Y Yi

High resolution dual detector volume-of-interest cone beam breast CT––Demonstration with a bench top system

PURPOSEnIn this study, we used a small field high resolution detector in conjunction with a full field flat panel detector to implement and investigate the dual detector volume-of-interest (VOI) cone beam breast computed tomography (CBCT) technique on a bench-top system. The potential of using this technique to image small calcifications without increasing the overall dose to the breast was demonstrated. Significant reduction of scatter components in the high resolution projection image data of the VOI was also shown.nnnMETHODSnWith the regular flat panel based CBCT technique, exposures were made at 80 kVp to generate an air kerma of 6 mGys at the isocenter. With the dual detector VOI CBCT technique, a high resolution small field CMOS detector was used to scan a cylindrical VOI (2.5 cm in diameter and height, 4.5 cm off-center) with collimated x-rays at four times of regular exposure level. A flat panel detector was used for full field scan with low x-ray exposures at half of the regular exposure level. The low exposure full field image data were used to fill in the truncated space in the VOI scan data and generate a complete projection image set. The Feldkamp-Davis-Kress (FDK) filtered backprojection algorithm was used to reconstruct high resolution images for the VOI. Two scanning techniques, one breast centered and the other VOI centered, were implemented and investigated. Paraffin cylinders with embedded thin aluminum (Al) wires were imaged and used in conjunction with optically stimulated luminescence (OSL) dose measurements to demonstrate the ability of this technique to image small calcifications without increasing the mean glandular dose (MGD).nnnRESULTSnUsing exposures that produce an air kerma of 6 mGys at the isocenter, the regular CBCT technique was able to resolve the cross-sections of Al wires as thin as 254 μm in diameter in the phantom. For the specific VOI studied, by increasing the exposure level by a factor of 4 for the VOI scan and reducing the exposure level by a factor of 2 for the full filed scan, the dual-detector CBCT technique was able to resolve the cross-sections of Al wires as thin as 152 μm in diameter. The CNR evaluated for the entire Al wire cross-section was found to be improved from 5.5 in regular CBCT to 14.4 and 16.8 with the breast centered and VOI centered scanning techniques, respectively. Even inside VOI center, the VOI scan resulted in significant dose saving with the dose reduced by a factor of 1.6 at the VOI center. Dose saving outside the VOI was substantial with the dose reduced by a factor of 7.3 and 7.8 at the breast center for the breast centered and VOI centered scans, respectively, when compared to full field scan at the same exposure level. The differences between the two dual detector techniques in terms of dose saving and scatter reduction were small with VOI scan at 4×u2009exposure level and full field scan at 0.5 ×u2009exposure level. The MGDs were only 94% of that from the regular CBCT scan.nnnCONCLUSIONSnFor the specific VOI studied, the dual detector VOI CBCT technique has the potential to provide high quality images inside the VOI with MGD similar to or even lower than that of full field breast CBCT. It was also found that our results were compromised by the use of inadequate detectors for the VOI scan. An appropriately selected detector would better optimize the image quality improvement that can be achieved with the VOI CBCT technique.

Radiation doses in cone-beam breast computed tomography: a Monte Carlo simulation study.

