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All sourcesNASA NTRSDOE OSTI
DOE OSTI2020

Operator Lévy Flight: Light Cones in Chaotic Long-Range Interacting Systems

We argue that chaotic power-law interacting systems have emergent limits on information propagation, analogous to relativistic light cones, which depend on the spatial dimension d and the exponent α governing the decay of interactions. Using the dephasing nature of quantum chaos, we map the problem to a stochastic model with a known phase diagram. A linear light cone results for α ≥ $\textit{d}$ + 1/2. We also provide a Lévy flight (long-range random walk) interpretation of the results and show consistent numerical data for 1D long-range spin models with 200 sites.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗
DOE OSTI2011

A general framework and review of scatter correction methods in x-ray cone-beam computerized tomography. Part 1: Scatter compensation approaches

Since scattered radiation in cone-beam volume CT implies severe degradation of CT images by quantification errors, artifacts, and noise increase, scatter suppression is one of the main issues related to image quality in CBCT imaging. The aim of this review is to structurize the variety of scatter suppression methods, to analyze the common structure, and to develop a general framework for scatter correction procedures. In general, scatter suppression combines hardware techniques of scatter rejection and software methods of scatter correction. The authors emphasize that scatter correction procedures consist of the main components scatter estimation (by measurement or mathematical modeling) and scatter compensation (deterministic or statistical methods). The framework comprises most scatter correction approaches and its validity also goes beyond transmission CT. Before the advent of cone-beam CT, a lot of papers on scatter correction approaches in x-ray radiography, mammography, emission tomography, and in Megavolt CT had been published. The opportunity to avail from research in those other fields of medical imaging has not yet been sufficiently exploited. Therefore additional references are included when ever it seems pertinent. Scatter estimation and scatter compensation are typically intertwined in iterative procedures. It makes sense to recognize iterative approaches in the light of the concept of self-consistency. The importance of incorporating scatter compensation approaches into a statistical framework for noise minimization has to be underscored. Signal and noise propagation analysis is presented. A main result is the preservation of differential-signal-to-noise-ratio (dSNR) in CT projection data by ideal scatter correction. The objective of scatter compensation methods is the restoration of quantitative accuracy and a balance between low-contrast restoration and noise reduction. In a synopsis section, the different deterministic and statistical methods are discussed with respect to their properties and applications. The current paper is focused on scatter compensation algorithms. The multitude of scatter estimation models will be dealt with in a separate paper.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Task-based modeling and optimization of a cone-beam CT scanner for musculoskeletal imaging

Purpose: This work applies a cascaded systems model for cone-beam CT imaging performance to the design and optimization of a system for musculoskeletal extremity imaging. The model provides a quantitative guide to the selection of system geometry, source and detector components, acquisition techniques, and reconstruction parameters. Methods: The model is based on cascaded systems analysis of the 3D noise-power spectrum (NPS) and noise-equivalent quanta (NEQ) combined with factors of system geometry (magnification, focal spot size, and scatter-to-primary ratio) and anatomical background clutter. The model was extended to task-based analysis of detectability index (d') for tasks ranging in contrast and frequency content, and d' was computed as a function of system magnification, detector pixel size, focal spot size, kVp, dose, electronic noise, voxel size, and reconstruction filter to examine trade-offs and optima among such factors in multivariate analysis. The model was tested quantitatively versus the measured NPS and qualitatively in cadaver images as a function of kVp, dose, pixel size, and reconstruction filter under conditions corresponding to the proposed scanner. Results: The analysis quantified trade-offs among factors of spatial resolution, noise, and dose. System magnification (M) was a critical design parameter with strong effect on spatial resolution, dose, and x-ray scatter, and a fairly robust optimum was identified at M {approx} 1.3 for the imaging tasks considered. The results suggested kVp selection in the range of {approx}65-90 kVp, the lower end (65 kVp) maximizing subject contrast and the upper end maximizing NEQ (90 kVp). The analysis quantified fairly intuitive results--e.g., {approx}0.1-0.2 mm pixel size (and a sharp reconstruction filter) optimal for high-frequency tasks (bone detail) compared to {approx}0.4 mm pixel size (and a smooth reconstruction filter) for low-frequency (soft-tissue) tasks. This result suggests a specific protocol for 1 x 1 (full-resolution) projection data acquisition followed by full-resolution reconstruction with a sharp filter for high-frequency tasks along with 2 x 2 binning reconstruction with a smooth filter for low-frequency tasks. The analysis guided selection of specific source and detector components implemented on the proposed scanner. The analysis also quantified the potential benefits and points of diminishing return in focal spot size, reduced electronic noise, finer detector pixels, and low-dose limits of detectability. Theoretical results agreed quantitatively with the measured NPS and qualitatively with evaluation of cadaver images by a musculoskeletal radiologist. Conclusions: A fairly comprehensive model for 3D imaging performance in cone-beam CT combines factors of quantum noise, system geometry, anatomical background, and imaging task. The analysis provided a valuable, quantitative guide to design, optimization, and technique selection for a musculoskeletal extremities imaging system under development.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2012

