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DOE OSTI2014

SU-F-18C-05: Characterization of a Silicon Strip Photon-Counting Detector in the Presence of Compton Scatter: A Simulation Study

Purpose: To investigate the effect of Compton scatter on detection efficiency and charge-sharing for a Si strip photon-counting detector as a function of pixel pitch, slice thickness and total pixel length. Methods: A CT imaging system employing a silicon photon-counting detector was implemented using the GATE Monte Carlo package. A focal spot size of 300 µm, magnification of 1.33, and pixel pitches of 0.1 and 0.5mm were initially investigated. A 60 kVp spectrum with 3 mm Al filter was used and energy spectral degradation based on a prototype detector was simulated. To study charge-sharing, a single pixel was illuminated, and the detector response in neighboring pixels was investigated. A longitudinally semiinfinite detector was simulated to optimize the quantum detection efficiency of the imaging system as a function of pixel pitch, slice thickness and depth of interaction. A 2.5 mm thick tungsten plate with a 0.01 mm by 1.5 mm slit was implemented to calculate the modulation transfer function (MTF) from projection-based images. A threshold of 15 keV was implemented in the detector simulation. The preliminary charge sharing investigation results considered only scattering effects and the detector electronics related factors were neglected. Results: Using a 15 keV threshold, 1% of the pixel charge migrated into neighboring pixels with a pixel size of 0.1×0.1 mm{sup 2}. The quantum detection efficiency was 77%, 84%, 87% and 89% for 15 mm, 22.5 mm, 30 mm, and 45 mm length silicon detector pixels, respectively. For a pixel pitch of 0.1 mm, the spatial frequency at 10% of the maximum MTF was found to be 5.2 lp/mm. This agreed with an experimental MTF measurement of 5.3 lp/mm with a similar detector configuration. Conclusion: Using optimized design parameters, Si strip photon-counting detectors can offer high detection efficiency and spatial resolution even in the presence of Compton scatter.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

MO-E-17A-08: Attenuation-Based Size Adjusted, Scanner-Independent Organ Dose Estimates for Head CT Exams: TG 204 for Head CT

Purpose: AAPM Task Group 204 described size specific dose estimates (SSDE) for body scans. The purpose of this work is to use a similar approach to develop patient-specific, scanner-independent organ dose estimates for head CT exams using an attenuation-based size metric. Methods: For eight patient models from the GSF family of voxelized phantoms, dose to brain and lens of the eye was estimated using Monte Carlo simulations of contiguous axial scans for 64-slice MDCT scanners from four major manufacturers. Organ doses were normalized by scannerspecific 16 cm CTDIvol values and averaged across all scanners to obtain scanner-independent CTDIvol-to-organ-dose conversion coefficients for each patient model. Head size was measured at the first slice superior to the eyes; patient perimeter and effective diameter (ED) were measured directly from the GSF data. Because the GSF models use organ identification codes instead of Hounsfield units, water equivalent diameter (WED) was estimated indirectly. Using the image data from 42 patients ranging from 2 weeks old to adult, the perimeter, ED and WED size metrics were obtained and correlations between each metric were established. Applying these correlations to the GSF perimeter and ED measurements, WED was calculated for each model. The relationship between the various patient size metrics and CTDIvol-to-organ-dose conversion coefficients was then described. Results: The analysis of patient images demonstrated the correlation between WED and ED across a wide range of patient sizes. When applied to the GSF patient models, an exponential relationship between CTDIvol-to-organ-dose conversion coefficients and the WED size metric was observed with correlation coefficients of 0.93 and 0.77 for the brain and lens of the eye, respectively. Conclusion: Strong correlation exists between CTDIvol normalized brain dose and WED. For the lens of the eye, a lower correlation is observed, primarily due to surface dose variations. Funding Support: Siemens-UCLA Radiology Master Research Agreement; Disclosures - Michael McNitt-Gray: Institutional Research Agreement, Siemens AG; Research Support, Siemens AG; Consultant, Flaherty Sensabaugh Bonasso PLLC; Consultant, Fulbright and Jaworski.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TU-A-12A-10: Robust Radiomics Feature Quantification Using Semiautomatic Volumetric Segmentation

