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Evaluation of Low-cost, Full HD, CMOS Cameras for Use in the Calcine Retrieval Project - 19530

This paper describes results from radiation testing conducted on low-cost, commercial off-the-shelf, full high-definition (HD) resolution (1920 x 1080 p), complementary metal-oxide-semiconductor (CMOS) camera sensors. The purpose of the testing was to evaluate the sensors' suitability for use in the Calcine Retrieval Project by determining their image quality and life expectancy while operating in an ionizing radiation field of 20.0 Gy/h. The two camera sensors tested were the Axis FA1105 and Axis FA1125. These commercial camera sensors were designed for retail security surveillance and have no radiation-hardened (rad-hard) components. In addition to radiation testing, the sensors' field-of-view, resolution, and low-light image quality were tested at several target distances to ensure they meet project requirements. Testing was divided into two phases. During Phase 1, four FA1105 sensors and four FA1125 sensors were tested simultaneously without any shielding in radiation fields of 25.5 Gy/h and 49.3 Gy/h. In Phase 2, three FA1105 and five FA1125 sensors were shielded by 22.2 mm of lead and tested simultaneously in radiation fields of 26.8 Gy/h, 52.3 Gy/h, 143.0 Gy/h, 200.7 Gy/h, 404.6 Gy/h, and 2,317.5 Gy/h. Dose rate values were established using film dosimetry readings. Apertures in the shielding allowed for a 40-degree field of view while shielding all parts of the sensor except for directly in front of the CMOS sensor array. All testing was conducted at the Idaho Accelerator Center in Pocatello, Idaho, using a 450 keV X-ray generator. Sensor images were automatically captured at regular intervals throughout the testing for qualitative evaluation by the test team. Film dosimetry was placed near the sensors to record actual dose totals. The 450 keV setting generates X-ray radiation with an energy level close to the primary gamma energy level produced by the Cesium-137 isotope in the calcine, which is 662 keV. Results from Phase 1 indicate the sensors failed at an average cumulative dose of 226.3 Gy. For a given 20.0 Gy/h field this results in a mean time to failure (MTTF) of 11.3 hours. Recorded images from all sensors showed minimal image degradation due to radiation-induced noise. When the sensors finally failed, the failure mode was an abrupt loss of video. The image went black suggesting some other component in the sensor head besides the CMOS sensor array was responsible for the failure. During a portion of Phase 1 testing, a commercial, rad-hard camera was irradiated in the 25.5 Gy/h field along with the eight Axis FA series sensors. Image quality from the FA series sensors significantly outperformed the image quality of the rad-hard camera in radiation-induced noise tolerance, image resolution, and dynamic range. During Phase 2 testing, all sensors produced excellent images in radiation fields as high as 404.6 Gy/h. One FA1125 sensor was tested at the highest dose rate of 2,317.5 Gy/h. At this dose rate, the image was color shifted towards red and contained a significant amount radiation-induced noise. The sensor did not fail and was producing usable imagery after one hour, at which time the test was ended due to allotted beam-time at the test facility. Eighteen hours after X-rays were shut off, the sensor image returned to normal color and all eight sensors continued to operate without any visible, permanent image degradation. For Phase 2 testing, it was not possible to establish a MTTF since none of the shielded sensors failed during the allotted test time. However, given the highest cumulative dose of 4,142.1 Gy received by a shielded FA1125 sensor, a minimum life expectancy of 207 hours (8.6 days) is predicted while operating in a 20.0 Gy/h field. Test results indicate the radiation tolerance of the FA series sensor's CMOS array, along with the small form factor, full HD image quality, wide dynamic range, and Ethernet standard makes it suitable for short-term use in monitoring and visually documenting waste remediation efforts for the Calcine Retrieval Project at the INL. The sensor's low-cost of about $140 US, compared to commercial rad-hard cameras costing between $5,000 and $7,000 US each, allow them to be used as an affordable, disposable resource for many short-duration, radioactive waste remediation efforts where decontamination of an expensive, commercial rad-hard camera is undesirable or not possible. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

SU-E-I-75: Evaluation of An Orthopedic Metal Artifact Reduction (O-MAR) Algorithm On Patients with Spinal Prostheses Near Spinal Tumors

