Ultrahigh resolution whole body photon counting computed tomography as a novel versatile tool for translational research from mouse to man

X-ray computed tomography (CT) is a cardinal tool in clinical practice. It provides cross-sectional images within seconds. The recent introduction of clinical photon-counting CT allowed for an increase in spatial resolution by more than a factor of two resulting in a pixel size in the center of rotation of about 150 µm. This level of spatial resolution is in the order of dedicated preclinical micro-CT systems. However so far, the need for different dedicated clinical and preclinical systems often hinders the rapid translation of early research results to applications in men. This drawback might be overcome by ultra-high resolution (UHR) clinical photon-counting CT unifying preclinical and clinical research capabilities in a single machine. Herein, the prototype of a clinical UHR PCD CT (SOMATOM CounT, Siemens Healthineers, Forchheim, Germany) was used. The system comprises a conventional energy-integrating detector (EID) and a novel photon-counting detector (PCD). While the EID provides a pixel size of 0.6 mm in the centre of rotation, the PCD provides a pixel size of 0.25 mm. Additionally, it provides a quantification of photon energies by sorting them into up to four distinct energy bins. This acquisition of multi-energy data allows for a multitude of applications, e.g. pseudo-monochromatic imaging. In particular, we examine the relation between spatial resolution, image noise and administered radiation dose for a multitude of use-cases. These cases include ultra-high resolution and multi-energy acquisitions of mice administered with a prototype bismuth-based contrast agent (nanoPET Pharma, Berlin, Germany) as well as larger animals and actual patients. The clinical EID provides a spatial resolution of about 9 lp/cm (modulation transfer function at 10%, MTF_10%) while UHR allows for the acquisition of images with up to 16 lp/cm allowing for the visualization of all relevant anatomical structures in preclinical and clinical specimen. The spectral capabilities of the system enable a variety of applications previously not available in preclinical research such as pseudo-monochromatic images. Clinical ultra-high resolution photon-counting CT has the potential to unify preclinical and clinical research on a single system enabling versatile imaging of specimens and individuals ranging from mice to man.

Threshold-dependent iodine imaging and spectral separation in a whole-body photon-counting CT system

OBJECTIVE

To evaluate the dual-energy (DE) performance and spectral separation with respect to iodine imaging in a photon-counting CT (PCCT) and compare it to dual-source CT (DSCT) DE imaging.

METHODS

A semi-anthropomorphic phantom extendable with fat rings equipped with iodine vials is measured in an experimental PCCT. The system comprises a PC detector with two energy bins (20 keV, T) and (T, eU) with threshold T and tube voltage U. Measurements using the PCCT are performed at all available tube voltages (80 to 140 kV) and threshold settings (50-90 keV). Further measurements are performed using a conventional energy-integrating DSCT. Spectral separation is quantified as the relative contrast media ratio R between the energy bins and low/high images. Image noise and dose-normalized contrast-to-noise ratio (CNRD) are evaluated in resulting iodine images. All results are validated in a post-mortem angiography study.

RESULTS

R of the PC detector varies between 1.2 and 2.6 and increases with higher thresholds and higher tube voltage. Reference R of the EI DSCT is found as 2.20 on average overall phantoms. Maximum CNRD in iodine images is found for T = 60/65/70/70 keV for 80/100/120/140 kV. The highest CNRD of the PCCT is obtained using 140 kV and is decreasing with decreasing tube voltage. All results could be confirmed in the post-mortem angiography study.

CONCLUSION

Intrinsically acquired DE data are able to provide iodine images similar to conventional DSCT. However, PCCT thresholds should be chosen with respect to tube voltage to maximize image quality in retrospectively derived image sets.

KEY POINTS

• Photon-counting CT allows for the computation of iodine images with similar quality compared to conventional dual-source dual-energy CT. • Thresholds should be chosen as a function of the tube voltage to maximize iodine contrast-to-noise ratio in derived image sets. • Image quality of retrospectively computed image sets can be maximized using optimized threshold settings.

Photon-counting detectors in computed tomography: from quantum physics to clinical practice

Over the last decade, a fundamentally new type of computed tomography (CT) detectors has proved its superior capabilities in both physical and preclinical evaluations and is now approaching the stage of clinical practice. These detectors are able to discriminate single photons and quantify their energy and are hence called photon-counting detectors. Among the promising benefits of this technology are improved radiation dose efficiency, increased contrast-to-noise ratio, reduced metal artifacts, improved spatial resolution, simultaneous multi-energy acquisitions, and the prospect of multi-phase imaging within a single acquisition using multiple contrast agents. Taking the conventional energy-integrating detectors as a reference, the authors demonstrate the technical principles of this new technology and provide phantom and patient images acquired by a whole-body photon-counting CT. These images serve as a basis for discussing the potential future of clinical CT.