Automatic tracking of implanted fiducial markers in cone beam CT projection images

Purpose: This paper describes a novel method for simultaneous intrafraction tracking of multiple fiducial markers. Although the proposed method is generic and can be adopted for a number of applications including fluoroscopy based patient position monitoring and gated radiotherapy, the tracking results presented in this paper are specific to tracking fiducial markers in a sequence of cone beam CT projection images. Methods: The proposed method is accurate and robust thanks to utilizing the mean shift and random sampling principles, respectively. The performance of the proposed method was evaluated with qualitative and quantitative methods, using data from two pancreatic and one prostate cancer patients and a moving phantom. The ground truth, for quantitative evaluation, was calculated based on manual tracking preformed by three observers. Results: The average dispersion of marker position error calculated from the tracking results for pancreas data (six markers tracked over 640 frames, 3840 marker identifications) was 0.25 mm (at iscoenter), compared with an average dispersion for the manual ground truth estimated at 0.22 mm. For prostate data (three markers tracked over 366 frames, 1098 marker identifications), the average error was 0.34 mm. The estimated tracking error in the pancreas data was < 1 mm (2 pixels) in 97.6% of cases where nearby image clutter was detected and in 100.0% of cases with no nearby image clutter. Conclusions: The proposed method has accuracy comparable to that of manual tracking and, in combination with the proposed batch postprocessing, superior robustness. Marker tracking in cone beam CT (CBCT) projections is useful for a variety of purposes, such as providing data for assessment of intrafraction motion, target tracking during rotational treatment delivery, motion correction of CBCT, and phase sorting for 4D CBCT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Cone-beam breast computed tomography with a displaced flat panel detector array