Purpose: To evaluate the impact of a commercial orthopedic metal artifact reduction (O-MAR) algorithm on CT image quality and dose calculation for patients with spinal prostheses near spinal tumors. Methods: A CT electron density phantom was scanned twice: with tissue-simulating inserts only, and with a titanium insert replacing solid water. A patient plan was mapped to the phantom images in two ways: with the titanium inside or outside of the spinal tumor. Pinnacle and Eclipse were used to evaluate the dosimetric effects of O-MAR on 12-bit and 16-bit CT data, respectively. CT images from five patients with spinal prostheses were reconstructed with and without O-MAR. Two observers assessed the image quality improvement from O-MAR. Both pencil beam and Monte Carlo dose calculation in iPlan were used for the patient study. The percentage differences between non-OMAR and O-MAR datasets were calculated for PTV-min, PTV-max, PTV-mean, PTV-V100, PTV-D90, OAR-V10Gy, OAR-max, and OAR-D0.1cc. Results: O-MAR improved image quality but did not significantly affect the dose distributions and DVHs for both 12-bit and 16- bit CT phantom data. All five patient cases demonstrated some degree of image quality improvement from O-MAR, ranging from small to large metal artifact reduction. For pencil beam, the largest discrepancy was observed for OARV-10Gy at 5.4%, while the other seven parameters were ≤0.6%. For Monte Carlo, the differences between non-O-MAR and O-MAR datasets were ≤3.0%. Conclusion: Both phantom and patient studies indicated that O-MAR can substantially reduce metal artifacts on CT images, allowing better visualization of the anatomical structures and metal objects. The dosimetric impact of O-MAR was insignificant regardless of the metal location, image bit-depth, and dose calculation algorithm. O-MAR corrected images are recommended for radiation treatment planning on patients with spinal prostheses because of the improved image quality and no need to modify current dose constraints. This work was supported by a research grant from Philips Healthcare. Paul Klahr is an employee of Philips Healthcare.

60 APPLIED LIFE SCIENCES↗

SU-C-207-03: Optimization of a Collimator-Based Sparse Sampling Technique for Low-Dose Cone-Beam CT

Purpose: In computed tomography (CT) imaging, radiation dose delivered to the patient is one of the major concerns. Sparse-view CT takes projections at sparser view angles and provides a viable option to reducing dose. However, a fast power switching of an X-ray tube, which is needed for the sparse-view sampling, can be challenging in many CT systems. We have earlier proposed a many-view under-sampling (MVUS) technique as an alternative to sparse-view CT. In this study, we investigated the effects of collimator parameters on the image quality and aimed to optimize the collimator design. Methods: We used a bench-top circular cone-beam CT system together with a CatPhan600 phantom, and took 1440 projections from a single rotation. The multi-slit collimator made of tungsten was mounted on the X-ray source for beam blocking. For image reconstruction, we used a total-variation minimization (TV) algorithm and modified the backprojection step so that only the measured data through the collimator slits are to be used in the computation. The number of slits and the reciprocation frequency have been varied and the effects of them on the image quality were investigated. We also analyzed the sampling efficiency: the sampling density and data incoherence in each case. We tested three sets of slits with their number of 6, 12 and 18, each at reciprocation frequencies of 10, 30, 50 and 70 Hz/ro. Results: Consistent results in the image quality have been produced with the sampling efficiency, and the optimum condition was found to be using 12 slits at 30 Hz/ro. As image quality indices, we used the CNR and the detectability. Conclusion: We conducted an experiment with a moving multi-slit collimator to realize a sparse-sampled cone-beam CT. Effects of collimator parameters on the image quality have been systematically investigated, and the optimum condition has been reached.

60 APPLIED LIFE SCIENCES↗

SU-C-12A-04: Diagnostic Imaging Research Using Decedents as a Proxy for the Living: Are Radiation Dosimetry and Tissue Property Measurements Affected by Post-Mortem Changes?

Purpose: Radiation dose (RD) from diagnostic imaging is a growing public health concern. Implanting dosimeters is a more accurate way to assess organ dose, relative to commonly used mathematical estimations. However, performing accurate dosimetry using live subjects is hindered by patient motion and safety considerations, which limit the RD and placement of implanted dosimeters. Performing multiple scans on the same subject would be the ideal way to assess the impact of dose reduction on image quality; however, performing multiple non-standard-of-care scans on live subjects for dosimetry and image quality measurements is generally prohibited by IRB committees. Our objective is to assess whether RD and tissue property (TP) measurements in post-mortem (PM) subjects are sufficiently similar to those in live subjects to justify the use of deceased subjects in future dosimetry and image quality studies. Methods: 4 MOSFET radiation dosimeters were placed enterically in each subject (2 sedated Rhesus Macaques) to measure the RD at 4 levels (carina, lung, heart, and liver) during CT scanning. The CT protocol was performed ante-mortem (AM) and 2 and 3 hours PM. For TP analysis, additional scans were taken at 24 hours PM. To compare AM and PM TP, regions-of-interest were drawn on selected organs and the average CT density with standard deviation (in units of HU) were taken; additionally, visual comparisons of images were made at each PM interval. Results: No significant difference was observed in 8 of 9 measurements comparing AM and PM RD. Only one measurement (liver of the first subject) showed a significant difference (7% lower on PM measurement), possibly due to subject re-positioning. Initial TP visual and quantitative analyses show little to no change PM. Conclusion: Our results suggest that realistic radiation dosimetry and image quality measurements based on tissue properties can be performed reliably on recently deceased subjects.