Purpose: Recent advances in medical imaging technologies provide opportunities to quantify the tumor phenotype throughout the course of treatment non-invasively. The emerging field of Radiomics addresses this by converting medical images into minable data by applying a large number of quantitative imaging algorithms. Accurate tumor segmentation is one of the main challenges of Radiomics. It has been shown that semiautomatic segmentation approaches efficiently reduce inter-observer variability as compared to the time consuming manual delineations. In this study, a semiautomatic volumetric segmentation algorithm, implemented in the free and publicly available 3D-Slicer platform, was investigated in terms of its robustness for Radiomics features quantification. Methods: Fifty-six 3D-Radiomics features, quantifying phenotypic differences based on the tumor intensity, shape and texture, were extracted from the computed tomography images of twenty lung cancer patients. These Radiomics features were derived from the 3D-tumor volumes defined by three independent observers twice using 3D-Slicer, and compared to manual slice-by-slice delineations of five independent physicians in terms of intra-class correlation coefficient (ICC) and feature range. Results: Radiomics features extracted from 3D-Slicer segmentations had significantly higher reproducibility (ICC= 0.85 0.15, p=0.0009) compared to the features extracted from the manual segmentations (ICC= 0.77 0.17). Furthermore, the features extracted from 3D-Slicer based segmentations, spread over significantly smaller range across observers as compared to those of the manual delineations (p= 3.819e-07). Moreover, the features derived from 3D-Slicer segmentations overlapped in range with those of the manual delineations, as the lower(higher) limit(s) being significantly higher(lower) for the 3D-Slicer features (p= 0.007, p= 5.863e-06). Conclusion: 3D-Slicer based semiautomatic segmentation significantly improves the robustness of radiomics features and thus could serve as a potential alternative to the time consuming manual segmentation process. So 3D-Slicer can have a large application in Radiomics, and be employed for high-throughput data mining research of medical imaging in clinical oncology.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-D-18C-01: Art of Imaging: Diagnostic Ultrasound Image Artifacts

Assumptions followed during construction of B-mode and color flow images are that the pulse-echo transit time can be converted to reflector depth through uniform tissue models, echoes originate only from locations along the transmit-receive axes of pulse propagation, and first order correction schemes adequately account for acoustic wave attenuation and absorption. The latter allows the display brightness to encode tissue echogenicity. This course will challenge participants to identify imaging artifacts whose origins stem from the more complex and realistic propagating and scattering conditions common in clinical ultrasound. Speckle, a very common artifact but a clinically employed feature, originates from simultaneous echoes from diffuse scatterers and is a result of coherent detection of signals. One of the most bothersome artifacts are those due to reverberations especially that originating from superficial tissue interfaces. Methods to overcome these will be discussed. This presentation also will describe and illustrate speed of sound, refraction, enhancement, shadowing, mirroring, beam width, beam-forming, and slice thickness artifacts. All are useful examples of limitations introduced by acoustic waves propagating through complex tissue paths. New formats for physician board certification exams are demanding the inclusion of image-based examples of ultrasound physics. Instructors' knowledge of, and access to examples of ultrasound artifacts are important in this effort. The presentation will incorporate an audience response system to challenge participants in correct identification of some of these artifacts. Learning Objectives: Review basic mechanisms for producing ultrasound images. Identify the etiology of speckle, reverberation noise, beam width and slice thickness artifacts, and artifacts associated with pulse propagation. Discuss methods that reduce the impact of artifacts OR employ artifacts effectively to facilitate clinical diagnosis.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-G-18C-02: Estimation of Optimal B-Value Set for Obtaining Apparent Diffusion Coefficient Free From Perfusion in Non-Small Cell Lung Cancer