Potential of ultra-high-resolution photon-counting CT of bone metastases: initial experiences in breast cancer patients

Conventional CT scanners use energy-integrating detectors (EIDs). Photon-counting detector (PCD) computed tomography (CT) utilizes a CT detector technology based on smaller detector pixels capable of counting single photons and in addition discriminating their energy. Goal of this study was to explore the potential of higher spatial resolution for imaging of bone metastases. Four female patients with histologically confirmed breast cancer and bone metastases were included between July and October 2019. All patients underwent conventional EID CT scans followed by a high resolution non-contrast experimental PCD CT scan. Ultra-high resolution (UHR) reconstruction kernels were used to reconstruct axial slices with voxel sizes of 0.3 mm × 0.3 mm (inplane) × 1 mm (z-direction). Four radiologists blinded for patient identity assessed the images and compared the quality to conventional CT using a qualitative Likert scale. In this case series, we present images of bone metastases in breast cancer patients using an experimental PCD CT scanner and ultra-high-resolution kernels. A tendency to both a smaller inter-reader variability in the structural assessment of lesion sizes and in the readers' opinion to an improved visualization of lesion margins and content was observed. In conclusion, while further studies are warranted, PCD CT has a high potential for therapy monitoring in breast cancer.

Neural networks-based regularization for large-scale medical image reconstruction

In this paper we present a generalized Deep Learning-based approach for solving ill-posed large-scale inverse problems occuring in medical image reconstruction. Recently, Deep Learning methods using iterative neural networks (NNs) and cascaded NNs have been reported to achieve state-of-the-art results with respect to various quantitative quality measures as PSNR, NRMSE and SSIM across different imaging modalities. However, the fact that these approaches employ the application of the forward and adjoint operators repeatedly in the network architecture requires the network to process the whole images or volumes at once, which for some applications is computationally infeasible. In this work, we follow a different reconstruction strategy by strictly separating the application of the NN, the regularization of the solution and the consistency with the measured data. The regularization is given in the form of an image prior obtained by the output of a previously trained NN which is used in a Tikhonov regularization framework. By doing so, more complex and sophisticated network architectures can be used for the removal of the artefacts or noise than it is usually the case in iterative NNs. Due to the large scale of the considered problems and the resulting computational complexity of the employed networks, the priors are obtained by processing the images or volumes as patches or slices. We evaluated the method for the cases of 3D cone-beam low dose CT and undersampled 2D radial cine MRI and compared it to a total variation-minimization-based reconstruction algorithm as well as to a method with regularization based on learned overcomplete dictionaries. The proposed method outperformed all the reported methods with respect to all chosen quantitative measures and further accelerates the regularization step in the reconstruction by several orders of magnitude.

AAfrag: Interpolation routines for Monte Carlo results on secondary production in proton-proton, proton-nucleus and nucleus-nucleus interactions

We provide a compilation of predictions of the QGSJET-II-04m model for the production of secondary species (photons, neutrinos, electrons, positrons, and antinucleons) that are covering a wide range of energies of the beam particles in proton-proton, proton-nucleus, nucleus-proton, and nucleus-nucleus reactions. The current version of QGSJET-II-04m has an improved treatment of the production of secondary particles at low energies: the parameters of the hadronization procedure have been fine-tuned, based on a number of recent benchmark experimental data, notably, from the LHCf, LHCb, and NA61 experiments. Our results for the production spectra are made publicly accessible through the interpolation routines AAfrag which are described below. Besides, we comment on the impact of Feynman scaling violation and isospin symmetry effects on antinucleon production.

Transition from Galactic to Extragalactic Cosmic Rays

The question at which energy the transition from Galactic to extragalactic cosmic rays takes place has been a long-standing conundrum in cosmic ray physics. In the past, the transition energy has been usually associated with one of the evident features of the cosmic ray spectrum: The second knee around E≃5 ×1017 eV or the ankle at E≃3 ×1018 eV. I review anisotropy and composition data and show that they require that the transition from Galacticto extragalactic CRs has to happen early, at few ×1017 eV. As a result, a successful model for the transition should explain the ankle as a feature of the extragalactic CR spectrum. I review briefly such models and their implications.

