Bowtie filters for dedicated breast CT: theory and computational implementation

Algorithm development for automatic laser alignment assessment on an ACR CT phantom and its evaluation on sixteen CT scanners

Purpose. The aim of this study is to develop software to automatically assess the laser alignment on the ACR CT phantom and evaluate its accuracy on sixteen CT scanners.Methods. Software for an automated method of laser alignment assessment on the ACR CT phantom was developed. Laser alignment assessment was based on the positions of the ball-bearing markers at the edge of the ACR CT phantom. The automatic assessment was performed using several steps, including segmentation to acquire the coordinates of the ball-bearing markers and determination of the distances between lines connecting them with lines through the center of the image. A comparison of the results from the automatic method with those from the manual method was performed. The manual measurements were carried out using MicroDicom Viewer. A Mann-Whitney U test was performed to determine the statistical difference between both methods. The evaluation was performed on images of the ACR CT phantom scanned with 16 CT scanners from 5 different CT manufacturers.Results. The results confirmed that our software successfully segments the ball-bearing markers and determines the laser alignment assessment on the ACR CT phantom. Evaluation of the algorithm with images from the 16 CT scanners revealed that the difference between the results from automatic and manual methods were about 0.2 mm with apvalue of around 0.7 (no statistical difference). Misalignment in they-axis was larger than the misalignment in the x-axisfor the majority of the scanners tested. It was found that the phantom tended to be placed 2 mm higher than the iso-center.Conclusions. Software to automatically assess CT laser alignment with the ACR CT phantom was successfully developed and evaluated. The automatic assessment was comparable to manual assessment. In addition, the automatic method was user independent and fast.

A novel hardware duo of beam modulation and shielding to reduce scatter acquisition and dose in cone-beam breast CT

PURPOSE

In cone-beam breast CT, scattered photons form a large portion of the acquired signal, adversely impacting image quality throughout the frequency response of the imaging system. Prior simulation studies provided proof of concept for utilization of a hardware solution to prevent scatter acquisition. Here, we report the design, implementation, and characterization of an auxiliary apparatus of fluence modulation and scatter shielding that does indeed lead to projections with a reduced level of scatter.

METHODS

An apparatus was designed for permanent installation within an existing cone-beam CT system. The apparatus is composed of two primary assemblies: a "Fluence Modulator" (FM) and a "Scatter Shield" (SS). The design of the assemblies enables them to operate in synchrony during image acquisition, converting the sourced x-rays into a moving narrow beam. During a projection, this narrow beam sweeps the entire fan angle coverage of the imaging system. As the two assemblies are contingent on one another, their joint implementation is described in the singular as apparatus FM-SS. The FM and the SS assemblies are each comprised a metal housing, a sensory system, and a robotic system. A controller unit handles their relative movements. A series of comparative studies were conducted to evaluate the performance of a cone-beam CT system in two "modes" of operation: with and without FM-SS installed, and to compare the results of physical implementation with those previously simulated. The dynamic range requirements of the utilized detector in the cone-beam CT imaging system were first characterized, independent of the mode of operation. We then characterized and compared the spatial resolution of the imaging system with, and without, FM-SS. A physical breast phantom, representative of an average size breast, was developed and imaged. Actual differences in signal level obtained with, versus without, FM-SS were then compared to the expected level gains based on previously reported simulations. Following these initial assessments, the scatter acquisition in each projection in both modes of operation was investigated. Finally, as an initial study of the impact of FM-SS on radiation dose in an average size breast, a series of Monte Carlo simulations were coupled with physical measurements of air kerma, with and without FM-SS.

RESULTS

With implementation of FM-SS, the detector's required dynamic range was reduced by a factor of 5.5. Substantial reduction in the acquisition of the scattered rays, by a factor of 5.1 was achieved. With the implementation of FM-SS, deposited dose was reduced by 27% in the studied breast.

