a carbon target and a flattened treatment beam.

PURPOSE To use an imaging beam line (IBL) to obtain the first megavoltage cone-beam computed tomography (MV CBCT) images of patients with a low atomic number (Z) target, and to compare these images to those taken of the same patients with the 6 MV flattened beam from the treatment beam line (TBL). METHODS The IBL, which produces a 4.2 MV unflattened beam from a carbon target, was installed on a linear accelerator in use for radiotherapy. Provision was made for switching between the IBL and TBL for imaging the same patient with beams from the low-Z and high-Z targets. Dose was quoted as monitor units times the dose per monitor unit for the standard calibration geometry. Images were acquired with institutional approval and patient consent with both the IBL and TBL on a series of 23 patients undergoing radiotherapy. Patients were imaged daily to weekly and aligned to the planning CT using the images. Doses were reduced over the course of treatment to determine the minimum doses required for alignment. Images were assessed offline. RESULTS IBL MV CBCT images of prostate, head and neck, lung, and abdomen showed improvement in soft tissue contrast for the same dose as the TBL images. Bony anatomy, air cavities, and fiducial markers were sharper. CBCT with a dose of 1 cGy was sufficient for alignment of prostate and head and neck patients based on bony anatomy or implanted gold seeds, 2-4 cGy for lung, abdomen, and pelvis. Photon scatter in the patient had minimal effect on image quality. The metallic hip prosthesis in one patient showed reduced artifacts compared to diagnostic CT. CONCLUSIONS The IBL has the advantage of improved image quality at the same dose, or reduced dose for the same image quality, over the TBL.