W Giles

Interleaved acquisition for cross scatter avoidance in dual cone-beam CT.

PURPOSE Cone-beam x-ray imaging with flat panel detectors is used for target localization in image guided radiation therapy. This imaging includes cone-beam computed tomography (CBCT) and planar imaging. Use of two orthogonal x-ray systems could reduce imaging time for CBCT, provide simultaneous orthogonal views in planar imaging, facilitate dual-energy methods, and be useful in alleviating cone-beam artifacts by providing two axially offset focal-spot trajectories. However, the potential advantages of a second cone-beam system come at the cost of cross scatter, i.e., scatter of photons originating from one tube into the noncorresponding detector. Herein, cross scatter is characterized for dual cone-beam imaging, and a method for avoiding cross scatter is proposed and evaluated. METHODS A prototype dual-source CBCT system has been developed that models the geometry of a gantry-mounted kV imaging device used in radiation therapy. Cross scatter was characterized from 70 to 145 kVp in projections and reconstructed images using this system and three cylindrical phantoms (15, 20, and 30 cm) with a common Catphan core. A novel strategy for avoiding cross scatter in dual CBCT was developed that utilized interleaved data acquisition on each imaging chain. Interleaving, while maintaining similar angular sampling, can be achieved by either doubling the data acquisition rate or, as presented herein, halving the rotation speed. RESULTS The ratio of cross scatter to the total detected signal was found to be as high as 0.59 in a 30 cm diameter phantom. The measured scatter-to-primary ratio in some cases exceeded 4. In the 30 cm phantom, reconstructed contrast was reduced across all ROIs by an average of 48.7% when cross scatter was present. These cross-scatter degradations were almost entirely avoided by the method of interleaved exposures. CONCLUSIONS Cross scatter is substantial in dual cone-beam imaging, but its effects can be largely removed by interleaved acquisition, which can be achieved at the same angular sampling rate either by doubling the data acquisition rate or halving the rotation speed.

Crescent artifacts in cone-beam CT.

PURPOSE In image-guided radiation therapy, cone-beam CT has been adopted for three-dimensional target localization in the treatment room. In many of these cone-beam CT images, dark and light crescent artifacts can be seen. This study investigates potential causes of this artifact and a technique for mitigating the crescents. METHODS Three deviations from an ideal geometry were simulated to assess their ability to cause crescent artifacts: Bowtie filter sag, x-ray tube sag, and x-ray tube rotation. The magnitudes of these deviations were estimated by matching shifts in simulated projections to those observed with clinical systems. To correct the artifacts, angle-dependent blank projections were acquired and incorporated into image reconstruction. The degree of artifact reduction was evaluated with varying numbers (1-380) of blank projections. Scanner-acquired phantom and patient studies were conducted to demonstrate the effectiveness of the proposed correction method. RESULTS All three investigated causes of the crescent artifact introduced similar mismodeling of the acquired projections and similar crescent artifacts. The deviations required for these artifacts were in the range of 0.5-5 mm or 0.1 degrees. RMS error is reduced from 8.91 x 10(-4) to 5.25 x 10(-7) for 1-380 blank projections over a 200 degrees scan angle. In the patient and phantom studies, reconstructions that utilized 380 blank projections largely mitigated the crescent artifacts. CONCLUSIONS Small deviations from an ideal geometry can result in crescent artifacts due to steep gradients in the bowtie filter. Angle-dependent blank projections can largely alleviate the artifacts.

Implementation of dual-energy technique for virtual monochromatic and linearly mixed CBCTs