CONCLUSIONS

The disclosed implementation of FM-SS, within a cone-beam breast CT system, results in reduction of scatter-components in acquired projections, reduction of dose deposit to the breast, and relaxation of requirements for the detector's dynamic range. Controlling or correcting for patient motion occurring during image acquisition remains an open problem to be solved prior to practical clinical usage of FM-SS cone-beam breast CT.

Decoupling of bowtie and object effects for beam hardening and scatter artefact reduction in iterative cone-beam CT

Cone-beam computed tomography (CBCT) is an important imaging modality for image-guided radiotherapy and adaptive radiotherapy. Feldkamp-Davis-Kress (FDK) method is widely adopted in clinical CBCT reconstructions due to its fast and robust application. While iterative algorithms have been shown to outperform FDK techniques in reducing noise and imaging dose, they are unable to correct projection-domain artefacts such as beam hardening and scatter. Empirical correction techniques require a holistic approach as beam hardening and scatter coexist in the measurement data. This multi-part proof of concept study conducted in MATLAB presents a novel approach to artefact reduction for CBCT image reconstruction. Firstly, we decoupled the beam hardening and scatter contributions originating from the imaging object and the bowtie filter. Next, a model was constructed to apply pixel-wise corrections to separately account for artefacts induced by the imaging object and the bowtie filter, in order to produce mono-energetic equivalent and scatter-compensated projections. Finally, the effectiveness of the correction model was tested on an offset phantom scan as well as a clinical brain scan. A conjugate-gradient least-squares algorithm was implemented over five iterations using FDK result as the initial input. Our proposed correction model was shown to effectively reduce cupping and shading artefacts in both phantom and clinical studies. This simple yet effective correction model could be readily implemented by physicists seeking to explore the benefits of iterative reconstruction.

Effect of miscentering and low-dose protocols on contrast resolution in computed tomography head examination

BACKGROUND

Unoptimized protocols, including a miscentered position, might affect the outcome of diagnostic in CT examinations. In this study, we investigate the effects of miscentering position during CT head examination on the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).

METHOD

We simulate the CT head examination using a water phantom with a standard protocol (120 kVp/180 mAs) and a low dose protocol (100 kVp/142 mAs). The table height was adjusted to simulate miscentering by 5 cm from the isocenter, where the height was miscentered superiorly (MCS) at 109, 114, 119, and 124 cm, and miscentered inferiorly (MCI) at 99, 94, 89, and 84 cm. Seven circular regions of interest were used, with one drawn at the center, four at the peripheral area of the phantom, and two at the background area of the image.

RESULTS

For the standard protocol, the mean CNR decreased uniformly as table height increased and significantly differed (p < 0.05) at +20 cm for MCS (435.70 ± 9.39) and -20 cm for MCI (438.91 ± 10.94) from the isocenter. Similarly, significant reductions (p < 0.05) were also noted for SNR for MCS (at +20 cm) and MCI (at -20 cm). For the low dose protocol, both CNR and SNR were significantly reduced (p < 0.05) at table heights of +20 and -20 cm from the isocenter.

CONCLUSION

Miscentering is proven to significantly affect the image quality in both low and standard dose protocols for head CT procedure. This study implies that accurate patient centering is one of the approaches that can improve CT optimization practice.

A fluence modulation and scatter shielding apparatus for dedicated breast CT: Theory of operation

PURPOSE

To introduce an auxiliary apparatus of fluence modulation and scatter shielding for dedicated breast computed tomography (bCT) and the corresponding patient-specific method of image acquisition.

METHODS

The apparatus is composed of two assemblies, referred to herein as the "Dynamic Fluence Gate" (FG) and "Scatter Shield" (SS), that work in synchrony to form a narrow beam sweeping the entire fan angle coverage of the imaging system during a projection. The apparatus, as a whole, is referred to as FG-SS. FG and SS are pre-patient and post-patient units, respectively. Each is composed of a rotating drum, on top of which are installed two sheets of high x-ray attenuating material, a sensory system, and the constituent robotics. The sheets of each unit are positioned such that an opening - a window Fluence Modulation and Scatter Shielding is formed between them. The rotations of the drums and positioning of the sheets are synchronized and adjusted such that a line of sight is created between the source, FG window, the breast, and the SS window. With line of sight achieved, the narrow beam transitions from the source to the detector. The fluence of the narrow beam during a projection depends on the size, shape, and positioning of the breast. The FG-SS method of imaging is discussed mathematically and demonstrated using computer simulations. A series of Monte Carlo simulations are conducted to evaluate the performance of the system as relates to its impact on the imager's dynamic range, dose distribution to the breast, noise inhomogeneity in reconstructed images, and scatter buildup in projections within small, medium, and large breasts composed of homogeneous medium breast tissue.