60 APPLIED LIFE SCIENCES↗

SU-E-J-158: Audiovisual Biofeedback Reduces Image Artefacts in 4DCT: A Digital Phantom Study

Purpose: Irregular breathing motion has a deleterious impact on 4DCT image quality. The breathing guidance system: audiovisual biofeedback (AVB) is designed to improve breathing regularity, however, its impact on 4DCT image quality has yet to be quantified. The purpose of this study was to quantify the impact of AVB on thoracic 4DCT image quality by utilizing the digital eXtended Cardiac Torso (XCAT) phantom driven by lung tumor motion patterns. Methods: 2D tumor motion obtained from 4 lung cancer patients under two breathing conditions (i) without breathing guidance (free breathing), and (ii) with guidance (AVB). There were two breathing sessions, yielding 8 tumor motion traces. This tumor motion was synchronized with the XCAT phantom to simulate 4DCT acquisitions under two acquisition modes: (1) cine mode, and (2) prospective respiratory-gated mode. Motion regularity was quantified by the root mean square error (RMSE) of displacement. The number of artefacts was visually assessed for each 4DCT and summed up for each breathing condition. Inter-session anatomic reproducibility was quantified by the mean absolute difference (MAD) between the Session 1 4DCT and Session 2 4DCT. Results: AVB improved tumor motion regularity by 30%. In cine mode, the number of artefacts was reduced from 61 in free breathing to 40 with AVB, in addition to AVB reducing the MAD by 34%. In gated mode, the number of artefacts was reduced from 63 in free breathing to 51 with AVB, in addition to AVB reducing the MAD by 23%. Conclusion: This was the first study to compare the impact of breathing guidance on 4DCT image quality compared to free breathing, with AVB reducing the amount of artefacts present in 4DCT images in addition to improving inter-session anatomic reproducibility. Results thus far suggest that breathing guidance interventions could have implications for improving radiotherapy treatment planning and interfraction reproducibility.

60 APPLIED LIFE SCIENCES↗

SU-E-CAMPUS-J-03: Commissioning of the On-Board Cone-Beam CT System Equipped On the Rotating Gantry of a Proton Therapy System

Purpose: Proton therapy requires highly-precise image guidance in patient setup to ensure accurate dose delivery. Cone-beam CT (CBCT) is expected to play an important role to reduce uncertainties in patient setup. Hokkaido University has developed a new proton therapy system dedicated to spot-scanning under a collaborative work with Hitachi Ltd. In our system, an orthogonal X-ray imaging system is mounted on a full-rotating gantry. On-board CBCT imaging is therefore available. We have conducted commissioning of the CBCT system for clinical use in proton therapy. Methods: The orthogonal X-ray imaging system, which consists of two sets of X-ray tubes and flat panel detectors (FPDs), are equipped on the rotating gantry. The FPDs are mounted on the proton beam nozzle and can be retracted when not in use. The distance between the X-ray source and the FPD is about 2.1 m. The maximum rotation speed of the gantry is 1 rpm, so CBCT images can be acquired in approximately 1 minute. The maximum reconstruction volume is nearly 40 cm in diameter and 20 cm in axial length. For commissioning of the CBCT system, mechanical accuracy of the rotating gantry first was evaluated. Imaging performance was examined via quantitative evaluation of image quality. Results: Through the mechanical test, the isocentricity of the gantry was confirmed to be less than 1 mm. Moreover, it was improved to 0.5 mm with an appropriate correction. The accurate rotation of the gantry contributes to the CBCT image quality. In the image quality test, objects with 7 line-pairs per cm, which corresponds to a line spacing of 0.071 cm, could be discerned. Spatial linearity and uniformity were also sufficient. Conclusion: Clinical commissioning of the on-board CBCT system for proton therapy was conducted, and CBCT images with sufficient quality were successfully obtained. This research was supported by the Cabinet Office, Government of Japan and the Japan Society for the Promotion of Science (JSPS) through the Funding Program for World-Leading Innovative R and D on Science and Technology (FIRST Program), initiated by the Council for Science and Technology Policy (CSTP)

07 ISOTOPE AND RADIATION SOURCES↗

GPU-accelerated regularized iterative reconstruction for few-view cone beam CT

Purpose: The present work proposes an iterative reconstruction technique designed for x-ray transmission computed tomography (CT). The main objective is to provide a model-based solution to the cone-beam CT reconstruction problem, yielding accurate low-dose images via few-views acquisitions in clinically acceptable time frames. Methods: The proposed technique combines a modified ordered subsets convex (OSC) algorithm and the total variation minimization (TV) regularization technique and is called OSC-TV. The number of subsets of each OSC iteration follows a reduction pattern in order to ensure the best performance of the regularization method. Considering the high computational cost of the algorithm, it is implemented on a graphics processing unit, using parallelization to accelerate computations. Results: The reconstructions were performed on computer-simulated as well as human pelvic cone-beam CT projection data and image quality was assessed. In terms of convergence and image quality, OSC-TV performs well in reconstruction of low-dose cone-beam CT data obtained via a few-view acquisition protocol. It compares favorably to the few-view TV-regularized projections onto convex sets (POCS-TV) algorithm. It also appears to be a viable alternative to full-dataset filtered backprojection. Execution times are of 1–2 min and are compatible with the typical clinical workflow for nonreal-time applications. Conclusions: Considering the image quality and execution times, this method may be useful for reconstruction of low-dose clinical acquisitions. It may be of particular benefit to patients who undergo multiple acquisitions by reducing the overall imaging radiation dose and associated risks.

