Marc Kachelriess

Electrocardiogram-correlated image reconstruction from subsecond spiral computed tomography scans of the heart

Subsecond computed tomography (CT) scanning offers potential for improved heart imaging. We therefore developed and validated dedicated reconstruction algorithms for imaging the heart with subsecond spiral CT utilizing electrocardiogram (ECG) information. We modified spiral CT z-interpolation algorithms on a subsecond spiral CT scanner. Two new classes of algorithms were investigated: (a) 180 degrees CI (cardio interpolation), a piecewise linear interpolation between adjacent spiral data segments belonging to the same heart phase where segments are selected by correlation with the simultaneously recorded ECG signal and (b) 180 degrees CD (cardio delta), a partial scan reconstruction of 180 degrees + delta with delta < fan angle, resulting in reduced effective scan times of less than 0.5 s. Computer simulations as well as processing of clinical data collected with 0.75 s scan time were carried out to evaluate these new approaches. Both 180 degrees CI and 180 degrees CD provided significant improvements in image quality. Motion artifacts in the reconstructed images were largely reduced as compared to standard spiral reconstructions; in particular, coronary calcifications were delineated more sharply and multiplanar reformations showed improved contiguity. However, new artifacts in the image plane are introduced, mostly due to the combination of different data segments. ECG-oriented image reconstructions improve the quality of heart imaging with spiral CT significantly. Image quality and the display of coronary calcification appear adequate to assess coronary calcium measurements with conventional subsecond spiral CT.

Geometric misalignment and calibration in cone‐beam tomography

We present a new high-precision method for the geometric calibration in cone-beam computed tomography. It is based on a Fourier analysis of the projection-orbit data, recorded with a flat-panel area detector, of individual point-like objects. For circular scan trajectories the complete set of misalignment parameters which determine the deviation of the detector alignment from the ideal scan geometry are obtained from explicit analytic expressions. To derive these expressions we show how to disentangle the problems of calculating misalignment parameters and point coordinates. The calculation of the coordinates of the point objects inside the scanned volume, in units of the distance from the focal spot to the center of rotation, is then possible analytically likewise. We simulate point-projection data on a misaligned detector with various amounts of randomness added to mimic measurement uncertainties. This data is then employed in our calibration to validate the method by comparing the resulting misalignment parameters and point coordinates to the known true ones. We also present our implementation and results for the geometric calibration of micro-CT systems. The effectiveness of the corresponding misalignment correction in reducing image artifacts is exemplified by reconstructed micro-CT images.

ECG-correlated imaging of the heart with subsecond multislice spiral CT

The new spiral multislice computed tomography (CT) scanners and the significant increase in rotation speed offer great potential for cardiac imaging with X-ray CT. The authors have therefore developed the dedicated cardiac reconstruction algorithms 180/spl deg/ multislice cardio interpolation (MCI) and 180/spl deg/ multislice cardio delta (MCD) and here offer further details and validation. The algorithm 180/spl deg/ MCI is an electrocardiogram (ECG)-correlated filtering (or weighting) algorithm in both the cardiac phase and in the z-position. Effective scan times (absolute temporal resolution) of as low as t/sub eff/=56 ms are possible, assuming M=4 simultaneously measured slices at a rotation time of t/sub r0t/=0.5 s and S/spl les/d/spl les/3S for the table feed d per rotation, where S denotes the collimated slice thickness. The relative temporal resolution w (fraction of the heart cycle depicted in the image), which is the more important parameter in cardiac imaging, will then be as low as w=12.5% of the heart cycle. The second approach, 180/spl deg/MCD, is an ECG-correlated partial scan reconstruction of 180/spl deg/+/spl delta/ data with /spl delta//spl Lt//spl Phi/ (fan-angle). Its absolute temporal resolution lies in the order of 250 ms (for the central ray, i.e., for the center of rotation), and the relative temporal resolution w increases with increasing heart rate, e.g., from typically w=25% at f/sub H/=60 min/sup -1/ to w=50% at f/sub H/=120 min/sup -1/, assuming again t/sub r0t/=0.5 s. For validation purposes, the authors have done simulations of a virtual cardiac motion phantom, measurements of a dedicated cardiac calibration and motion phantom, and they have reconstructed patient data with simultaneously acquired ECG. Both algorithms significantly improve the image quality compared with the standard reconstruction algorithms 180/spl deg/ multislice linear interpolation (MLI) and 180/spl deg/ multislice filtered interpolation (MFI). However, 180/spl deg/ MCI is clearly superior to 180/spl deg/MCD for all heart rates. This is best illustrated by multiplanar reformations (MPR) or other three-dimensional (3-D) displays of the volume, 180/spl deg/ MCI, due to its higher temporal resolution, is best for spatial and temporal four-dimensional (4-D) tracking of the anatomy. A tunable scanner rotation time to avoid resonance behavior of the heart rate and the scanners rotation and shorter rotation times would be of further benefit.

