Dirk Schaefer

Performance of standard fluoroscopy antiscatter grids in flat-detector-based cone-beam CT

In this paper, the performance of focused lamellar anti-scatter grids, which are currently used in fluoroscopy, is studied in order to determine guidelines of grid usage for flat detector based cone beam CT. The investigation aims at obtaining the signal to noise ratio improvement factor by the use of anti-scatter grids. First, the results of detailed Monte Carlo simulations as well as measurements are presented. From these the general characteristics of the impinging field of scattered and primary photons are derived. Phantoms modeling the head, thorax and pelvis regions have been studied for various imaging geometries with varying phantom size, cone and fan angles and patient-detector distances. Second, simulation results are shown for ideally focused and vacuum spaced grids as best case approach as well as for grids with realistic spacing materials. The grid performance is evaluated by means of the primary and scatter transmission and the signal to noise ratio improvement factor as function of imaging geometry and grid parameters. For a typical flat detector cone beam CT setup, the grid selectivity and thus the performance of anti-scatter grids is much lower compared to setups where the grid is located directly behind the irradiated object. While for small object-to-grid distances a standard grid improves the SNR, the SNR for geometries as used in flat detector based cone beam CT is deteriorated by the use of an anti-scatter grid for many application scenarios. This holds even for the pelvic region. Standard fluoroscopy anti-scatter grids were found to decrease the SNR in many application scenarios of cone beam CT due to the large patient-detector distance and have, therefore, only a limited benefit in flat detector based cone beam CT.

Soft-tissue contrast resolution within the head of human cadaver by means of flat-detector-based cone-beam CT

In this paper, soft tissue contrast visibility in neural applications is investigated for volume imaging based on flat X-ray detector cone-beam CT. Experiments have been performed on a high precision bench-top system with rotating object table and fixed X-ray tube-detector arrangement. Several scans of a post mortem human head specimen have been performed under various conditions. Hereby two different flat X-ray detectors with 366 x 298mm2 (Trixell Pixium 4700) and 176 x 176mm2 (Trixell Pixium 4800) active area have been employed. During a single rotation up to 720 projections have been acquired. For reconstruction of the 3D images a Feldkamp algorithm has been employed. Reconstructed images of the head of human cadaver demonstrate that added soft tissue contrast down to 10 HU is detectable for X-ray dose comparable to CT. However, the limited size of the smaller detector led to truncation artifacts, which were partly compensated by extrapolation of the projections outside the field of view. To reduce cupping artifacts resulting from scattered radiation and to improve visibility of low contrast details, a novel homogenization procedure based on segmentation and polynomial fitting has been developed and applied on the reconstructed voxel data. Even for narrow HU-Windows, limitations due to scatter induced cupping artifacts are no longer noticeable after applying the homogenization procedure.

3D reconstruction of coronary stents in vivo based on motion compensated x-ray angiograms

A new method is introduce for the three-dimensional (3D) reconstruction of the coronary stents in-vivo utilizing two-dimensional projection images acquired during rotational angiography (RA). The method is based on the application of motion compensated techniques to the acquired angiograms resulting in a temporal snapshot of the stent within the cardiac cycle. For the first time results of 3D reconstructed coronary stents in vivo, with high spatial resolution are presented. The proposed method allows for a comprehensive and unique quantitative 3D assessment of stent expansion that rivals current x-ray and intravascular ultrasound techniques.

Image quality of flat-panel cone beam CT

We present results on 3D image quality in terms of spatial resolution (MTF) and low contrast detectability, obtained on a flat dynamic X-ray detector (FD) based cone-beam CT (CB-CT) setup. Experiments have been performed on a high precision bench-top system with rotating object table, fixed X-ray tube and 176 x 176 mm2 active detector area (Trixell Pixium 4800). Several objects, including CT performance-, MTF- and pelvis phantoms, have been scanned under various conditions, including a high dose setup in order to explore the 3D performance limits. Under these optimal conditions, the system is capable of resolving less than 1% (~10 HU) contrast in a water background. Within a pelvis phantom, even inserts of muscle and fat equivalent are clearly distinguishable. This also holds for fast acquisitions of up to 40 fps. Focusing on the spatial resolution, we obtain an almost isotropic three-dimensional resolution of up to 30 lp/cm at 10% modulation.

4D coronary artery reconstruction based on retrospectively gated rotational angiography: first in-human results

A method is proposed that allows for a fully automated computation of a series of high-resolution volumetric reconstructions of a patients coronary arteries based on a single rotational acquisition. During the 7.2 second acquisition the coronary arteries are injected with contrast material while the imaging system rotates around the patient to obtain a series of X-ray projection images over an angular range of 180 degrees. Based on the simultaneously recorded ECG-signal the projection images corresponding to the same cardiac cycle can be utilized to reconstruct three-dimensional (3D) high-spatial-resolution angiograms of the coronary arteries in multiple (3D+t) cardiac phases within the cardiac cycle. The proposed acquisition protocol has been applied to 22 patients and the tomograpic reconstructions depicted the main arteries as well as the main bifurcations in multiple cardiac phases in all enrolled patients. For the first time, this feasibility study shows that a three-dimensional description of the coronary arteries can be obtained intraprocedurally in a conventional interventional suite by means of tomographic reconstruction from projection images without any user interaction.

Cardiac-motion correction for helical CT

The motion of the heart is a major challenge for cardiac imaging using computed tomography. An approach to decrease motion blur and to improve the signal-to-noise ratio is motion-corrected reconstruction which takes motion-vector fields into account in order to compensate motion. In this paper, the determination of a motion-vector field is described in a cardiac region-of-interest using elastic image registration while the reconstruction algorithm remains the same. The method can be applied to high contrast objects moving with the heart, such as vessels filled with contrast agent, calcified plaques or devices like stents.