Dual-energy computed tomography is a novel imaging tool that has the potential to reduce beam hardening artifacts and
enhance material separation over conventional imaging techniques. Dual-energy acquisitions can be performed by using
a fast kVp technology to switch between acquiring adjacent projections at two distinct x-ray spectra (80 and 140 kVp).
These datasets can be used to further compute material density and monochromatic images for better material separation
and beam hardening reduction by virtue of the projection domain process. The purpose of this study was to evaluate the
feasibility of using dual-energy in cardiac imaging for myocardial perfusion detection and coronary artery lumen
visualization. Data was acquired on a heart phantom, which consisted of the chambers and aorta filled with Iodine
density solution (500 HU @ 120 kVp), a defect region between the aorta and chamber (40 HU @ 120 kVp), two Iodinefilled
vessels (400 HU @ 120 kVp) of different diameters with high attenuation (hydroxyapatite) plaques (HAP), and
with a 30-cm water equivalent body ring around the phantom. Prospective ECG-gated single-energy and prospective
ECG-gated dual-energy imaging was performed. Results showed that the generated monochromatic images had minimal
beam hardening artifacts which improved the accuracy and detection of the myocardial defect region. Material density
images were useful in differentiating and quantifying the actual size of the plaque and coronary artery lumen. Overall,
this study shows that dual-energy cardiac imaging will be a valuable tool for cardiac applications.
Today lowering patient radiation dose while maintaining image quality in Computed Tomography has become a very
active research field. Various iterative reconstruction algorithms have been designed to improve/maintain image quality
for low dose patient scans. Typically radiation dose variation will result in detectability variation for low contrast
objects. This paper assesses the low contrast detectability performance of the images acquired at different dose levels
and obtained using different image generation algorithms via two-alterative forced choice human observer method.
Filtered backprojection and iterative reconstruction algorithms were used in the study. Results showed that for the
objects and scan protocol used, the iterative algorithm employed in this study has similar low contrast detectability
performance compared to filtered backprojection algorithm at a 4 times lower dose level. It also demonstrated that well
controlled human observer study is feasible to assess the image quality of a CT system.
With a dedicated breast CT system using a quasi-monochromatic x-ray source and flat-panel digital detector, the 2D and
3D scatter to primary ratios (SPR) of various geometric phantoms having different densities were characterized in detail.
Projections were acquired using geometric and anthropomorphic breast phantoms. Each phantom was filled with 700ml
of 5 different water-methanol concentrations to simulate effective boundary densities of breast compositions from 100%
glandular (1.0g/cm3) to 100% fat (0.79g/cm3). Projections were acquired with and without a beam stop array. For each
projection, 2D scatter was determined by cubic spline interpolating the values behind the shadow of each beam stop
through the object. Scatter-corrected projections were obtained by subtracting the scatter, and the 2D SPRs were
obtained as a ratio of the scatter to scatter-corrected projections. Additionally the (un)corrected data were individually
iteratively reconstructed. The (un)corrected 3D volumes were subsequently subtracted, and the 3D SPRs obtained from
the ratio of the scatter volume-to-scatter-corrected (or primary) volume. Results show that the 2D SPR values peak in the
center of the volumes, and were overall highest for the simulated 100% glandular composition. Consequently, scatter
corrected reconstructions have visibly reduced cupping regardless of the phantom geometry, as well as more accurate
linear attenuation coefficients. The corresponding 3D SPRs have increased central density, which reduces radially. Not
surprisingly, for both 2D and 3D SPRs there was a dependency on both phantom geometry and object density on the
measured SPR values, with geometry dominating for 3D SPRs. Overall, these results indicate the need for scatter
correction given different geometries and breast densities that will be encountered with 3D cone beam breast CT.
With advances in 3D in vivo imaging technology, non-invasive procedures can be used to characterize tissues to identify
tumors and monitor changes over time. Using a dedicated breast CT system with a quasi-monochromatic cone-beam x-ray source and
flat-panel digital detector, this study was performed in an effort to directly characterize different materials in vivo based on their absolute attenuation coefficients. CT acquisitions were first acquired using a multi-material rod phantom with acrylic, delrin, polyethylene, fat-equivalent, and glandular-equivalent plastic rods, and also with a human cadaver breast. Projections were collected with and without a beam stop array for scatter correction. For each projection, the 2D scatter was estimated with cubic spline interpolation of the average values behind the shadow of each beam stop overlapping the object. Scatter-corrected projections were subsequently calculated by subtracting the scatter images
containing only the region of the object from corresponding projections (consisting of primary and scatter x-rays)
without the beam stop array. Iterative OSTR was used to reconstruct the data and estimate the non-uniform attenuation
distribution. Preliminary results show that with reduced beam hardening from the x-ray beam, scatter correction further reduces the cupping artifact, improves image contrast, and yields attenuation coefficients < 8% of narrow-beam values of the known materials (range 1.2 - 7.8%). Peaks in the histogram showed clear separation between the different material attenuation coefficients. These findings indicate that minimizing beam hardening and applying scatter correction make it practical to directly characterize different tissues in vivo using absolute attenuation coefficients.
