Dose reduction potential in diagnostic single energy CT through patient-specific prefilters and a wider range of tube voltages

PURPOSE

Various studies have demonstrated that additional prefilters and/or reduced tube voltages have the potential to significantly increase the contrast-to-noise ratios at unit dose (CNRDs) and thereby to significantly reduce patient dose in clinical CT. An exhaustive analysis, accounting for a wide range of filter thicknesses and a wide range of tube voltages extending beyond the 70 to 150 kV range of today's CT systems, including their specific choice depending on the patient size, is, however, missing. Therefore, this work analyzes the dose reduction potential for patient-specific selectable prefilters combined with a wider range of tube voltages. We do so for soft tissue and iodine contrast in single energy CT. The findings may be helpful to guide further developments of x-ray tubes and automatic filter changers.

METHODS

CT acquisitions were simulated for different patient sizes (semianthropomorphic phantoms for child, adult, and obese patients), tube voltages (35-150 kV), prefilter materials (tin and copper), and prefilter thicknesses (up to 5 mm). For each acquisition soft tissue and iodine CNRDs were determined. Dose was calculated using Monte Carlo simulations of a computed tomography dose index (CTDI) phantom. CNRD values of acquisitions with different parameters were used to evaluate dose reduction.

RESULTS

Dose reduction through patient-specific prefilters depends on patient size and available tube current among others. With an available tube current time product of 1000 mAs dose reductions of 17% for the child, 32% for the adult and 29% for the obese phantom were achieved for soft tissue contrast. For iodine contrast dose reductions were 57%, 49%, and 39% for child, adult, and obese phantoms, respectively. Here, a tube voltage range extended to lower kV is important.

CONCLUSIONS

Substantial dose reduction can be achieved by utilizing patient-specific prefilters. Tube voltages lower than 70 kV are beneficial for dose reduction with iodine contrast, especially for small patients. The optimal implementation of patient-specific prefilters benefits from higher tube power. Tin prefilters should be available in 0.1 mm steps or lower, copper prefilter in 0.3 mm steps or lower. At least 10 different prefilter thicknesses should be used to cover the dose optima of all investigated patient sizes and contrast mechanisms. In many cases it would be advantageous to adapt the prefilter thickness rather than the tube current to the patient size, that is, to always use the maximum available tube current and to control the exposure by adjusting the thickness of the prefilter.

Dynamic fluence field modulation in computed tomography using multiple aperture devices

A novel beam filter consisting of multiple aperture devices (MADs) has been developed for dynamic fluence field modulation (FFM) in CT. Each MAD achieves spatial modulation of x-ray through fine-scale, highly attenuating tungsten bars of varying widths and spacings. Moiré patterns produced by relative motions between two MADs provide versatile classes of modulation profiles. The dual-MAD filter can be designed to achieve specific classes of target profiles. The designed filter was manufactured through a laser-sintering process and integrated to an experimental imaging system that enables linear actuation of the MADs. Dynamic FFM was achieved through a combination of beam shape modulation (by relative MAD motion) and amplitude modulation (by view-dependent mAs). To correct for gains associated with the MADs, we developed an algorithm to account for possible focal spot changes during/between scans and spectral effects introduced by the MADs. We performed FFM designs for phantoms following two imaging objectives: (1) to achieve minimum mean variance in filtered backprojection (FBP) reconstruction, and (2) to flatten the fluence behind the phantom. Comparisons with conventional FFM strategies involving a static bowtie and pulse width modulation were performed. The dual-MAD filter produced modulation profiles closely matched with the design target, providing varying beam widths not achievable by the static bowtie. The entire range of modulation profiles was achieved by 0.373 mm of MAD displacement. The correction algorithm effectively alleviated ring artifacts as a result of MADs while preserving phantom details such as wires and tissue boundaries. Dynamic FFM enabled by the MADs were effective in achieving the imaging objectives and demonstrated superior FFM capabilities compared to the static bowtie. In an ellipse phantom, the FFM of objective 1 achieved the lowest mean variance in all cases investigated. The FFM of objective 2 produce nearly isotropic local noise power spectrum and homogeneous noise magnitude. The dual-MAD filter provides an effective tool for fluence control in CT to overcome limitations of conventional static bowties and to further enable patient-specific FFM studies for a wide range of dose and image quality objectives.

Dual-energy computed tomography using a gantry-based preclinical cone-beam microcomputed tomography scanner

Dual-energy microcomputed tomography (DECT) can provide quantitative information about specific materials of interest, facilitating automated segmentation, and visualization of complex three-dimensional tissues. It is possible to implement DECT on currently available preclinical gantry-based cone-beam micro-CT scanners; however, optimal decomposition image quality requires customized spectral shaping (through added filtration), optimized acquisition protocols, and elimination of misregistration artifacts. We present a method for the fabrication of customized x-ray filters-in both shape and elemental composition-needed for spectral shaping. Fiducial markers, integrated within the sample holder, were used to ensure accurate co-registration between sequential low- and high-energy image volumes. The entire acquisition process was automated through the use of a motorized filter-exchange mechanism. We describe the design, implementation, and evaluation of a DECT system on a gantry-based-preclinical cone-beam micro-CT scanner.