Purpose: Diffusion-weighted MRI (DW-MRI) is increasingly being investigated for radiotherapy planning and response assessment. Selection of a limited number of b-values in DW-MRI is important to keep geometrical variations low and imaging time short. We investigated various b-value sets to determine an optimal set for obtaining monoexponential apparent diffusion coefficient (ADC) close to perfusion-insensitive intravoxel incoherent motion (IVIM) model ADC (ADC IVIM ) in nonsmall cell lung cancer. Methods: Seven patients had 27 DW-MRI scans before and during radiotherapy in a 1.5T scanner. Respiratory triggering was applied to the echo-planar DW-MRI with TR=4500ms approximately, TE=74ms, pixel size=1.98X1.98mm{sub 2}, slice thickness=4–6mm and 7 axial slices. Diffusion gradients were applied to all three axes producing traceweighted images with eight b-values of 0–1000μs/μm{sup 2}. Monoexponential model ADC values using various b-value sets were compared to ADC IVIM using all b-values. To compare the relative noise in ADC maps, intra-scan coefficient of variation (CV) of active tumor volumes was computed. Results: ADC IVIM , perfusion coefficient and perfusion fraction for tumor volumes were in the range of 880-1622 μm{sup 2}/s, 8119-33834 μm{sup 2}/s and 0.104–0.349, respectively. ADC values using sets of 250, 800 and 1000; 250, 650 and 1000; and 250–1000μs/μm{sup 2} only were not significantly different from ADC IVIM (p>0.05, paired t-test). Error in ADC values for 0–1000, 50–1000, 100–1000, 250–1000, 500–1000, and three b-value sets- 250, 500 and 1000; 250, 650 and 1000; and 250, 800 and 1000μs/μm{sup 2} were 15.0, 9.4, 5.6, 1.4, 11.7, 3.7, 2.0 and 0.2% relative to the reference-standard ADC IVIM , respectively. Mean intrascan CV was 20.2, 20.9, 21.9, 24.9, 32.6, 25.8, 25.4 and 24.8%, respectively, whereas that for ADC IVIM was 23.3%. Conclusion: ADC values of two 3 b-value sets (250, 650 and 1000; and 250, 800 and 1000μs/μm{sup 2}) approached ADC IVIM , with relative noise comparable to that of ADC IVIM . These sets may be used to obtain perfusion-insensitive ADC values in lung tumors. E. Weiss: Funding through Varian Medical Systems and Philips Oncology Systems, UpToDate royalties. G. Hugo: NIH R01CA166119, P01 CA116602, NHMRC Project Grant.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-G-18C-07: Accelerated Water/fat Separation in MRI for Radiotherapy Planning Using Multi-Band Imaging Techniques

Purpose: Dixon sequences are used to characterize disease processes, obtain good fat or water separation in cases where fat suppression fails and to obtain pseudo-CT datasets. Dixon's method uses at least two images acquired with different echo times and thus requires prolonged acquisition times. To overcome associated problems (e.g., for DCE/cine-MRI), we propose to use a method for water/fat separation based on spectrally selective RF pulses. Methods: Two alternating RF pulses were used, that imposes a fat selective phase cycling over the phase encoding lines, which results in a spatial shift for fat in the reconstructed image, identical to that in CAIPIRINHA. Associated aliasing artefacts were resolved using the encoding power of a multi-element receiver array, analogous to SENSE. In vivo measurements were performed on a 1.5T clinical MR-scanner in a healthy volunteer's legs, using a four channel receiver coil. Gradient echo images were acquired with TE/TR = 2.3/4.7ms, flip angle 20°, FOV 45×22.5cm{sup 2}, matrix 480×216, slice thickness 5mm. Dixon images were acquired with TE,1/TE,2/TR=2.2/4.6/7ms. All image reconstructions were done in Matlab using the ReconFrame toolbox (Gyrotools, Zurich, CH). Results: RF pulse alternation yields a fat image offset from the water image. Hence the water and fat images fold over, which is resolved using in-plane SENSE reconstruction. Using the proposed technique, we achieved excellent water/fat separation comparable to Dixon images, while acquiring images at only one echo time. Conclusion: The proposed technique yields both inphase water and fat images at arbitrary echo times and requires only one measurement, thereby shortening the acquisition time by a factor 2. In future work the technique may be extended to a multi-band water/fat separation sequence that is able to achieve single point water/fat separation in multiple slices at once and hence yields higher speed-up factors.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Interactive lung segmentation in abnormal human and animal chest CT scans

Purpose: Many medical image analysis systems require segmentation of the structures of interest as a first step. For scans with gross pathology, automatic segmentation methods may fail. The authors’ aim is to develop a versatile, fast, and reliable interactive system to segment anatomical structures. In this study, this system was used for segmenting lungs in challenging thoracic computed tomography (CT) scans. Methods: In volumetric thoracic CT scans, the chest is segmented and divided into 3D volumes of interest (VOIs), containing voxels with similar densities. These VOIs are automatically labeled as either lung tissue or nonlung tissue. The automatic labeling results can be corrected using an interactive or a supervised interactive approach. When using the supervised interactive system, the user is shown the classification results per slice, whereupon he/she can adjust incorrect labels. The system is retrained continuously, taking the corrections and approvals of the user into account. In this way, the system learns to make a better distinction between lung tissue and nonlung tissue. When using the interactive framework without supervised learning, the user corrects all incorrectly labeled VOIs manually. Both interactive segmentation tools were tested on 32 volumetric CT scans of pigs, mice and humans, containing pulmonary abnormalities. Results: On average, supervised interactive lung segmentation took under 9 min of user interaction. Algorithm computing time was 2 min on average, but can easily be reduced. On average, 2.0% of all VOIs in a scan had to be relabeled. Lung segmentation using the interactive segmentation method took on average 13 min and involved relabeling 3.0% of all VOIs on average. The resulting segmentations correspond well to manual delineations of eight axial slices per scan, with an average Dice similarity coefficient of 0.933. Conclusions: The authors have developed two fast and reliable methods for interactive lung segmentation in challenging chest CT images. Both systems do not require prior knowledge of the scans under consideration and work on a variety of scans.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Sci—Sat AM: Stereo — 04: Evaluation of VMAT interplay effect for lung SABR using TrueBeam 10XFFF beam