PURPOSEnIn this article, we describe a method to estimate the spatial dose variation, average dose and mean glandular dose (MGD) for a real breast using Monte Carlo simulation based on cone beam breast computed tomography (CBBCT) images. We present and discuss the dose estimation results for 19 mastectomy breast specimens, 4 homogeneous breast models, 6 ellipsoidal phantoms, and 6 cylindrical phantoms.nnnMETHODSnTo validate the Monte Carlo method for dose estimation in CBBCT, we compared the Monte Carlo dose estimates with the thermoluminescent dosimeter measurements at various radial positions in two polycarbonate cylinders (11- and 15-cm in diameter). Cone-beam computed tomography (CBCT) images of 19 mastectomy breast specimens, obtained with a bench-top experimental scanner, were segmented and used to construct 19 structured breast models. Monte Carlo simulation of CBBCT with these models was performed and used to estimate the point doses, average doses, and mean glandular doses for unit open air exposure at the iso-center. Mass based glandularity values were computed and used to investigate their effects on the average doses as well as the mean glandular doses. Average doses for 4 homogeneous breast models were estimated and compared to those of the corresponding structured breast models to investigate the effect of tissue structures. Average doses for ellipsoidal and cylindrical digital phantoms of identical diameter and height were also estimated for various glandularity values and compared with those for the structured breast models.nnnRESULTSnThe absorbed dose maps for structured breast models show that doses in the glandular tissue were higher than those in the nearby adipose tissue. Estimated average doses for the homogeneous breast models were almost identical to those for the structured breast models (p=1). Normalized average doses estimated for the ellipsoidal phantoms were similar to those for the structured breast models (root mean square (rms) percentage difference = 1.7%; p = 0.01), whereas those for the cylindrical phantoms were significantly lower (rms percentage difference = 7.7%; p < 0.01). Normalized MGDs were found to decrease with increasing glandularity.nnnCONCLUSIONSnOur results indicate that it is sufficient to use homogeneous breast models derived from CBCT generated structured breast models to estimate the average dose. This investigation also shows that ellipsoidal digital phantoms of similar dimensions (diameter and height) and glandularity to actual breasts may be used to represent a real breast to estimate the average breast dose with Monte Carlo simulation. We have also successfully demonstrated the use of structured breast models to estimate the true MGDs and shown that the normalized MGDs decreased with the glandularity as previously reported by other researchers for CBBCT or mammography.

Reduction in x-ray scatter and radiation dose for volume-of-interest (VOI) cone-beam breast CT—a phantom study

With volume-of-interest (VOI) cone-beam computed tomography (CBCT) imaging, one set of projection images are acquired with the VOI collimator at a regular or high exposure level and the second set of projection images are acquired without the collimator at a reduced exposure level. The high exposure VOI scan data inside the VOI and the low exposure full-field scan data outside the VOI are then combined together to generate composite projection images for image reconstruction. To investigate and quantify scatter reduction, dose saving and image quality improvement in VOI CBCT imaging, a flat panel detector-based bench-top experimental CBCT system was built to measure the dose, the scatter-to-primary ratio (SPR), the image contrast, noise level, the contrast-to-noise ratio (CNR) and the figure of merit (FOM) in the CBCT reconstructed images for two polycarbonate cylinders simulating the small and the large phantoms. The results showed that, compared to the full field CBCT technique, radiation doses for the VOI CBCT technique were reduced by a factor of 1.20 and 1.36 for the small and the large phantoms at the phantom center, respectively, and from 2.7 to 3.0 on the edge of the phantom, respectively. Inside the VOI, the SPRs were substantially reduced by a factor of 6.6 and 10.3 for the small and the large phantoms, the contrast signals were improved by a factor of 1.35 and 1.8, and the noise levels were increased by a factor of 1.27 and 1.6, respectively. As a result, the CNRs were improved by a factor of 1.06 and 1.13 for the small and the large phantoms and the FOM improved by a factor of 1.4 and 1.7, respectively.

Breast density measurement: 3D cone beam computed tomography (CBCT) images versus 2D digital mammograms

Breast density has been recognized as one of the major risk factors for breast cancer. However, breast density is currently estimated using mammograms which are intrinsically 2D in nature and cannot accurately represent the real breast anatomy. In this study, a novel technique for measuring breast density based on the segmentation of 3D cone beam CT (CBCT) images was developed and the results were compared to those obtained from 2D digital mammograms. 16 mastectomy breast specimens were imaged with a bench top flat-panel based CBCT system. The reconstructed 3D CT images were corrected for the cupping artifacts and then filtered to reduce the noise level, followed by using threshold-based segmentation to separate the dense tissue from the adipose tissue. For each breast specimen, volumes of the dense tissue structures and the entire breast were computed and used to calculate the volumetric breast density. BI-RADS categories were derived from the measured breast densities and compared with those estimated from conventional digital mammograms. The results show that in 10 of 16 cases the BI-RADS categories derived from the CBCT images were lower than those derived from the mammograms by one category. Thus, breasts considered as dense in mammographic examinations may not be considered as dense with the CBCT images. This result indicates that the relation between breast cancer risk and true (volumetric) breast density needs to be further investigated.

