Iacovos S. Kyprianou

Generalizing the MTF and DQE to include x-ray scatter and focal spot unsharpness: application to a new microangiographic system.

Detector characterization with modulation transfer function (MTF) and detective quantum efficiency (DQE) inadequately predicts image quality when the imaging system includes focal spot unsharpness and patient scatter. The concepts of MTF, noise power spectrum, noise equivalent quanta and DQE were referenced to the object plane and generalized to include the effect of geometric unsharpness due to the finite size of the focal spot and the effect of the spatial distribution and magnitude of x-ray scatter due to the patient. The generalized quantities provide performance characteristics that consider the complete imaging system, but reduce to a description of the detector properties without magnification or scatter. We have evaluated a new neurovascular angiography imaging system based on a region of interest (ROI) microangiographic detector using these generalized quantities. A uniform head-equivalent phantom was used as a filter and x-ray scatter source. This allowed the study of all properties of the detector under clinically relevant x-ray spectra and x-ray scatter conditions. Realistic focal spots (0.8 mm nominal), beam energies (60-100 kVp), and detector exposures (0.8-2.3 mR) were used, and the effects of different scatter fractions (0-0.62) resulting from changing the beam size (0-100 cm2) were investigated. The generalized MTF and DQE were found to have very little dependence on the tube voltage and the detector entrance exposure. Magnification, with the focal spot used, results in a large decrease of the generalized DQE at higher frequencies (about 100-fold at 10 cycles/mm), but a significantly smaller decrease at lower frequencies. Scatter on the other hand, causes a constant drop in the generalized DQE (factor of 3 for scatter fraction 0.3) for all frequencies. Our results show that there are tradeoffs in the choice of the different system parameters; therefore this methodology of studying the imaging system as a whole could provide guidance in system design.

Anisotropic imaging performance in indirect x‐ray imaging detectors

We report on the variability in imaging system performance due to oblique x-ray incidence, and the associated transport of quanta (both x rays and optical photons) through the phosphor, in columnar indirect digital detectors. The analysis uses MANTIS, a combined x-ray, electron, and optical Monte Carlo transport code freely available. We describe the main features of the simulation method and provide some validation of the phosphor screen models considered in this work. We report x-ray and electron three-dimensional energy deposition distributions and point-response functions (PRFs), including optical spread in columnar phosphor screens of thickness 100 and 500 microm, for 19, 39, 59, and 79 keV monoenergetic x-ray beams incident at 0 degrees, 10 degrees, and 15 degrees. In addition, we present pulse-height spectra for the same phosphor thickness, x-ray energies, and angles of incidence. Our results suggest that the PRF due to the phosphor blur is highly nonsymmetrical, and that the resolution properties of a columnar screen in a tomographic, or tomosynthetic imaging system varies significantly with the angle of x-ray incidence. Moreover, we find that the noise due to the variability in the number of light photons detected per primary x-ray interaction, summarized in the information or Swank factor, is somewhat independent of thickness and incidence angle of the x-ray beam. Our results also suggest that the anisotropy in the PRF is not less in screens with absorptive backings, while the noise introduced by variations in the gain and optical transport is larger. Predictions from MANTIS, after additional validation, can provide the needed understanding of the extent of such variations, and eventually, lead to the incorporation of the changes in imaging performance with incidence angle into the reconstruction algorithms for volumetric x-ray imaging systems.

Monte Carlo study of the effects of system geometry and antiscatter grids on cone‐beam CT scatter distributions