During a VMAT treatment delivery, the interplay effect between the moving target and varying machine parameters result in dose distributions that are different from those initially planned. In this work, we investigate this effect for lung SABR by using 4D dose calculation derived from the Varian TrueBeam trajectory log file. The impact of treatment start phase is also evaluated. A QUASAR™ respiratory motion phantom was scanned with motion amplitudes of 0.4, 1, 2 and 3 cm with a 4 second period. MIP and the average dataset were generated from the 4DCT. A static CT was also acquired with the tumor in its centre position. Plans were optimized with 10X FFF beam until PTV and fictitious critical structures met the dose constraints. Ten temporally interleaved plans were constructed with the temporal machine parameter information from the trajectory log file. Ten plans were calculated with isocentre shifts to simulate respiratory motion and then summed. For each motion amplitude, three separate sum plans were created with various phase shifts (no phase shift, maximum inhalation and maximum exhalation) to assess the impact of treatment start phase. For all the phase shifts investigated, the DVH for PTV demonstrated good dose coverage. However, a careful review of slice by slice plan comparison indicates dose “holes” are observed within PTV. The PTV dose difference between various treatment start phases can be as high as 19%. This assumes all treatment fractions have identical treatment start phase. Our future work includes evaluation of interplay effect for various breathing periods.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Position tracking of moving liver lesion based on real-time registration between 2D ultrasound and 3D preoperative images

Purpose: Registration between 2D ultrasound (US) and 3D preoperative magnetic resonance (MR) (or computed tomography, CT) images has been studied recently for US-guided intervention. However, the existing techniques have some limits, either in the registration speed or the performance. The purpose of this work is to develop a real-time and fully automatic registration system between two intermodal images of the liver, and subsequently an indirect lesion positioning/tracking algorithm based on the registration result, for image-guided interventions. Methods: The proposed position tracking system consists of three stages. In the preoperative stage, the authors acquire several 3D preoperative MR (or CT) images at different respiratory phases. Based on the transformations obtained from nonrigid registration of the acquired 3D images, they then generate a 4D preoperative image along the respiratory phase. In the intraoperative preparatory stage, they properly attach a 3D US transducer to the patient’s body and fix its pose using a holding mechanism. They then acquire a couple of respiratory-controlled 3D US images. Via the rigid registration of these US images to the 3D preoperative images in the 4D image, the pose information of the fixed-pose 3D US transducer is determined with respect to the preoperative image coordinates. As feature(s) to use for the rigid registration, they may choose either internal liver vessels or the inferior vena cava. Since the latter is especially useful in patients with a diffuse liver disease, the authors newly propose using it. In the intraoperative real-time stage, they acquire 2D US images in real-time from the fixed-pose transducer. For each US image, they select candidates for its corresponding 2D preoperative slice from the 4D preoperative MR (or CT) image, based on the predetermined pose information of the transducer. The correct corresponding image is then found among those candidates via real-time 2D registration based on a gradient-based similarity measure. Finally, if needed, they obtain the position information of the liver lesion using the 3D preoperative image to which the registered 2D preoperative slice belongs. Results: The proposed method was applied to 23 clinical datasets and quantitative evaluations were conducted. With the exception of one clinical dataset that included US images of extremely low quality, 22 datasets of various liver status were successfully applied in the evaluation. Experimental results showed that the registration error between the anatomical features of US and preoperative MR images is less than 3 mm on average. The lesion tracking error was also found to be less than 5 mm at maximum. Conclusions: A new system has been proposed for real-time registration between 2D US and successive multiple 3D preoperative MR/CT images of the liver and was applied for indirect lesion tracking for image-guided intervention. The system is fully automatic and robust even with images that had low quality due to patient status. Through visual examinations and quantitative evaluations, it was verified that the proposed system can provide high lesion tracking accuracy as well as high registration accuracy, at performance levels which were acceptable for various clinical applications.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Report of improved performance in Talbot–Lau phase-contrast computed tomography

