Jan Kuntz

Intrinsic gating for small-animal computed tomography: a robust ECG-less paradigm for deriving cardiac phase information and functional imaging.

Background—A projection-based method of intrinsic cardiac gating in small-animal computed tomography imaging is presented. Methods and Results—In this method, which operates without external ECG monitoring, the gating reference signal is derived from the raw data of the computed tomography projections. After filtering, the derived gating reference signal is used to rearrange the projection images retrospectively into data sets representing different time points in the cardiac cycle during expiration. These time-stamped projection images are then used for tomographic reconstruction of different phases of the cardiac cycle. Intrinsic gating was evaluated in mice and rats and compared with extrinsic retrospective gating. An excellent agreement was achieved between ECG-derived gating signal and self-gating signal (coverage probability for a difference between the 2 measurements to be less than 5 ms was 89.2% in mice and 85.9% in rats). Functional parameters (ventricular volumes and ejection fraction) obtained from the intrinsic and the extrinsic data sets were not significantly different. The ease of use and reliability of intrinsic gating were demonstrated via a chemical stress test on 2 mice, in which the system performed flawlessly despite an increased heart rate. Because of intrinsic gating, the image quality was improved to the extent that even the coronary arteries of mice could be visualized in vivo despite a heart rate approaching 430 bpm. Feasibility of intrinsic gating for functional imaging and assessment of cardiac wall motion abnormalities was successfully tested in a mouse model of myocardial infarction. Conclusions—Our results demonstrate that self-gating using advanced software postprocessing of projection data promises to be a valuable tool for rodent computed tomography imaging and renders ECG gating with external electrodes superfluous.

Gating in small-animal cardio-thoracic CT

Gating is necessary in cardio-thoracic small-animal imaging because of the physiological motions that are present during scanning. In small-animal computed tomography (CT), gating is mainly performed on a projection base because full scans take much longer than the motion cycle. This paper presents and discusses various gating concepts of small-animal CT, and provides examples of concrete implementation. Since a wide variety of small-animal CT scanner systems exist, scanner systems are discussed with respect to the most suitable gating methods. Furthermore, an overview is given of cardio-thoracic imaging and gating applications. The necessary contrast media are discussed as well as gating limitations. Gating in small-animal imaging requires the acquisition of a gating signal during scanning. This can be done extrinsically (additional hardware, e.g. electrocardiogram) or intrinsically from the projection data itself. The gating signal is used retrospectively during CT reconstruction, or prospectively to trigger parts of the scan. Gating can be performed with respect to the phase or the amplitude of the gating signal, providing different advantages and challenges. Gating methods should be optimized with respect to the diagnostic question, scanner system, animal model, type of narcosis and actual setup. The software-based intrinsic gating approaches increasingly employed give the researcher independence from difficult and expensive hardware changes.

Fully automated intrinsic respiratory and cardiac gating for small animal CT

A fully automated, intrinsic gating algorithm for small animal cone-beam CT is described and evaluated. A parameter representing the organ motion, derived from the raw projection images, is used for both cardiac and respiratory gating. The proposed algorithm makes it possible to reconstruct motion-corrected still images as well as to generate four-dimensional (4D) datasets representing the cardiac and pulmonary anatomy of free-breathing animals without the use of electrocardiogram (ECG) or respiratory sensors. Variation analysis of projections from several rotations is used to place a region of interest (ROI) on the diaphragm. The ROI is cranially extended to include the heart. The centre of mass (COM) variation within this ROI, the filtered frequency response and the local maxima are used to derive a binary motion-gating parameter for phase-sensitive gated reconstruction. This algorithm was implemented on a flat-panel-based cone-beam CT scanner and evaluated using a moving phantom and animal scans (seven rats and eight mice). Volumes were determined using a semiautomatic segmentation. In all cases robust gating signals could be obtained. The maximum volume error in phantom studies was less than 6%. By utilizing extrinsic gating via externally placed cardiac and respiratory sensors, the functional parameters (e.g. cardiac ejection fraction) and image quality were equivalent to this current gold standard. This algorithm obviates the necessity of both gating hardware and user interaction. The simplicity of the proposed algorithm enables adoption in a wide range of small animal cone-beam CT scanners.