A Supernova at 50 pc: Effects on the Earth's Atmosphere and Biota

Recent 60Fe results have suggested that the estimated distances of supernovae in the last few million years should be reduced from ∼100 to ∼50 pc. Two events or series of events are suggested, one about 2.7 million years to 1.7 million years ago, and another about 6.5-8.7 million years ago. We ask what effects such supernovae are expected to have on the terrestrial atmosphere and biota. Assuming that the Local Bubble was formed before the event being considered, and that the supernova and the Earth were both inside a weak, disordered magnetic field at that time, TeV-PeV cosmic rays (CRs) at Earth will increase by a factor of a few hundred. Tropospheric ionization will increase proportionately, and the overall muon radiation load on terrestrial organisms will increase by a factor of ∼150. All return to pre-burst levels within 10 kyr. In the case of an ordered magnetic field, effects depend strongly on the field orientation. The upper bound in this case is with a largely coherent field aligned along the line of sight to the supernova, in which case, TeV-PeV CR flux increases are ∼104; in the case of a transverse field they are below current levels. We suggest a substantial increase in the extended effects of supernovae on Earth and in the "lethal distance" estimate; though more work is needed. This paper is an explicit follow-up to Thomas et al. We also provide more detail on the computational procedures used in both works.

TERRESTRIAL EFFECTS OF NEARBY SUPERNOVAE IN THE EARLY PLEISTOCENE

Recent results have strongly confirmed that multiple supernovae happened at distances of ∼100 pc, consisting of two main events: one at 1.7-3.2 million years ago, and the other at 6.5-8.7 million years ago. These events are said to be responsible for excavating the Local Bubble in the interstellar medium and depositing 60Fe on Earth and the Moon. Other events are indicated by effects in the local cosmic ray (CR) spectrum. Given this updated and refined picture, we ask whether such supernovae are expected to have had substantial effects on the terrestrial atmosphere and biota. In a first look at the most probable cases, combining photon and CR effects, we find that a supernova at 100 pc can have only a small effect on terrestrial organisms from visible light and that chemical changes such as ozone depletion are weak. However, tropospheric ionization right down to the ground, due to the penetration of ⩾TeV CRs, will increase by nearly an order of magnitude for thousands of years, and irradiation by muons on the ground and in the upper ocean will increase twentyfold, which will approximately triple the overall radiation load on terrestrial organisms. Such irradiation has been linked to possible changes in climate and increased cancer and mutation rates. This may be related to a minor mass extinction around the Pliocene-Pleistocene boundary, and further research on the effects is needed.

Signatures of a Two Million Year Old Supernova in the Spectra of Cosmic Ray Protons, Antiprotons, and Positrons

The locally observed cosmic ray spectrum has several puzzling features, such as the excess of positrons and antiprotons above ~20  GeV and the discrepancy in the slopes of the spectra of cosmic ray protons and heavier nuclei in the TeV-PeV energy range. We show that these features are consistently explained by a nearby source which was active approximately two million years ago and has injected (2-3)×10^{50} erg in cosmic rays. The transient nature of the source and its overall energy budget point to the supernova origin of this local cosmic ray source. The age of the supernova suggests that the local cosmic ray injection was produced by the same supernova that has deposited ^{60}Fe isotopes in the deep ocean crust.

The retrobulbar sinus is superior to the lateral tail vein for the injection of contrast media in small animal cardiac imaging

Cardiac perfusion studies using computed tomography are a common tool in clinical practice. Recent technical advances and the availability of dedicated small animal scanners allow the transfer of these techniques to the preclinical sector in general and to mouse models of cardiac diseases in particular. This necessitates new requirements for contrast injection techniques as a rapid transport of contrast media from the intravenous access to the animal heart. Clinical contrast agents containing high iodine concentrations are used within small animal studies although they exhibit a high viscosity which might limit their transport within the vasculature. The authors provide a comparison of the transport of contrast media following an injection into the lateral tail vein and an injection into the retrobulbar sinus and discuss the anatomy involved. The temporal evolution of a contrast bolus and its in vivo distribution is visualized. It is demonstrated that injecting contrast agents into the lateral tail vein of mice results in a retrograde blood flow to the liver veins and therefore does not deliver a detectable contrast bolus to the heart, and thus it cannot be used for cardiac perfusion studies. By contrast, boli injected into the retrobulbar sinus are rapidly transported to the heart and provide ventricular contrast enabling perfusion studies similar to those in human patients. The results demonstrate that an injection into the retrobulbar sinus is superior to an injection into the lateral tail vein for the delivery of contrast boli to the animal heart, while all drawbacks of an injection into the lateral tail vein are overcome.