Purpose: Many expectations have been raised since the use of conventional x-ray tubes on grating-based x-ray phase-contrast imaging. Despite a reported increase in contrast-to-noise ratio (CNR) in many publications, there is doubt on whether phase-contrast computed tomography (CT) is advantageous in clinical CT scanners in vivo. The aim of this paper is to contribute to this discussion by analyzing the performance of a phase-contrast CT laboratory setup. Methods: A phase-contrast CT performance analysis was done. Projection images of a phantom were recorded, and image slices were reconstructed using standard filtered back projection methods. The resulting image slices were analyzed by determining the CNRs in the attenuation and phase image. These results were compared to analytically calculated expectations according to the already published phase-contrast CT performance analysis by Raupach and Flohr [Med. Phys. 39, 4761–4774 (2012)]. There, a severe mistake was found leading to wrong predictions of the performance of phase-contrast CT. The error was corrected and with the new formulae, the experimentally obtained results matched the analytical calculations. Results: The squared ratios of the phase-contrast CNR and the attenuation CNR obtained in the authors’ experiment are five- to ten-fold higher than predicted by Raupach and Flohr [Med. Phys. 39, 4761–4774 (2012)]. The effective lateral spatial coherence length deduced outnumbers the already optimistic assumption of Raupach and Flohr [Med. Phys. 39, 4761–4774 (2012)] by a factor of 3. Conclusions: The authors’ results indicate that the assumptions made in former performance analyses are pessimistic. The break-even point, when phase-contrast CT outperforms attenuation CT, is within reach even with realistic, nonperfect gratings. Further improvements to state-of-the-art clinical CT scanners, like increasing the spatial resolution, could change the balance in favor of phase-contrast computed tomography even more. This could be done by, e.g., quantum-counting pixel detectors with four-fold smaller pixel pitches.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

T2-weighted four dimensional magnetic resonance imaging with result-driven phase sorting

Purpose: T2-weighted MRI provides excellent tumor-to-tissue contrast for target volume delineation in radiation therapy treatment planning. This study aims at developing a novel T2-weighted retrospective four dimensional magnetic resonance imaging (4D-MRI) phase sorting technique for imaging organ/tumor respiratory motion. Methods: A 2D fast T2-weighted half-Fourier acquisition single-shot turbo spin-echo MR sequence was used for image acquisition of 4D-MRI, with a frame rate of 2–3 frames/s. Respiratory motion was measured using an external breathing monitoring device. A phase sorting method was developed to sort the images by their corresponding respiratory phases. Besides, a result-driven strategy was applied to effectively utilize redundant images in the case when multiple images were allocated to a bin. This strategy, selecting the image with minimal amplitude error, will generate the most representative 4D-MRI. Since we are using a different image acquisition mode for 4D imaging (the sequential image acquisition scheme) with the conventionally used cine or helical image acquisition scheme, the 4D dataset sufficient condition was not obviously and directly predictable. An important challenge of the proposed technique was to determine the number of repeated scans (N{sub R}) required to obtain sufficient phase information at each slice position. To tackle this challenge, the authors first conducted computer simulations using real-time position management respiratory signals of the 29 cancer patients under an IRB-approved retrospective study to derive the relationships between N{sub R} and the following factors: number of slices (N{sub S}), number of 4D-MRI respiratory bins (N{sub B}), and starting phase at image acquisition (P{sub 0}). To validate the authors’ technique, 4D-MRI acquisition and reconstruction were simulated on a 4D digital extended cardiac-torso (XCAT) human phantom using simulation derived parameters. Twelve healthy volunteers were involved in an IRB-approved study to investigate the feasibility of this technique. Results: 4D data acquisition completeness (C{sub p}) increases as NR increases in an inverse-exponential fashion (C{sub p} = 100 − 99 × exp(−0.18 × N{sub R}), when N{sub B} = 6, fitted using 29 patients’ data). The N{sub R} required for 4D-MRI reconstruction (defined as achieving 95% completeness, C{sub p} = 95%, N{sub R} = N{sub R,95}) is proportional to N{sub B} (N{sub R,95} ∼ 2.86 × N{sub B}, r = 1.0), but independent of N{sub S} and P{sub 0}. Simulated XCAT 4D-MRI showed a clear pattern of respiratory motion. Tumor motion trajectories measured on 4D-MRI were comparable to the average input signal, with a mean relative amplitude error of 2.7% ± 2.9%. Reconstructed 4D-MRI for healthy volunteers illustrated clear respiratory motion on three orthogonal planes, with minimal image artifacts. The artifacts were presumably caused by breathing irregularity and incompleteness of data acquisition (95% acquired only). The mean relative amplitude error between critical structure trajectory and average breathing curve for 12 healthy volunteers is 2.5 ± 0.3 mm in superior–inferior direction. Conclusions: A novel T2-weighted retrospective phase sorting 4D-MRI technique has been developed and successfully applied on digital phantom and healthy volunteers.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Three dimensional dose distribution comparison of simple and complex acquisition trajectories in dedicated breast CT