Purpose: In cone-beam computed tomography (CBCT), and in particular in cone-beam breast computed tomography (CBBCT), an important issue is the reduction of the image artifacts produced by photon scatter and the reduction of patient dose. In this work, the authors propose to apply the detector displacement technique (also known as asymmetric detector or ''extended view'' geometry) to approach this goal. Potentially, this type of geometry, and the accompanying use of a beam collimator to mask the unirradiated half-object in each projection, permits some reduction of radiation dose with respect to conventional CBBCT and a sizeable reduction of the overall amount of scatter in the object, for a fixed contrast-to-noise ratio (CNR). Methods: The authors consider a scan configuration in which the projection data are acquired from an asymmetrically positioned detector that covers only one half of the scan field of view. Monte Carlo simulations and measurements, with their CBBCT laboratory scanner, were performed using PMMA phantoms of cylindrical (70-mm diameter) and hemiellipsoidal (140-mm diameter) shape simulating the average pendant breast, at 80 kVp. Image quality was evaluated in terms of contrast, noise, CNR, contrast-to-noise ratio per unit of dose (CNRD), and spatial resolution as width of line spread function for high contrast details. Results: Reconstructed images with the asymmetric detector technique deviate less than 1% from reconstruction with a conventional symmetric detector (detector view) and indicate a reduction of the cupping artifact in CT slices. The maximum scatter-to-primary ratio at the center of the phantom decreases by about 50% for both small and large diameter phantoms (e.g., from 0.75 in detector view to 0.40 in extended view geometry at the central axis of the 140-mm diameter PMMA phantom). Less cupping produces an increase of the CT number accuracy and an improved image detail contrast, but the associated increase of noise observed may produce a decrease of detail CNR. By simulating the energy deposited inside the phantoms, the authors evaluated a maximum 50% reduction of the absorbed dose at the expense of a decrease of CNR, for the half beam irradiation of the object performed with the displaced detector technique with respect to full beam irradiation. The decrease in CNR, and in absorbed dose as well, translates into a detail CNRD showing values comparable to or higher than the ones obtained for a conventional symmetric detector technique, attributed to the effect of decreased scatter in particular at the axis of the irradiated object. An estimate is provided (about 12%) for the average dose reduction possible in CBBCT at constant CNR for the average uncompressed breast (14 cm diameter, 50% glandularity), in case of minimum image overlapping in extended view. Conclusions: Simulations and experiments show that CBCT reconstructions with the displaced detector technique and with a half beam collimator are less affected by scatter artifacts, which could lead to some decrease of the radiation dose to the irradiated object with respect to a conventional reconstruction. This dose reduction is associated with increase of noise, decrease of CNR, but equal or improved CNRD values. The use of a small area detector would allow also to reduce the apparatus cost and to improve the data transfer speed with a corresponding increment of frame rate.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Small fields output factors measurements and correction factors determination for several detectors for a CyberKnife{sup Registered-Sign} and linear accelerators equipped with microMLC and circular cones

Purpose: The use of small photon fields is now an established practice in stereotactic radiosurgery and radiotherapy. However, due to a lack of lateral electron equilibrium and high dose gradients, it is difficult to accurately measure the dosimetric quantities required for the commissioning of such systems. Moreover, there is still no metrological dosimetric reference for this kind of beam today. In this context, the first objective of this work was to determine and to compare small fields output factors (OF) measured with different types of active detectors and passive dosimeters for three types of facilities: a CyberKnife{sup Registered-Sign} system, a dedicated medical linear accelerator (Novalis) equipped with m3 microMLC and circular cones, and an adaptive medical linear accelerator (Clinac 2100) equipped with an additional m3 microMLC. The second one was to determine the k{sub Q{sub c{sub l{sub i{sub n,Q{sub m{sub s{sub r}{sup f{sub c}{sub l}{sub i}{sub n},f{sub m}{sub s}{sub r}}}}}}}}} correction factors introduced in a recently proposed small field dosimetry formalism for different active detectors.Methods: Small field sizes were defined either by microMLC down to 6 Multiplication-Sign 6 mm{sup 2} or by circular cones down to 4 mm in diameter. OF measurements were performed with several commercially available active detectors dedicated to measurements in small fields (high resolution diodes: IBA SFD, Sun Nuclear EDGE, PTW 60016, PTW 60017; ionizing chambers: PTW 31014 PinPoint chamber, PTW 31018 microLion liquid chamber, and PTW 60003 natural diamond). Two types of passive dosimeters were used: LiF microcubes and EBT2 radiochromic films.Results: Significant differences between the results obtained by several dosimetric systems were observed, particularly for the smallest field size for which the difference in the measured OF reaches more than 20%. For passive dosimeters, an excellent agreement was observed (better than 2%) between EBT2 and LiF microcubes for all OF measurements. Moreover, it has been shown that these passive dosimeters do not require correction factors and can then be used as reference dosimeters. Correction factors for the active detectors have then been determined from the mean experimental OF measured by the passive dosimeters.Conclusions: Four sets of correction factors needed to apply the new small field dosimetry formalism are provided for several active detectors. A protocol for small photon beams OF determination based on passive dosimeters measurements has been recently proposed to French radiotherapy treatment centers.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

Cone beam breast CT with a high pitch (75 μm), thick (500 μm) scintillator CMOS flat panel detector: Visibility of simulated microcalcifications