RESULTS

Implementation of FG-SS results in near scatter-free projections, reduction in both dose and the required dynamic range of the imager, and equalization of the quantum noise distribution in the reconstructed image. Using the disclosed design, the dynamic range was reduced by factors ranging from 1.6 to 5.5 across the range of breast sizes studied. A reduction in the acquisition of the scattered rays, varying between the factors of 6.1 (in the small breast) and 9.8 (in that large breast) was achieved and consequently, shading artifacts were suppressed. Noise in the CT image was equalized by reducing the overall spatial variation from 29% to <5% in small breast and from 45% to 14% in the large breast. An overall reduction in deposited dose to the breast was achieved - between 26% and 39% depending on the breast size.

CONCLUSIONS

Utilization of the FG-SS apparatus and technique was demonstrated via simulations to result in: significant reductions in dose to the breast, reductions in scatter uptake in projections, reduced required dynamic range of the imager, and homogenizing of quantum noise throughout the reconstructed image.

Mathematical modelling of scanner-specific bowtie filters for Monte Carlo CT dosimetry

The purpose of bowtie filters in CT scanners is to homogenize the x-ray intensity measured by the detectors in order to improve the image quality and at the same time to reduce the dose to the patient because of the preferential filtering near the periphery of the fan beam. For CT dosimetry, especially for Monte Carlo calculations of organ and tissue absorbed doses to patients, it is important to take the effect of bowtie filters into account. However, material composition and dimensions of these filters are proprietary. Consequently, a method for bowtie filter simulation independent of access to proprietary data and/or to a specific scanner would be of interest to many researchers involved in CT dosimetry. This study presents such a method based on the weighted computer tomography dose index, CTDI_w, defined in two cylindrical PMMA phantoms of 16 cm and 32 cm diameter. With an EGSnrc-based Monte Carlo (MC) code, ratios CTDI_w/CTDI_100,a were calculated for a specific CT scanner using PMMA bowtie filter models based on sigmoid Boltzmann functions combined with a scanner filter factor (SFF) which is modified during calculations until the calculated MC CTDI_w/CTDI_100,a matches ratios CTDI_w/CTDI_100,a, determined by measurements or found in publications for that specific scanner. Once the scanner-specific value for an SFF has been found, the bowtie filter algorithm can be used in any MC code to perform CT dosimetry for that specific scanner. The bowtie filter model proposed here was validated for CTDI_w/CTDI_100,a considering 11 different CT scanners and for CTDI_100,c, CTDI_100,p and their ratio considering 4 different CT scanners. Additionally, comparisons were made for lateral dose profiles free in air and using computational anthropomorphic phantoms. CTDI_w/CTDI_100,a determined with this new method agreed on average within 0.89% (max. 3.4%) and 1.64% (max. 4.5%) with corresponding data published by CTDosimetry (www.impactscan.org) for the CTDI HEAD and BODY phantoms, respectively. Comparison with results calculated using proprietary data for the PHILIPS Brilliance 64 scanner showed agreement on average within 2.5% (max. 5.8%) and with data measured for that scanner within 2.1% (max. 3.7%). Ratios of CTDI_100,c/CTDI₁₀₀, _p for this study and corresponding data published by CTDosimetry (www.impactscan.org) agree on average within about 11% (max. 28.6%). Lateral dose profiles calculated with the proposed bowtie filter and with proprietary data agreed within 2% (max. 5.9%), and both calculated data agreed within 5.4% (max. 11.2%) with measured results. Application of the proposed bowtie filter and of the exactly modelled filter to human phantom Monte Carlo calculations show agreement on the average within less than 5% (max. 7.9%) for organ and tissue absorbed doses.