60 APPLIED LIFE SCIENCES↗

WE-G-204-09: Medical Physics 2.0 in Practice: Automated QC Assessment of Clinical Chest Images

Purpose: To determine whether a proposed suite of objective image quality metrics for digital chest radiographs is useful for monitoring image quality in our clinical operation. Methods: Seventeen gridless AP Chest radiographs from a GE Optima portable digital radiography (DR) unit (Group 1), seventeen (routine) PA Chest radiographs from a GE Discovery DR unit (Group 2), and sixteen gridless (non-routine) PA Chest radiographs from the same Discovery DR unit (Group 3) were chosen for analysis. Groups were selected to represent “sub-standard” (Group 1), “standard-of-care” (Group 2), and images with a gross technical error (Group 3). Group 1 images were acquired with lower kVp (90 vs. 125), shorter source-to-image distance (127cm vs 183cm) and were expected to have lower quality than images in Group 2. Group 3 was expected to have degraded contrast versus Group 2.This evaluation was approved by the institutional Quality Improvement Assurance Board (QIAB). Images were anonymized and securely transferred to the Duke University Clinical Imaging Physics Group for analysis using software previously described{sup 1} and validated{sup 2}. Image quality for individual images was reported in terms of lung grey level(Lgl); lung noise(Ln); rib-lung contrast(RLc); rib sharpness(Rs); mediastinum detail(Md), noise(Mn), and alignment(Ma); subdiaphragm-lung contrast(SLc); and subdiaphragm area(Sa). Metrics were compared across groups. Results: Metrics agreed with published Quality Consistency Ranges with three exceptions: higher Lgl, lower RLc, and SDc. Higher bit depth (16 vs 12) accounted for higher Lgl values in our images. Values were most internally consistent for Group 2. The most sensitive metric for distinguishing between groups was Mn followed closely by Ln. The least sensitive metrics were Md and RLc. Conclusion: The software appears promising for objectively and automatically identifying substandard images in our operation. The results can be used to establish local quality consistency ranges and action limits per facility preferences.

60 APPLIED LIFE SCIENCES↗

SU-F-207-14: Low Contrast Detectability (LCD) at Different Diagnostic Reference Levels for Adult Abdominal CT Procedures

Purpose Using diagnostic reference levels (DRL) to optimize CT protocols has potential to reduce radiation dose and meet regulatory requirements. However, DRL’s tend to be misconstrued as dose limits, are typically designed for specific patient populations, and are assumed to have acceptable image quality (AIQ) associated with them. To determine the image quality that is associated with established DRL’s for adult abdominal CT studies, a LCD phantom study was employed. Methods: A CT phantom (CIRS) containing three columns of 7 spherical targets, ranging from 10mm to 2.4 mm, that are 5, 10, and 20 HU below the background (HUBB) matrix was scanned with a GE HD750 64 slice scanner. The phantom was scanned at the NEXT 2006 25th CTDIvol of 12 mGy, the NCRP 172 achievable dose (AD) CTDIvol of 17 mGy and 75th CTDIvol of 25 mGy and at the ACR recommended CTDIvol of 25 mGy. It was also scanned at a CTDIvol 20% greater than the AD at 20 mGy and the ACR maximum threshold of 30 mGy. Results: At the NEXT 2006 25th percentile CTDIvol of 12 mGy, a 6.3 mm low contrast lesion was detectable in the 20 HUBB; 6.3 mm in the 10 HUBB and 10 mm in the 5 HUBB column. Increasing the CTDIvol to the NCRP 172 AD of 17 mGy, an additional 4.8 mm lesion was visualized in the 20 HUBB column. At 20 mGy, an additional 4.8 mm lesion was detectable in the 10 HUBB column. No further lesions were visible between 20 and 30 mGy. However, conspicuity of all lesions increased with each additional step up in CTDI. Conclusion: Optimizing radiation dose to achieve AIQ is a critical aspect of any dose optimization committee. Hence, judicious monitoring of radiation exposure to patients has to be balanced with diagnostic image quality.