PURPOSE To implement dual-energy imaging technique for virtual monochromatic (VM) and linearly mixed (LM) cone beam CTs (CBCTs) and to demonstrate their potential applications in metal artifact reduction and contrast enhancement in image-guided radiation therapy (IGRT). METHODS A bench-top CBCT system was used to acquire 80 kVp and 150 kVp projections, with an additional 0.8 mm tin filtration. To implement the VM technique, these projections were first decomposed into acrylic and aluminum basis material projections to synthesize VM projections, which were then used to reconstruct VM CBCTs. The effect of VM CBCT on the metal artifact reduction was evaluated with an in-house titanium-BB phantom. The optimal VM energy to maximize contrast-to-noise ratio (CNR) for iodine contrast and minimize beam hardening in VM CBCT was determined using a water phantom containing two iodine concentrations. The LM technique was implemented by linearly combining the low-energy (80 kVp) and high-energy (150 kVp) CBCTs. The dose partitioning between low-energy and high-energy CBCTs was varied (20%, 40%, 60%, and 80% for low-energy) while keeping total dose approximately equal to single-energy CBCTs, measured using an ion chamber. Noise levels and CNRs for four tissue types were investigated for dual-energy LM CBCTs in comparison with single-energy CBCTs at 80, 100, 125, and 150 kVp. RESULTS The VM technique showed substantial reduction of metal artifacts at 100 keV with a 40% reduction in the background standard deviation compared to a 125 kVp single-energy scan of equal dose. The VM energy to maximize CNR for both iodine concentrations and minimize beam hardening in the metal-free object was 50 keV and 60 keV, respectively. The difference of average noise levels measured in the phantom background was 1.2% between dual-energy LM CBCTs and equivalent-dose single-energy CBCTs. CNR values in the LM CBCTs of any dose partitioning are better than those of 150 kVp single-energy CBCTs. The average CNR for four tissue types with 80% dose fraction at low-energy showed 9.0% and 4.1% improvement relative to 100 kVp and 125 kVp single-energy CBCTs, respectively. CNRs for low-contrast objects improved as dose partitioning was more heavily weighted toward low-energy (80 kVp) for LM CBCTs. CONCLUSIONS Dual-energy CBCT imaging techniques were implemented to synthesize VM CBCT and LM CBCTs. VM CBCT was effective at achieving metal artifact reduction. Depending on the dose-partitioning scheme, LM CBCT demonstrated the potential to improve CNR for low contrast objects compared to single-energy CBCT acquired with equivalent dose.

Evaluation of the effect of respiratory and anatomical variables on a Fourier technique for markerless, self-sorted 4D-CBCT

A novel technique based on Fourier transform theory has been developed that directly extracts respiratory information from projections without the use of external surrogates. While the feasibility has been demonstrated with three patients, a more extensive validation is necessary. Therefore, the purpose of this work is to investigate the effects of a variety of respiratory and anatomical scenarios on the performance of the technique with the 4D digital extended cardiac torso phantom. FT-phase and FT-magnitude methods were each applied to identify peak-inspiration projections and quantitatively compared to the gold standard of visual identification. Both methods proved to be robust across the studied scenarios with average differences in respiratory phase <10% and percentage of projections assigned within 10% of the gold standard >90%, when incorporating minor modifications to region-of-interest (ROI) selection and/or low-frequency location for select cases of DA and lung percentage in the field of view of the projection. Nevertheless, in the instance where one method initially faltered, the other method prevailed and successfully identified peak-inspiration projections. This is promising because it suggests that the two methods provide complementary information to each other. To ensure appropriate clinical adaptation of markerless, self-sorted four-dimensional cone-beam CT (4D-CBCT), perhaps an optimal integration of the two methods can be developed.

A dual cone-beam CT system for image guided radiotherapy: Initial performance characterization

PURPOSE The purpose of this study is to evaluate the performance of a recently developed benchtop dual cone-beam computed tomography (CBCT) system with two orthogonally placed tube∕detector sets. METHODS The benchtop dual CBCT system consists of two orthogonally placed 40 × 30 cm flat-panel detectors and two conventional x-ray tubes with two individual high-voltage generators sharing the same rotational axis. The x-ray source to detector distance is 150 cm and x-ray source to rotational axis distance is 100 cm for both subsystems. The objects are scanned through 200° of rotation. The dual CBCT system utilized 110° of projection data from one detector and 90° from the other while the two individual single CBCTs utilized 200° data from each detector. The system performance was characterized in terms of uniformity, contrast, spatial resolution, noise power spectrum, and CT number linearity. The uniformities, within the axial slice and along the longitudinal direction, and noise power spectrum were assessed by scanning a water bucket; the contrast and CT number linearity were measured using the Catphan phantom; and the spatial resolution was evaluated using a tungsten wire phantom. A skull phantom and a ham were also scanned to provide qualitative evaluation of high- and low-contrast resolution. Each measurement was compared between dual and single CBCT systems. RESULTS Compared to single CBCT, the dual CBCT presented: (1) a decrease in uniformity by 1.9% in axial view and 1.1% in the longitudinal view, as averaged for four energies (80, 100, 125, and 150 kVp); (2) comparable or slightly better contrast (0∼25 HU) for low-contrast objects and comparable contrast for high-contrast objects; (3) comparable spatial resolution; (4) comparable CT number linearity with R(2) ≥ 0.99 for all four tested energies; (5) lower noise power spectrum in magnitude. Dual CBCT images of the skull phantom and the ham demonstrated both high-contrast resolution and good soft-tissue contrast. CONCLUSIONS The performance of a benchtop dual CBCT imaging system has been characterized and is comparable to that of a single CBCT.

