Paul F. FitzGerald

Biological performance of a size-fractionated core-shell tantalum oxide nanoparticle x-ray contrast agent.

ObjectivesMetal-containing nanoparticles show great promise as x-ray contrast media and could enable reduced radiation dose, increased contrast, and the visualization of smaller anatomic features. In this study, we report progress toward these goals using a size-fractionated core-shell tantalum oxide nanoparticle contrast agent. Materials and MethodsA core-shell tantalum oxide nanoparticle contrast agent was synthesized and size fractionated for preclinical investigation of biodistribution, blood half-life, organ retention, and histopathology. Fractionated agent was injected at anticipated clinical dose and at 3 times the anticipated clinical dose to evaluate biological performance. Computed tomography (CT) imaging studies were also performed to evaluate short-term clearance kinetics and new imaging applications. ResultsImproved control of 2-diethylphosphatoethylsilane-TaO nanoparticle size resulted in significantly reduced retention of injected tantalum. In vivo and in vitro CT imaging studies demonstrated short-term biodistribution differences in the kidney between small-molecule iodinated contrast media and fractionated 2-diethylphosphatoethylsilane-TaO, as well as preliminary data about new “Ta-only” imaging applications using multienergy CT image acquisition. ConclusionsSize-fractionated core-shell tantalum oxide nanoparticles with a well-defined particle size distribution have several key features required of clinically viable vascular imaging compounds and may be used in developing multienergy CT imaging applications.

Inverse geometry CT: The next-generation CT architecture?

We present a new system architecture for X-ray computed tomography (CT). A multi-source inverse-geometry CT scanner is composed of a large distributed X-ray source with an array of discrete electron emitters and focal spots, and a high frame-rate flat-panel X-ray detector. In this work we study the advantages and the challenges of this new architecture. We predict potential breakthroughs in volumetric coverage, dose efficiency, and spatial resolution. We also present experimental results obtained with a universal benchtop system.

CT Image Contrast of High-Z Elements: Phantom Imaging Studies and Clinical Implications

PURPOSE To quantify the computed tomographic (CT) image contrast produced by potentially useful contrast material elements in clinically relevant imaging conditions. MATERIALS AND METHODS Equal mass concentrations (grams of active element per milliliter of solution) of seven radiodense elements, including iodine, barium, gadolinium, tantalum, ytterbium, gold, and bismuth, were formulated as compounds in aqueous solutions. The compounds were chosen such that the active element dominated the x-ray attenuation of the solution. The solutions were imaged within a modified 32-cm CT dose index phantom at 80, 100, 120, and 140 kVp at CT. To simulate larger body sizes, 0.2-, 0.5-, and 1.0-mm-thick copper filters were applied. CT image contrast was measured and corrected for measured concentrations and presence of chlorine in some compounds. RESULTS Each element tested provided higher image contrast than iodine at some tube potential levels. Over the range of tube potentials that are clinically practical for average-sized and larger adults-that is, 100 kVp and higher-barium, gadolinium, ytterbium, and tantalum provided consistently increased image contrast compared with iodine, respectively demonstrating 39%, 56%, 34%, and 24% increases at 100 kVp; 39%, 66%, 53%, and 46% increases at 120 kVp; and 40%, 72%, 65%, and 60% increases at 140 kVp, with no added x-ray filter. CONCLUSION The consistently high image contrast produced with 100-140 kVp by tantalum compared with bismuth and iodine at equal mass concentration suggests that tantalum could potentially be favorable for use as a clinical CT contrast agent.

Completeness map evaluation demonstrated with candidate next‐generation cardiac CT architectures

