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Velocity reconstruction in the era of DESI and Rubin/LSST. II. Realistic samples on the light cone

Reconstructing the galaxy peculiar velocity field from the distribution of large-scale structure plays an important role in cosmology. On one hand, it gives us an insight into structure formation and gravity; on the other, it allows us to selectively extract the kinetic Sunyaev-Zel’dovich (kSZ) effect from cosmic microwave background maps. In this work, we employ high-accuracy synthetic galaxy catalogs on the light cone to investigate how well we can recover the velocity field when utilizing the three-dimensional spatial distribution of the galaxies in a modern large-scale structure experiment such as the Dark Energy Spectroscopic Instrument (DESI) and the Rubin Observatory Legacy Survey of Space and Time. In particular, we adopt the standard technique used in baryon acoustic oscillation analysis for reconstructing the Zel’dovich displacements of galaxies through the continuity equation, which yields a first-order approximation to their large-scale velocities. We investigate variations in the number density, bias, mask, area, redshift noise, and survey depth, as well as modifications to the settings of the standard reconstruction algorithm. Since our main goal is to provide guidance for planned kSZ analysis between DESI and the Atacama Cosmology Telescope, we apply velocity reconstruction to a faithful representation of DESI spectroscopic and photometric targets. We report the cross-correlation coefficient between the reconstructed and the true velocities along the line of sight. For the DESI Y1 spectroscopic survey, we expect the correlation coefficient to be r ≈ 0.64, while for a photometric survey with δ z /(1+z) = 0.02, as is approximately the case for the Legacy Survey used in the target selection of DESI galaxies, r shrinks by half to r ≈ 0.31. Here, we hope the results in this paper can be used to inform future kSZ stacking studies and other velocity reconstruction analyses planned with the next generation of cosmology experiments.

79 ASTRONOMY AND ASTROPHYSICS↗

Transport of an intense proton beam from a cone-structured target through plastic foam with unique proton source modeling

Laser-accelerated proton beams are applicable to several research areas within high-energy density science, including warm dense matter generation, proton radiography, and inertial confinement fusion, which all involve transport of the beam through matter. Here, we report on experimental measurements of intense proton beam transport through plastic foam blocks. The intense proton beam was accelerated by the 10 ps, 700 $\textit{J}$ OMEGA EP laser irradiating a curved foil target, and focused by an attached hollow cone. The protons then entered the foam block of density 0.38 g/cm 3 and thickness 0.55 or 1.00 mm. At the rear of the foam block, a Cu layer revealed the cross section of the intense beam via proton- and hot electron-induced Cu-K α emission. Images of x-ray emission show a bright spot on the rear Cu film indicative of a forward-directed beam without major breakup. 2D fluid-PIC simulations of the transport were conducted using a unique multi-injection source model incorporating energy-dependent beam divergence. Along with postprocessed calculations of the Cu – $K_α$ emission profile, simulations showed that protons retain their ballistic transport through the foam and are able to heat the foam up to several keV in temperature. The total experimental emission profile for the 1.0 mm foam agrees qualitatively with the simulated profile, suggesting that the protons indeed retain their beamlike qualities.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗

Cone beam neutron interferometry: From modeling to applications

Phase-grating moiré interferometers (PGMIs) have emerged as promising candidates for the next generation of neutron interferometry, enabling the use of a polychromatic beam and manifesting interference patterns that can be directly imaged by existing neutron cameras. However, the modeling of the various PGMI configurations is limited to cumbersome numerical calculations and backward propagation models which often do not enable one to explore the setup parameters. Here we generalize the Fresnel scaling theorem to introduce a k -space model for PGMI setups illuminated by a cone beam, thus enabling an intuitive forward propagation model for a wide range of parameters and experimental setups. The interference manifested by a PGMI is shown to be a special case of the Talbot effect, and the optimal fringe visibility is shown to occur at the moiré location of the Talbot distances. We derive analytical expressions for the contrast and the propagating intensity profiles in various conditions and provide the first analysis of the PGMI dark-field imaging signal when considering sample characterization. The model's predictions are compared to experimental measurements and good agreement is found between them. Last, we propose and experimentally verify a method to recover contrast at typically inaccessible PGMI autocorrelation lengths. The presented work provides a toolbox for analyzing and understanding existing PGMI setups and their future applications, for example extensions to two-dimensional PGMIs and characterization of samples with nontrivial structures. Published by the American Physical Society 2024

Sarenac, D. (ORCID:0000000185753367)↗

Deformable planning CT to cone-beam CT image registration in head-and-neck cancer

