Carlo Tognina

Megavoltage cone-beam computed tomography using a high-efficiency image receptor

PURPOSE To develop an image receptor capable of forming high-quality megavoltage CT images using modest radiation doses. METHODS AND MATERIALS A flat-panel imaging system consisting of a conventional flat-panel sensor attached to a thick CsI scintillator has been fabricated. The scintillator consists of individual CsI crystals 8 mm thick by 0.38 mm x 0.38-mm pitch. Five sides of each crystal are coated with a reflecting powder/epoxy mixture, and the sixth side is in contact with the flat-panel sensor. A timing interface coordinates acquisition by the imaging system and pulsing of the linear accelerator. With this interface, as little as one accelerator pulse (0.023 cGy at the isocenter) can be used to form projection images. Different CT phantoms irradiated by a 6-MV X-ray beam have been imaged to evaluate the performance of the imaging system. The phantoms have been mounted on a rotating stage and rotated while 360 projection images are acquired in 48 s. These projections have been reconstructed using the Feldkamp cone-beam CT reconstruction algorithm. RESULTS AND DISCUSSION Using an irradiation of 16 cGy (360 projections x 0.046 cGy/projection), the contrast resolution is approximately 1% for large objects. High-contrast structures as small as 1.2 mm are clearly visible. The reconstructed CT values are linear (R(2) = 0.98) for electron densities between 0.001 and 2.16 g/cm(3), and the reconstruction time for a 512 x 512 x 512 data set is 6 min. Images of an anthropomorphic phantom show that soft-tissue structures such as the heart, lung, kidneys, and liver are visible in the reconstructed images (16 cGy, 5-mm-thick slices). CONCLUSIONS The acquisition of megavoltage CT images with soft-tissue contrast is possible with irradiations as small as 16 cGy.

Multiple-gain-ranging readout method to extend the dynamic range of amorphous silicon flat-panel imagers

The dynamic range of many flat panel imaging systems are fundamentally limited by the dynamic range of the charge amplifier and readout signal processing. We developed two new flat panel readout methods that achieve extended dynamic range by changing the read out charge amplifier feedback capacitance dynamically and on a real-time basis. In one method, the feedback capacitor is selected automatically by a level sensing circuit, pixel-by-pixel, based on its exposure level. Alternatively, capacitor selection is driven externally, such that each pixel is read out two (or more) times, each time with increased feedback capacitance. Both methods allow the acquisition of X-ray image data with a dynamic range approaching the fundamental limits of flat panel pixels. Data with an equivalent bit depth of better than 16 bits are made available for further image processing. Successful implementation of these methods requires careful matching of selectable capacitor values and switching thresholds, with the imager noise and sensitivity characteristics, to insure X-ray quantum limited operation over the whole extended dynamic range. Successful implementation also depends on the use of new calibration methods and image reconstruction algorithms, to insure artifact free rebuilding of linear image data by the downstream image processing systems. The multiple gain ranging flat panel readout method extends the utility of flat panel imagers and paves the way to new flat panel applications, such as cone beam CT. We believe that this method will provide a valuable extension to the clinical application of flat panel imagers.

Photodiode forward bias to reduce temporal effects in a-Si based flat panel detectors

Lag and sensitivity modulation are well known temporal artifacts of a-Si photodiode based flat panel detectors. Both effects are caused by charge carriers being trapped in the semiconductor. Trapping and releasing of these carriers is a statistical process with time constants much longer than the frame time of flat panel detectors. One way to reduce these temporal artifacts is to keep the traps filled by applying a pulse of light over the entire detector area every frame before the x-ray exposure. This paper describes an alternative method, forward biasing the a-Si photodiodes and supplying free carriers to fill the traps. The array photodiodes are forward biased and then reversed biased again every frame between the panel readout and x-ray exposure. The method requires no change to the mechanical construction of the detector, only minor modifications of the detector electronics and no image post processing. An existing flat panel detector was modified and evaluated for lag and sensitivity modulation. The required changes of the panel configuration, readout scheme and readout timing are presented in this paper. The results of applying the new technique are presented and compared to the standard mode of operation. The improvements are better than an order of magnitude for both sensitivity modulation and lag; lowering their values to levels comparable to the scintillator afterglow. To differentiate the contribution of the a-Si array, from that of the scintillator, a large area light source was used. Possible implementations and applications of the method are discussed.

