George S. K. Fung

A simple approach to measure computed tomography (CT) modulation transfer function (MTF) and noise-power spectrum (NPS) using the American College of Radiology (ACR) accreditation phantom

PURPOSE To develop an easily-implemented technique with free publicly-available analysis software to measure the modulation transfer function (MTF) and noise-power spectrum (NPS) of a clinical computed tomography (CT) system from images acquired using a widely-available and standardized American College of Radiology (ACR) CT accreditation phantom. METHODS Images of the ACR phantom were acquired on a Siemens SOMATOM Definition Flash system using a standard adult head protocol: 120 kVp, 300 mAs, and reconstructed voxel size of 0.49 mm × 0.49 mm × 4.67 mm. The radial (axial) MTF was measured using an edge method where the boundary of the third module of the ACR phantom, originally designed to measure uniformity and noise, was used as a circular edge. The 3D NPS was measured using images from this same module and using a previously-described methodology that quantifies noise magnitude and 3D noise correlation. RESULTS The axial MTF was radially symmetrical and had a value of 0.1 at 0.62 mm(-1). The 3D NPS shape was consistent with the filter-ramp function of filtered-backprojection reconstruction algorithms and previously reported values. The radial NPS peak value was ∼115 HU(2)mm(3) at ∼0.25 mm(-1) and dropped to 0 HU(2)mm(3) by 0.8 mm(-1). CONCLUSIONS The authors have developed an easily-implementable technique to measure the axial MTF and 3D NPS of clinical CT systems using an ACR phantom. The widespread availability of the phantom along with the free software the authors have provided will enable many different institutions to immediately measure MTF and NPS values for comparison of protocols and systems.

Advances in PET myocardial perfusion imaging: F-18 labeled tracers.

Coronary artery disease and its related cardiac disorders represent the most common cause of death in the USA and Western world. Despite advancements in treatment and accompanying improvements in outcome with current diagnostic and therapeutic modalities, it is the correct assignment of these diagnostic techniques and treatment options which are crucial. From a diagnostic standpoint, SPECT myocardial perfusion imaging (MPI) using traditional radiotracers like thallium-201 chloride, Tc-99m sestamibi or Tc-99m tetrofosmin is the most utilized imaging technique. However, PET MPI using N-13 ammonia, rubidium-82 chloride or O-15 water is increasing in availability and usage as a result of the growing number of medical centers with new-generation PET/CT systems taking advantage of the superior imaging properties of PET over SPECT. The routine clinical use of PET MPI is still limited, in part because of the short half-life of conventional PET MPI tracers. The disadvantages of these conventional PET tracers include expensive onsite production and inconvenient on-scanner tracer administration making them unsuitable for physical exercise stress imaging. Recently, two F-18 labeled radiotracers with longer radioactive half-lives than conventional PET imaging agents have been introduced. These are flurpiridaz F 18 (formerly known as F-18 BMS747158-02) and F-18 fluorobenzyltriphenylphosphonium. These longer half-life F-18 labeled perfusion tracers can overcome the production and protocol limitations of currently used radiotracers for PET MPI.

Differentiation of Kidney Stones Using Dual-Energy CT With and Without a Tin Filter

OBJECTIVE The aim of this in vitro study was to examine the capability of three protocols of dual-energy CT imaging in distinguishing calcium oxalate, calcium phosphate, and uric acid kidney stones. MATERIALS AND METHODS A total of 48 calcium oxalate, calcium phosphate, and uric acid human kidney stone samples were placed in individual containers inside a cylindric water phantom and imaged with a dual-energy CT scanner using the following three scanning protocols of different combinations of tube voltage, with and without a tin filter: 80 and 140 kVp without a tin filter, 100 and 140 kVp with a tin filter, and 80 and 140 kVp with a tin filter. The mean attenuation value (in Hounsfield units) of each stone was recorded in both low- and high-energy CT images in each protocol. The dual-energy ratio of the mean attenuation values of each stone was computed for each protocol. RESULTS For all three protocols, the uric acid stones were significantly different (p < 0.001) from the calciferous stones according to their dual-energy ratio values. For differentiating calcium oxalate and calcium phosphate stones, the difference between their dual-energy ratio values was statistically significant, with different degrees of significance (range, p < 0.001 to p = 0.03) for all three protocols. On the basis of the values of the area under receiver operating characteristic curve (AUC) of calcified stone differentiation, the three protocols were ranked in the following order: the 80- and 140-kVp tin filter protocol (AUC, 0.996), the 100- and 140-kVp tin filter protocol (AUC, 0.918), and the 80- and 140-kVp protocol (AUC, 0.871). CONCLUSION The tin filter added to the high-energy tube and the use of a wider dual-energy difference are important for improving the stone differentiation capability of dual-energy CT imaging.

