Jang-Hwan Choi

CONRAD--a software framework for cone-beam imaging in radiology.

PURPOSE In the community of x-ray imaging, there is a multitude of tools and applications that are used in scientific practice. Many of these tools are proprietary and can only be used within a certain lab. Often the same algorithm is implemented multiple times by different groups in order to enable comparison. In an effort to tackle this problem, the authors created CONRAD, a software framework that provides many of the tools that are required to simulate basic processes in x-ray imaging and perform image reconstruction with consideration of nonlinear physical effects. METHODS CONRAD is a Java-based state-of-the-art software platform with extensive documentation. It is based on platform-independent technologies. Special libraries offer access to hardware acceleration such as OpenCL. There is an easy-to-use interface for parallel processing. The software package includes different simulation tools that are able to generate up to 4D projection and volume data and respective vector motion fields. Well known reconstruction algorithms such as FBP, DBP, and ART are included. All algorithms in the package are referenced to a scientific source. RESULTS A total of 13 different phantoms and 30 processing steps have already been integrated into the platform at the time of writing. The platform comprises 74.000 nonblank lines of code out of which 19% are used for documentation. The software package is available for download at http://conrad.stanford.edu. To demonstrate the use of the package, the authors reconstructed images from two different scanners, a table top system and a clinical C-arm system. Runtimes were evaluated using the RabbitCT platform and demonstrate state-of-the-art runtimes with 2.5 s for the 256 problem size and 12.4 s for the 512 problem size. CONCLUSIONS As a common software framework, CONRAD enables the medical physics community to share algorithms and develop new ideas. In particular this offers new opportunities for scientific collaboration and quantitative performance comparison between the methods of different groups.

Dynamic detector offsets for field of view extension in C-arm computed tomography with application to weight-bearing imaging.

PURPOSE In C-arm computed tomography (CT), the field of view (FOV) is often not sufficient to acquire certain anatomical structures, e.g., a full hip or thorax. Proposed methods to extend the FOV use a fixed detector displacement and a 360° scan range to double the radius of the FOV. These trajectories are designed for circular FOVs. However, there are cases in which the required FOV is not circular but rather an ellipsoid. METHODS In this work, the authors show that in fan-beam CT, the use of a dynamically adjusting detector offset can reduce the required scan range when using a noncircular FOV. Furthermore, the authors present an analytic solution to determine the minimal required scan ranges for elliptic FOVs given a certain detector size and an algorithmic approach for arbitrary FOVs. RESULTS The authors show that the proposed method can result in a substantial reduction of the required scan range. Initial reconstructions of data sets acquired with our new minimal trajectory yielded image quality comparable to reconstructions of data acquired using a fixed detector offset and a full 360° rotation. CONCLUSIONS Our results show a promising reduction of the necessary scan range especially for ellipsoidal objects that extend the FOV. In noncircular FOVs, there exists a set of solutions that allow a trade-off between detector size and scan range.

Scatter correction using a primary modulator on a clinical angiography C‐arm CT system

Purpose Cone beam computed tomography (CBCT) suffers from a large amount of scatter, resulting in severe scatter artifacts in the reconstructions. Recently, a new scatter correction approach, called improved primary modulator scatter estimation (iPMSE), was introduced. That approach utilizes a primary modulator that is inserted between the X‐ray source and the object. This modulation enables estimation of the scatter in the projection domain by optimizing an objective function with respect to the scatter estimate. Up to now the approach has not been implemented on a clinical angiography C‐arm CT system. Methods In our work, the iPMSE method is transferred to a clinical C‐arm CBCT. Additional processing steps are added in order to compensate for the C‐arm scanner motion and the automatic X‐ray tube current modulation. These challenges were overcome by establishing a reference modulator database and a block‐matching algorithm. Experiments with phantom and experimental in vivo data were performed to evaluate the method. Results We show that scatter correction using primary modulation is possible on a clinical C‐arm CBCT. Scatter artifacts in the reconstructions are reduced with the newly extended method. Compared to a scan with a narrow collimation, our approach showed superior results with an improvement of the contrast and the contrast‐to‐noise ratio for the phantom experiments. In vivo data are evaluated by comparing the results with a scan with a narrow collimation and with a constant scatter correction approach. Conclusions Scatter correction using primary modulation is possible on a clinical CBCT by compensating for the scanner motion and the tube current modulation. Scatter artifacts could be reduced in the reconstructions of phantom scans and in experimental in vivo data.

