G. Fountos

In vivo measurement of radius calcium/phosphorus ratio by X-ray absorptiometry.

We describe a new method for assessing the skeletal Ca/P ratio in vivo using X-ray absorptiometry. By placing cerium (Ce) and samarium (Sm) filters in the X-ray beam from a commercial X-ray source (Norland), mean photon energies of 39 and 89 keV were obtained. The instrument was designed to take measurements of the forearm, at a site located at the distal 1/3 of the radius. The system was calibrated with three bone phantoms: Ca10(PO4)6(OH)2, Ca(HPO4)(H2O)2 and Ca(HPO4)2(H2O)). The precision for measuring the Ca/P ratio in the human radius was 2.3% CV for a skin dose to the forearm ranging from 0.3 to 0.4 mGy, depending on the width of the arm. The Ca/P ratio of the radius was significantly lower in patients with postmenopausal osteoporosis than in premenopausal controls.

Experimental and Theoretical Evaluation of a High Resolution CMOS Based Detector Under X-Ray Imaging Conditions

Fundamental imaging performance in terms of Modulation Transfer Function (MTF), Noise Power Spectrum (NPS) and Detective Quantum Efficiency (DQE) was investigated for a high resolution CMOS based imaging sensor. The device consists of a 33.91 mg/cm2 Gd2O2S:Tb scintillator screen, placed in direct contact with a CMOS photodiode array. The CMOS photodiode array, featuring 1200×1600 pixels with a pixel pitch of 22.5 μm, was used as an optical photon detector. In addition to the conventional frequency dependent parameters characterizing image quality, image information content was assessed through the application of information capacity (IC). The MTF was measured using the slanted-edge method to avoid aliasing while the Normalized NPS (NNPS) was determined by two-dimensional (2D) Fourier transforming of uniformly exposed images. Both measurements were performed under the representative radiation quality (RQA) settings, RQA-5 (70 kVp digital-radiography) and RQA-M2 (28 kVp digital-mammography) recommended by the International Electrotechnical Commission Reports 62220-1 and 62220-1-2 respectively. The DQE was assessed from the measured MTF, NPS and the direct entrance surface air-Kerma (ESAK) obtained from X-ray spectra measurement with a portable cadmium telluride (CdTe) detector. The ESAK values ranged between 11-87 μGy for RQA-5 and 6-40 μGy for RQA-M2. Additionally the output electrons per X-ray photon of the detector and its signal transfer characteristics were assessed via an analytical model, within the framework of the linear cascaded systems (LCS) theory. It was found that the detector response function was linear for the exposure ranges under investigation. Additionally our results showed that for the same RQA quality the output electrons per X-ray photon, as well as the measured and analytically predicted MTF, were not significantly affected by ESAK. MTF and DQE where found better compared to previously published data for other CCD and CMOS sensors, while the NNPS appeared to be comparable in the frequency range under investigation (0-10 cycles/mm).

Evaluation of the Red Emitting

The aim of the present study was to investigate the imaging transfer characteristics and the luminescence efficiency (XLE) of Gd2O2S:Eu powder scintillator for use in X-ray mammography detectors. Gd2O2S:Eu emits in the red part of the visible spectrum, having very good spectral compatibility with optical sensors employed in digital imaging systems. Three Gd2O2S:Eu powder scintillating screens, with coating thicknesses 33.1, 46.4 and 63.1 mg/cm2 , were prepared in our laboratory. The imaging performance of these screens was assessed by experimental determination of the modulation transfer function (MTF), the noise transfer function (NTF) and the detective quantum efficiency (DQE) as well as a single index image quality parameter such as the information capacity (IC). A theoretical model, describing radiation and light transfer, was used to fit experimental MTF data. This has allowed the estimation of optical attenuation coefficients of the scintillator. In addition, a previously validated Monte Carlo code, based on the X-ray attenuation properties and on the Mie light scattering theory, was used to estimate the X-ray detection efficiency, the Swank factor and the zero frequency DQE of the Gd2O2S:Eu scintillator. Results showed that Gd2O2S:Eu exhibits high MTF and DQE values, which are comparable to those of a commercially employed Gd2O2S:Tb screen. In addition Gd2O2S:Eu shows high compatibility (effective gain) to CCDs and to recently introduced CMOS based detectors. Considering our image quality parameters and luminescence efficiency results, this material can potentially be considered for use in digital X-ray mammography detectors.