PURPOSE The proliferation of cone-beam CT (CBCT) has created interest in performance optimization, with x-ray scatter identified among the main limitations to image quality. CBCT often contends with elevated scatter, but the wide variety of imaging geometry in different CBCT configurations suggests that not all configurations are affected to the same extent. Graphics processing unit (GPU) accelerated Monte Carlo (MC) simulations are employed over a range of imaging geometries to elucidate the factors governing scatter characteristics, efficacy of antiscatter grids, guide system design, and augment development of scatter correction. METHODS A MC x-ray simulator implemented on GPU was accelerated by inclusion of variance reduction techniques (interaction splitting, forced scattering, and forced detection) and extended to include x-ray spectra and analytical models of antiscatter grids and flat-panel detectors. The simulator was applied to small animal (SA), musculoskeletal (MSK) extremity, otolaryngology (Head), breast, interventional C-arm, and on-board (kilovoltage) linear accelerator (Linac) imaging, with an axis-to-detector distance (ADD) of 5, 12, 22, 32, 60, and 50 cm, respectively. Each configuration was modeled with and without an antiscatter grid and with (i) an elliptical cylinder varying 70-280 mm in major axis; and (ii) digital murine and anthropomorphic models. The effects of scatter were evaluated in terms of the angular distribution of scatter incident upon the detector, scatter-to-primary ratio (SPR), artifact magnitude, contrast, contrast-to-noise ratio (CNR), and visual assessment. RESULTS Variance reduction yielded improvements in MC simulation efficiency ranging from ∼17-fold (for SA CBCT) to ∼35-fold (for Head and C-arm), with the most significant acceleration due to interaction splitting (∼6 to ∼10-fold increase in efficiency). The benefit of a more extended geometry was evident by virtue of a larger air gap-e.g., for a 16 cm diameter object, the SPR reduced from 1.5 for ADD = 12 cm (MSK geometry) to 1.1 for ADD = 22 cm (Head) and to 0.5 for ADD = 60 cm (C-arm). Grid efficiency was higher for configurations with shorter air gap due to a broader angular distribution of scattered photons-e.g., scatter rejection factor ∼0.8 for MSK geometry versus ∼0.65 for C-arm. Grids reduced cupping for all configurations but had limited improvement on scatter-induced streaks and resulted in a loss of CNR for the SA, Breast, and C-arm. Relative contribution of forward-directed scatter increased with a grid (e.g., Rayleigh scatter fraction increasing from ∼0.15 without a grid to ∼0.25 with a grid for the MSK configuration), resulting in scatter distributions with greater spatial variation (the form of which depended on grid orientation). CONCLUSIONS A fast MC simulator combining GPU acceleration with variance reduction provided a systematic examination of a range of CBCT configurations in relation to scatter, highlighting the magnitude and spatial uniformity of individual scatter components, illustrating tradeoffs in CNR and artifacts and identifying the system geometries for which grids are more beneficial (e.g., MSK) from those in which an extended geometry is the better defense (e.g., C-arm head imaging). Compact geometries with an antiscatter grid challenge assumptions of slowly varying scatter distributions due to increased contribution of Rayleigh scatter.

Anisotropic imaging performance in breast tomosynthesis.

We describe the anisotropy in imaging performance caused by oblique x-ray incidence in indirect detectors for breast tomosynthesis based on columnar scintillator screens. We use MANTIS, a freely available combined x-ray, electron, and optical Monte Carlo transport package which models the indirect detection processes in columnar screens, interaction by interaction. The code has been previously validated against published optical distributions. In this article, initial validation results are provided concerning the blur for particular designs of phosphor screens for which some details with respect to the columnar geometry are available from scanning electron microscopy. The polyenergetic x-ray spectrum utilized comes from a database of experimental data for three different anode/filter/kVp combinations: Mo/Mo at 28 kVp, Rh/Rh at 28 kVp, and W/Al at 42 kVp. The x-ray spectra were then filtered with breast tissue (3, 4, and 6 cm thickness), compression paddle, and support base, according to the oblique paths determined by the incidence angle. The composition of the breast tissue was 50%/50% adipose/glandular tissue mass ratio. Results are reported on the pulse-height statistics of the light output and on spatial blur, expressed as the response of the detector to a pencil beam with a certain incidence angle. Results suggest that the response is nonsymmetrical and that the resolution properties of a tomosynthesis system vary significantly with the angle of x-ray incidence. In contrast, it is found that the noise due to the variability in the number of light photons detected per primary x-ray interaction changes only a few percent. The anisotropy in the response is not less in screens with absorptive backings while the noise introduced by variations in the depth-dependent light output and optical transport is larger. The results suggest that anisotropic imaging performance across the detector area can be incorporated into reconstruction algorithms for improving the image quality of breast tomosynthesis. This study also demonstrates that the assessment of image quality of breast tomosynthesis systems requires a more complete description of the detector response beyond local, center measurements of resolution and noise that assume some degree of symmetry in the detector performance.