Purpose: To measure and investigate the improvement of microcalcification (MC) visibility in cone beam breast CT with a high pitch (75 μm), thick (500 μm) scintillator CMOS/CsI flat panel detector (Dexela 2923, Perkin Elmer).Methods: Aluminum wires and calcium carbonate grains of various sizes were embedded in a paraffin cylinder to simulate imaging of calcifications in a breast. Phantoms were imaged with a benchtop experimental cone beam CT system at various exposure levels. In addition to the Dexela detector, a high pitch (50 μm), thin (150 μm) scintillator CMOS/CsI flat panel detector (C7921CA-09, Hamamatsu Corporation, Hamamatsu City, Japan) and a widely used low pitch (194 μm), thick (600 μm) scintillator aSi/CsI flat panel detector (PaxScan 4030CB, Varian Medical Systems) were also used in scanning for comparison. The images were independently reviewed by six readers (imaging physicists). The MC visibility was quantified as the fraction of visible MCs and measured as a function of the estimated mean glandular dose (MGD) level for various MC sizes and detectors. The modulation transfer functions (MTFs) and detective quantum efficiencies (DQEs) were also measured and compared for the three detectors used.Results: The authors have demonstrated that the use of a high pitch (75 μm) CMOS detector coupled with a thick (500 μm) CsI scintillator helped make the smaller 150–160, 160–180, and 180–200 μm MC groups more visible at MGDs up to 10.8, 9, and 10.8 mGy, respectively. It also made the larger 200–212 and 212–224 μm MC groups more visible at MGDs up to 7.2 mGy. No performance improvement was observed for 224–250 μm or larger size groups. With the higher spatial resolution of the Dexela detector based system, the apparent dimensions and shapes of MCs were more accurately rendered. The results show that with the aforementioned detector, a 73% visibility could be achieved in imaging 160–180 μm MCs as compared to 28% visibility achieved by the low pitch (194 μm) aSi/CsI flat panel detector. The measurements confirm that the Hamamatsu detector has the highest MTF, followed by the Dexel detector, and then the Varian detector. However, the Dexela detector, with its thick (500 μm) CsI scintillator and low noise level, has the highest DQE at all frequencies, followed by the Varian detector, and then the Hamamatsu detector. The findings on the MC visibility correlated well with the differences in MTFs, noise power spectra, and DQEs measured for these three detectors.Conclusions: The authors have demonstrated that the use of the CMOS type Dexela detector with its high pitch (75 μm) and thick (500 μm) CsI scintillator could help improve the MC visibility. However, the improvement depended on the exposure level and the MC size. For imaging larger MCs or scanning at high exposure levels, there was little advantage in using the Dexela detector as compared to the aSi type Varian detector. These findings correlate well with the higher measured DQEs of the Dexela detector, especially at higher frequencies.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

SU-E-J-92: On-Line Cone Beam CT Based Planning for Emergency and Palliative Radiation Therapy

Purpose: To evaluate and develop the feasibility of on-line cone beam CT based planning for emergency and palliative radiotherapy treatments. Methods: Subsequent to phantom studies, a case library of 28 clinical megavoltage cone beam CT (MVCBCT) was built to assess dose-planning accuracies on MVCBCT for all anatomical sites. A simple emergency treatment plan was created on the MVCBCT and copied to its reference CT. The agreement between the dose distributions of each image pair was evaluated by the mean dose difference of the dose volume and the gamma index of the central 2D axial plane. An array of popular urgent and palliative cases was also evaluated for imaging component clearance and field-of-view. Results: The treatment cases were categorized into four groups (head and neck, thorax/spine, pelvis and extremities). Dose distributions for head and neck treatments were predicted accurately in all cases with a gamma index of >95% for 2% and 2 mm criteria. Thoracic spine treatments had a gamma index as low as 60% indicating a need for better uniformity correction and tissue density calibration. Small anatomy changes between CT and MVCBCT could contribute to local errors. Pelvis and sacral spine treatment cases had a gamma index between 90% and 98% for 3%/3 mm criteria. The limited FOV became an issue for large pelvis patients. Imaging clearance was difficult for cases where the tumor was positioned far off midline. Conclusion: The MVCBCT based dose planning and delivery approach is feasible in many treatment cases. Dose distributions for head and neck patients are unrestrictedly predictable. Some FOV restrictions apply to other treatment sites. Lung tissue is most challenging for accurate dose calculations given the current imaging filters and corrections. Additional clinical cases for extremities need to be included in the study to assess the full range of site-specific planning accuracies. This work is supported by Siemens.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-99: Reconstruction of Cone Beam CT Image Using Volumetric Modulated Arc Therapy Exit Beams