Design and performance of a new a-Si flat-panel imager for use in cardiovascular and mobile C-arm imaging systems

This paper describes a new flat panel imager designed for use in cardiovascular and mobile C-arm imaging systems. The a-Si sensor array has a 1024 x 1024 matrix with a pixel pitch of 194 μm, resulting in an active area of 198.7 mm x 198.7 mm. The imager allows frame rates of up to 30 fps in full resolution fluoroscopy mode and up to 60 fps in a 2 x 2 binned low dose fluoroscopy mode. Typically, a 600 μm thick deposited columnar CsI(Tl) layer is used as the scintillator. Improvements in the pixel architecture, charge amplifier ASICs, and system level electronics resulted in a very low electronic noise floor, such that both the fluoroscopy and low dose fluoroscopy modes of the panel are x-ray quantum limited below 1 μR/frame. Low power consumption electronics combined with a mechanical design optimized for heat transfer and dissipation makes air-cooling sufficient for most environments. The small size of 24.1 x 24.1 x 6 cm and the weight of only 4.1 kg meet the requirements of C-Arm systems. Special consideration was given to the border around the active area, which has been reduced to 2 cm. Reported performance parameters include linearity, lag, contrast ratio, MTF, and DQE. For the full resolution mode, the MTF is greater than 0.53 and 0.21 at 1 and 2 lp/mm, respectively. DQE measured at 22 nGy/frame was greater than 0.68, 0.50, and 0.23 at 0, 1, and 2 lp/mm, respectively.

A forward bias method for lag correction of an a-Si flat panel detector.

PURPOSE Digital a-Si flat panel (FP) x-ray detectors can exhibit detector lag, or residual signal, of several percent that can cause ghosting in projection images or severe shading artifacts, known as the radar artifact, in cone-beam computed tomography (CBCT) reconstructions. A major contributor to detector lag is believed to be defect states, or traps, in the a-Si layer of the FP. Software methods to characterize and correct for the detector lag exist, but they may make assumptions such as system linearity and time invariance, which may not be true. The purpose of this work is to investigate a new hardware based method to reduce lag in an a-Si FP and to evaluate its effectiveness at removing shading artifacts in CBCT reconstructions. The feasibility of a novel, partially hardware based solution is also examined. METHODS The proposed hardware solution for lag reduction requires only a minor change to the FP. For pulsed irradiation, the proposed method inserts a new operation step between the readout and data collection stages. During this new stage the photodiode is operated in a forward bias mode, which fills the defect states with charge. A Varian 4030CB panel was modified to allow for operation in the forward bias mode. The contrast of residual lag ghosts was measured for lag frames 2 and 100 after irradiation ceased for standard and forward bias modes. Detector step response, lag, SNR, modulation transfer function (MTF), and detective quantum efficiency (DQE) measurements were made with standard and forward bias firmware. CBCT data of pelvic and head phantoms were also collected. RESULTS Overall, the 2nd and 100th detector lag frame residual signals were reduced 70%-88% using the new method. SNR, MTF, and DQE measurements show a small decrease in collected signal and a small increase in noise. The forward bias hardware successfully reduced the radar artifact in the CBCT reconstruction of the pelvic and head phantoms by 48%-81%. CONCLUSIONS Overall, the forward bias method has been found to greatly reduce detector lag ghosts in projection data and the radar artifact in CBCT reconstructions. The method is limited to improvements of the a-Si photodiode response only. A future hybrid mode may overcome any limitations of this method.