Reconstruction from truncated projections in CT using adaptive detruncation

If the object exceeds the field of measurement (FOM) of a given CT scanner, severe artifacts may result. In this work, we propose an adaptive detruncation (ADT) method to reconstruct images from medical CT projections which are truncated in the transaxial direction. The truncated projections are extrapolated by estimating the convex hull of the patient. The ADT method allows us not only to achieve artifact-free images in the FOM but also to extend the images beyond the FOM, and can therefore be very attractive, for example, in PET/CT scanners for attenuation correction.

Novel approximate approach for high-quality image reconstruction in helical cone-beam CT at arbitrary pitch

We present a novel approximate image reconstruction technique for helical cone-beam CT, called the Advanced Multiple Plane Reconstruction (AMPR). The method is an extension of the ASSR algorithm presented in Medical Physics vol. 27, no. 4, 2000 by Kachelriess et al. In the ASSR, the pitch is fixed to a certain value and dose usage is not optimum. These limitations have been overcome in the AMPR algorithm by reconstructing several image planes from any given half scan range of projection angles. The image planes are tilted in two orientations so as to optimally use the data available on the detector. After reconstruction of several sets of tilted images, a subsequent interpolation step reformats the oblique image planes to a set of voxels sampled on a cartesian grid. Using our novel approach on a scanner with 16 slices, we can achieve image quality superior to what is currently a standard for four-slice scanners. Dose usage in the order of 95% for all pitch values can be achieved. We present simulations of semi-antropomorphic phantoms using a standard CT scanner geometry and a 16 slice design.

Single-slice rebinning reconstruction in spiral cone-beam computed tomography

At the advent of multislice computed tomography (CT) a variety of approximate cone-beam algorithms have been proposed suited for reconstruction of small cone-angle CT data in a spiral mode of operation. The goal of this study is to identify a practical and efficient approximate cone-beam method, extend its potential for medical use, and demonstrate its performance at medium cone-angles required for area detector CT. The authors investigate two different approximate single-slice rebinning algorithms for cone-beam CT: the multirow Fourier reconstruction (MFR) and an extension of the advanced single-slice rebinning method (ASSR), which combines the idea of ASSR with a z-filtering approach. Thus, both algorithms, MFR and ASSR, are formulated in the framework of z-filtering using optimized spiral interpolation algorithms. In each view, X-ray samples to be used for reconstruction are identified, which describe an approximation to a virtual reconstruction plane. The performance of approximate reconstruction should improve as the virtual reconstruction plane better fits the spiral focus path. The image quality of the respective reconstruction is assessed with respect to image artifacts, spatial resolution, contrast resolution, and image noise. It turns out that the ASSR method using tilted reconstruction planes is a practical and efficient algorithm, providing image quality comparable to that of a single-row scanning system even with a 46-row detector at a table feed of 64 mm. Both algorithms tolerate any table feed below the maximum value associated to the detector height. Due to the z-filter approach, all detector data sampled can be used for image reconstruction.

Normalized metal artifact reduction in head and neck computed tomography.

ObjectiveArtifacts from dental hardware affect image quality and the visualization of lesions in the oral cavity and oropharynx in computed tomography (CT). Therefore, magnetic resonance imaging is considered the imaging modality of choice in this region. Standard methods for metal artifact reduction (MAR) in CT replace the metal-affected raw data by interpolation, which is prone to new artifacts. We developed a generalized normalization technique for MAR (NMAR) that aims to suppress algorithm-induced artifacts and validated the performance of this algorithm in a clinical trial. Material and MethodsA 3-dimensional forward projection identifies the metal-affected raw data in the original projections after metal is segmented in the image domain by thresholding. A prior image is used to normalize the projections before interpolation. The original raw data are divided pixel-wise by the projection data of the prior image and, after interpolation, are denormalized again. Data from 19 consecutive patients with metal artifacts from dental hardware were reconstructed with standard filtered backprojection (FBP), linear interpolation MAR (LIMAR), and NMAR. The image quality of slices containing metal was analyzed for the severity of artifacts and diagnostic value; magnetic resonance imaging performed the same day on a 3-T system served as a reference standard in all cases. ResultsA total of 260 slices containing metal dental hardware were analyzed. A total of 164 slices were nondiagnostic with FBP, 157 slices with LIMAR, and 87 slices with NMAR. The mean (SD) number of slices per patient with severe artifacts was 10.1 (3.7), 9.6 (4.6), and 5.4 (3.6) and the mean (SD) number of slices with artifacts affecting diagnostic confidence was 3.3 (1.7), 4.9 (2.9), and 3.7 (1.9) for FBP, LIMAR, and NMAR, respectively (P < 0.001). Pairwise comparison did not show significant differences between FBP and LIMAR (P = 0.40), but there were significant differences between FBP and NMAR as well as LIMAR and NMAR (both P < 0.001). Interobserver agreement was excellent (&kgr; = 0.974). Two malignant lesions were unmasked with NMAR image reconstructions. No algorithm-related artifacts were detected in regions that did not contain metal in NMAR images. ConclusionNormalized MAR has the potential to improve image quality in patients with artifacts from dental hardware and to improve the diagnostic accuracy of CT of the oral cavity and oropharynx.