Purpose: A novel breast CT system capable of arbitrary 3D trajectories has been developed to address cone beam sampling insufficiency as well as to image further into the patient’s chest wall. The purpose of this study was to characterize any trajectory-related differences in 3D x-ray dose distribution in a pendant target when imaged with different orbits. Methods: Two acquisition trajectories were evaluated: circular azimuthal (no-tilt) and sinusoidal (saddle) orbit with ±15° tilts around a pendant breast, using Monte Carlo simulations as well as physical measurements. Simulations were performed with tungsten (W) filtration of a W-anode source; the simulated source flux was normalized to the measured exposure of a W-anode source. A water-filled cylindrical phantom was divided into 1 cm{sup 3} voxels, and the cumulative energy deposited was tracked in each voxel. Energy deposited per voxel was converted to dose, yielding the 3D distributed dose volumes. Additionally, three cylindrical phantoms of different diameters (10, 12.5, and 15 cm) and an anthropomorphic breast phantom, initially filled with water (mimicking pure fibroglandular tissue) and then with a 75% methanol-25% water mixture (mimicking 50–50 fibroglandular-adipose tissues), were used to simulate the pendant breast geometry and scanned on the physical system. Ionization chamber calibrated radiochromic film was used to determine the dose delivered in a 2D plane through the center of the volume for a fully 3D CT scan using the different orbits. Results: Measured experimental results for the same exposure indicated that the mean dose measured throughout the central slice for different diameters ranged from 3.93 to 5.28 mGy, with the lowest average dose measured on the largest cylinder with water mimicking a homogeneously fibroglandular breast. These results align well with the cylinder phantom Monte Carlo studies which also showed a marginal difference in dose delivered by a saddle trajectory in the central slice. Regardless of phantom material or filled fluid density, dose delivered by the saddle scan was negligibly different than the simple circular, no-tilt scans. The average dose measured in the breast phantom was marginally higher for saddle than the circular no tilt scan at 3.82 and 3.87 mGy, respectively. Conclusions: Not only does nontraditional 3D-trajectory CT scanning yield more complete sampling of the breast volume but also has comparable dose deposition throughout the breast and anterior chest volume, as verified by Monte Carlo simulation and physical measurements.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-I-17: Evaluation of Commercially Available Extension Plates for the ACR CT Accreditation Phantom

Purpose: To evaluate the impact of commercially available extension plates on Hounsfield Unit (HU) values in the ACR CT accreditation phantom (Model 464, Gammex Inc., Middleton, Wi). The extension plates are intended to improve water HU values in scanners where the traditional solution involves scanning the phantom with an adjacent water or CTDI phantom. Methods: The Model 464 phantom was scanned on 9 different CT scanners at 8 separate sites representing 16 and 64 slice MDCT technology from four CT manufacturers. The phantom was scanned with and without the extension plates (Gammex 464 EXTPLT-KIT) in helical and axial modes. A water phantom was also scanned to verify water HU calibration. Technique was 120 kV tube potential, 350 mAs, and 210 mm display field of view. Slice thickness and reconstruction algorithm were based on site clinical protocols. The widest available beam collimation was used. Regions of interest were drawn on the HU test objects in Module 1 of the phantom and mean values recorded. Results: For all axial mode scans, water HU values were within limits with or without the extension plates. For two scanners (both Lightspeed VCT, GE Medical Systems, Waukesha WI), axial mode bone HU values were above the specified range both with and without the extension plates though they were closer to the specified range with the plates installed. In helical scan mode, two scanners (both GE Lightspeed VCT) had water HU values above the specified range without the plates installed. With the plates installed, the water HU values were within range for all scanners in all scan modes. Conclusion: Using the plates, the Lightspeed VCT scanners passed the water HU test when scanning in helical mode. The benefit of the extension plates was evident in helical mode scanning with GE scanners using a nominal 4 cm beam. Disclosure: The extension plates evaluated in this work were provided free of charge to the authors. The authors have no other financial interest in Gammex Inc.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-I-19: Optimization of Low Contrast Detectability Across Two CT Manufacturers