Purpose: To test the possibility of obtaining an image of the treated volume during volumetric modulated arc therapy (VMAT) with exit beams. Method: Using a Varian Clinac 21EX and MVCT detector the following three sets of detector projection data were obtained for cone beam CT reconstruction with and without a Catphan 504 phantom. 1) 72 projection images from 20 × 16 cm{sup 2} open beam with 3 MUs, 2) 72 projection images from 20 × 16 cm{sup 2} MLC closed beam with 14 MUs. 3) 137 projection images from a test RapicArc QA plan. All projection images were obtained in ‘integrated image’ mode. We used OSCaR code to reconstruct the cone beam CT images. No attempts were made to reduce scatter or artifacts. Results: With projection set 1) we obtained a good quality MV CBCT image by optimizing the reconstruction parameters. Using projection set 2) we were not able to obtain a CBCT image of the phantom, which was determined to be due to the variation of interleaf leakage with gantry angle. From projection set 3), we were able to obtain a weak but meaningful signal in the image, especially in the target area where open beam signals were dominant. This finding suggests that one might be able to acquire CBCT images with rough body shape and some details inside the irradiated target area. Conclusion: Obtaining patient images using the VMAT exit beam is challenging but possible. We were able to determine sources of image degradation such as gantry angle dependent interleaf leakage and beams with a large scatter component. We are actively working on improving image quality.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-F-18C-15: Model-Based Multiscale Noise Reduction On Low Dose Cone Beam Projection

Purpose: To improve image quality of low dose cone beam CT for patient positioning in radiation therapy. Methods: In low dose cone beam CT (CBCT) imaging systems, Poisson process governs the randomness of photon fluence at x-ray source and the detector because of the independent binomial process of photon absorption in medium. On a CBCT projection, the variance of fluence consists of the variance of noiseless imaging structure and that of Poisson noise, which is proportional to the mean (noiseless) of the fluence at the detector. This requires multiscale filters to smoothen noise while keeping the structure information of the imaged object. We used a mathematical model of Poisson process to design multiscale filters and established the balance of noise correction and structure blurring. The algorithm was checked with low dose kilo-voltage CBCT projections acquired from a Varian OBI system. Results: From the investigation of low dose CBCT of a Catphan phantom and patients, it showed that our model-based multiscale technique could efficiently reduce noise and meanwhile keep the fine structure of the imaged object. After the image processing, the number of visible line pairs in Catphan phantom scanned with 4 ms pulse time was similar to that scanned with 32 ms, and soft tissue structure from simulated 4 ms patient head-and-neck images was also comparable with scanned 20 ms ones. Compared with fixed-scale technique, the image quality from multiscale one was improved. Conclusion: Use of projection-specific multiscale filters can reach better balance on noise reduction and structure information loss. The image quality of low dose CBCT can be improved by using multiscale filters.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Sci—Fri AM: Mountain — 02: A comparison of dose reduction methods on image quality for cone beam CT