{\rm Gd}_{2}{\rm O}_{2}{\rm S}\!\!:\!\!{\rm Eu}

The aim of this study was to examine Gd2O2S:Eu (also known as GOS:Eu) powder scintillator under X-ray mammography imaging conditions. For this purpose, three scintillator screens with coating thicknesses of 33.1, 46.4 and 63.1 mg/cm2 were prepared in our laboratory by sedimentation of Gd2O2S:Eu powder. Light emission efficiency and optical emission spectra of the screens were measured under X-ray excitation using X-ray tube voltages (22-49 kVp) employed in mammography. Spectral compatibility with various optical photon detectors (photodiodes, photocathodes, charge coupled devices, films) and intrinsic conversion efficiency value (0.12) were determined by using emission spectrum data. In addition, parameters related to X-ray detection and energy absorption efficiency were calculated. Gd2O2S:Eu showed peak emission in the wavelength range 620-630 nm. The 63.1 mg/cm2 phosphor screen appeared with the maximum light emission efficiency. Due to its reddish emission spectrum, Gd2O2S:Eu showed excellent compatibility with the sensitivity of many currently used photodetectors and could be considered for application in X-ray imaging especially in various digital detectors.

Powder Scintillator for Use in Indirect X-Ray Digital Mammography Detectors

The aim of the present work is to study the performance of scintillators currently used in PET and animal PET systems, under conditions met in radiation therapy and PET/CT imaging. The results of this study will be useful in applications where both CT and PET photons as well as megavoltage cone beam CT (MV CBCT) photons could be detected using a common detector unit. To this aim crystal samples of GSO, LSO, LYSO, LuYAP and YAP scintillators, doped with cerium (Ce+3) were examined under a wide energy range of photon energies. Evaluation was performed by determining the absolute luminescence efficiency (emitted light flux over incident X-ray exposure) in the energy range employed in X-ray CT, in Nuclear Medicine (70 keV up to 662 keV) and in radiotherapy 6 MV (approx. 2.0 MeV mean energy)-18 MV (approx. 4.5 MeV mean energy). Measurements were performed using an experimental set-up based on a photomultiplier coupled to a light integration sphere. The emission spectrum under X-ray excitation was measured, using an optical grating monochromator, to determine the spectral compatibility to optical photon detectors incorporated in medical imaging systems. Maximum absolute luminescence efficiency values were observed at 70 keV for YAP:Ce and LuYAP:Ce and at 140 keV for LSO:Ce, LYSO:Ce and GSO:Ce. Highest absolute efficiency between the scintillators examined was observed for LSO:Ce, followed by LYSO:Ce. The detector optical gain (DOG) exhibited a significant variation with the increase of energy between 70 keV to 2.0 MeV. All scintillators exhibited low compatibility when combined with GaAsP (G5645) photodetector.

Light Emission Efficiency of

Objectives. In this work, a simple technique to assess the image quality characteristics of the postprocessed image is developed and an easy to use figure of image quality (FIQ) is introduced. This FIQ characterizes images in terms of resolution and noise. In addition information capacity, defined within the context of Shannons information theory, was used as an overall image quality index. Materials and Methods. A digital mammographic image was postprocessed with three digital filters. Resolution and noise were calculated via the Modulation Transfer Function (MTF), the coefficient of variation, and the figure of image quality. In addition, frequency dependent parameters such as the noise power spectrum (NPS) and noise equivalent quanta (NEQ) were estimated and used to assess information capacity. Results. FIQs for the “raw image” data and the image processed with the “sharpen edges” filter were found 907.3 and 1906.1, correspondingly. The information capacity values were 60.86 × 103 and 78.96 × 103 bits/mm2. Conclusion. It was found that, after the application of the postprocessing techniques (even commercial nondedicated software) on the raw digital mammograms, MTF, NPS, and NEQ are improved for medium to high spatial frequencies leading to resolving smaller structures in the final image.

{\rm Gd}_{2} {\rm O} _{2} {\rm S}\!\!\!:\!\!\!{\rm Eu}

Dual energy methods can suppress the contrast between adipose and glandular tissues in the breast and therefore enhance the visibility of calcifications. In this study, a dual energy method based on analytical modeling was developed for the detection of minimum microcalcification thickness. To this aim, a modified radiographic X-ray unit was considered, in order to overcome the limited kVp range of mammographic units used in previous DE studies, combined with a high resolution CMOS sensor (pixel size of 22.5 μm) for improved resolution. Various filter materials were examined based on their K-absorption edge. Hydroxyapatite (HAp) was used to simulate microcalcifications. The contrast to noise ratio (CNRtc) of the subtracted images was calculated for both monoenergetic and polyenergetic X-ray beams. The optimum monoenergetic pair was 23/58 keV for the low and high energy, respectively, resulting in a minimum detectable microcalcification thickness of 100 μm. In the polyenergetic X-ray study, the optimal spectral combination was 40/70 kVp filtered with 100 μm cadmium and 1000 μm copper, respectively. In this case, the minimum detectable microcalcification thickness was 150 μm. The proposed dual energy method provides improved microcalcification detectability in breast imaging with mean glandular dose values within acceptable levels.