Purpose: Our goal was to evaluate low contrast detectability (LCD) for abdominal CT protocols across two CT scanner manufacturers, while producing a similar noise texture and CTDIvol for acquired images. Methods: A CIRS tissue equivalent LCD phantom containing three columns of 7 spherical targets, ranging from 10 mm to 2.4 mm, that are 5, 10, and 20 HU below the background matrix (HUBB) was scanned using two a GE HD750 64 slice scanner and a Siemens Somatom Definition AS 64 slice scanner. Protocols were designed to deliver a CTDIvol of 12.26 mGy and images were reconstructed with FBP, ASIR and Sapphire. Comparisons were made with those algorithms that had matching noise power spectrum peaks (NPS). NPS information was extracted from a previously published article that matched NPS peak frequencies across manufacturers by calculating the NPS from uniform phantom images reconstructed with several IR algorithms. Results: The minimum detectable lesion size in the 20 HUBB and 10 HUBB column was 6.3 mm, and 10 mm in the 5 HUBB column for the GE HD 750 scanner. The minimum detectable lesion size in the 20 HUBB column was 4.8 mm, in the 10 HUBB column, 9.5 mm, and the 5 HUBB column, 10 mm for the Siemens Somatom Definition AS. Conclusion: Reducing radiation dose while improving or maintaining LCD is possible with application of IR. However, there are several different IR algorithms, with each generating a different resolution and noise texture. In multi-manufacturer settings, matching only the CTDIvol between manufacturers may Result in a loss of clinically relevant information.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-I-21: Dosimetric Characterization and Image Quality Evaluation of the AIRO Mobile CT Scanner

Purpose: The AIRO Mobile CT system was recently introduced which overcomes the limitations from existing CT, CT fluoroscopy, and intraoperative O-arm. With an integrated table and a large diameter bore, the system is suitable for cranial, spine and trauma procedures, making it a highly versatile intraoperative imaging system. This study is to investigate radiation dose and image quality of the AIRO and compared with those from a routine CT scanner. Methods: Radiation dose was measured using a conventional 100mm pencil ionization chamber and CT polymethylmetacrylate (PMMA) body and head phantoms. Image quality was evaluated with a CATPHAN 500 phantom. Spatial resolution, low contrast resolution (CNR), Modulation Transfer Function (MTF), and Normalized Noise Power Spectrum (NNPS) were analyzed. Results: Under identical technique conditions, radiation dose (mGy/mAs) from the AIRO mobile CT system (AIRO) is higher than that from a 64 slice CT scanner. MTFs show that both Soft and Standard filters of the AIRO system lost resolution quickly compared to the Sensation 64 slice CT. With the Standard kernel, the spatial resolutions of the AIRO system are 3lp/cm and 4lp/cm for the body and head FOVs, respectively. NNPSs show low frequency noise due to ring-like artifacts. Due to a higher dose in terms of mGy/mAs at both head and body FOV, CNR of the AIRO system is higher than that of the Siemens scanner. However detectability of the low contrast objects is poorer in the AIRO due to the presence of ring artifacts in the location of the targets. Conclusion: For image guided surgery applications, the AIRO has some advantages over a routine CT scanner due to its versatility, large bore size, and acceptable image quality. Our evaluation of the physical performance helps its future improvements.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-I-23: A General KV Constrained Optimization of CNR for CT Abdominal Imaging

Purpose: While Tube current modulation has been well accepted for CT dose reduction, kV adjusting in clinical settings is still at its early stage. This is mainly due to the limited kV options of most current CT scanners. kV adjusting can potentially reduce radiation dose and optimize image quality. This study is to optimize CT abdomen imaging acquisition based on the assumption of a continuous kV, with the goal to provide the best contrast to noise ratio (CNR). Methods: For a given dose (CTDIvol) level, the CNRs at different kV and pitches were measured with an ACR GAMMEX phantom. The phantom was scanned in a Siemens Sensation 64 scanner and a GE VCT 64 scanner. A constrained mathematical optimization was used to find the kV which led to the highest CNR for the anatomy and pitch setting. Parametric equations were obtained from polynomial fitting of plots of kVs vs CNRs. A suitable constraint region for optimization was chosen. Subsequent optimization yielded a peak CNR at a particular kV for different collimations and pitch setting. Results: The constrained mathematical optimization approach yields kV of 114.83 and 113.46, with CNRs of 1.27 and 1.11 at the pitch of 1.2 and 1.4, respectively, for the Siemens Sensation 64 scanner with the collimation of 32 x 0.625mm. An optimized kV of 134.25 and 1.51 CNR is obtained for a GE VCT 64 slice scanner with a collimation of 32 x 0.625mm and a pitch of 0.969. At 0.516 pitch and 32 x 0.625 mm an optimized kV of 133.75 and a CNR of 1.14 was found for the GE VCT 64 slice scanner. Conclusion: CNR in CT image acquisition can be further optimized with a continuous kV option instead of current discrete or fixed kV settings. A continuous kV option is a key for individualized CT protocols.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-I-60: Quality Assurance Testing Methods and Customized Phantom for Magnetic Resonance Imaging and Spectroscopy