Compensation for spill-in and spill-out partial volume effects in cardiac PET imaging

BackgroundPartial volume effects (PVEs) in PET imaging result in incorrect regional activity estimates due to both spill-out and spill-in from activity in neighboring regions. It is important to compensate for both effects to achieve accurate quantification. In this study, an image-based partial volume compensation (PVC) method was developed and validated for cardiac PET.Methods and ResultsThe method uses volume-of-interest (VOI) maps segmented from contrast-enhanced CTA images to compensate for both spill-in and spill-out in each VOI. The PVC method was validated with simulation studies and also applied to images of dog cardiac perfusion PET data. The PV effects resulting from cardiac motion and myocardial uptake defects were investigated and the efficacy of the proposed PVC method in compensating for these effects was evaluated.ResultsResults indicate that the magnitude and the direction of PVEs in cardiac imaging change over time. This affects the accuracy of activity distributions estimates obtained during dynamic studies. The defect regions have different PVEs as compared to the normal myocardium. Cardiac motion contributes around 10% to the PVEs. PVC effectively removed both spill-in and spill-out in cardiac imaging.ConclusionsPVC improved left ventricular wall uniformity and quantitative accuracy. The best strategy for PVC was to compensate for the PVEs in each cardiac phase independently and treat severe uptake defects as independent regions from the normal myocardium.

Spectral response compensation for photon-counting clinical x-ray CT using sinogram restoration

The x-ray spectrum recorded by a photon-counting x-ray detector (PCXD) is distorted due to the following physical effects which are independent of the count rate: finite energy-resolution, Compton scattering, charge-sharing, and Kescape. If left uncompensated, the spectral response (SR) of a PCXD due to the above effects will result in image artifacts and inaccurate material decomposition. We propose a new SR compensation (SRC) algorithm using the sinogram restoration approach. The two main contributions of our proposed algorithm are: (1) our algorithm uses an efficient conjugate gradient method in which the first and second derivatives of the cost functions are directly calculated analytically, whereas a slower optimization method that requires numerous function evaluations was used in other work; (2) our algorithm guarantees convergence by combining the non-linear conjugate gradient method with line searches that satisfy Wolfe conditions, whereas the algorithm in other work is not backed by theorems from optimization theory to guarantee convergence. In this study, we validate the performance of the proposed algorithm using computer simulations. The bias was reduced to zero from 11%, and image artifacts were removed from the reconstructed images. Quantitative K-edge imaging in possible only when SR compensation is done.

Toward time resolved 4D cardiac CT imaging with patient dose reduction: estimating the global heart motion

Coronary artery imaging with multi-slice helical computed tomography is a promising noninvasive imaging technique. The current major issues include the insufficient temporal resolution and large patient dose. We propose an image reconstruction method which provides a solution to both of the problems. The method uses an iterative approach repeating the following four steps until the difference between the two projection data sets falls below a certain criteria in step-4: 1) estimating or updating the cardiac motion vectors, 2) reconstructing the time-resolved 4D dynamic volume images using the motion vectors, 3) calculating the projection data from the current 4D images, 4) comparing them with the measured ones. In this study, we obtain the first estimate of the motion vector. We use the 4D NCAT phantom, a realistic computer model for the human anatomy and cardiac motions, to generate the dynamic fan-beam projection data sets as well to provide a known truth for the motion. Then, the halfscan reconstruction with the sliding time-window technique is used to generate cine images: f(t, r r). Here, we use one heart beat for each position r so that the time information is retained. Next, the magnitude of the first derivative of f(t, r r) with respect to time, i.e., |df/dt|, is calculated and summed over a region-of-interest (ROI), which is called the mean-absolute difference (MAD). The initial estimation of the vector field are obtained using MAD for each ROI. Results of the preliminary study are presented.

Development of a model of the coronary arterial tree for the 4D XCAT phantom

A detailed three-dimensional (3D) model of the coronary artery tree with cardiac motion has great potential for applications in a wide variety of medical imaging research areas. In this work, we first developed a computer-generated 3D model of the coronary arterial tree for the heart in the extended cardiac-torso (XCAT) phantom, thereby creating a realistic computer model of the human anatomy. The coronary arterial tree model was based on two datasets: (1) a gated cardiac dual-source computed tomography (CT) angiographic dataset obtained from a normal human subject and (2) statistical morphometric data of porcine hearts. The initial proximal segments of the vasculature and the anatomical details of the boundaries of the ventricles were defined by segmenting the CT data. An iterative rule-based generation method was developed and applied to extend the coronary arterial tree beyond the initial proximal segments. The algorithm was governed by three factors: (1) statistical morphometric measurements of the connectivity, lengths and diameters of the arterial segments; (2) avoidance forces from other vessel segments and the boundaries of the myocardium, and (3) optimality principles which minimize the drag force at the bifurcations of the generated tree. Using this algorithm, the 3D computational model of the largest six orders of the coronary arterial tree was generated, which spread across the myocardium of the left and right ventricles. The 3D coronary arterial tree model was then extended to 4D to simulate different cardiac phases by deforming the original 3D model according to the motion vector map of the 4D cardiac model of the XCAT phantom at the corresponding phases. As a result, a detailed and realistic 4D model of the coronary arterial tree was developed for the XCAT phantom by imposing constraints of anatomical and physiological characteristics of the coronary vasculature. This new 4D coronary artery tree model provides a unique simulation tool that can be used in the development and evaluation of instrumentation and methods for imaging normal and pathological hearts with myocardial perfusion defects.