PURPOSE In this report, the authors introduce the general concept of the completeness map, as a means to evaluate the completeness of data acquired by a given CT system design (architecture and scan mode). They illustrate the utility of completeness map by applying the completeness map concept to a number of candidate CT system designs, as part of a study to advance the state-of-the-art in cardiac CT. METHODS In order to optimally reconstruct a point within a volume of interest (VOI), the Radon transform on all possible planes through that point should be measured. The authors quantified the extent to which this ideal condition is satisfied for the entire image volume. They first determined a Radon completeness number for each point in the VOI, as the percentage of possible planes that is actually measured. A completeness map is then defined as a 3D matrix of the completeness numbers for the entire VOI. The authors proposed algorithms to analyze the projection datasets in Radon space and compute the completeness number for a fixed point and apply these algorithms to various architectures and scan modes that they are evaluating. In this report, the authors consider four selected candidate architectures, operating with different scan modes, for a total of five system design alternatives. Each of these alternatives is evaluated using completeness map. RESULTS If the detector size and cone angle are large enough to cover the entire cardiac VOI, a single-source circular scan can have ≥99% completeness over the entire VOI. However, only the central z-slice can be exactly reconstructed, which corresponds to 100% completeness. For a typical single-source architecture, if the detector is limited to an axial dimension of 40 mm, a helical scan needs about five rotations to form an exact reconstruction region covering the cardiac VOI, while a triple-source helical scan only requires two rotations, leading to a 2.5x improvement in temporal resolution. If the source and detector of an inverse-geometry (IGCT) system have the same axial extent, and the spacing of source points in the axial and transaxial directions is sufficiently small, the IGCT can also form an exact reconstruction region for the cardiac VOI. If the VOI can be covered by the x-ray beam in any view, a composite-circling scan can generate an exact reconstruction region covering the VOI. CONCLUSIONS The completeness map evaluation provides useful information for selecting the next-generation cardiac CT system design. The proposed completeness map method provides a practical tool for analyzing complex scanning trajectories, where the theoretical image quality for some complex system designs is impossible to predict, without yet-undeveloped reconstruction algorithms.

Opportunities for new CT contrast agents to maximize the diagnostic potential of emerging spectral CT technologies.

The introduction of spectral CT imaging in the form of fast clinical dual-energy CT enabled contrast material to be differentiated from other radiodense materials, improved lesion detection in contrast-enhanced scans, and changed the way that existing iodine and barium contrast materials are used in clinical practice. More profoundly, spectral CT can differentiate between individual contrast materials that have different reporter elements such that high-resolution CT imaging of multiple contrast agents can be obtained in a single pass of the CT scanner. These spectral CT capabilities would be even more impactful with the development of contrast materials designed to complement the existing clinical iodine- and barium-based agents. New biocompatible high-atomic number contrast materials with different biodistribution and X-ray attenuation properties than existing agents will expand the diagnostic power of spectral CT imaging without penalties in radiation dose or scan time.

Complementary contrast media for metal artifact reduction in dual-energy computed tomography

Abstract. Metal artifacts have been a problem associated with computed tomography (CT) since its introduction. Recent techniques to mitigate this problem have included utilization of high-energy (keV) virtual monochromatic spectral (VMS) images, produced via dual-energy CT (DECT). A problem with these high-keV images is that contrast enhancement provided by all commercially available contrast media is severely reduced. Contrast agents based on higher atomic number elements can maintain contrast at the higher energy levels where artifacts are reduced. This study evaluated three such candidate elements: bismuth, tantalum, and tungsten, as well as two conventional contrast elements: iodine and barium. A water-based phantom with vials containing these five elements in solution, as well as different artifact-producing metal structures, was scanned with a DECT scanner capable of rapid operating voltage switching. In the VMS datasets, substantial reductions in the contrast were observed for iodine and barium, which suffered from contrast reductions of 97% and 91%, respectively, at 140 versus 40 keV. In comparison under the same conditions, the candidate agents demonstrated contrast enhancement reductions of only 20%, 29%, and 32% for tungsten, tantalum, and bismuth, respectively. At 140 versus 40 keV, metal artifact severity was reduced by 57% to 85% depending on the phantom configuration.

Cardiac CT: A system architecture study.