60 APPLIED LIFE SCIENCES↗

Model-based CT performance assessment and optimization for iodinated and noniodinated imaging tasks as a function of kVp and body size

Purpose: The goal of this study was to assess the comparative performance of iterative reconstruction in space (IRIS) and filtered back projection (FBP) reconstruction algorithms in terms of image quality and dose across kVps and phantom sizes. Methods: The ACR CT phantom (model 464) was supplemented with the addition of an iodinated spherical capsule (1.5 mm diameter, 3.4 mg iodine per ml) to simulate the contrast filled structures and with an additional circular attachment consisting of an array of 500 um brass beads for spatial resolution measurements. A larger sized phantom was also created by wrapping the original phantom with additional tissue equivalent material of 4 cm thickness. The phantoms were imaged on a 64 detector array multidetector computed tomography scanner (Somatom Definition, Siemens, Germany) using clinically applicable protocols (0.5 s rotation time; 80, 100, 120, and 140 kVp; 64 to 640 mA; 220 to 250 mm field of view). Images were reconstructed using the FBP and the IRIS algorithms. Combining measurements of image noise and spatial resolution with a task function, a figure of merit (FOM) for image quality was generated taking into account the type of visualization required from the image for the detection of either large or small image features with and without iodine content. The FOM was further reported in terms of area under the receiver operating characteristic (ROC) curve (A{sub Z}) to predict the comparative diagnostic performance of the two algorithms at different dose levels. Results: For a given dose level, the predicted A{sub Z} for IRIS consistently outperformed that of FBP. At comparative A{sub Z}, depending on protocol and task, the dose requirement for the optimal technique (optimized kVp with IRIS) was 2-3 times lower than that for standard technique (120 kVp with FBP). The potential for dose reduction was found to be higher when performing small feature detection tasks in comparison to larger feature detection tasks. The optimal kVp was from 80 to 100 kVp for the small phantom, 100 to 120 kVp for the larger phantom. Conclusions: Overall, greater dose reduction may be achieved with IRIS compared to FBP, with enhanced advantage at thinner slice reconstructions. The results highlight how IRIS may offer a superior balance between image quality and dose across a range of imaging tasks, thus enabling dose reduction at constant quality or image quality improvement at constant dose. The prediction of the investigation can be used toward effective design of subsequent clinical studies.

60 APPLIED LIFE SCIENCES↗

SU-E-I-62: Assessing Radiation Dose Reduction and CT Image Optimization Through the Measurement and Analysis of the Detector Quantum Efficiency (DQE) of CT Images Using Different Beam Hardening Filters

Purpose: Reducing patient dose while maintaining (or even improving) image quality is one of the foremost goals in CT imaging. To this end, we consider the feasibility of optimizing CT scan protocols in conjunction with the application of different beam-hardening filtrations and assess this augmentation through noise-power spectrum (NPS) and detector quantum efficiency (DQE) analysis. Methods: American College of Radiology (ACR) and Catphan phantoms (The Phantom Laboratory) were scanned with a 64 slice CT scanner when additional filtration of thickness and composition (e.g., copper, nickel, tantalum, titanium, and tungsten) had been applied. A MATLAB-based code was employed to calculate the image of noise NPS. The Catphan Image Owl software suite was then used to compute the modulated transfer function (MTF) responses of the scanner. The DQE for each additional filter, including the inherent filtration, was then computed from these values. Finally, CT dose index (CTDIvol) values were obtained for each applied filtration through the use of a 100 mm pencil ionization chamber and CT dose phantom. Results: NPS, MTF, and DQE values were computed for each applied filtration and compared to the reference case of inherent beam-hardening filtration only. Results showed that the NPS values were reduced between 5 and 12% compared to inherent filtration case. Additionally, CTDIvol values were reduced between 15 and 27% depending on the composition of filtration applied. However, no noticeable changes in image contrast-to-noise ratios were noted. Conclusion: The reduction in the quanta noise section of the NPS profile found in this phantom-based study is encouraging. The reduction in both noise and dose through the application of beam-hardening filters is reflected in our phantom image quality. However, further investigation is needed to ascertain the applicability of this approach to reducing patient dose while maintaining diagnostically acceptable image qualities in a clinical setting.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Accelerated acquisition of tagged MRI for cardiac motion correction in simultaneous PET-MR: Phantom and patient studies

Purpose: Degradation of image quality caused by cardiac and respiratory motions hampers the diagnostic quality of cardiac PET. It has been shown that improved diagnostic accuracy of myocardial defect can be achieved by tagged MR (tMR) based PET motion correction using simultaneous PET-MR. However, one major hurdle for the adoption of tMR-based PET motion correction in the PET-MR routine is the long acquisition time needed for the collection of fully sampled tMR data. In this work, the authors propose an accelerated tMR acquisition strategy using parallel imaging and/or compressed sensing and assess the impact on the tMR-based motion corrected PET using phantom and patient data. Methods: Fully sampled tMR data were acquired simultaneously with PET list-mode data on two simultaneous PET-MR scanners for a cardiac phantom and a patient. Parallel imaging and compressed sensing were retrospectively performed by GRAPPA and kt-FOCUSS algorithms with various acceleration factors. Motion fields were estimated using nonrigid B-spline image registration from both the accelerated and fully sampled tMR images. The motion fields were incorporated into a motion corrected ordered subset expectation maximization reconstruction algorithm with motion-dependent attenuation correction. Results: Although tMR acceleration introduced image artifacts into the tMR images for both phantom and patient data, motion corrected PET images yielded similar image quality as those obtained using the fully sampled tMR images for low to moderate acceleration factors (<4). Quantitative analysis of myocardial defect contrast over ten independent noise realizations showed similar results. It was further observed that although the image quality of the motion corrected PET images deteriorates for high acceleration factors, the images were still superior to the images reconstructed without motion correction. Conclusions: Accelerated tMR images obtained with more than 4 times acceleration can still provide relatively accurate motion fields and yield tMR-based motion corrected PET images with similar image quality as those reconstructed using fully sampled tMR data. The reduction of tMR acquisition time makes it more compatible with routine clinical cardiac PET-MR studies.