Purpose: The purpose of this work was to implement and validate a deformable CT to cone-beam computed tomography (CBCT) image registration method in head-and-neck cancer to eventually facilitate automatic target delineation on CBCT. Methods: Twelve head-and-neck cancer patients underwent a planning CT and weekly CBCT during the 5-7 week treatment period. The 12 planning CT images (moving images) of these patients were registered to their weekly CBCT images (fixed images) via the symmetric force Demons algorithm and using a multiresolution scheme. Histogram matching was used to compensate for the intensity difference between the two types of images. Using nine known anatomic points as registration targets, the accuracy of the registration was evaluated using the target registration error (TRE). In addition, region-of-interest (ROI) contours drawn on the planning CT were morphed to the CBCT images and the volume overlap index (VOI) between registered contours and manually delineated contours was evaluated. Results: The mean TRE value of the nine target points was less than 3.0 mm, the slice thickness of the planning CT. Of the 369 target points evaluated for registration accuracy, the average TRE value was 2.6{+-}0.6 mm. The mean TRE for bony tissue targets was 2.4{+-}0.2 mm, while the mean TRE for soft tissue targets was 2.8{+-}0.2 mm. The average VOI between the registered and manually delineated ROI contours was 76.2{+-}4.6%, which is consistent with that reported in previous studies. Conclusions: The authors have implemented and validated a deformable image registration method to register planning CT images to weekly CBCT images in head-and-neck cancer cases. The accuracy of the TRE values suggests that they can be used as a promising tool for automatic target delineation on CBCT.

60 APPLIED LIFE SCIENCES↗

Demons deformable registration of CT and cone-beam CT using an iterative intensity matching approach

Purpose: A method of intensity-based deformable registration of CT and cone-beam CT (CBCT) images is described, in which intensity correction occurs simultaneously within the iterative registration process. The method preserves the speed and simplicity of the popular Demons algorithm while providing robustness and accuracy in the presence of large mismatch between CT and CBCT voxel values (''intensity''). Methods: A variant of the Demons algorithm was developed in which an estimate of the relationship between CT and CBCT intensity values for specific materials in the image is computed at each iteration based on the set of currently overlapping voxels. This tissue-specific intensity correction is then used to estimate the registration output for that iteration and the process is repeated. The robustness of the method was tested in CBCT images of a cadaveric head exhibiting a broad range of simulated intensity variations associated with x-ray scatter, object truncation, and/or errors in the reconstruction algorithm. The accuracy of CT-CBCT registration was also measured in six real cases, exhibiting deformations ranging from simple to complex during surgery or radiotherapy guided by a CBCT-capable C-arm or linear accelerator, respectively. Results: The iterative intensity matching approach was robust against all levels of intensity variation examined, including spatially varying errors in voxel value of a factor of 2 or more, as can be encountered in cases of high x-ray scatter. Registration accuracy without intensity matching degraded severely with increasing magnitude of intensity error and introduced image distortion. A single histogram match performed prior to registration alleviated some of these effects but was also prone to image distortion and was quantifiably less robust and accurate than the iterative approach. Within the six case registration accuracy study, iterative intensity matching Demons reduced mean TRE to (2.5{+-}2.8) mm compared to (3.5{+-}3.0) mm with rigid registration. Conclusions: A method was developed to iteratively correct CT-CBCT intensity disparity during Demons registration, enabling fast, intensity-based registration in CBCT-guided procedures such as surgery and radiotherapy, in which CBCT voxel values may be inaccurate. Accurate CT-CBCT registration in turn facilitates registration of multimodality preoperative image and planning data to intraoperative CBCT by way of the preoperative CT, thereby linking the intraoperative frame of reference to a wealth of preoperative information that could improve interventional guidance.

60 APPLIED LIFE SCIENCES↗

A method for robust segmentation of arbitrarily shaped radiopaque structures in cone-beam CT projections

Purpose: Implanted markers are commonly used in radiotherapy for x-ray based target localization. The projected marker position in a series of cone-beam CT (CBCT) projections can be used to estimate the three dimensional (3D) target trajectory during the CBCT acquisition. This has important applications in tumor motion management such as motion inclusive, gating, and tumor tracking strategies. However, for irregularly shaped markers, reliable segmentation is challenged by large variations in the marker shape with projection angle. The purpose of this study was to develop a semiautomated method for robust and reliable segmentation of arbitrarily shaped radiopaque markers in CBCT projections. Methods: The segmentation method involved the following three steps: (1) Threshold based segmentation of the marker in three to six selected projections with large angular separation, good marker contrast, and uniform background; (2) construction of a 3D marker model by coalignment and backprojection of the threshold-based segmentations; and (3) construction of marker templates at all imaging angles by projection of the 3D model and use of these templates for template-based segmentation. The versatility of the segmentation method was demonstrated by segmentation of the following structures in the projections from two clinical CBCT scans: (1) Three linear fiducial markers (Visicoil) implanted in or near a lung tumor and (2) an artificial cardiac valve in a lung cancer patient. Results: Automatic marker segmentation was obtained in more than 99.9% of the cases. The segmentation failed in a few cases where the marker was either close to a structure of similar appearance or hidden behind a dense structure (data cable). Conclusions: A robust template-based method for segmentation of arbitrarily shaped radiopaque markers in CBCT projections was developed.