BACKGROUND We are interested in exploring dedicated, high-performance cardiac CT systems optimized to provide the best tradeoff between system cost, image quality, and radiation dose. OBJECTIVE We sought to identify and evaluate a broad range of CT architectures that could provide an optimal, dedicated cardiac CT solution. METHODS We identified and evaluated thirty candidate architectures using consistent design choices. We defined specific evaluation metrics related to cost and performance. We then scored the candidates versus the defined metrics. Lastly, we applied a weighting system to combine scores for all metrics into a single overall score for each architecture. CT experts with backgrounds in cardiovascular radiology, x-ray physics, CT hardware and CT algorithms performed the scoring and weighting. RESULTS We found nearly a twofold difference between the most and the least promising candidate architectures. Architectures employed by contemporary commercial diagnostic CT systems were among the highest-scoring candidates. We identified six architectures that show sufficient promise to merit further in-depth analysis and comparison. CONCLUSION Our results suggest that contemporary diagnostic CT system architectures outperform most other candidates that we evaluated, but the results for a few alternatives were relatively close. We selected six representative high-scoring candidates for more detailed design and further comparative evaluation.

Quest for the Ultimate Cardiac CT Scanner

Purpose To quantitatively evaluate and compare six proposed system architectures for cardiac CT scanning. Methods Starting from the clinical requirements for cardiac CT, we defined six dedicated cardiac CT architectures. We selected these architectures based on a previous screening study and defined them in sufficient detail to comprehensively analyze their cost and performance. We developed rigorous comparative evaluation methods for the most important aspects of performance and cost, and we applied these evaluation criteria to the defined cardiac CT architectures. Results We found that CT system architectures based on the third‐generation geometry provide nearly linear performance improvement versus the increased cost of additional beam lines (i.e., source–detector pairs), although similar performance improvement could be achieved with advanced motion‐correction algorithms. The third‐generation architectures outperform even the most promising of the proposed architectures that deviate substantially from the traditional CT system architectures. Conclusion This work confirms the validity of the current trend in commercial CT scanner design. However, we anticipate that over time, CT hardware and software technologies will evolve, the relative importance of the performance criteria will change, the relative costs of components will vary, some of the remaining challenges will be addressed, and perhaps new candidate architectures will be identified; therefore, the conclusion of a comparative analysis like this may change. The evaluation methods that we used can provide a framework for other researchers to analyze their own proposed CT architectures.

The Effect of Patient Diameter on the Dual-Energy Ratio of Selected Contrast-Producing Elements.

Objectives The aim of this study was to assess whether the low- to high-kVp computed tomography (CT) number ratio at dual-energy CT is affected by changes in patient diameter. Methods Seven contrast-producing elements were housed sequentially within an abdomen phantom. Fat rings enlarged the phantom diameter from 26 to 44 cm. The phantom was scanned using single-energy CT at tube potentials of 80 and 140 kVp and rapid-kVp-switching dual-energy CT. Results CT numbers decreased proportionally (∼20% CT number reduction for smallest to largest phantom diameters) for low- and high-energy acquisitions but resulted in consistent dual-energy ratios for each contrast element. For 17 of 21 material pair combinations, the dual-energy ratio ranges of the two elements did not overlap, implying that discrimination should remain possible for these material pairs at all patient sizes. Conclusions The dual-energy ratio for different contrast materials is largely unaffected by changes in phantom diameter. This should allow for robust separation of most contrast material combinations irrespective of patient size.

Experimental demonstration of a dynamic bowtie for region-based CT fluence optimization

Technology development in Computed Tomography (CT) is driven by clinical needs, for example the need for image quality sufficient for the clinical task, and the need to obtain the required image quality using the lowest possible radiation dose to the patient. One approach to manage dose without compromising image quality is to spatially vary the X-ray flux such that regions of high interest receive more radiation while regions of low interest or regions sensitive to radiation receive less dose. If the region of interest (ROI) is centered at the CT system’s axis of rotation, a simple stationary bowtie mounted between the X-ray tube and the patient is sufficient to reduce the X-ray flux outside the central region. If the ROI is off center, then a dynamic bowtie that can track the ROI as the gantry rotates is preferred. We experimentally demonstrated the dynamic bowtie using a design that is relatively simple, low cost, requires no auxiliary power supply, and can be retrofitted to an existing clinical CT scanner. We installed our prototype dynamic bowtie on a clinical CT scanner, and we scanned a phantom with a pre-selected off-center ROI. The dynamic bowtie reduced the X-ray intensity outside the targeted ROI tenfold. As a result, the reconstructed image shows significantly lower noise within the dynamic bowtie ROI compared to regions outside it. Our preliminary results suggest that a dynamic bowtie could be an effective solution for further reducing CT radiation dose.