Evolution in computed tomography: the battle for speed and dose

AbstractThe advent of computed tomography (CT) has revolutionized radiology. Starting as head-only scanners, modern CT systems are now capable of performing whole-body examinations within a couple of seconds in isotropic resolution. Technical advancements of scanner hardware and image reconstruction techniques are reviewed and discussed in their clinical context. These improvements have led to a steady increase of CT examinations in all age groups for a number of reasons. On the one hand, it is very easy today to obtain whole-body data for oncologic staging and follow-up or for trauma imaging. On the other hand, new examinations such as cardiac imaging, virtual colonoscopy, gout imaging, and whole-organ perfusion imaging have widened the application profile of CT. The increasing awareness of risks associated with radiation exposure triggered the development of a variety of dose reduction techniques. Effective dose values below 1 mSv, less than the annual natural background radiation (3.1 mSv/year on average in the United States), are now routinely possible for a number of dedicated examinations, even for coronary CT angiography.

Multithreaded cardiac CT

Phase-correlated CT, as it is used for cardiac imaging, is the most popular and the most important but also the most demanding special CT application in the clinical routine, today. Basically, it fulfills the four-dimensional imaging task of depicting a quasiperiodically moving object at any desired motion phase with significantly reduced motion artifacts. Although image quality with phase-correlated reconstruction is far better than with standard reconstruction, there are motion artifacts remaining and improvements of temporal resolution are required. As a well-known alternative to simply decreasing rotation time, we consider a spiral cone-beam CT scanner that has G x-ray guns and detectors mounted. We call this a multisource or a multithreaded CT scanner. Aiming for improved temporal resolution the relative temporal resolution tau, which measures the fraction of a motion period that enters the image, is studied as a function of the motion rate (heart rate) and the degree of scan overlap (pitch value) for various configurations. The parameters to optimize are the number of threads G and the interthread parameters delta alpha and delta z, which are the angular and the longitudinal separation between adjacent threads, respectively. To demonstrate the improvements approximate image reconstruction of multithreaded raw data is performed by using a generalization of the extended parallel back projection cone-beam reconstruction algorithm [Med. Phys. 31(6), 1623-1641 (2004)] to the case of multithreaded CT. Reconstructions of a simulated cardiac motion phantom and of simulated semi-antropomorphic phantoms are presented for two and three threads and compared to the single-threaded case to demonstrate the potential of multithreaded cardiac CT. Patient data were acquired using a clinical double-threaded CT scanner to validate the theoretical results. The optimum angle delta alpha between the tubes is 90 degrees for a double-threaded system, and for triple-threaded scanners it is 60 degrees or 120 degrees. In all cases, delta z = 0 results as an optimum, which means that the threads should be mounted in the same transversal plane. However, the dependency of the temporal resolution on delta z is very weak and a longitudinal separation delta z not = 0 would not deteriorate image quality. The mean temporal resolution achievable with an optimized multithreaded CT scanner is a factor of G better than the mean temporal resolution obtained with a single-threaded scanner. The standard reconstructions showed decreased cone-beam artifacts with multithreaded CT compared to the single-threaded case. Our phase-correlated reconstructions demonstrate that temporal resolution is significantly improved with multithreaded CT. The clinical patient data confirm our results.

Flying focal spot (FFS) in cone-beam CT

In the beginning of 2004 medical spiral-CT scanners that acquire up to 64 slices simultaneously became available. Most manufacturers use a straightforward acquisition principle, namely an x-ray focus rotating on a circular path and an opposing cylindrical detector whose rotational center coincides with the x-ray focus. The 64-slice scanner available to us, a Somatom Sensation 64 spiral cone-beam CT scanner (Siemens, Medical Solutions, Forchheim, Germany), makes use of a flying focal spot (FFS) that allows for view-by-view deflections of the focal spot in the rotation direction (/spl alpha/FFS) and in the z-direction (zFFS) with the goal of reducing aliasing artifacts. The FFS feature doubles the sampling density in the radial direction (channel direction, /spl alpha/FFS) and in the longitudinal direction (detector row direction or z-direction, zFFS). The cost of increased radial and azimuthal sampling is a two- or four-fold reduction of azimuthal sampling (angular sampling). To compensate for the potential reduction of azimuthal sampling the scanner simply increases the number of detector read-outs (readings) per rotation by a factor two or four. Then, up to four detector readings contribute to what we define as one view or one projection. A significant reduction of in-plane aliasing and of aliasing in the z-direction can be expected. Especially the latter is of importance to spiral CT scans where aliasing is known to produce so-called windmill artifacts. We have derived and analyzed the optimal focal spot deflection values /spl part//spl alpha/ and /spl part/z as they would ideally occur in our scanner. Based upon these we show how image reconstruction can be performed in general. A simulation study showing reconstructions of mathematical phantoms further provides evidence that image quality can be significantly improved with the FFS. Aliasing artifacts, that manifest as streaks emerging from high-contrast objects, and windmill artifacts are reduced by almost an order of magnitude with the FFS compared to a simulation without FFS. Patient images acquired with our 64-slice cone-beam CT scanner support these results.