A general method for cupping artifact correction of cone-beam breast computed tomography images

PurposeCone-beam breast computed tomography (CBBCT), a promising breast cancer diagnostic technique, has been under investigation for the past decade. However, owing to scattered radiation and beam hardening, CT numbers are not uniform on CBBCT images. This is known as cupping artifact, and it presents an obstacle for threshold-based volume segmentation. In this study, we proposed a general post-reconstruction method for cupping artifact correction.MethodsThere were four steps in the proposed method. First, three types of local region histogram peaks were calculated: adipose peaks with low CT numbers, glandular peaks with high CT numbers, and unidentified peaks. Second, a linear discriminant analysis classifier, which was trained by identified adipose and glandular peaks, was employed to identify the unidentified peaks as adipose or glandular peaks. Third, adipose background signal profile was fitted according to the adipose peaks using the least squares method. Finally, the adipose background signal profile was subtracted from original image to obtain cupping corrected imageResultsIn experimental study, standard deviation of adipose tissue CT numbers was obviously reduced and the CT numbers were more uniform after cupping correction by proposed method; in simulation study, root-mean-square errors were significantly reduced for both symmetric and asymmetric cupping artifacts, indicating that the proposed method was effective to both artifacts.ConclusionsA general method without a circularly symmetric assumption was proposed to correct cupping artifacts in CBBCT images for breast. It may be properly applied to images of real patient breasts with natural pendent geometry.

SU‐FF‐I‐41: Accuracy and Computing Time of a Ray‐Driven Projector/back‐Projector for Simulation and Reconstruction in Tomosynthesis and Cone Beam CT Imaging

Accurate and fast projector/back‐projector (PBP) is the key to successful simulation and iterative reconstruction of tomosynthesis and cone beam CT. In this study, the accuracy and computation speed of a ray‐driven PBP operator were investigated. To simulate x‐ray tomographyimaging, a ray‐driven projector was developed and implemented on a 64 computing node PC Cluster. Each x‐ray path is represented by sampling points in the object. Their μ values are summed up to compute the integral attenuation along the path. To evaluate the accuracy of the reprojection algorithm as the function of sampling ratio (Sampling length / voxel length), reprojections obtained with a significantly smaller sampling ratio were used as reference. To minimize the additional loss of accuracy from pixelization, the pixel size of the projection images was selected to be one third of the voxel size projected back to the image plane. Error images were formed by subtracting the re‐projection from the reference re‐projection and used to compute the percentage errors. SART were implemented for image reconstruction in tomosynthesis and CBCTimaging. To evaluate its accuracy, CBCTimagesreconstructed with 300 projection views over 360 degree were compared to the original CBCTimages. Errors were computed from the subtraction images and plotted together the computing time as the function of the sampling ratio. With reduced sampling ratio, the accuracies of both the re‐projection and SART algorithms were improved at the expense of longer computing time. The improvement was accelerated with smaller sampling ratios. Aliasing artifacts were visible when the sampling ratios were greater than 0.5. We have demonstrated that the accuracy of the re‐projection and SART reconstructions improved with reduced the sampling ratio at the expense of longer computing time for a ray‐driven PBP. The tradeoff between accuracy and computing time should be determined by the imaging requirement.