Modern radiotherapy uses highly conformai dose distributions and therefore relies on daily image guidance for accurate patient positioning. Kilovoltage cone beam CT is one technique that is routinely used for patient set-up and results in a high dose to the patient relative to planar imaging techniques. This study uses an Elekta Synergy linac equipped with XVI cone beam CT to investigate the impact of various imaging parameters on dose and image quality. Dose and image quality are assessed as functions of x-ray tube voltage, tube current and the number of projections in the scan. In each case, the dose measurements confirm that as each parameter increases the dose increases. The assessment of high contrast resolution shows little dependence on changes to the image technique. However, low contrast visibility suggests a trade off between dose and image quality. Particularly for changes in tube potential, the dose increases much faster as a function of voltage than the corresponding increase in low contrast image quality. This suggests using moderate values of the peak tube voltage (100 – 120 kVp) since higher values result in significant dose increases with little gain in image quality. Measurements also indicate that increasing tube current achieves the greatest degree of improvement in the low contrast visibility. The results of this study highlight the need to establish careful imaging protocols to limit dose to the patient and to limit changes to the imaging parameters to those cases where there is a clear clinical requirement for improved image quality.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Poster — Thur Eve — 06: Dose assessment of cone beam CT imaging protocols as part of SPECT/CT examinations

Purpose: To assess radiation dose from the cone beam CT (CBCT) component of SPECT/CT studies and to compare with other CT examinations performed in our institution. Methods: We used an anthropomorphic chest phantom and the 6 cc ion chamber to measure entrance breast dose for several CBCT and diagnostic CT acquisition protocols. The CBCT effective dose was calculated with ImPACT software; the CT effective dose was evaluated from the DLP value and conversion factor, dependent on the anatomic region. The RADAR medical procedure radiation dose calculator was used to assess the nuclear medicine component of exam dose. Results: The entrance dose to the breast measured with the anthropomorphic phantom was 0.48 mGy and 9.41 mGy for cardiac and chest CBCT scans; and 4.59 mGy for diagnostic thoracic CT. The effective doses were 0.2 mSv, 3.2 mSv and 2.8 mSv respectively. For a small patient represented by the anthropomorphic phantom, the dose from the diagnostic CT was lower than from the CBCT scan, as a result of the exposure reduction options available on modern CT scanners. The CBCT protocols used the same fixed scanning techniques. The diagnostic CT dose based on the patient data was 35% higher than the phantom dose. For most SPECT/CT studies the dose from the CBCT component was comparable with the dose from the radiopharmaceutical. Conclusions: The patient radiation dose from the cone beam CT scan can be higher than that from a diagnostic CT and should be taken into consideration in evaluating total SPECT/CT patient dose.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

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↗
DOE OSTI2015

SU-C-207-05: A Comparative Study of Noise-Reduction Algorithms for Low-Dose Cone-Beam Computed Tomography

Purpose: To study different noise-reduction algorithms and to improve the image quality of low dose cone beam CT for patient positioning in radiation therapy. Methods: In low-dose cone-beam CT, the reconstructed image is contaminated with excessive quantum noise. In this study, three well-developed noise reduction algorithms namely, a) penalized weighted least square (PWLS) method, b) split-Bregman total variation (TV) method, and c) compressed sensing (CS) method were studied and applied to the images of a computer–simulated “Shepp-Logan” phantom and a physical CATPHAN phantom. Up to 20% additive Gaussian noise was added to the Shepp-Logan phantom. The CATPHAN phantom was scanned by a Varian OBI system with 100 kVp, 4 ms and 20 mA. For comparing the performance of these algorithms, peak signal-to-noise ratio (PSNR) of the denoised images was computed. Results: The algorithms were shown to have the potential in reducing the noise level for low-dose CBCT images. For Shepp-Logan phantom, an improvement of PSNR of 2 dB, 3.1 dB and 4 dB was observed using PWLS, TV and CS respectively, while for CATPHAN, the improvement was 1.2 dB, 1.8 dB and 2.1 dB, respectively. Conclusion: Penalized weighted least square, total variation and compressed sensing methods were studied and compared for reducing the noise on a simulated phantom and a physical phantom scanned by low-dose CBCT. The techniques have shown promising results for noise reduction in terms of PSNR improvement. However, reducing the noise without compromising the smoothness and resolution of the image needs more extensive research.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-D-207-01: Markerless Respiratory Motion Tracking with Contrast Enhanced Thoracic Cone Beam CT Projections