The rotate‐plus‐shift C‐arm trajectory. Part I. Complete data with less than 180° rotation

PURPOSE In the last decade, C-arm-based cone-beam CT became a widely used modality for intraoperative imaging. Typically a C-arm CT scan is performed using a circular or elliptical trajectory around a region of interest. Therefore, an angular range of at least 180° plus fan angle must be covered to ensure a completely sampled data set. However, mobile C-arms designed with a focus on classical 2D applications like fluoroscopy may be limited to a mechanical rotation range of less than 180° to improve handling and usability. The method proposed in this paper allows for the acquisition of a fully sampled data set with a system limited to a mechanical rotation range of at least 180° minus fan angle using a new trajectory design. This enables CT like 3D imaging with a wide range of C-arm devices which are mainly designed for 2D imaging. METHODS The proposed trajectory extends the mechanical rotation range of the C-arm system with two additional linear shifts. Due to the divergent character of the fan-beam geometry, these two shifts lead to an additional angular range of half of the fan angle. Combining one shift at the beginning of the scan followed by a rotation and a second shift, the resulting rotate-plus-shift trajectory enables the acquisition of a completely sampled data set using only 180° minus fan angle of rotation. The shifts can be performed using, e.g., the two orthogonal positioning axes of a fully motorized C-arm system. The trajectory was evaluated in phantom and cadaver examinations using two prototype C-arm systems. RESULTS The proposed trajectory leads to reconstructions without limited angle artifacts. Compared to the limited angle reconstructions of 180° minus fan angle, image quality increased dramatically. Details in the rotate-plus-shift reconstructions were clearly depicted, whereas they are dominated by artifacts in the limited angle scan. CONCLUSIONS The method proposed here employs 3D imaging using C-arms with less than 180° rotation range adding full 3D functionality to a C-arm device retaining both handling comfort and the usability of 2D imaging. This method has a clear potential for clinical use especially to meet the increasing demand for an intraoperative 3D imaging.

The rotate‐plus‐shift C‐arm trajectory. Part II. Exact reconstruction from less than 180° rotation

PURPOSE CT reconstruction requires an angular coverage of 180° or more for each point within the field of measurement. Thus, common trajectories use a 180° plus fan angle rotation. This is sometimes combined with a translation of the rotational isocenter in order to achieve circular trajectories with an isocenter different from the mechanical rotation center or elliptical trajectories. Rays measured redundantly are appropriately weighted. In case of an angular coverage smaller than 180°, the reconstructed images suffer from limited angle artifacts. In mechanical constructions with a rotation range limited to less than 180° plus fan angle, the angular coverage can be extended by adding one or two shifts to the rotational motion. If the missing angle is less than the fan angle, the shifts can completely compensate for the limited rotational capabilities. METHODS The authors give weight functions that can be viewed as generalized Parker weights, which can be applied to the raw data before image reconstruction. Raw data of Forbild phantoms using the rotate-plus-shift trajectory are simulated with the geometry of a typical mobile flat detector-based C-arm system. Filtered backprojection (FBP) reconstructions using the new redundancy weight are performed and compared to FBP reconstructions of limited angle scans as well as short-scan reference trajectories using Parker weight. RESULTS The new weighting method is exact in 2D, and for 3D Feldkamp-type reconstructions, it is exact in the mid-plane. The proposed weight shows a mathematically exact match with Parker weight for conventional short-scan trajectories. Reconstructions of rotate-plus-shift trajectories using the new weight do not suffer from limited angle artifacts, whereas scans limited to less than 180° without shift show prominent artifacts. Image noise in rotate-plus-shift scans is comparable to that of corresponding short scans. CONCLUSIONS The new weight function enables the straightforward reconstruction using filtered backprojection of data acquired with the rotate-plus-shift C-arm trajectory and a large variety of other advanced trajectories.

The rotate-plus-shift C-arm trajectory: complete CT data with limited angular rotation

In the last decade C–arm–based cone–beam CT became a widely used modality for intraoperative imaging. Typically a C–arm scan is performed using a circle–like trajectory around a region of interest. Therefor an angular range of at least 180° plus fan–angle must be covered to ensure a completely sampled data set. This fact defines some constraints on the geometry and technical specifications of a C–arm system, for example a larger C radius or a smaller C opening respectively. These technical modifications are usually not beneficial in terms of handling and usability of the C–arm during classical 2D applications like fluoroscopy. The method proposed in this paper relaxes the constraint of 180◦ plus fan–angle rotation to acquire a complete data set. The proposed C–arm trajectory requires a motorization of the orbital axis of the C and of ideally two orthogonal axis in the C plane. The trajectory consists of three parts: A rotation of the C around a defined iso–center and two translational movements parallel to the detector plane at the begin and at the end of the rotation. Combining these three parts to one trajectory enables for the acquisition of a completely sampled dataset using only 180° minus fan–angle of rotation. To evaluate the method we show animal and cadaver scans acquired with a mobile C-arm prototype. We expect that the transition of this method into clinical routine will lead to a much broader use of intraoperative 3D imaging in a wide field of clinical applications.