Comparison of Different Approaches for Measuring Tibial Cartilage Thickness

Abstract Osteoarthritis is a degenerative disease affecting bones and cartilage especially in the human knee. In this context, cartilage thickness is an indicator for knee cartilage health. Thickness measurements are performed on medical images acquired in-vivo. Currently, there is no standard method agreed upon that defines a distance measure in articular cartilage. In this work, we present a comparison of different methods commonly used in literature. These methods are based on nearest neighbors, surface normal vectors, local thickness and potential field lines. All approaches were applied to manual segmentations of tibia and lateral and medial tibial cartilage performed by experienced raters. The underlying data were contrast agent-enhanced cone-beam C-arm CT reconstructions of one healthy subject’s knee. The subject was scanned three times, once in supine position and two times in a standing weight-bearing position. A comparison of the resulting thickness maps shows similar distributions and high correlation coefficients between the approaches above 0.90. The nearest neighbor method results on average in the lowest cartilage thickness values, while the local thickness approach assigns the highest values. We showed that the different methods agree in their thickness distribution. The results will be used for a future evaluation of cartilage change under weight-bearing conditions.

Effective One Step-iterative Fiducial Marker-based Compensation for Involuntary Motion in Weight-bearing C-arm Cone-beam CT Scanning of Knees

We previously introduced three different fiducial marker-based correction methods (2D projection shifting, 2D projection warping, and 3D image warping) for patients’ involuntary motion in the lower body during weight-bearing Carm CT scanning. The 3D warping method performed better than 2D methods since it could more accurately take into account the lower body motion in 3D. However, as the 3D warping method applies different rotational and translational movement to the reconstructed image for each projection frame, distance-related weightings were slightly twisted and thus result in overlaying background noise over the entire image. In order to suppress background noise and artifacts (e.g. metallic marker-caused streaks), the 3D warping method has been improved by incorporating bilateral filtering and a Landwebertype iteration in one step. A series of projection images of five healthy volunteers standing at various flexion angles were acquired using a C-arm cone-beam CT system with a flat panel. A horizontal scanning trajectory of the C-arm was calibrated to generate projection matrices. Using the projection matrices, the static reference marker coordinates in 3D were estimated and used for the improved 3D warping method. The improved 3D warping method effectively reduced background noise down below the noise level of 2D methods and also eliminated metal-generated streaks. Thus, improved visibility of soft tissue structures (e.g. fat and muscle) was achieved while maintaining sharp edges at bone-tissue interfaces. Any high resolution weight-bearing cone-beam CT system can apply this method for motion compensation.

Over-exposure correction in knee cone-beam CT imaging with automatic exposure control using a partial low dose scan

C-arm-based cone-beam CT (CBCT) systems with flat-panel detectors are suitable for diagnostic knee imaging due to their potentially flexible selection of CT trajectories and wide volumetric beam coverage. In knee CT imaging, over-exposure artifacts can occur because of limitations in the dynamic range of the flat panel detectors present on most CBCT systems. We developed a straightforward but effective method for correction and detection of over-exposure for an Automatic Exposure Control (AEC)-enabled standard knee scan incorporating a prior low dose scan. The radiation dose associated with the low dose scan was negligible (0.0042mSv, 2.8% increase) which was enabled by partially sampling the projection images considering the geometry of the knees and lowering the dose further to be able to just see the skin-air interface. We combined the line integrals from the AEC and low dose scans after detecting over-exposed regions by comparing the line profiles of the two scans detector row-wise. The combined line integrals were reconstructed into a volumetric image using filtered back projection. We evaluated our method using in vivo human subject knee data. The proposed method effectively corrected and detected over-exposure, and thus recovered the visibility of exterior tissues (e.g., the shape and density of the patella, and the patellar tendon), incorporating a prior low dose scan with a negligible increase in radiation exposure.