60 APPLIED LIFE SCIENCES↗

Correction for patient table-induced scattered radiation in cone-beam computed tomography (CBCT)

Purpose: In image-guided radiotherapy, an artifact typically seen in axial slices of x-ray cone-beam computed tomography (CBCT) reconstructions is a dark region or ''black hole'' situated below the scan isocenter. The authors trace the cause of the artifact to scattered radiation produced by radiotherapy patient tabletops and show it is linked to the use of the offset-detector acquisition mode to enlarge the imaging field-of-view. The authors present a hybrid scatter kernel superposition (SKS) algorithm to correct for scatter from both the object-of-interest and the tabletop. Methods: Monte Carlo simulations and phantom experiments were first performed to identify the source of the black hole artifact. For correction, a SKS algorithm was developed that uses separate kernels to estimate scatter from the patient tabletop and the object-of-interest. Each projection is divided into two regions, one defined by the shadow cast by the tabletop on the imager and one defined by the unshadowed region. The region not shadowed by the tabletop is processed using the recently developed fast adaptive scatter kernel superposition (fASKS) method which employs asymmetric kernels that best model scatter transport through bodylike objects. The shadowed region is convolved with a combination of slab-derived symmetric SKS kernels and asymmetric fASKS kernels. The composition of the hybrid kernels is projection-angle-dependent. To test the algorithm, pelvis phantom and in vivo data were acquired using a CBCT test stand, a Varian Acuity simulator, and a Varian On-Board Imager, all of which have similar geometries and components. Artifact intensities and Hounsfield unit (HU) accuracies in the reconstructions were assessed before and after the correction. Results: The hybrid kernel algorithm provided effective correction and produced substantially better scatter estimates than the symmetric SKS or asymmetric fASKS methods alone. HU nonuniformities in the reconstructed pelvis phantom were reduced from 220 to 50 HU (i.e., 22%-5%). In the in vivo scans, the black hole artifact was reduced by up to 147 HU, a 73% improvement, and anatomical details in the prostate and rectum areas were made considerably more visible. Conclusions: Radiotherapy tabletops, which are generally flatter and larger than those used for diagnostic CT, can produce significant scatter-related artifacts. The proposed hybrid SKS algorithm accurately estimates scatter from both the object-of-interest and the patient tabletop, and resulting image uniformities and HU accuracies are greatly improved.

60 APPLIED LIFE SCIENCES↗

Cone-beam artifact evaluation of the factorization method

Purpose: The authors investigate the CB artifact behavior of the factorization approach recently suggested for image reconstruction in circular cone-beam computed tomography. This investigation is carried out in a typical C-arm geometry and involves simulated data and for the first time also phantom and clinical CB data acquired with a commercially available angiographic system. Methods: The CB artifact level is first measured using quantitative figures-of-merit that are computed from the reconstructions of the mathematical FORBILD head phantom and of a modified disk phantom. The authors then show reconstructions from a physical thorax phantom and clinical head data sets for a visual assessment of image quality. The performance of the factorization method is primarily compared to that of short-scan FDK, but the authors also show the results obtained with the full-scan FDK and the virtual PI-line BPF method for the simulation studies, as a benchmark. Results: Quantitatively, the FORBILD head phantom reconstructions of both FDK methods show a spatially averaged bias of up to 1.2% in the axial slices about 9 cm away from the plane of the scan, which is placed 4 cm below the central slice through the phantom. The artifact level for the short-scan FDK method and the virtual PI-line BPF method noticeably depends on the scan orientation. The factorization approach can significantly reduce both, this dependency as well as the reconstruction bias. It also shows visually an improved quality of the clinical images compared to short-scan FDK, particularly close to the spine and in the subcranial regions of the clinical data sets. Conclusions: The factorization approach comes with noticeably lower reconstruction bias than the FDK methods and is least sensitive to the scan orientation among all considered short-scan methods. The data inconsistencies contained in the real data sets, such as scatter, beam hardening, or data truncation, show only little impact on the factorization results. Hence, in both, reconstructions from real and simulated data, the factorization method yields better image quality than short-scan FDK, albeit at the cost of some slight, directed high-frequency artifacts that are mostly visible in axial slices.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Mobile C-arm cone-beam CT for guidance of spine surgery: Image quality, radiation dose, and integration with interventional guidance