Scatter Reduction and Correction for Dual-Source Cone-Beam CT Using Prepatient Grids

Purpose: Scatter significantly limits the application of the dual-source cone-beam computed tomography by inducing scatter artifacts and degrading contrast-to-noise ratio, Hounsfield-unit accuracy, and image uniformity. Although our previously developed interleaved acquisition mode addressed the cross scatter between the 2 X-ray sources, it doubles the scanning time and doesn’t address the forward scatter issue. This study aims to develop a prepatient grid system to address both forward scatter and cross scatter in the dual-source cone-beam computed tomography. Methods: Grids attached to both X-ray sources provide physical scatter reduction during the image acquisition. Image data were measured in the unblocked region, while both forward scatter and cross scatter were measured in the blocked region of the projection for postscan scatter correction. Complementary projections were acquired with grids at complementary locations and were merged to form complete projections for reconstruction. Experiments were conducted with different phantom sizes, grid blocking ratios, image acquisition modes, and reconstruction algorithms to investigate their effects on the scatter reduction and correction. The image quality improvement by the prepatient grids was evaluated both qualitatively through the artifact reduction and quantitatively through contrast-to-noise ratio, Hounsfield-unit accuracy, and uniformity using a CATphan 504 phantom. Results: Scatter artifacts were reduced by scatter reduction and were removed by scatter correction method. Contrast-to-noise ratio, Hounsfield-unit accuracy, and image uniformity were improved substantially. The simultaneous acquisition mode achieved comparable contrast-to-noise ratio as the interleaved and sequential modes after scatter reduction and correction. Higher grid blocking ratio and smaller phantom size led to higher contrast-to-noise ratio for the simultaneous mode. The iterative reconstruction with total variation regularization was more effective than the Feldkamp, Davis, and Kress method in reducing noise caused by the scatter correction to enhance contrast-to-noise ratio. Conclusion: The prepatient grid system is effective in removing the scatter effects in the simultaneous acquisition mode of the dual-source cone-beam computed tomography, which is useful for scanning time reduction or dual energy imaging.

Regional SPECT imaging using sampling Principles and Multiple Pinholes

There may be many SPECT imaging applications in which a small region is primarily of interest. One such case is imaging in the radiation therapy treatment room, as the patient is on the treatment table in position for radiation therapy. This onboard imaging is currently performed by cone-beam CT. The purpose of this onboard imaging is to fine tune localization of the tumor target. It has been proposed that onboard SPECT could be useful for target localization and also for imaging biological function for the purpose of real-time re-planning of therapy beams. Onboard imaging would need to be accomplished within about 5 minutes. Herein we propose that this might be done by regional SPECT imaging in which multi-pinhole collimation is used to concentrate a large detector surface on a small (e.g. 7cm-diameter) region. Pinhole trajectories are designed in accord with recent developments regarding complete sampling in the presence of truncation. A 9-pinhole system is found to outperform two single-pinhole systems as well as a smaller, reference parallel-hole-collimated detector. Realistic computer-aided design (CAD) studies are shown to illustrate how an onboard SPECT system could be implemented.

Onboard functional and molecular imaging: A design investigation for robotic multipinhole SPECT

PURPOSE Onboard imaging-currently performed primarily by x-ray transmission modalities-is essential in modern radiation therapy. As radiation therapy moves toward personalized medicine, molecular imaging, which views individual gene expression, may also be important onboard. Nuclear medicine methods, such as single photon emission computed tomography (SPECT), are premier modalities for molecular imaging. The purpose of this study is to investigate a robotic multipinhole approach to onboard SPECT. METHODS Computer-aided design (CAD) studies were performed to assess the feasibility of maneuvering a robotic SPECT system about a patient in position for radiation therapy. In order to obtain fast, high-quality SPECT images, a 49-pinhole SPECT camera was designed which provides high sensitivity to photons emitted from an imaging region of interest. This multipinhole system was investigated by computer-simulation studies. Seventeen hot spots 10 and 7 mm in diameter were placed in the breast region of a supine female phantom. Hot spot activity concentration was six times that of background. For the 49-pinhole camera and a reference, more conventional, broad field-of-view (FOV) SPECT system, projection data were computer simulated for 4-min scans and SPECT images were reconstructed. Hot-spot localization was evaluated using a nonprewhitening forced-choice numerical observer. RESULTS The CAD simulation studies found that robots could maneuver SPECT cameras about patients in position for radiation therapy. In the imaging studies, most hot spots were apparent in the 49-pinhole images. Average localization errors for 10-mm- and 7-mm-diameter hot spots were 0.4 and 1.7 mm, respectively, for the 49-pinhole system, and 3.1 and 5.7 mm, respectively, for the reference broad-FOV system. CONCLUSIONS A robot could maneuver a multipinhole SPECT system about a patient in position for radiation therapy. The system could provide onboard functional and molecular imaging with 4-min scan times.