Purpose: The objectives of this study are to develop an magnetic resonance imaging and spectroscopy (MRI-MRS) fused phantom along with the inserts for metabolite quantification and to conduct quantitative analysis and evaluation of the layered vials of brain-mimicking solution for quality assurance (QA) performance, according to the localization sequence. Methods: The outer cylindrical phantom body is made of acrylic materials. The section other than where the inner vials are located was filled with copper sulfate and diluted with water so as to reduce the T1 relaxation time. Sodium chloride was included to provide conductivity similar to the human body. All measurements of MRI and MRS were made using a 3.0 T scanner (Achiva Tx 3.0 T; Philips Medical Systems, Netherlands). The MRI scan parameters were as follows: (1) spin echo (SE) T1-weighted image: repetition time (TR), 500ms; echo time (TE), 20ms; matrix, 256×256; field of view (FOV), 250mm; gap, 1mm; number of signal averages (NSA), 1; (2) SE T2-weighted image: TR, 2,500 ms; TE, 80 ms; matrix, 256×256; FOV, 250mm; gap, 1mm; NSA, 1; 23 slice images were obtained with slice thickness of 5mm. The water signal of each volume of interest was suppressed by variable pulse power and optimized relaxation delays (VAPOR) applied before the scan. By applying a point-resolved spectroscopy sequence, the MRS scan parameters were as follows: voxel size, 0.8×0.8×0.8 cm{sup 3}; TR, 2,000ms; TE, 35ms; NSA, 128. Results: Using the fused phantom, the results of measuring MRI factors were: geometric distortion, <2% and ±2 mm; image intensity uniformity, 83.09±1.33%; percent-signal ghosting, 0.025±0.004; low-contrast object detectability, 27.85±0.80. In addition, the signal-to-noise ratio of N-acetyl-aspartate was consistently high (42.00±5.66). Conclusion: The MRI-MRS QA factors obtained simultaneously using the phantom can facilitate evaluation of both images and spectra, and provide guidelines for obtaining MRI and MRS QA factors simultaneously. This study was supported by grant (2012-007883 and 2014R1A2A1A10050270) from the Mid-career Researcher Program through the NRF funded by Ministry of Science. In addition, this study was supported by the Industrial R&D of MOTIE/KEIT (10048997, Development of the core technology for integrated therapy devices based on real-time MRI-guided tumor tracking)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-J-25: End-To-End (E2E) Testing On TomoHDA System Using a Real Pig Head for Intracranial Radiosurgery

Purpose: To determine the MVCT imaging uncertainty on the TomoHDA system for intracranial radiosurgery treatments. To determine the end-to-end (E2E) overall accuracy of the TomoHDA system for intracranial radiosurgery. Methods: A pig head was obtained from the butcher, cut coronally through the brain, and preserved in formaldehyde. The base of the head was fixed to a positioning plate allowing precise movement, i.e. translation and rotation, in all 6 axes. A repeatability test was performed on the pig head to determine uncertainty in the image bone registration algorithm. Furthermore, the test studied images with MVCT slice thicknesses of 1 and 3 mm in unison with differing scan lengths. A sensitivity test was performed to determine the registration algorithm’s ability to find the absolute position of known translations/rotations of the pig head. The algorithm’s ability to determine absolute position was compared against that of manual operators, i.e. a radiation therapist and radiation oncologist. Finally, E2E tests for intracranial radiosurgery were performed by measuring the delivered dose distributions within the pig head using Gafchromic films. Results: The repeatability test uncertainty was lowest for the MVCTs of 1-mm slice thickness, which measured less than 0.10 mm and 0.12 deg for all axes. For the sensitivity tests, the bone registration algorithm performed better than human eyes and a maximum difference of 0.3 mm and 0.4 deg was observed for the axes. E2E test results in absolute position difference measured 0.03 ± 0.21 mm in x-axis and 0.28 ± 0.18 mm in y-axis. A maximum difference of 0.32 and 0.66 mm was observed in x and y, respectively. The average peak dose difference between measured and calculated dose was 2.7 cGy or 0.4%. Conclusion: Our tests using a pig head phantom estimate the TomoHDA system to have a submillimeter overall accuracy for intracranial radiosurgery.

60 APPLIED LIFE SCIENCES↗