Purpose: A flat-panel detector based mobile isocentric C-arm for cone-beam CT (CBCT) has been developed to allow intraoperative 3D imaging with sub-millimeter spatial resolution and soft-tissue visibility. Image quality and radiation dose were evaluated in spinal surgery, commonly relying on lower-performance image intensifier based mobile C-arms. Scan protocols were developed for task-specific imaging at minimum dose, in-room exposure was evaluated, and integration of the imaging system with a surgical guidance system was demonstrated in preclinical studies of minimally invasive spine surgery. Methods: Radiation dose was assessed as a function of kilovolt (peak) (80-120 kVp) and milliampere second using thoracic and lumbar spine dosimetry phantoms. In-room radiation exposure was measured throughout the operating room for various CBCT scan protocols. Image quality was assessed using tissue-equivalent inserts in chest and abdomen phantoms to evaluate bone and soft-tissue contrast-to-noise ratio as a function of dose, and task-specific protocols (i.e., visualization of bone or soft-tissues) were defined. Results were applied in preclinical studies using a cadaveric torso simulating minimally invasive, transpedicular surgery. Results: Task-specific CBCT protocols identified include: thoracic bone visualization (100 kVp; 60 mAs; 1.8 mGy); lumbar bone visualization (100 kVp; 130 mAs; 3.2 mGy); thoracic soft-tissue visualization (100 kVp; 230 mAs; 4.3 mGy); and lumbar soft-tissue visualization (120 kVp; 460 mAs; 10.6 mGy) - each at (0.3 x 0.3 x 0.9 mm{sup 3}) voxel size. Alternative lower-dose, lower-resolution soft-tissue visualization protocols were identified (100 kVp; 230 mAs; 5.1 mGy) for the lumbar region at (0.3 x 0.3 x 1.5 mm{sup 3}) voxel size. Half-scan orbit of the C-arm (x-ray tube traversing under the table) was dosimetrically advantageous (prepatient attenuation) with a nonuniform dose distribution ({approx}2 x higher at the entrance side than at isocenter, and {approx}3-4 lower at the exit side). The in-room dose (microsievert) per unit scan dose (milligray) ranged from {approx}21 {mu}Sv/mGy on average at tableside to {approx}0.1 {mu}Sv/mGy at 2.0 m distance to isocenter. All protocols involve surgical staff stepping behind a shield wall for each CBCT scan, therefore imparting {approx}zero dose to staff. Protocol implementation in preclinical cadaveric studies demonstrate integration of the C-arm with a navigation system for spine surgery guidance-specifically, minimally invasive vertebroplasty in which the system provided accurate guidance and visualization of needle placement and bone cement distribution. Cumulative dose including multiple intraoperative scans was {approx}11.5 mGy for CBCT-guided thoracic vertebroplasty and {approx}23.2 mGy for lumbar vertebroplasty, with dose to staff at tableside reduced to {approx}1 min of fluoroscopy time ({approx}40-60 {mu}Sv), compared to 5-11 min for the conventional approach. Conclusions: Intraoperative CBCT using a high-performance mobile C-arm prototype demonstrates image quality suitable to guidance of spine surgery, with task-specific protocols providing an important basis for minimizing radiation dose, while maintaining image quality sufficient for surgical guidance. Images demonstrate a significant advance in spatial resolution and soft-tissue visibility, and CBCT guidance offers the potential to reduce fluoroscopy reliance, reducing cumulative dose to patient and staff. Integration with a surgical guidance system demonstrates precise tracking and visualization in up-to-date images (alleviating reliance on preoperative images only), including detection of errors or suboptimal surgical outcomes in the operating room.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

A dedicated cone-beam CT system for musculoskeletal extremities imaging: Design, optimization, and initial performance characterization