Study of the generalized MTF and DQE for a new microangiographic system

We study the properties of a new microangiographic system, consisting of a Region of Interest (ROI) microangiographic detector, x-ray source, and patient. The study was performed under conditions intended for clinical procedures such as neurological diagnostic angiograms as well as treatments of intracranial aneurysms, and vessel-stenoses. The study was performed in two steps; first a uniform head equivalent phantom was used as a “filter”. This allowed us to study the properties of the detector alone, under clinically relevant x-ray spectra. We report the detector MTF, NPS, NEQ, and DQE for beam energies ranging from 60-100kVp and for different detector entrance exposures. For the second step, the phantom was placed adjacent to the detector, allowing scatter to enter the detector and new measurements were obtained for the same beam energies and detector entrance exposures. Different radiation field sizes were studied, and the effects of different scatter amounts were investigated. The spatial distribution of scatter was studied using the edge-spread method and a generalized system MTF was obtained by combining the scatter MTF weighted by the scatter fraction with the detector MTF and focal spot unsharpness due to magnification. The NPS combined with the generalized MTF gave the generalized system NEQ and DQE. The generalized NEQ and the ideal object detectability were used to calculate the Dose Area Product to the patient for 75% object detection probability. This was used as a system optimization method.

Monte Carlo reference data sets for imaging research: Executive summary of the report of AAPM Research Committee Task Group 195

The use of Monte Carlo simulations in diagnostic medical imaging research is widespread due to its flexibility and ability to estimate quantities that are challenging to measure empirically. However, any new Monte Carlo simulation code needs to be validated before it can be used reliably. The type and degree of validation required depends on the goals of the research project, but, typically, such validation involves either comparison of simulation results to physical measurements or to previously published results obtained with established Monte Carlo codes. The former is complicated due to nuances of experimental conditions and uncertainty, while the latter is challenging due to typical graphical presentation and lack of simulation details in previous publications. In addition, entering the field of Monte Carlo simulations in general involves a steep learning curve. It is not a simple task to learn how to program and interpret a Monte Carlo simulation, even when using one of the publicly available code packages. This Task Group report provides a common reference for benchmarking Monte Carlo simulations across a range of Monte Carlo codes and simulation scenarios. In the report, all simulation conditions are provided for six different Monte Carlo simulation cases that involve common x-ray based imaging research areas. The results obtained for the six cases using four publicly available Monte Carlo software packages are included in tabular form. In addition to a full description of all simulation conditions and results, a discussion and comparison of results among the Monte Carlo packages and the lessons learned during the compilation of these results are included. This abridged version of the report includes only an introductory description of the six cases and a brief example of the results of one of the cases. This work provides an investigator the necessary information to benchmark his/her Monte Carlo simulation software against the reference cases included here before performing his/her own novel research. In addition, an investigator entering the field of Monte Carlo simulations can use these descriptions and results as a self-teaching tool to ensure that he/she is able to perform a specific simulation correctly. Finally, educators can assign these cases as learning projects as part of course objectives or training programs.

Signal detection and location‐dependent noise in cone‐beam computed tomography using the spatial definition of the Hotelling SNR

PURPOSE Quality assurance in computed tomography (CT) is commonly performed with the Fourier-based modulation transfer function (MTF) and the noise variance, while more recently the noise power spectrum (NPS) has increased in popularity. The Fourier-based methods make assumptions such as shift-invariance and cyclostationarity. These assumptions are violated in real clinical systems and consequently are expected to result in systematic errors. A spatial approach, based on the object transfer matrix (T) and the covariance matrix (K) theory, does not require these assumptions and can provide a more general description of the imaging system. In this paper, the authors present an experimental methodology and data treatment for quality assessment of a lab cone-beam CT system by comparing the spatial with the Fourier approach in 2D reconstructed slices. METHODS In order to have control over all experimental parameters and image reconstruction, a bench-top flat-panel-based cone-beam CT scanner and a cylindrical water-filled poly(methyl methacrylate) (PMMA) phantom were used for the noise measurements. An aluminum foil inserted in the water phantom enabled the estimation of the line response function (LRF) with a limited number of assumptions. The authors evaluated the spatial blur, the noise and the signal-to-noise ratio (SNR) using the spatial approach as well as the Fourier-based approach. In order to evaluate the degree of noise nonstationarity of their cone-beam CT system, the authors evaluated both the local and global CT noise properties and compared them using both approaches. RESULTS For the laboratory cone-beam CT, the location-dependent noise evaluation showed that in addition to the noise variance, the NPS and covariance eigenvector symmetry depend on the location in the image. The estimated signal transfer was similar for both approaches. Unlike the Fourier approach which uses the same exponential wave function basis for both MTF and NPS, the eigenvectors of T and K were significantly different. CONCLUSIONS By using the eigenvectors of the noise and object transfer to characterize the system, the spatial approach provides additional information to the Fourier approach and is therefore an important tool for a thorough understanding of a CT system.