In current dedicated breast computed tomography (mammotomography) systems, comfortable patient positioning on a
stationary bed restricts the practicable range of source-detector trajectories, thus compromising the system's ability to
adequately image the patient's anterior chest wall. This study examines the effect on detecting small, low-contrast
lesion-like-spheres using limited angle x-ray source-detector trajectories and trajectories that intentionally raise the
tomographic imaging system mid-acquisition. These modified acquisition paths may increase chest wall visualization,
simplify the design of the imaging system and increase patient comfort by allowing the design of an improved patient
bed. Thin walled balloons of various volumes filled with iodine act as surrogate high contrast lesions to initially
investigate the effect of these novel trajectories. Then, stacks of 5mm acrylic spheres regularly spaced in concentric
circles are placed in water to simulate a low contrast environment in a uniform scatter medium. 360° azimuthal scans are
acquired at various bed heights with contiguous projections subsequently removed to create limited angle acquisitions
from 240-360°. Projections from the different bed heights are interwoven to form trajectories that mimic discontinuously
raising the imaging system mid-acquisition. The resulting iteratively reconstructed volumes are evaluated with an
observer study. Initial images suggest that using limited angles and raising the system is possible while increasing the
observer's ability to visualize objects near the chest wall. Based on the results of this study, an improved patient bed to
facilitate chest wall imaging will be designed, and the feasibility of vertical system motion to increase imaged breast
volume explored.
A hybrid SPECT-CT system for dedicated 3D breast cancer imaging (mammotomography) is in development. Using
complex 3D imaging acquisition trajectories, the versatile integrated system will be capable of contouring and imaging
an uncompressed breast suspended in a 3D volume located below a radio-opaque patient bed, providing co-registered
volumetric anatomical and functional information. This study examines tradeoffs involved in the design of the patient
bed to satisfy concomitant and competing technical and ergonomic requirements specific to this imaging paradigm. The
complementary source-detector arrangement of the CT system is geometrically more restrictive than that of the single
detector SPECT system. Additionally, the compact dimensions and size of the CT system components (primarily the x-ray
tube) are key constraints on the bed design and so the focus is concentrated there. Using computer-aided design
software, several design geometry options are examined to simultaneously consider and optimize the following
parameters: image magnification, imaged breast volume, azimuthal imaging span, and patient comfort. Several CT
system source to image distances are examined (55-80cm), as well as axial patient tilt up to 35°. An optimal patient bed
design for a completely under-bed hybrid imaging system was determined. A 60cm SID, magnification factor of ~1.5,
and patient bed angled at ~15° provided the optimal dimensions. Additional bed dimensions allow the CT projection
beam to nearly entirely image the chest wall, however at the cost of reduced angular sampling for CT. Acquired x-ray
mammotomographic image data is used to assess the feasibility of this reduced angle acquisition approach.