Effects of exposure equalization on image signal-to-noise ratios in digital mammography: A simulation study with an anthropomorphic breast phantom

PURPOSEnThe scan equalization digital mammography (SEDM) technique combines slot scanning and exposure equalization to improve low-contrast performance of digital mammography in dense tissue areas. In this study, full-field digital mammography (FFDM) images of an anthropomorphic breast phantom acquired with an anti-scatter grid at various exposure levels were superimposed to simulate SEDM images and investigate the improvement of low-contrast performance as quantified by primary signal-to-noise ratios (PSNRs).nnnMETHODSnWe imaged an anthropomorphic breast phantom (Gammex 169 Rachel, Gammex RMI, Middleton, WI) at various exposure levels using a FFDM system (Senographe 2000D, GE Medical Systems, Milwaukee, WI). The exposure equalization factors were computed based on a standard FFDM image acquired in the automatic exposure control (AEC) mode. The equalized image was simulated and constructed by superimposing a selected set of FFDM images acquired at 2, 1, 1/2, 1/4, 1/8, 1/16, and 1/32 times of exposure levels to the standard AEC timed technique (125 mAs) using the equalization factors computed for each region. Finally, the equalized image was renormalized regionally with the exposure equalization factors to result in an appearance similar to that with standard digital mammography. Two sets of FFDM images were acquired to allow for two identically, but independently, formed equalized images to be subtracted from each other to estimate the noise levels. Similarly, two identically but independently acquired standard FFDM images were subtracted to estimate the noise levels. Corrections were applied to remove the excess system noise accumulated during image superimposition in forming the equalized image. PSNRs over the compressed area of breast phantom were computed and used to quantitatively study the effects of exposure equalization on low-contrast performance in digital mammography.nnnRESULTSnWe found that the highest achievable PSNR improvement factor was 1.89 for the anthropomorphic breast phantom used in this study. The overall PSNRs were measured to be 79.6 for the FFDM imaging and 107.6 for the simulated SEDM imaging on average in the compressed area of breast phantom, resulting in an average improvement of PSNR by ∼35% with exposure equalization. We also found that the PSNRs appeared to be largely uniform with exposure equalization, and the standard deviations of PSNRs were estimated to be 10.3 and 7.9 for the FFDM imaging and the simulated SEDM imaging, respectively. The average glandular dose for SEDM was estimated to be 212.5 mrad, ∼34% lower than that of standard AEC-timed FFDM (323.8 mrad) as a result of exposure equalization for the entire breast phantom.nnnCONCLUSIONSnExposure equalization was found to substantially improve image PSNRs in dense tissue regions and result in more uniform image PSNRs. This improvement may lead to better low-contrast performance in detecting and visualizing soft tissue masses and micro-calcifications in dense tissue areas for breast imaging tasks.

SU-FF-I-23: Full-Scan Versus Half-Scan in Cone Beam Breast CT - a Quantitative Comparison

Purpose: To evaluate and compare half‐scan and full scan techniques for cone beam breast CT in terms of CT number, radiation dose distribution and CNR.Method and Materials:CT number comparison: A 11 cm diameter breast phantom, made of a stack of glandular and fat tissue, was analytically modeled to evaluate the difference of CT numbers reconstructed from Feldkamp algorithm based half and full scan reconstruction. Radiation dose distribution: An 11 cm diameter cylindrical breast model was constructed to evaluate the dose distribution with Geant4 based Monte Carlo simulation.CNR evaluation: An 11 cm diameter polycarbonate cylinder was imaged to simulate breast imaging. Five holes of the same size (5 mm in diameter) were drilled at different radial distance from the phantom center. The phantom, filled with iodine solution, was imaged with an aSi/CsI flat panel detector based cone beam CT scanner. Iodine CNRs were measured for different half‐scan coverage selection. Results: It has been found that the CT numbers reconstructed from half‐scan were close to those from full‐scan. The radiation doses in the half‐scan coverage can be twice than those out the coverage as the radial distance increasing. The CNRs for different half‐scan coverage were approximately identical. Conclusion: Our results show that the reconstructed data from half‐scan are comparable to that from full‐scan. The radiation doses are low for the positions out the half‐scan coverage. The CNRs vary little with half‐scan coverage. Acknowledgement: This work was supported in part by grants CA104759 and CA124585 from NIH‐NCI, a grant EB00117 from NIH‐NIBIB, and a subcontract from NIST‐ATP.