An interprojection sensor fusion approach to estimate blocked projection signal in synchronized moving grid-based CBCT system

PURPOSE A preobject grid can reduce and correct scatter in cone beam computed tomography (CBCT). However, half of the signal in each projection is blocked by the grid. A synchronized moving grid (SMOG) has been proposed to acquire two complimentary projections at each gantry position and merge them into one complete projection. That approach, however, suffers from increased scanning time and the technical difficulty of accurately merging the two projections per gantry angle. Herein, the authors present a new SMOG approach which acquires a single projection per gantry angle, with complimentary grid patterns for any two adjacent projections, and use an interprojection sensor fusion (IPSF) technique to estimate the blocked signal in each projection. The method may have the additional benefit of reduced imaging dose due to the grid blocking half of the incident radiation. METHODS The IPSF considers multiple paired observations from two adjacent gantry angles as approximations of the blocked signal and uses a weighted least square regression of these observations to finally determine the blocked signal. The method was first tested with a simulated SMOG on a head phantom. The signal to noise ratio (SNR), which represents the difference of the recovered CBCT image to the original image without the SMOG, was used to evaluate the ability of the IPSF in recovering the missing signal. The IPSF approach was then tested using a Catphan phantom on a prototype SMOG assembly installed in a bench top CBCT system. RESULTS In the simulated SMOG experiment, the SNRs were increased from 15.1 and 12.7 dB to 35.6 and 28.9 dB comparing with a conventional interpolation method (inpainting method) for a projection and the reconstructed 3D image, respectively, suggesting that IPSF successfully recovered most of blocked signal. In the prototype SMOG experiment, the authors have successfully reconstructed a CBCT image using the IPSF-SMOG approach. The detailed geometric features in the Catphan phantom were mostly recovered according to visual evaluation. The scatter related artifacts, such as cupping artifacts, were almost completely removed. CONCLUSIONS The IPSF-SMOG is promising in reducing scatter artifacts and improving image quality while reducing radiation dose.

SU‐E‐J‐22: Measurement‐Based Cross‐Scatter Correction in Dual Detector Cone‐Beam CT

Purpose: A dual detector cone‐beam CT(CBCT)system could potentially allow for dual energy CBCT and dual‐view DTS. However, image quality in this system is severely degraded by the presence of scatter between the two imaging chains, i.e. cross‐scatter. The aim of this work is to develop a measurement‐based method for correcting cross‐scatter without increasing scan‐time or exposure and without adding additional hardware. Methods: The dual detectorCBCTimagingsystem has two tube/detector pairs mounted orthogonally; each 40×30 cm detector has an anti‐scatter grid. The cross‐scatter distribution was measured at a certain angular intervals by firing a single x‐ray tube and reading out both detectors. Cross‐scatter at intermediate angles was estimated by cubic spline interpolation. The cross‐scatter estimates were subtracted from the projections prior to reconstruction. The angular interval between cross‐scatter measurements was optimized for an anthropomorphic pelvic phantom. Accuracy of scatter interpolation was evaluated by comparing to directly measured cross‐scatter. Effectiveness of scatter correction was evaluated by measures of contrast and contrast‐to‐noise ratio (CNR) in reconstructions of an image quality phantom from projection data acquired with and without cross‐scatter. Results: For the pelvic phantom and an angular interval of 11 degrees, interpolated cross‐scatter distributions were within 2.5% of measured cross‐scatter distributions. This error remained constant as the angular interval decreased below 11 degrees and rose sharply to about 90% as the angular interval increased to 34 degrees. The contrast was 58.0%, 70.8% and 70.8%, in the uncorrected, corrected, and cross‐scatter free reconstructions and similarly the CNR was 23.6, 22.8 and 24.9. Conclusions: This measurement‐based method effectively corrects for cross‐scatter without any additional hardware or imaging dose. This work is partially supported by a research grant from Varian Medical Systems.