Micro-angiographic detector with fluoroscopic capability

New neuro-interventional devices such as stents require high spatial-resolution image guidance to enable accurate localization both along the vessel axis as well as in a preferred rotational orientation around the axis. A new high-resolution angiographic detector has been designed with capability for micro-angiography at rates exceeding the 5 fps of our current detector and, additionally, with noise low enough and gain high enough for fluoroscopy. Although the performance requirements are demanding and the detector must fit within practical clinical space constraints, image guidance is only needed within a approximately 5 cm region of interest at the site of the intervention. To achieve the design goals, the new detector is being assembled from available components which include a CsI(Tl) phosphor module coupled to a fiber-optic taper assembly with a two stage light image intensifier and a mirror between the output of the fiber taper and the input to a conventional high performance optical CCD camera. Resulting acquisition modes include 50-micron effective pixels at up to 30 fps with the capability to adjust sensitivity for both fluoroscopy and angiography. Estimates of signal at the various stages of detection are made with quantum accounting diagrams (QAD).

Micro-angiography for neuro-vascular imaging. I. Experimental evaluation and feasibility.

Minimally invasive image-guided neuro-vascular interventions require very high image-resolution and quality, specifically over regions-of-interest (ROI) crucial to the procedure. ROI imaging or micro-angiography, allows limited patient integral radiation dose while permitting rapid frame transfer of high-resolution images. The design and performance of a charge coupled device (CCD) based x-ray detector or micro-angiographic camera was assessed for neuro-vascular procedures. The detector consists of a 250-microm-thick CsI(Tl) phosphor fiber-optically coupled through a 1.8:1 taper to a CCD chip, with an effective image pixel size of 50 microm and a frame rate of 5 fps in the 2:1 pixel-binned mode. The characteristics of the camera including the modulation transfer function (MTF), the noise equivalent quanta, the detective quantum efficiency, observer studies, and the effect of geometric magnification were evaluated. The MTF was found to have nonzero (1.7%) value at the Nyquist frequency of 10 cycles/mm, while the DQE(0) had a value of approximately 55%. All values were measured using head equivalent attenuating material in the beam at 80 kVp. Human observer studies performed using the 2 Alternative Forced Choice method revealed that iodinated vessels with inner diameter of 100 microm and 2 cm in length can be seen with a confidence level greater than 75%. The observer studies included a comparison with ideal observer performance calculations based on the integral signal to noise ratio in the image. Probabilities of visualization of various objects of interest in a neuro-intervention, such as stents, were assessed. A geometric magnification of 1 was found to be best for imaging under neuro-angiographic conditions. The detector appeared to satisfy all the demands of neuro-angiography and showed promise as an improvement over existing angiographic detectors.

Generalized Performance Evaluation of X-ray Image Intensifier compared with a Microangiographic System

Standard objective parameters such as MTF, NPS, NEQ and DQE do not reflect complete system performance, because they do not account for geometric unsharpness due to finite focal spot size and scatter due to the patient. The inclusion of these factors led to the generalization of the objective quantities, termed GMTF, GNNPS, GNEQ and GDQE defined at the object plane. In this study, a commercial x-ray image intensifier (II) is evaluated under this generalized approach and compared with a high-resolution, ROI microangiographic system previously developed and evaluated by our group. The study was performed using clinically relevant spectra and simulated conditions for neurovascular angiography specific for each system. A head-equivalent phantom was used, and images were acquired from 60 to 100 kVp. A source to image distance of 100 cm (75 cm for the microangiographic system) and a focal spot of 0.6 mm were used. Effects of varying the irradiation field-size, the air-gaps, and the magnifications (1.1 to 1.3) were compared. A detailed comparison of all of the generalized parameters is presented for the two systems. The detector MTF for the microangiographic system is in general better than that for the II system. For the total x-ray imaging system, the GMTF and GDQE for the II are better at low spatial frequencies, whereas the microangiographic system performs substantially better at higher spatial frequencies. This generalized approach can be used to more realistically evaluate and compare total system performance leading to improved system designs tailored to the imaging task.