Detector-unit-dependent calibration for polychromatic projections of rock core CT

Computed tomography (CT) plays an important role in digital rock analysis, which is a new prospective technique for oil and gas industry. But the artifacts in CT images will influence the accuracy of the digital rock model. In this study, we proposed and demonstrated a novel method to restore detector-unit-dependent functions for polychromatic projection calibration by scanning some simple shaped reference samples. As long as the attenuation coefficients of the reference samples are similar to the scanned object, the size or position is not needed to be exactly known. Both simulated and real data were used to verify the proposed method. The results showed that the new method reduced both beam hardening artifacts and ring artifacts effectively. Moreover, the method appeared to be quite robust.

Attenuator design method for dedicated whole-core CT

In whole-core CT imaging, scanned data corresponding to the central portion of a cylindrical core often suffer from photon starvation, because increasing photon flux will cause overflow on some detector units under the restriction of detector dynamic range. Either photon starvation or data overflow will lead to increased noise or severe artifacts in the reconstructed CT image. In addition, cupping shaped beam hardening artifacts also appear in the whole-core CT image. In this paper, we present a method to design an attenuator for cone beam whole-core CT, which not only reduces the dynamic range requirement for high SNR data scanning, but also corrects beam hardening artifacts. Both simulation and real data are employed to verify our design method.

Bowtie filters for dedicated breast CT: Analysis of bowtie filter material selection

PURPOSE

For a given bowtie filter design, both the selection of material and the physical design control the energy fluence, and consequently the dose distribution, in the object. Using three previously described bowtie filter designs, the goal of this work is to demonstrate the effect that different materials have on the bowtie filter performance measures.

METHODS

Three bowtie filter designs that compensate for one or more aspects of the beam-modifying effects due to the differences in path length in a projection have been designed. The nature of the designs allows for their realization using a variety of materials. The designs were based on a phantom, 14 cm in diameter, composed of 40% fibroglandular and 60% adipose tissue. Bowtie design #1 is based on single material spectral matching and produces nearly uniform spectral shape for radiation incident upon the detector. Bowtie design #2 uses the idea of basis-material decomposition to produce the same spectral shape and intensity at the detector, using two different materials. With bowtie design #3, it is possible to eliminate the beam hardening effect in the reconstructed image by adjusting the bowtie filter thickness so that the effective attenuation coefficient for every ray is the same. Seven different materials were chosen to represent a range of chemical compositions and densities. After calculation of construction parameters for each bowtie filter design, a bowtie filter was created using each of these materials (assuming reasonable construction parameters were obtained), resulting in a total of 26 bowtie filters modeled analytically and in the penelope Monte Carlo simulation environment. Using the analytical model of each bowtie filter, design profiles were obtained and energy fluence as a function of fan-angle was calculated. Projection images with and without each bowtie filter design were also generated using penelope and reconstructed using FBP. Parameters such as dose distribution, noise uniformity, and scatter were investigated.

RESULTS

Analytical calculations with and without each bowtie filter show that some materials for a given design produce bowtie filters that are too large for implementation in breast CT scanners or too small to accurately manufacture. Results also demonstrate the ability to manipulate the energy fluence distribution (dynamic range) by using different materials, or different combinations of materials, for a given bowtie filter design. This feature is especially advantageous when using photon counting detector technology. Monte Carlo simulation results from penelope show that all studied material choices for bowtie design #2 achieve nearly uniform dose distribution, noise uniformity index less than 5%, and nearly uniform scatter-to-primary ratio. These same features can also be obtained using certain materials with bowtie designs #1 and #3.

CONCLUSIONS

With the three bowtie filter designs used in this work, the selection of material is an important design consideration. An appropriate material choice can improve image quality, dose uniformity, and dynamic range.