60 APPLIED LIFE SCIENCES↗

Fiducial marker-based correction for involuntary motion in weight-bearing C-arm CT scanning of knees. II. Experiment

Purpose: A C-arm CT system has been shown to be capable of scanning a single cadaver leg under loaded conditions by virtue of its highly flexible acquisition trajectories. In Part I of this study, using the 4D XCAT-based numerical simulation, the authors predicted that the involuntary motion in the lower body of subjects in weight-bearing positions would seriously degrade image quality and the authors suggested three motion compensation methods by which the reconstructions could be corrected to provide diagnostic image quality. Here, the authors demonstrate that a flat-panel angiography system is appropriate for scanning both legs of subjectsin vivo under weight-bearing conditions and further evaluate the three motion-correction algorithms using in vivo data. Methods: The geometry of a C-arm CT system for a horizontal scan trajectory was calibrated using the PDS-2 phantom. The authors acquired images of two healthy volunteers while lying supine on a table, standing, and squatting at several knee flexion angles. In order to identify the involuntary motion of the lower body, nine 1-mm-diameter tantalum fiducial markers were attached around the knee. The static mean marker position in 3D, a reference for motion compensation, was estimated by back-projecting detected markers in multiple projections using calibrated projection matrices and identifying the intersection points in 3D of the back-projected rays. Motion was corrected using three different methods (described in detail previously): (1) 2D projection shifting, (2) 2D deformable projection warping, and (3) 3D rigid body warping. For quantitative image quality analysis, SSIM indices for the three methods were compared using the supine data as a ground truth. Results: A 2D Euclidean distance-based metric of subjects’ motion ranged from 0.85 mm (±0.49 mm) to 3.82 mm (±2.91 mm) (corresponding to 2.76 to 12.41 pixels) resulting in severe motion artifacts in 3D reconstructions. Shifting in 2D, 2D warping, and 3D warping improved the SSIM in the central slice by 20.22%, 16.83%, and 25.77% in the data with the largest motion among the five datasets (SCAN5); improvement in off-center slices was 18.94%, 29.14%, and 36.08%, respectively. Conclusions: The authors showed that C-arm CT control can be implemented for nonstandard horizontal trajectories which enabled us to scan and successfully reconstruct both legs of volunteers in weight-bearing positions. As predicted using theoretical models, the proposed motion correction methods improved image quality by reducing motion artifacts in reconstructions; 3D warping performed better than the 2D methods, especially in off-center slices.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Contrast and harmonic imaging improves accuracy and efficiency of novice readers for dobutamine stress echocardiography

BACKGROUND: Newer contrast agents as well as tissue harmonic imaging enhance left ventricular (LV) endocardial border delineation, and therefore, improve LV wall-motion analysis. Interpretation of dobutamine stress echocardiography is observer-dependent and requires experience. This study was performed to evaluate whether these new imaging modalities would improve endocardial visualization and enhance accuracy and efficiency of the inexperienced reader interpreting dobutamine stress echocardiography. METHODS AND RESULTS: Twenty-nine consecutive patients with known or suspected coronary artery disease underwent dobutamine stress echocardiography. Both fundamental (2.5 MHZ) and harmonic (1.7 and 3.5 MHZ) mode images were obtained in four standard views at rest and at peak stress during a standard dobutamine infusion stress protocol. Following the noncontrast images, Optison was administered intravenously in bolus (0.5-3.0 ml), and fundamental and harmonic images were obtained. The dobutamine echocardiography studies were reviewed by one experienced and one inexperienced echocardiographer. LV segments were graded for image quality and function. Time for interpretation also was recorded. Contrast with harmonic imaging improved the diagnostic concordance of the novice reader to the expert reader by 7.1%, 7.5%, and 12.6% (P < 0.001) as compared with harmonic imaging, fundamental imaging, and fundamental imaging with contrast, respectively. For the novice reader, reading time was reduced by 47%, 55%, and 58% (P < 0.005) as compared with the time needed for fundamental, fundamental contrast, and harmonic modes, respectively. With harmonic imaging, the image quality score was 4.6% higher (P < 0.001) than for fundamental imaging. Image quality scores were not significantly different for noncontrast and contrast images. CONCLUSION: Harmonic imaging with contrast significantly improves the accuracy and efficiency of the novice dobutamine stress echocardiography reader. The use of harmonic imaging reduces the frequency of nondiagnostic wall segments.