A hybrid SPECT-CT system for dedicated 3D breast imaging (mammotomography) is currently under development. Each imaging system will be placed on top of a single rotation stage and moved in unison azimuthally, with the SPECT system additionally capable of polar and radial motions. In this initial prototype, the CT system will initially be positioned at a fixed polar tilt. Using a phantom with three tungsten wires, the MTF of the CT system was measured in 3D for different CT system tilts. A phantom with uniformly arranged 0.5cm diameter acrylic spheres was suspended in air in the CT field of view, and also placed at multiple locations and orientations inside an oil-filled breast phantom to evaluate the effect of CT system tilt on lesion visibility and distortion. Projection images were collected using various simple circular orbits with fixed polar tilts ranging between ±15°, and complex 3D saddle trajectories including combined polar and azimuthal motions at maximum polar tilt angles. Reconstructions were performed using an iterative reconstruction algorithm on 4x4 binned projection images with 0.508mm3 voxels. There was minor variation in the MTF in the imaged volume for the CT system at all trajectories, potentially due to the use of an iterative reconstruction algorithm. Results from the spherical cross phantoms indicated that there was more reconstruction inaccuracy and geometric distortion in the reconstructed slices with simple circular orbits with fixed tilt in contrast to complex 3D trajectories. Line profiles further showed a cupping artifact in planes farther away from the flat plane of the x-ray cone beam placed at different tilts. However, this cupping artifact was not seen for images acquired with complex 3D trajectories. This indicated that cupping artifacts can also be caused by undersampled cone beam data. These findings generally indicate that despite insufficient sampling with the cone beam imaging geometry, it is possible to place the CT system at a stationary polar tilt with the CT tube positioned upward such that a patient can be comfortably placed above the system and allow complete sampling near the top of the pendant, uncompressed breast and chest wall. However, a complex 3D trajectory allows for more complete sampling of the entire image volume.
Patient positioning on a bed is an integral part of accurate imaging for dedicated 3D breast imaging. For both dedicated
breast SPECT (single photon emission computed tomography) and breast CT (computed tomography or computed
mammotomography, CmT) which are under development in our lab, maximum access to the breast in the imaging
system's field of view is required to obtain the largest imaged breast volume. Accurate bed positioning will be necessary
as it may be integrated with a guided biopsy apparatus. Thus, a patient bed with flexible 3D positioning capability is
being integrated into the various independent and hybrid 3D imaging systems. The customized bed has both manual and
computer controlled positioning capability, and the accuracy and reproducibility of the system are being characterized.
Computer controlled positioning and feedback provide seemingly reproducible results. However, gross movements may
vary in their accuracy to the given input position. While linear with slopes near 1.0 and intercepts near 0.0cm, lateral
(Y) movement translates less than the input amount, while axial (X) movement translates farther than the input amount.
Vertical (Z) directional movement follows a quadratic shift with a small dc component with or without added weight on
the table. A variety of patient imaging conditions along with x-ray image data are evaluated to demonstrate the
reproducibility of positioning accuracy. Individual directional repositioning accuracy is found to be better than multiple,
combined directional repositioning accuracy. Imaging results indicate a reproducibility (error) of less than 1mm, which
may be suitable for SPECT imaging but perhaps not for higher resolution dedicated breast CT. However, for the
independent SPECT system, bed motion is not necessary because the detector's line of sight can already acquire data at
the chest wall.
A hybrid, dual modality single photon emission computed tomography (SPECT) and x-ray computed mammotomography (CmT) scanner for dedicated breast and axillary imaging is under development. CmT imaging provides high resolution anatomical images, whereas SPECT provides functional images albeit with coarser resolution. As is being seen clinically in whole body imaging, integration of the images is expected to enhance (visually) and improve (with attenuation correction of SPECT) information provided by either modality for the detection, characterization and potentially staging of breast cancer. The registration of these images considers variations in object positions between the different modalities and imaging parameters (pixel size, conditions of acquisition, scan limitations). Automatic methods can be used which find the geometric transformations of the different imaging modalities involved. Here we demonstrate the initial stages of iterative 2-dimensional registration and fusion of SPECT with parallel beam geometry and CmT with offset cone-beam acquisition geometry for mammotomography with images acquired and reconstructed independently on each system. Two registration algorithms are considered: the first is an intrinsic correlation, Mutual Information (MI) method based on intrinsic image content; the second is a rigid body transform method, Iterative Closest Point (ICP) method based on identification of fiducial markers visible to both emission (SPECT) and transmission (CmT) imaging modalities. Experiments include use of a geometric resolution/frequency phantom imaged under different conditions, and two different anthropomorphic breast phantom sizes (325 and 935mL). Initial results with the geometric phantom demonstrate that MI can be misled by highly symmetric features, and ICP using control points is more accurate to within fractions of a voxel. Initial breast phantom studies indicate that object size and SPECT resolution limitations may contribute to registration errors.