An interventricular sulcus guided cardiac motion estimation method

Accurate estimation of cardiac motion from clinical medical images especially motion components parallel to edges has been found to be difficult using the intensity based optical flow algorithm without any prior information. This research aims to develop a new feature guided cardiac motion estimation method for gated myocardial perfusion (MP) PET images whose quality has greatly improved in recent years. A unique anatomical feature of human heart-the interventricular sulcus, which contains important motion information, is becoming visible and can potentially be extracted from MP PET images to guide the motion estimation process. In this work the motion of the extracted anatomical feature was used to create an initial estimate of the cardiac motion vector field (MVF) to be combined with the optical flow motion estimation algorithm to improve the estimation accuracy. To evaluate the proposed cardiac motion method, we simulated cardiac gated MP PET images from the 4-D XCAT phantom. The feature-guided initial MVFs were used in combination with the optical flow algorithm and applied to the simulated gated MP PET images to obtain the estimated cardiac MVF. The results were evaluated quantitatively by comparison with the cardiac MVF of the XCAT phantom which was regarded as the ground truth, and with those from non-feature based motion estimation method. The comparison indicates that our feature-guided method can achieve more accurate estimation of cardiac motion than non-feature-based method.

Effect of heart rate on CT angiography using the enhanced cardiac model of the 4D NCAT

We investigate the effect of heart rate on the quality and artifact generation in coronary artery images obtained using multi-slice computed tomography (MSCT) with the purpose of finding the optimal time resolution for data acquisition. To perform the study, we used the 4D NCAT phantom, a computer model of the normal human anatomy and cardiac and respiratory motions developed in our laboratory. Although capable of being far more realistic, the 4D NCAT cardiac model was originally designed for low-resolution imaging research, and lacked the anatomical detail to be applicable to high-resolution CT. In this work, we updated the cardiac model to include a more detailed anatomy and physiology based on high-resolution clinical gated MSCT data. To demonstrate its utility in high-resolution dynamic CT imaging research, the enhanced 4D NCAT was then used in a pilot simulation study to investigate the effect of heart rate on CT angiography. The 4D NCAT was used to simulate patients with different heart rates (60-120 beats/minute) and with various cardiac plaques of known size and location within the coronary arteries. For each simulated patient, MSCT projection data was generated with data acquisition windows ranging from 100 to 250 ms centered within the quiet phase (mid-diastole) of the heart using an analytical CT projection algorithm. CT images were reconstructed from the projection data, and the contrast of the plaques was then measured to assess the effect of heart rate and to determine the optimal time resolution required for each case. The 4D NCAT phantom with its realistic model for the cardiac motion was found to provide a valuable tool from which to optimize CT cardiac applications. Our results indicate the importance of optimizing the time resolution with regard to heart rate and plaque location for improved CT images at a reduced patient dose.

Joint estimation of tissue types and linear attenuation coefficients for photon counting CT.

PURPOSE Newly developed spectral computed tomography (CT) such as photon counting detector CT enables more accurate tissue-type identification through material decomposition technique. Many iterative reconstruction methods, including those developed for spectral CT, however, employ a regularization term whose penalty transition is designed using pixel value of CT image itself. Similarly, the tissue-type identification methods are then applied after reconstruction; thus, it is impossible to take into account probability distribution obtained from projection likelihood. The purpose of this work is to develop comprehensive image reconstruction and tissue-type identification algorithm which improves quality of both reconstructed image and tissue-type map. METHODS The authors propose a new framework to jointly perform image reconstruction, material decomposition, and tissue-type identification for photon counting detector CT by applying maximum a posteriori estimation with voxel-based latent variables for the tissue types. The latent variables are treated using a voxel-based coupled Markov random field to describe the continuity and discontinuity of human organs and a set of Gaussian distributions to incorporate the statistical relation between the tissue types and their attenuation characteristics. The performance of the proposed method is quantitatively compared to that of filtered backprojection and a quadratic penalized likelihood method by 100 noise realization. RESULTS Results showed a superior trade-off between image noise and resolution to current reconstruction methods. The standard deviation (SD) and bias of reconstructed image were improved from quadratic penalized likelihood method: bias, -0.9 vs -0.1 Hounsfield unit (HU); SD, 46.8 vs 27.4 HU. The accuracy of tissue-type identification was also improved from quadratic penalized likelihood method: 80.1% vs 86.9%. CONCLUSIONS The proposed method makes it possible not only to identify tissue types more accurately but also to reconstruct CT images with decreased noise and enhanced sharpness owing to the information about the tissue types.