Purpose: This paper reports on the design and initial imaging performance of a dedicated cone-beam CT (CBCT) system for musculoskeletal (MSK) extremities. The system complements conventional CT and MR and offers a variety of potential clinical and logistical advantages that are likely to be of benefit to diagnosis, treatment planning, and assessment of therapy response in MSK radiology, orthopaedic surgery, and rheumatology. Methods: The scanner design incorporated a host of clinical requirements (e.g., ability to scan the weight-bearing knee in a natural stance) and was guided by theoretical and experimental analysis of image quality and dose. Such criteria identified the following basic scanner components and system configuration: a flat-panel detector (FPD, Varian 3030+, 0.194 mm pixels); and a low-power, fixed anode x-ray source with 0.5 mm focal spot (SourceRay XRS-125-7K-P, 0.875 kW) mounted on a retractable C-arm allowing for two scanning orientations with the capability for side entry, viz. a standing configuration for imaging of weight-bearing lower extremities and a sitting configuration for imaging of tensioned upper extremity and unloaded lower extremity. Theoretical modeling employed cascaded systems analysis of modulation transfer function (MTF) and detective quantum efficiency (DQE) computed as a function of system geometry, kVp and filtration, dose, source power, etc. Physical experimentation utilized an imaging bench simulating the scanner geometry for verification of theoretical results and investigation of other factors, such as antiscatter grid selection and 3D image quality in phantom and cadaver, including qualitative comparison to conventional CT. Results: Theoretical modeling and benchtop experimentation confirmed the basic suitability of the FPD and x-ray source mentioned above. Clinical requirements combined with analysis of MTF and DQE yielded the following system geometry: a {approx}55 cm source-to-detector distance; 1.3 magnification; a 20 cm diameter bore (20 x 20 x 20 cm{sup 3} field of view); total acquisition arc of {approx}240 deg. The system MTF declines to 50% at {approx}1.3 mm{sup -1} and to 10% at {approx}2.7 mm{sup -1}, consistent with sub-millimeter spatial resolution. Analysis of DQE suggested a nominal technique of 90 kVp (+0.3 mm Cu added filtration) to provide high imaging performance from {approx}500 projections at less than {approx}0.5 kW power, implying {approx}6.4 mGy (0.064 mSv) for low-dose protocols and {approx}15 mGy (0.15 mSv) for high-quality protocols. The experimental studies show improved image uniformity and contrast-to-noise ratio (without increase in dose) through incorporation of a custom 10:1 GR antiscatter grid. Cadaver images demonstrate exquisite bone detail, visualization of articular morphology, and soft-tissue visibility comparable to diagnostic CT (10-20 HU contrast resolution). Conclusions: The results indicate that the proposed system will deliver volumetric images of the extremities with soft-tissue contrast resolution comparable to diagnostic CT and improved spatial resolution at potentially reduced dose. Cascaded systems analysis provided a useful basis for system design and optimization without costly repeated experimentation. A combined process of design specification, image quality analysis, clinical feedback, and revision yielded a prototype that is now awaiting clinical pilot studies. Potential advantages of the proposed system include reduced space and cost, imaging of load-bearing extremities, and combined volumetric imaging with real-time fluoroscopy and digital radiography.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Three-dimensional anisotropic adaptive filtering of projection data for noise reduction in cone beam CT

Purpose: The combination of quickly rotating C-arm gantry with digital flat panel has enabled the acquisition of three-dimensional data (3D) in the interventional suite. However, image quality is still somewhat limited since the hardware has not been optimized for CT imaging. Adaptive anisotropic filtering has the ability to improve image quality by reducing the noise level and therewith the radiation dose without introducing noticeable blurring. By applying the filtering prior to 3D reconstruction, noise-induced streak artifacts are reduced as compared to processing in the image domain. Methods: 3D anisotropic adaptive filtering was used to process an ensemble of 2D x-ray views acquired along a circular trajectory around an object. After arranging the input data into a 3D space (2D projections + angle), the orientation of structures was estimated using a set of differently oriented filters. The resulting tensor representation of local orientation was utilized to control the anisotropic filtering. Low-pass filtering is applied only along structures to maintain high spatial frequency components perpendicular to these. The evaluation of the proposed algorithm includes numerical simulations, phantom experiments, and in-vivo data which were acquired using an AXIOM Artis dTA C-arm system (Siemens AG, Healthcare Sector, Forchheim, Germany). Spatial resolution and noise levels were compared with and without adaptive filtering. A human observer study was carried out to evaluate low-contrast detectability. Results: The adaptive anisotropic filtering algorithm was found to significantly improve low-contrast detectability by reducing the noise level by half (reduction of the standard deviation in certain areas from 74 to 30 HU). Virtually no degradation of high contrast spatial resolution was observed in the modulation transfer function (MTF) analysis. Although the algorithm is computationally intensive, hardware acceleration using Nvidia's CUDA Interface provided an 8.9-fold speed-up of the processing (from 1336 to 150 s). Conclusions: Adaptive anisotropic filtering has the potential to substantially improve image quality and/or reduce the radiation dose required for obtaining 3D image data using cone beam CT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Four-dimensional volume-of-interest reconstruction for cone-beam computed tomography-guided radiation therapy