Purpose: To develop a novel technique to enhance the image contrast of clinical cone beam CT projections and extract respiratory signals based on anatomical motion using the modified Amsterdam Shroud (AS) method to benefit image guided radiation therapy. Methods: Thoracic cone beam CT projections acquired prior to treatment were preprocessed to increase their contrast for better respiratory signal extraction. Air intensity on raw images was firstly estimated and then applied to correct the projections to generate new attenuation images that were subsequently improved with deeper anatomy feature enhancement through taking logarithm operation, derivative along superior-inferior direction, respectively. All pixels on individual post-processed two dimensional images were horizontally summed to one column and all projections were combined side by side to create an AS image from which patient’s respiratory signal was extracted. The impact of gantry rotation on the breathing signal rendering was also investigated. Ten projection image sets from five lung cancer patients acquired with the Varian Onboard Imager on 21iX Clinac (Varian Medical Systems, Palo Alto, CA) were employed to assess the proposed technique. Results: Application of the air correction on raw projections showed that more than an order of magnitude of contrast enhancement was achievable. The typical contrast on the raw projections is around 0.02 while that on attenuation images could greater than 0.5. Clear and stable breathing signal can be reliably extracted from the new images while the uncorrected projection sets failed to yield clear signals most of the time. Conclusion: Anatomy feature plays a key role in yielding breathing signal from the projection images using the AS technique. The air correction process facilitated the contrast enhancement significantly and attenuation images thus obtained provides a practical solution to obtaining markerless breathing motion tracking.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-P-41: Imaging Coordination of Cone Beam CT, On-Board Image Conjunction with Optical Image Guidance for SBRT Treatment with Respiratory Motion Management

Purpose: To spare normal tissue for SBRT lung/liver patients, especially for patients with significant tumor motion, image guided respiratory motion management has been widely implemented in clinical practice. The purpose of this study was to evaluate imaging coordination of cone beam CT, on-board X-ray image conjunction with optical image guidance for SBRT treatment with motion management. Methods: Currently in our clinic a Varian Novlis Tx was utilized for treating SBRT patients implementing CBCT. A BrainLAB X-ray ExacTrac imaging system in conjunction with optical guidance was primarily used for SRS patients. CBCT and X-ray imaging system were independently calibrated with 1.0 mm tolerance. For SBRT lung/liver patients, the magnitude of tumor motion was measured based-on 4DCT and the measurement was analyzed to determine if patients would be beneficial with respiratory motion management. For patients eligible for motion management, an additional CT with breath holding would be scanned and used as primary planning CT and as reference images for Cone beam CT. During the SBRT treatment, a CBCT with pause and continuing technology would be performed with patients holding breath, which may require 3–4 partially scanned CBCT to combine as a whole CBCT depending on how long patients capable of holding breath. After patients being setup by CBCT images, the ExactTrac X-ray imaging system was implemented with patients’ on-board X-ray images compared to breath holding CT-based DRR. Results: For breath holding patients SBRT treatment, after initially localizing patients with CBCT, we then position patients with ExacTrac X-ray and optical imaging system. The observed deviations of real-time optical guided position average at 3.0, 2.5 and 1.5 mm in longitudinal, vertical and lateral respectively based on 35 treatments. Conclusion: The respiratory motion management clinical practice improved our physician confidence level to give tighter tumor margin for sparing normal tissue for SBRT lung/liver patients.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-I-05: A Correction Algorithm for Kilovoltage Cone-Beam Computed Tomography Dose Calculations in Cervical Cancer Patients