Radiation doses in volume‐of‐interest breast computed tomography—A Monte Carlo simulation study

PURPOSEnCone beam breast computed tomography (breast CT) with true three-dimensional, nearly isotropic spatial resolution has been developed and investigated over the past decade to overcome the problem of lesions overlapping with breast anatomical structures on two-dimensional mammographic images. However, the ability of breast CT to detect small objects, such as tissue structure edges and small calcifications, is limited. To resolve this problem, the authors proposed and developed a volume-of-interest (VOI) breast CT technique to image a small VOI using a higher radiation dose to improve that regions visibility. In this study, the authors performed Monte Carlo simulations to estimate average breast dose and average glandular dose (AGD) for the VOI breast CT technique.nnnMETHODSnElectron-Gamma-Shower system code-based Monte Carlo codes were used to simulate breast CT. The Monte Carlo codes estimated were validated using physical measurements of air kerma ratios and point doses in phantoms with an ion chamber and optically stimulated luminescence dosimeters. The validated full cone x-ray source was then collimated to simulate half cone beam x-rays to image digital pendant-geometry, hemi-ellipsoidal, homogeneous breast phantoms and to estimate breast doses with full field scans. 13-cm in diameter, 10-cm long hemi-ellipsoidal homogeneous phantoms were used to simulate median breasts. Breast compositions of 25% and 50% volumetric glandular fractions (VGFs) were used to investigate the influence on breast dose. The simulated half cone beam x-rays were then collimated to a narrow x-ray beam with an area of 2.5 × 2.5 cm(2) field of view at the isocenter plane and to perform VOI field scans. The Monte Carlo results for the full field scans and the VOI field scans were then used to estimate the AGD for the VOI breast CT technique.nnnRESULTSnThe ratios of air kerma ratios and dose measurement results from the Monte Carlo simulation to those from the physical measurements were 0.97 ± 0.03 and 1.10 ± 0.13, respectively, indicating that the accuracy of the Monte Carlo simulation was adequate. The normalized AGD with VOI field scans was substantially reduced by a factor of about 2 over the VOI region and by a factor of 18 over the entire breast for both 25% and 50% VGF simulated breasts compared with the normalized AGD with full field scans. The normalized AGD for the VOI breast CT technique can be kept the same as or lower than that for a full field scan with the exposure level for the VOI field scan increased by a factor of as much as 12.nnnCONCLUSIONSnThe authors Monte Carlo estimates of normalized AGDs for the VOI breast CT technique show that this technique can be used to markedly increase the dose to the breast and thus the visibility of the VOI region without increasing the dose to the breast. The results of this investigation should be helpful for those interested in using VOI breast CT technique to image small calcifications with dose concern.

Contrast-to-noise ratio improvement in volume-of-interest cone beam breast CT

In this study, we demonstrated the contrast-to-noise ratio (CNR) improvement in breast cone beam CT (CBCT) using the volume-of-interest (VOI) scanning technique. In VOI breast CBCT, the breast is first scanned at a low exposure level. A pre-selected VOI is then scanned at a higher exposure level with collimated x-rays. The two image sets are combined together to reconstruct high quality 3-D images of the VOI. A flat panel detector based system was built to demonstrate and investigate the CNR improvement in VOI breast CBCT. The CNRs of the 8 plastic cones (Teflon, Delrin, polycarbonate, Lucite, solid water, high density polystyrene, nylon and polystyrene) in a breast phantom were measured in images obtained with the VOI CBCT technique and compared to those measured in standard full field CBCT images. CNRs in VOI CBCT images were found to be higher than those in regular CBCT images in all plastic cones. The mean glandular doses (MGDs) from the combination of a high exposure VOI scan and a low exposure full-field scan was estimated to be similar to that from regular full-field scan at standard exposure level. The VOI CBCT technique allows a VOI to be imaged with enhanced image quality with an MGD similar to that from regular CBCT technique.