Purpose: Data sufficiency are a major problem in four-dimensional cone-beam computed tomography (4D-CBCT) on linear accelerator-integrated scanners for image-guided radiotherapy. Scan times must be in the range of 4-6 min to avoid undersampling artifacts. Various image reconstruction algorithms have been proposed to accommodate undersampled data acquisitions, but these algorithms are computationally expensive, may require long reconstruction times, and may require algorithm parameters to be optimized. The authors present a novel reconstruction method, 4D volume-of-interest (4D-VOI) reconstruction which suppresses undersampling artifacts and resolves lung tumor motion for undersampled 1-min scans. The 4D-VOI reconstruction is much less computationally expensive than other 4D-CBCT algorithms. Methods: The 4D-VOI method uses respiration-correlated projection data to reconstruct a four-dimensional (4D) image inside a VOI containing the moving tumor, and uncorrelated projection data to reconstruct a three-dimensional (3D) image outside the VOI. Anatomical motion is resolved inside the VOI and blurred outside the VOI. The authors acquired a 1-min. scan of an anthropomorphic chest phantom containing a moving water-filled sphere. The authors also used previously acquired 1-min scans for two lung cancer patients who had received CBCT-guided radiation therapy. The same raw data were used to test and compare the 4D-VOI reconstruction with the standard 4D reconstruction and the McKinnon-Bates (MB) reconstruction algorithms. Results: Both the 4D-VOI and the MB reconstructions suppress nearly all the streak artifacts compared with the standard 4D reconstruction, but the 4D-VOI has 3-8 times greater contrast-to-noise ratio than the MB reconstruction. In the dynamic chest phantom study, the 4D-VOI and the standard 4D reconstructions both resolved a moving sphere with an 18 mm displacement. The 4D-VOI reconstruction shows a motion blur of only 3 mm, whereas the MB reconstruction shows a motion blur of 13 mm. With graphics processing unit hardware used to accelerate computations, the 4D-VOI reconstruction required a 40-s reconstruction time. Conclusions: 4D-VOI reconstruction effectively reduces undersampling artifacts and resolves lung tumor motion in 4D-CBCT. The 4D-VOI reconstruction is computationally inexpensive compared with more sophisticated iterative algorithms. Compared with these algorithms, our 4D-VOI reconstruction is an attractive alternative in 4D-CBCT for reconstructing target motion without generating numerous streak artifacts.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Megavoltage cone beam CT near surface dose measurements: potential implications for breast radiotherapy

Purpose: Cone beam computed tomography (CBCT) is fast becoming standard on modern linear accelerators. CBCT increases the dose to regions within and outside the treatment field, potentially increasing secondary cancer induction and toxicity. This study quantified megavoltage (MV) CBCT skin dose and compared it to skin dose delivered during standard tangential breast radiotherapy.Method: Dosimetry was performed both in- and out-of-field using thermoluminescent dosimeters (TLDs) and a metal-oxide-semiconductor-field-effect-transistor (MOSFET) detector specifically designed for skin dosimetry; these were placed superficially on a female anthropomorphic phantom. Results: The skin dose from a single treatment fraction ranged from 0.5 to 1.4 Gy on the ipsilateral breast, 0.031-0.18 Gy on the contralateral breast, and 0-0.02 Gy in the head and pelvic region. An 8 MU MV CBCT delivered a skin dose that ranged from 0.02 to 0.05 Gy in the chest region and was less than 0.01 Gy in the head and pelvis regions. One MV CBCT per fraction was found to increase the out-of-field skin dose from both the CBCT and the treatment fields by approximately 20%. The imaging dose as a percentage of treatment doses in the ipsilateral breast region was 3% for both dosimeters.Conclusion: Imaging increases the skin dose to regions outside the treatment field particularly regions immediately adjacent the target volume. This small extra dose to the breasts should be considered when developing clinical protocols and assessing dose for clinical trials.

61 RADIATION PROTECTION AND DOSIMETRY↗

Image quality improvement in megavoltage cone beam CT using an imaging beam line and a sintered pixelated array system