Purpose: To investigate the accuracy and feasibility of dose calculations using kilovoltage cone beam computed tomography in cervical cancer radiotherapy using a correction algorithm. Methods: The Hounsfield units (HU) and electron density (HU-density) curve was obtained for both planning CT (pCT) and kilovoltage cone beam CT (CBCT) using a CIRS-062 calibration phantom. The pCT and kV-CBCT images have different HU values, and if the HU-density curve of CBCT was directly used to calculate dose in CBCT images may have a deviation on dose distribution. It is necessary to normalize the different HU values between pCT and CBCT. A HU correction algorithm was used for CBCT images (cCBCT). Fifteen intensity-modulated radiation therapy (IMRT) plans of cervical cancer were chosen, and the plans were transferred to the pCT and cCBCT data sets without any changes for dose calculations. Phantom and patient studies were carried out. The dose differences and dose distributions were compared between cCBCT plan and pCT plan. Results: The HU number of CBCT was measured by several times, and the maximum change was less than 2%. To compare with pCT, the CBCT and cCBCT has a discrepancy, the dose differences in CBCT and cCBCT images were 2.48%±0.65% (range: 1.3%∼3.8%) and 0.48%±0.21% (range: 0.1%∼0.82%) for phantom study, respectively. For dose calculation in patient images, the dose differences were 2.25%±0.43% (range: 1.4%∼3.4%) and 0.63%±0.35% (range: 0.13%∼0.97%), respectively. And for the dose distributions, the passing rate of cCBCT was higher than the CBCTs. Conclusion: The CBCT image for dose calculation is feasible in cervical cancer radiotherapy, and the correction algorithm offers acceptable accuracy. It will become a useful tool for adaptive radiation therapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-EF-207-05: Dedicated Cone-beam Breast CT

Breast imaging technology is advancing on several fronts. In digital mammography, the major technological trend has been on optimization of approaches for performing combined mammography and tomosynthesis using the same system. In parallel, photon-counting slot-scan mammography is now in clinical use and more efforts are directed towards further development of this approach for spectral imaging. Spectral imaging refers to simultaneous acquisition of two or more energy-windowed images. Depending on the detector and associated electronics, there are a number of ways this can be accomplished. Spectral mammography using photon-counting detectors can suppress electronic noise and importantly, it enables decomposition of the image into various material compositions of interest facilitating quantitative imaging. Spectral imaging can be particularly important in intravenously injected contrast mammography and eventually tomosynthesis. The various approaches and applications of spectral mammography are discussed. Digital breast tomosynthesis relies on the mechanical movement of the x-ray tube to acquire a number of projections in a predefined arc, typically from 9 to 25 projections over a scan angle of +/−7.5 to 25 degrees depending on the particular system. The mechanical x-ray tube motion requires relatively long acquisition time, typically between 3.7 to 25 seconds depending on the system. Moreover, mechanical scanning may have an effect on the spatial resolution due to internal x-ray filament or external mechanical vibrations. New x-ray source arrays have been developed and they are aimed at replacing the scanned x-ray tube for improved acquisition time and potentially for higher spatial resolution. The potential advantages and challenges of this approach are described. Combination of digital mammography and tomosynthesis in a single system places increased demands on certain functional aspects of the detector and overall performance, particularly in the tomosynthesis mode due to lower photon fluence per projection. This may require fast-frame acquisition and symmetric or asymmetric pixel binning in some systems. Recent studies investigated the performance of increased conversion layer thickness for contrast-enhanced imaging of the breast in dual-energy acquisition mode. In other direct conversion detectors operating in the avalanche mode, sensitivities close to the single photon response are also explored for mammography and breast tomosynthesis. The potential advantages and challenges of this approach are described. Dedicated breast CT brings x-ray imaging of the breast to true tomographic 3D imaging. It can eliminate the tissue superposition problem and does not require physical compression of the breast. Using cone beam geometry and a flat-panel detector, several hundred projections are acquired and reconstructed to near isotropic voxels. Multiplanar reconstruction facilitates viewing the breast volume in any desired orientation. Ongoing clinical studies, the current state-of-the art, and research to advance the technology are described. Learning Objectives: To understand the ongoing developments in x-ray imaging of the breast To understand the approaches and applications of spectral mammography To understand the potential advantages of distributed x-ray source arrays for digital breast tomosynthesis To understand the ongoing developments in detector technology for digital mammography and breast tomosynthesis To understand the current state-of-the-art for dedicated cone-beam breast CT and research to advance the technology. Research collaboration with Koning Corporation.

60 APPLIED LIFE SCIENCES↗