Non-NASA Center↗

Radiation dose reduction in medical x-ray CT via Fourier-based iterative reconstruction

Purpose: A Fourier-based iterative reconstruction technique, termed Equally Sloped Tomography (EST), is developed in conjunction with advanced mathematical regularization to investigate radiation dose reduction in x-ray CT. The method is experimentally implemented on fan-beam CT and evaluated as a function of imaging dose on a series of image quality phantoms and anonymous pediatric patient data sets. Numerical simulation experiments are also performed to explore the extension of EST to helical cone-beam geometry. Methods: EST is a Fourier based iterative algorithm, which iterates back and forth between real and Fourier space utilizing the algebraically exact pseudopolar fast Fourier transform (PPFFT). In each iteration, physical constraints and mathematical regularization are applied in real space, while the measured data are enforced in Fourier space. The algorithm is automatically terminated when a proposed termination criterion is met. Experimentally, fan-beam projections were acquired by the Siemens z-flying focal spot technology, and subsequently interleaved and rebinned to a pseudopolar grid. Image quality phantoms were scanned at systematically varied mAs settings, reconstructed by EST and conventional reconstruction methods such as filtered back projection (FBP), and quantified using metrics including resolution, signal-to-noise ratios (SNRs), and contrast-to-noise ratios (CNRs). Pediatric data sets were reconstructed at their original acquisition settings and additionally simulated to lower dose settings for comparison and evaluation of the potential for radiation dose reduction. Numerical experiments were conducted to quantify EST and other iterative methods in terms of image quality and computation time. The extension of EST to helical cone-beam CT was implemented by using the advanced single-slice rebinning (ASSR) method. Results: Based on the phantom and pediatric patient fan-beam CT data, it is demonstrated that EST reconstructions with the lowest scanner flux setting of 39 mAs produce comparable image quality, resolution, and contrast relative to FBP with the 140 mAs flux setting. Compared to the algebraic reconstruction technique and the expectation maximization statistical reconstruction algorithm, a significant reduction in computation time is achieved with EST. Finally, numerical experiments on helical cone-beam CT data suggest that the combination of EST and ASSR produces reconstructions with higher image quality and lower noise than the Feldkamp Davis and Kress (FDK) method and the conventional ASSR approach. Conclusions: A Fourier-based iterative method has been applied to the reconstruction of fan-bean CT data with reduced x-ray fluence. This method incorporates advantageous features in both real and Fourier space iterative schemes: using a fast and algebraically exact method to calculate forward projection, enforcing the measured data in Fourier space, and applying physical constraints and flexible regularization in real space. Our results suggest that EST can be utilized for radiation dose reduction in x-ray CT via the readily implementable technique of lowering mAs settings. Numerical experiments further indicate that EST requires less computation time than several other iterative algorithms and can, in principle, be extended to helical cone-beam geometry in combination with the ASSR method.

60 APPLIED LIFE SCIENCES↗

Generation of hybrid sinograms for the recovery of kV-CT images with metal artifacts for helical tomotherapy

Purpose: The overall goal of this study is to restore kilovoltage computed tomography (kV-CT) images which are disfigured by patients’ metal prostheses. By generating a hybrid sinogram that is a combination of kV and megavoltage (MV) projection data, the authors suggest a novel metal artifact-reduction (MAR) method that retains the image quality to match that of kV-CT and simultaneously restores the information of metal prostheses lost due to photon starvation. Methods: CT projection data contain information about attenuation coefficients and the total length of the attenuation. By normalizing raw kV projections with their own total lengths of attenuation, mean attenuation projections were obtained. In the same manner, mean density projections of MV-CT were obtained by the normalization of MV projections resulting from the forward projection of density-calibrated MV-CT images with the geometric parameters of the kV-CT device. To generate the hybrid sinogram, metal-affected signals of the kV sinogram were identified and replaced by the corresponding signals of the MV sinogram following a density calibration step with kV data. Filtered backprojection was implemented to reconstruct the hybrid CT image. To validate the authors’ approach, they simulated four different scenarios for three heads and one pelvis using metallic rod inserts within a cylindrical phantom. Five inserts describing human body elements were also included in the phantom. The authors compared the image qualities among the kV, MV, and hybrid CT images by measuring the contrast-to-noise ratio (CNR), the signal-to-noise ratio (SNR), the densities of all inserts, and the spatial resolution. In addition, the MAR performance was compared among three existing MAR methods and the authors’ hybrid method. Finally, for clinical trials, the authors produced hybrid images of three patients having dental metal prostheses to compare their MAR performances with those of the kV, MV, and three existing MAR methods. Results: The authors compared the image quality and MAR performance of the hybrid method with those of other imaging modalities and the three MAR methods, respectively. The total measured mean of the CNR (SNR) values for the nonmetal inserts was determined to be 14.3 (35.3), 15.3 (37.8), and 25.5 (64.3) for the kV, MV, and hybrid images, respectively, and the spatial resolutions of the hybrid images were similar to those of the kV images. The measured densities of the metal and nonmetal inserts in the hybrid images were in good agreement with their true densities, except in cases of extremely low densities, such as air and lung. Using the hybrid method, major streak artifacts were suitably removed and no secondary artifacts were introduced in the resultant image. In clinical trials, the authors verified that kV and MV projections were successfully combined and turned into the resultant hybrid image with high image contrast, accurate metal information, and few metal artifacts. The hybrid method also outperformed the three existing MAR methods with regard to metal information restoration and secondary artifact prevention. Conclusions: The authors have shown that the hybrid method can restore the overall image quality of kV-CT disfigured by severe metal artifacts and restore the information of metal prostheses lost due to photon starvation. The hybrid images may allow for the improved delineation of structures of interest and accurate dose calculations for radiation treatment planning for patients with metal prostheses.