Purpose: To quantify the improvement in megavoltage cone beam computed tomography (MVCBCT) image quality enabled by the combination of a 4.2 MV imaging beam line (IBL) with a carbon electron target and a detector system equipped with a novel sintered pixelated array (SPA) of translucent Gd{sub 2}O{sub 2}S ceramic scintillator. Clinical MVCBCT images are traditionally acquired with the same 6 MV treatment beam line (TBL) that is used for cancer treatment, a standard amorphous Si (a-Si) flat panel imager, and the Kodak Lanex Fast-B (LFB) scintillator. The IBL produces a greater fluence of keV-range photons than the TBL, to which the detector response is more optimal, and the SPA is a more efficient scintillator than the LFB. Methods: A prototype IBL + SPA system was installed on a Siemens Oncor linear accelerator equipped with the MVision{sup TM} image guided radiation therapy (IGRT) system. A SPA strip consisting of four neighboring tiles and measuring 40 cm by 10.96 cm in the crossplane and inplane directions, respectively, was installed in the flat panel imager. Head- and pelvis-sized phantom images were acquired at doses ranging from 3 to 60 cGy with three MVCBCT configurations: TBL + LFB, IBL + LFB, and IBL + SPA. Phantom image quality at each dose was quantified using the contrast-to-noise ratio (CNR) and modulation transfer function (MTF) metrics. Head and neck, thoracic, and pelvic (prostate) cancer patients were imaged with the three imaging system configurations at multiple doses ranging from 3 to 15 cGy. The systems were assessed qualitatively from the patient image data. Results: For head and neck and pelvis-sized phantom images, imaging doses of 3 cGy or greater, and relative electron densities of 1.09 and 1.48, the CNR average improvement factors for imaging system change of TBL + LFB to IBL + LFB, IBL + LFB to IBL + SPA, and TBL + LFB to IBL + SPA were 1.63 (p < 10{sup -8}), 1.64 (p < 10{sup -13}), 2.66 (p < 10{sup -9}), respectively. For all imaging doses, soft tissue contrast was more easily differentiated on IBL + SPA head and neck and pelvic images than TBL + LFB and IBL + LFB. IBL + SPA thoracic images were comparable to IBL + LFB images, but less noisy than TBL + LFB images at all imaging doses considered. The mean MTFs over all imaging doses were comparable, at within 3%, for all imaging system configurations for both the head- and pelvis-sized phantoms. Conclusions: Since CNR scales with the square root of imaging dose, changing from TBL + LFB to IBL + LFB and IBL + LFB to IBL + SPA reduces the imaging dose required to obtain a given CNR by factors of 0.38 and 0.37, respectively. MTFs were comparable between imaging system configurations. IBL + SPA patient image quality was always better than that of the TBL + LFB system and as good as or better than that of the IBL + LFB system, for a given dose.

61 RADIATION PROTECTION AND DOSIMETRY↗

High resolution dual detector volume-of-interest cone beam breast CT - Demonstration with a bench top system

Purpose: In this study, we used a small field high resolution detector in conjunction with a full field flat panel detector to implement and investigate the dual detector volume-of-interest (VOI) cone beam breast computed tomography (CBCT) technique on a bench-top system. The potential of using this technique to image small calcifications without increasing the overall dose to the breast was demonstrated. Significant reduction of scatter components in the high resolution projection image data of the VOI was also shown. Methods: With the regular flat panel based CBCT technique, exposures were made at 80 kVp to generate an air kerma of 6 mGys at the isocenter. With the dual detector VOI CBCT technique, a high resolution small field CMOS detector was used to scan a cylindrical VOI (2.5 cm in diameter and height, 4.5 cm off-center) with collimated x-rays at four times of regular exposure level. A flat panel detector was used for full field scan with low x-ray exposures at half of the regular exposure level. The low exposure full field image data were used to fill in the truncated space in the VOI scan data and generate a complete projection image set. The Feldkamp-Davis-Kress (FDK) filtered backprojection algorithm was used to reconstruct high resolution images for the VOI. Two scanning techniques, one breast centered and the other VOI centered, were implemented and investigated. Paraffin cylinders with embedded thin aluminum (Al) wires were imaged and used in conjunction with optically stimulated luminescence (OSL) dose measurements to demonstrate the ability of this technique to image small calcifications without increasing the mean glandular dose (MGD). Results: Using exposures that produce an air kerma of 6 mGys at the isocenter, the regular CBCT technique was able to resolve the cross-sections of Al wires as thin as 254 {mu}m in diameter in the phantom. For the specific VOI studied, by increasing the exposure level by a factor of 4 for the VOI scan and reducing the exposure level by a factor of 2 for the full filed scan, the dual-detector CBCT technique was able to resolve the cross-sections of Al wires as thin as 152 {mu}m in diameter. The CNR evaluated for the entire Al wire cross-section was found to be improved from 5.5 in regular CBCT to 14.4 and 16.8 with the breast centered and VOI centered scanning techniques, respectively. Even inside VOI center, the VOI scan resulted in significant dose saving with the dose reduced by a factor of 1.6 at the VOI center. Dose saving outside the VOI was substantial with the dose reduced by a factor of 7.3 and 7.8 at the breast center for the breast centered and VOI centered scans, respectively, when compared to full field scan at the same exposure level. The differences between the two dual detector techniques in terms of dose saving and scatter reduction were small with VOI scan at 4x exposure level and full field scan at 0.5x exposure level. The MGDs were only 94% of that from the regular CBCT scan. Conclusions: For the specific VOI studied, the dual detector VOI CBCT technique has the potential to provide high quality images inside the VOI with MGD similar to or even lower than that of full field breast CBCT. It was also found that our results were compromised by the use of inadequate detectors for the VOI scan. An appropriately selected detector would better optimize the image quality improvement that can be achieved with the VOI CBCT technique.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Antiscatter grids in mobile C-arm cone-beam CT: Effect on image quality and dose