Parameter investigation and first results from a digital flat panel detector with forward bias capability

Digital flat panel a-Si x-ray detectors can exhibit image lag of several percent. The image lag can limit the temporal resolution of the detector, and introduce artifacts into CT reconstructions. It is believed that the majority of image lag is due to defect states, or traps, in the a-Si layer. Software methods to characterize and correct for the image lag exist, but they may make assumptions such as the system behaves in a linear time-invariant manner. The proposed method of reducing lag is a hardware solution that makes few additional hardware changes. For pulsed irradiation, the proposed method inserts a new stage in between the readout of the detector and the data collection stages. During this stage the photodiode is operated in a forward bias mode, which fills the defect states with charge. Parameters of importance are current per diode and current duration, which were investigated under light illumination by the following design parameters: 1.) forward bias voltage across the photodiode and TFT switch, 2.) number of rows simultaneously forward biased, and 3.) duration of the forward bias current. From measurements, it appears that good design criteria for the particular imager used are 8 or fewer active rows, 2.9V (or greater) forward bias voltage, and a row frequency of 100 kHz or less. Overall, the forward bias method has been found to reduce first frame lag by as much as 95%. The panel was also tested under x-ray irradiation. Image lag improved (94% reduction), but the temporal response of the scintillator became evident in the turn-on step response.

Multidetector-row CT with a 64–row amorphous silicon flat panel detector

A unique 64-row flat panel (FP) detector has been developed for sub-second multidetector-row CT (MDCT). The intent was to explore the image quality achievable with relatively inexpensive amorphous silicon (a-Si) compared to existing diagnostic scanners with discrete crystalline diode detectors. The FP MDCT system is a bench-top design that consists of three FP modules. Each module uses a 30 cm x 3.3 cm a-Si array with 576 x 64 photodiodes. The photodiodes are 0.52 mm x 0.52 mm, which allows for about twice the spatial resolution of most commercial MDCT scanners. The modules are arranged in an overlapping geometry, which is sufficient to provide a full-fan 48 cm diameter scan. Scans were obtained with various detachable scintillators, e.g. ceramic Gd2O2S, particle-in-binder Gd2O2S:Tb and columnar CsI:Tl. Scan quality was evaluated with a Catphan-500 performance phantom and anthropomorphic phantoms. The FP MDCT scans demonstrate nearly equivalent performance scans to a commercial 16-slice MDCT scanner at comparable 10 - 20 mGy/100mAs doses. Thus far, a high contrast resolution of 15 lp/cm and a low contrast resolution of 5 mm @ 0.3 % have been achieved on 1 second scans. Sub-second scans have been achieved with partial rotations. Since the future direction of MDCT appears to be in acquiring single organ coverage per scan, future efforts are planned for increasing the number of detector rows beyond the current 64- rows.

Improved DQE by means of X-ray spectra and scintillator optimization for FFDM

The focus of this work was to improve the DQE performance of a full-field digital mammography (FFDM) system by means of selecting an optimal X-ray tube anode-filter combination in conjunction with an optimal scintillator configuration. The flat panel detector in this work is a Varian PaxScan 3024M. The detector technology is comprised of a 2816 row × 3584 column amorphous silicon (a-Si) photodiode array with a pixel pitch of 83μm. The scintillator is cesium iodide and is deposited directly onto the photodiode array and available with configurable optical and x-ray properties. Two X-ray beam spectra were generated with the anode/filter combinations, Molybdenum/Molybdenum (Mo/Mo) and Tungsten/Aluminum (W/Al), to evaluate the imaging performance of two types of scintillators, high resolution (HR) type and high light output (HL) type. The results for the HR scintillator with W/Al anode-filter (HRW/ Al) yielded a DQE(0) of 67%, while HR-Mo/Mo was lower with a DQE(0) of 50%. In addition, the DQE(0) of the HR-W/Al configuration was comparable to the DQE(0) of the HL-Mo/Mo configuration. The significance of this result is the HR type scintillator yields about twice the light output with the W/Al spectrum, at about half the dose, as compared to the Mo/Mo spectrum. The light output or sensitivity was measured in analog-to-digital convertor units (ADU) per dose. The sensitivities (ADU/uGy) were 8.6, 16.8 and 25.4 for HR-Mo/Mo, HR-W/Al, HL-Mo/Mo, respectively. The Nyquist frequency for the 83 μm pixel is 6 lp/mm. The MTF at 5 lp/mm for HR-Mo/Mo and HR-W/Al were equivalent at 37%, while the HL-Mo/Mo MTF was 24%. According to the DQE metric, the more favorable anodefilter combination was W/Al with the HR scintillator. Future testing will evaluate the HL-W/Al configuration, as well as other x-ray filters materials and other scintillator optimizations. While higher DQE values were achieved, the more general conclusion is that the imaging performance can be tuned as required by the application by modifying optical and x-ray properties of the scintillator to match the spectral output of the chosen anode-filter combination.