A novel phantom has been developed to measure the modulation transfer function (MTF) in 3D for x-ray computed tomography. The phantom consists of three tungsten wires, positioned nearly orthogonal to each other. Simultaneous measurements of the MTF are taken at various locations along the three orthogonal reconstructed planes. Our computed mammotomography (CmT) system uses a Varian Paxscan 2520 digital x-ray detector which can be positioned anywhere in ~2pi steradian band and can have arbitrary trajectories. With a half-cone beam geometry and with the phantom positioned near the center of rotation, projection images are acquired over 360 degrees. Various 3D orbits are evaluated including vertical axis of rotation and saddle. Reconstructions were performed using an iterative ordered-subsets transmission algorithm on rebinned projection images, using various numbers of iterations. Rotation of reconstructed slices isolated each wire into its own plane. At various locations along the length of each wire, corresponding MTFs were calculated from 1D line spread functions. Through measurement, accuracy of wire method was verified by comparison of the projection MTFs computed from a wire and a standard edge device. Results indicated minor variations in MTF among the three orthogonal planes, which imply a high degree of uniform sampling in the imaged volume. Findings indicate that the phantom can be used to assess the intrinsic image resolution in 3D as well as potential degradative effects of measurements in various media.
KEYWORDS: Breast, Distortion, Chest, Imaging systems, Computing systems, 3D image reconstruction, 3D acquisition, 3D image processing, Breast imaging, Sensors
We investigate cone-beam acquisitions implemented on a novel dedicated cone-beam transmission computed mammotomography (CmT) system with unique arbitrary orbit capability for pendant, uncompressed breasts. We use a previously reported optimized quasi-monochromatic beam technique together with orbits made possible with a novel CmT gantry system, to evaluate Vertical-Axis-Of-Rotation (VAOR), Circle-Plus-Two-Arcs (CP2A), and Saddle trajectories. Aquisition parameters include: W target, 60 kVp tube potential, 100th VL Nd filtration, 1.25 mAs, 55 cm SID, CsI(Tl) digital flat panel x-ray detector, and 7.7cm diameter uniform disc (Defrise) and resolution phantoms. Complex orbits were also performed for a realistic breast phantom. Reconstructions used an iterative ordered subsets transmission (OSTR) algorithm with 4x4 binned projections, 8 subsets, and 10 iterations, with 0.125 mm3 voxels. We evaluate the results for image artifacts, distortion, and resolution. Reconstructed images of the disc coronal and sagittal slices show significant distortion of the discs and phantom interfaces away from the central plane of the cone-beam for VAOR, less distortion for CP2A, and minimal distortion for the complex 3D Saddle orbit. Resolution phantoms indicate no loss of resolution with the Saddle orbit, with the smallest 1.1mm diameter rods clearly resolved. Other image artifacts such as streaking were also significantly reduced in the Saddle orbit case. Results indicate that arbitrary orbits of pendant uncompressed breasts using cone-beam acquisitions and OSTR iterative reconstructions can be successfully implemented for dedicated CmT to improve angular sampling with significant reduction in distortion and other image artifacts. This capability has the potential to improve the performance of dedicated CmT by adequately sampling the breast and anterior chest volumes of prone patients with pendant, uncompressed breasts.
Our effort to implement a volumetric x-ray computed mammotomography (CmT) system dedicated to imaging breast disease comprises: demonstrated development of a quasi-monochromatic x-ray beam providing minimal dose and other optimal imaging figures of merit; new development of a compact, variable field-of-view, fully-3D acquisition gantry with a digital flat-panel detector facilitating more nearly complete sampling of frequency space and the physical breast volume; incorporation of iterative ordered-subsets transmission (OSTR) image reconstruction allowing modeling of the system matrix. Here, we describe the prototype 3D gantry and demonstrate initial system performance. Data collected on the prototype gantry demonstrate the feasibility of using OSTR with realistic reconstruction times. The gantry consists of a rotating W-anode x-ray tube using ultra-thick K-edge filtration, and an ~20x25cm2 digital flat-panel detector located at <60cm SID. This source/detector combination can be shifted laterally changing the location of the central ray relative to the system center-of-rotation, hence changing the effective imaging field-of-view, and is mounted on a goniometric cradle allowing <50° polar tilt, then on a 360° azimuthal rotation stage. Combined, these stages provide for positioning flexibility in a banded region about a sphere, facilitating simple circle-plus-arc-like trajectories, as well as considerably more complex 3D trajectories. Complex orbits are necessary to avoid physical hindrances from the patient while acquiring the largest imaging volume of the breast. The system capabilities are demonstrated with fully-3D reconstructed images of geometric sampling and resolution phantoms, a fabricated breast phantom containing internal features of interest, and a cadaveric breast specimen. This compact prototype provides flexibility in dedicated, fully-3D CmT imaging of healthy and diseased breasts.
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