Dual-energy C-arm CT in the angiographic suite

Dual-energy CT techniques have demonstrated tremendous clinical value due to their ability to distinguish materials based on atomic number. C-arm CT is currently used to guide interventional procedures, but there are no commercially available systems that employ dual-energy material decomposition. This paper explores the feasibility of implementing a fast kV-switching technique to perform dual-energy C-arm CT on a clinical angiography system. As an initial proof of concept, a fast kV-switching scan with energies of 90 kV and 125 kV was compared to respective constant kV scans. During rapid kV-switching acquisitions, the energy produced by the tube at each pulse is up to 5% lower than the energy produced during kV-constant acquisitions. The small instability in the produced kV, measured as the standard deviation of the kV produced in each pulse, is up to 4 times higher for kV-switching acquisitions. These minor deficits resulted in a small reduction in contrast resolution of the fast kV-switching 3D reconstructions.

Practical dose point-based methods to characterize dose distribution in a stationary elliptical body phantom for a cone-beam C-arm CT system

PURPOSE To propose new dose point measurement-based metrics to characterize the dose distributions and the mean dose from a single partial rotation of an automatic exposure control-enabled, C-arm-based, wide cone angle computed tomography system over a stationary, large, body-shaped phantom. METHODS A small 0.6 cm(3) ion chamber (IC) was used to measure the radiation dose in an elliptical body-shaped phantom made of tissue-equivalent material. The IC was placed at 23 well-distributed holes in the central and peripheral regions of the phantom and dose was recorded for six acquisition protocols with different combinations of minimum kVp (109 and 125 kVp) and z-collimator aperture (full: 22.2 cm; medium: 14.0 cm; small: 8.4 cm). Monte Carlo (MC) simulations were carried out to generate complete 2D dose distributions in the central plane (z = 0). The MC model was validated at the 23 dose points against IC experimental data. The planar dose distributions were then estimated using subsets of the point dose measurements using two proposed methods: (1) the proximity-based weighting method (method 1) and (2) the dose point surface fitting method (method 2). Twenty-eight different dose point distributions with six different point number cases (4, 5, 6, 7, 14, and 23 dose points) were evaluated to determine the optimal number of dose points and their placement in the phantom. The performances of the methods were determined by comparing their results with those of the validated MC simulations. The performances of the methods in the presence of measurement uncertainties were evaluated. RESULTS The 5-, 6-, and 7-point cases had differences below 2%, ranging from 1.0% to 1.7% for both methods, which is a performance comparable to that of the methods with a relatively large number of points, i.e., the 14- and 23-point cases. However, with the 4-point case, the performances of the two methods decreased sharply. Among the 4-, 5-, 6-, and 7-point cases, the 7-point case (1.0% [±0.6%] difference) and the 6-point case (0.7% [±0.6%] difference) performed best for method 1 and method 2, respectively. Moreover, method 2 demonstrated high-fidelity surface reconstruction with as few as 5 points, showing pixelwise absolute differences of 3.80 mGy (±0.32 mGy). Although the performance was shown to be sensitive to the phantom displacement from the isocenter, the performance changed by less than 2% for shifts up to 2 cm in the x- and y-axes in the central phantom plane. CONCLUSIONS With as few as five points, method 1 and method 2 were able to compute the mean dose with reasonable accuracy, demonstrating differences of 1.7% (±1.2%) and 1.3% (±1.0%), respectively. A larger number of points do not necessarily guarantee better performance of the methods; optimal choice of point placement is necessary. The performance of the methods is sensitive to the alignment of the center of the body phantom relative to the isocenter. In body applications where dose distributions are important, method 2 is a better choice than method 1, as it reconstructs the dose surface with high fidelity, using as few as five points.