60 APPLIED LIFE SCIENCES↗

WE-G-18C-08: Real Time Tumor Imaging Using a Novel Dynamic Keyhole MRI Reconstruction Technique

Purpose: To test the hypothesis that the novel Dynamic Keyhole MRI reconstruction technique can accelerate image acquisition whilst maintaining high image quality for lung cancer patients. Methods: 18 MRI datasets from 5 lung cancer patients were acquired using a 3T MRI scanner. These datasets were retrospectively reconstructed using (A) The novel Dynamic Keyhole technique, (B) The conventional keyhole technique and (C) the conventional zero filling technique. The dynamic keyhole technique in MRI refers to techniques in which previously acquired k-space data is used to supplement under sampled data obtained in real time. The novel Dynamic Keyhole technique utilizes a previously acquired a library of kspace datasets in conjunction with central k-space datasets acquired in realtime. A simultaneously acquired respiratory signal is utilized to sort, match and combine the two k-space streams with respect to respiratory displacement. Reconstruction performance was quantified by (1) comparing the keyhole size (which corresponds to imaging speed) required to achieve the same image quality, and (2) maintaining a constant keyhole size across the three reconstruction methods to compare the resulting image quality to the ground truth image. Results: (1) The dynamic keyhole method required a mean keyhole size which was 48% smaller than the conventional keyhole technique and 60% smaller than the zero filling technique to achieve the same image quality. This directly corresponds to faster imaging. (2) When a constant keyhole size was utilized, the Dynamic Keyhole technique resulted in the smallest difference of the tumor region compared to the ground truth. Conclusion: The dynamic keyhole is a simple and adaptable technique for clinical applications requiring real-time imaging and tumor monitoring such as MRI guided radiotherapy. Based on the results from this study, the dynamic keyhole method could increase the imaging frequency by a factor of five compared with full k-space methods.

60 APPLIED LIFE SCIENCES↗

SU-E-I-37: Low-Dose Real-Time Region-Of-Interest X-Ray Fluoroscopic Imaging with a GPU-Accelerated Spatially Different Bilateral Filtering

Purpose: The purpose of our study is to reduce imaging radiation dose while maintaining image quality of region of interest (ROI) in X-ray fluoroscopy. A low-dose real-time ROI fluoroscopic imaging technique which includes graphics-processing-unit- (GPU-) accelerated image processing for brightness compensation and noise filtering was developed in this study. Methods: In our ROI fluoroscopic imaging, a copper filter is placed in front of the X-ray tube. The filter contains a round aperture to reduce radiation dose to outside of the aperture. To equalize the brightness difference between inner and outer ROI regions, brightness compensation was performed by use of a simple weighting method that applies selectively to the inner ROI, the outer ROI, and the boundary zone. A bilateral filtering was applied to the images to reduce relatively high noise in the outer ROI images. To speed up the calculation of our technique for real-time application, the GPU-acceleration was applied to the image processing algorithm. We performed a dosimetric measurement using an ion-chamber dosimeter to evaluate the amount of radiation dose reduction. The reduction of calculation time compared to a CPU-only computation was also measured, and the assessment of image quality in terms of image noise and spatial resolution was conducted. Results: More than 80% of dose was reduced by use of the ROI filter. The reduction rate depended on the thickness of the filter and the size of ROI aperture. The image noise outside the ROI was remarkably reduced by the bilateral filtering technique. The computation time for processing each frame image was reduced from 3.43 seconds with single CPU to 9.85 milliseconds with GPU-acceleration. Conclusion: The proposed technique for X-ray fluoroscopy can substantially reduce imaging radiation dose to the patient while maintaining image quality particularly in the ROI region in real-time.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