Lung cancer, respiratory 3D motion imaging, with a 19 focal spot kV x-ray tube and a 60 fps flat panel imager

The combinations of a 60 fps kV x-ray flat panel imager, a 19 focal spot kV x-ray tube enabled by a steered electron beam, plus SART or SIRT sliding reconstruction via GPUs, allow real time 6 fps 3D-rendered digital tomosynthesis tracking of the respiratory motion of lung cancer lesions. The tube consists of a “U” shaped vacuum chamber with 19 tungsten anodes, spread uniformly over 3 sides of a 30 cm x 30 cm square, each attached to a cylindrical copper heat sink cooled by flowing water. The beam from an electron gun was steered and focused onto each of the 19 anodes in a predetermined sequence by a series of dipole, quadrupole and solenoid magnets. The imager consists of 0.194 mm pixels laid out in 1576 rows by 2048 columns, binned 4x4 to achieve 60 fps projection image operation with 16 bits dynamic range. These are intended for application with free breathing patients during ordinary linac C-arm radiotherapy with modest modifications to typical system hardware or to standard clinical treatment delivery protocols. The sliding digital tomosynthesis reconstruction is completed after every 10 projection images acquired at 60 fps, but using the last 19 such projection images for each such reconstruction at less than 8 mAs exposure per 3D rendered frame. Comparisons, to “ground truth” optical imaging and to diagnostic 4D CT (10 phase) images, are being used to determine the accuracy and limitations of the various versions of this new “19 projection image x-ray tomosynthesis fluorooscopy” motion tracking technique.

SU-FF-I-27: Can a Flat Panel Cone Beam CT Imager Pass the American College of Radiology CT Accreditation Requirements for Head Scans?

Purpose: To evaluate the performance of a flat panel cone‐beam CT system with the American College of Radiology (ACR) CT Accreditation Program. Methods and Materials: A bench‐top flat panel (FP) cone‐beam CT system using the Varian Medical Systems 4030CB panel and G424/B130 x‐ray tube with a rotating stage were used. The FP was operated in the dynamic gain mode with a frame rate of 15 fps and a scan time of 42 seconds and 625 views. The source and detector geometry were such that a full‐fan head size 25 cm field‐of‐view was reconstructed. The Gammex Inc. 464 ACR accreditation phantom and ACT automated evaluation software were used to form an unbiased pass/fail determination of the ACR head scan criteria. Standard CTDIdosimetry measurements were performed with a 16 cm diameter PMMA phantom and Victoreen 660 survey meter with 10 cm ionization chamber.Results: The ACR phantom has 4 sections, which are to evaluate a number of performance criteria. The scans were performed at a measured CTDI100 of 45 mGy absorbed dose in air. These results are from the first attempt at using the ACR phantom on the FP CBCT system. The image quality was sufficient to pass the majority of the criteria, but failed to pass the CT number accuracy by 1 HU on the acrylic sample and by 1–2 HU on the CT number uniformity test. Conclusion: The results indicate that the CT number accuracy and uniformity are areas that can be improved with better software beam hardening and scatter corrections. Also these scans were taken without an anti scatter grid, which if used should improve CT number uniformity. Therefore, there are significant indications that we can pass all categories of the ACR head accreditation tests. Additional test are then to be performed on a C‐arm based system.