(GOS:Eu) Powder Screens Under X-Ray Mammography Conditions

In the present study scintillating screens prepared from Y3Al5O12:Ce (YAG:Ce) powder phosphor were evaluated for use in digital mammography. YAG:Ce has never previously been used in X-ray medical imaging, however since it emits green light (i.e peak at 550 nm), it is expected to match well the spectral sensitivities of most photodetectors (photodiodes, CCDs and amorphous silicon sensors) incorporated in various digital mammography detectors. YAG:Ce was purchased in powder form and was used in order to prepare test screens in the laboratory. Screens were evaluated by determining the quantum detection efficiency (QDE), the energy absorption efficiency (EAE), the absolute luminescence efficiency, the X-ray luminescence efficiency (XLE), the light emission spectrum, the X-ray to light intrinsic conversion efficiency and the spectral compatibility with various photodetectors. Results were compared with phosphor materials commercially employed in X-ray imaging such as CsI:Tl and Gd2O2 S:Tb. Maximum YAG:Ce emission efficiency was observed for the 63 mg/cm2 screen at 49 kVp. The spectral compatibility with amorphous silicon photodiodes (0.93) and CCDs (0.95) was found to be very high, better than the corresponding compatibility of the CsI:Tl screen, mostly used in current digital radiography detectors. Taking into account the YAG:Ce overall performance, its short decay time as well as its spectral compatibility with amorphous silicon detectors and CCDs, YAG:Ce could be of interest for further investigation for applications in digital mammography.

Comparative Investigation of

The aim of this study was to develop a Monte-Carlo model that can be used for the optimization of positron emission tomography (PET) procedures and image quality metrics. This model was developed using the Monte Carlo package of Geant4 application for tomographic emission (GATE) and the software for tomographic image reconstruction (STIR) with cluster computing to obtain reconstructed images. The PET scanner used in this study was the General Electric Discovery-ST (US). The GATE model was validated by comparing results obtained in accordance with the National Electrical Manufacturers Association NEMA-NU-2-2001 protocol [Mawlawi et al (2004) and Bettinardi et al (2004)]. All images were reconstructed with the commonly used 2D filtered back projection and the 3D reprojection algorithms. We found that the simulated spatial resolution in terms of full width at half maximum (FWHM) agreed within less than 3.29% in 2D and less than 2.51% in 3D with published data of others, respectively. The 2D values for the sensitivity, scatter fraction and count-rate were found to agree within less than 0.46%, 4.59% and 7.86%, respectively with these published values. Accordingly, our study showed that the corresponding 3D values were found to agree to less than 1.62%, 2.85% and 9.13%, respectively with Mawlawi et al (2004) published values. Sensitivity, which was also estimated without the presence of attenuation material by simulating an ideal source, showed differences between the extrapolated and the ideal source values (with and without attenuation) ranging in 2D from 0.04% to 0.82% (radial location R=0cm) and 0.52% to 0.67% in 3D mode (radial locations R=10cm). The simulated noise equivalent count rate was found to be 94.31kcps in 2D and 66.9kcps in 3D at 70 and 15kBq/mL respectively, compared to 94.08kcps in 2D and 70.88kcps in 3D at 54.6kBq/mL and 14kBq/mL respectively, from the published by others values. The simulated image quality was found in excellent agreement with these published values. In conclusion, our study showed that our Monte Carlo model can be used to assess, optimize, simplify and reduce the simulation time for the quality control procedure of PET scanners. By using this model, sensitivity can be obtained in a more simplified procedure. Reconstructed images by STIR can be also used to obtain radiopharmaceutical distribution of images and direct dose maps, quite useful to nuclear medicine practitioners.

{\rm Ce}^{3+}

Breast microcalcifications are mainly composed of calcite (CaCO3), calcium oxalate (CaC2O4) and apatite (a calcium-phosphate mineral form). Any pathologic alteration (carcinogenesis) of the breast may produce apatite. In the present simulation study, an analytical model was implemented in order to distinguish malignant and non-malignant lesions. The Calcium/Phosphorus (Ca/P) mass ratio and the standard deviation (SD) of the calcifications were calculated. The size of the calcifications ranged from 100 to 1000 μm, in 50 μm increments. The simulation was performed for hydroxyapatite, calcite and calcium oxalate calcifications. The optimum pair of energies for all calcifications was 22keV and 50keV. Hydroxyapatite and calcite calcifications were sufficiently characterized through their distinct confidence interval (99.7%, 3SD) values for calcifications sizes above 500 μm, while the corresponding sizes for hydroxyapatite and calcium oxalate characterization were found above 250 μm. Initial computer simulation results indicate that the proposed method can be used in breast cancer diagnosis, reducing the need for invasive methods, such as biopsies.