CT-Guided Interventions: Current Practice and Future Directions

Computed tomography (CT) plays an important role in interventional procedures such as biopsy, abscess drainage, tumor ablation, catheter placement, and orthopedic instrumentation. All these procedures involve precise incremental advancement of a needle or a probe. This chapter reviews the current state of the art and advanced applications of CT in interventional procedures, including the use of C-arm CT, multi-detector CT, and ultrahigh-resolution flat-panel CT. Interventional capabilities of C-arm CT, which combines the advantages of a digital flat-panel detector with the versatility of a C-arm, are described. Ultrahigh-resolution flat-panel CT, another technology-based flat-panel detector, is also described. Recent development of portable CT not only provides on-site imaging for critically ill patients; it also enables faster response to imaging requests and increased productivity of the care team. The new advancements covered by this chapter introduce robot-assisted image-guided interventions. The current CT-guided intervention only provides 3D data in a discontinuous, manipulate, and rescan fashion. A new paradigm for real-time 4D imaging, which could play an important role in intervention guidance in the near future, is described and illustrated with the help of examples.

Technical Note: Intrinsic Rawdata-based CT Misalignment Correction without Redundant Data

PURPOSE CT image reconstruction requires accurate knowledge of the used geometry or image quality might be degraded by misalignment artifacts. To overcome this issue, an intrinsic method, that is, a method not requiring a dedicated calibration phantom, to perform a raw data-based misalignment correction for CT is proposed herein that does not require redundant data and hence is applicable to measurements with less than 180 ∘ plus fan-angle of data. METHODS The forward projection of a volume reconstructed from a misaligned geometry resembles the acquired raw data if no redundant data are used, that is, if less than 180 ∘ plus fan-angle are used for image reconstruction. Hence, geometric parameters cannot be deduced from such data by an optimization of the geometry-dependent raw data fidelity. We propose to use a nonlinear transform applied to the reconstructed volume to introduce inconsistencies in the raw data that can be employed to estimate geometric parameters using less than 180 ∘ plus fan-angle of data. The proposed method is evaluated using simulations of the FORBILD head phantom and using actual measurements of a contrast-enhanced scan of a mouse acquired using a micro-CT. RESULTS Noisy simulations and actual measurements demonstrate that the proposed method is capable of correcting for artifacts arising from a misaligned geometry without redundant data while ensuring raw data fidelity. CONCLUSIONS The proposed method extends intrinsic raw data-based misalignment correction methods to an angular range of 180 ∘ or less and is thus applicable to systems with a limited scan range.

Influence of data completion on scatter artifact correction for truncated cone-beam CT data

X-ray scatter leads to one of the major artifacts limiting the image quality in cone-beam CT (CBCT). Hence the interest to perform an accurate scatter correction is very high. A particularly large amount of scatter is created in CBCT, due to the large cone-angle and the small distance between the rotation axis and the detector. Even if an anti-scatter grid is used, a scatter correction is necessary. The performance of an accurate scatter correction is difficult, especially when the data are additionally truncated due to a small field of measurement (FOM) (e.g. dental CT systems or C-Arm CT systems). In addition to the image degradation due to scatter artifacts, numerous CBCT artifacts like beam-hardening artifacts and cone-beam artifacts contribute to a further reduction in image quality. In this paper different detruncation methods are compared with respect to scatter to find a quantitative scatter correction approach for truncated CBCT data. The evaluation shows that a precise detruncation is crucial for an appropriate scatter correction. Additionally, the general image quality limit is enhanced by performing further artifact correction methods to reconstruct a nearly artifact-free CBCT volume.

Model-based sphere localization (MBSL) in x-ray projections

The detection of spherical markers in x-ray projections is an important task in a variety of applications, e.g. geometric calibration and detector distortion correction. Therein, the projection of the sphere center on the detector is of particular interest as the used spherical beads are no ideal point-like objects. Only few methods have been proposed to estimate this respective position on the detector with sufficient accuracy and surrogate positions, e.g. the center of gravity, are used, impairing the results of subsequent algorithms. We propose to estimate the projection of the sphere center on the detector using a simulation-based method matching an artificial projection to the actual measurement. The proposed algorithm intrinsically corrects for all polychromatic effects included in the measurement and absent in the simulation by a polynomial which is estimated simultaneously. Furthermore, neither the acquisition geometry nor any object properties besides the fact that the object is of spherical shape need to be known to find the center of the bead. It is shown by simulations that the algorithm estimates the center projection with an error of less than [Formula: see text] of the detector pixel size in case of realistic noise levels and that the method is robust to the sphere material, sphere size, and acquisition parameters. A comparison to three reference methods using simulations and measurements indicates that the proposed method is an order of magnitude more accurate compared to these algorithms. The proposed method is an accurate algorithm to estimate the center of spherical markers in CT projections in the presence of polychromatic effects and noise.