Purpose: X-ray scatter is a major detriment to image quality in cone-beam CT (CBCT). Existing geometries exhibit strong differences in scatter susceptibility with more compact geometries, e.g., dental or musculoskeletal, benefiting from antiscatter grids, whereas in more extended geometries, e.g., IGRT, grid use carries tradeoffs in image quality per unit dose. This work assesses the tradeoffs in dose and image quality for grids applied in the context of low-dose CBCT on a mobile C-arm for image-guided surgery. Methods: Studies were performed on a mobile C-arm equipped with a flat-panel detector for high-quality CBCT. Antiscatter grids of grid ratio (GR) 6:1-12:1, 40 lp/cm, were tested in ''body'' surgery, i.e., spine, using protocols for bone and soft-tissue visibility in the thoracic and abdominal spine. Studies focused on grid orientation, CT number accuracy, image noise, and contrast-to-noise ratio (CNR) in quantitative phantoms at constant dose. Results: There was no effect of grid orientation on possible gridline artifacts, given accurate angle-dependent gain calibration. Incorrect calibration was found to result in gridline shadows in the projection data that imparted high-frequency artifacts in 3D reconstructions. Increasing GR reduced errors in CT number from 31%, thorax, and 37%, abdomen, for gridless operation to 2% and 10%, respectively, with a 12:1 grid, while image noise increased by up to 70%. The CNR of high-contrast objects was largely unaffected by grids, but low-contrast soft-tissues suffered reduction in CNR, 2%-65%, across the investigated GR at constant dose. Conclusions: While grids improved CT number accuracy, soft-tissue CNR was reduced due to attenuation of primary radiation. CNR could be restored by increasing dose by factors of {approx}1.6-2.5 depending on GR, e.g., increase from 4.6 mGy for the thorax and 12.5 mGy for the abdomen without antiscatter grids to approximately 12 mGy and 30 mGy, respectively, with a high-GR grid. However, increasing the dose poses a significant impediment to repeat intraoperative CBCT and can cause the cumulative intraoperative dose to exceed that of a single diagnostic CT scan. This places the mobile C-arm in the category of extended CBCT geometries with sufficient air gap for which the tradeoffs between CNR and dose typically do not favor incorporation of an antiscatter grid.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Scatter correction in cone-beam CT via a half beam blocker technique allowing simultaneous acquisition of scatter and image information

Purpose: X-ray scatter incurred to detectors degrades the quality of cone-beam computed tomography (CBCT) and represents a problem in volumetric image guided and adaptive radiation therapy. Several methods using a beam blocker for the estimation and subtraction of scatter have been proposed. However, due to missing information resulting from the obstruction of the blocker, such methods require dual scanning or dynamically moving blocker to obtain a complete volumetric image. Here, we propose a half beam blocker-based approach, in conjunction with a total variation (TV) regularized Feldkamp-Davis-Kress (FDK) algorithm, to correct scatter-induced artifacts by simultaneously acquiring image and scatter information from a single-rotation CBCT scan. Methods: A half beam blocker, comprising lead strips, is used to simultaneously acquire image data on one side of the projection data and scatter data on the other half side. One-dimensional cubic B-Spline interpolation/extrapolation is applied to derive patient specific scatter information by using the scatter distributions on strips. The estimated scatter is subtracted from the projection image acquired at the opposite view. With scatter-corrected projections where this subtraction is completed, the FDK algorithm based on a cosine weighting function is performed to reconstruct CBCT volume. To suppress the noise in the reconstructed CBCT images produced by geometric errors between two opposed projections and interpolated scatter information, total variation regularization is applied by a minimization using a steepest gradient descent optimization method. The experimental studies using Catphan504 and anthropomorphic phantoms were carried out to evaluate the performance of the proposed scheme. Results: The scatter-induced shading artifacts were markedly suppressed in CBCT using the proposed scheme. Compared with CBCT without a blocker, the nonuniformity value was reduced from 39.3% to 3.1%. The root mean square error relative to values inside the regions of interest selected from a benchmark scatter free image was reduced from 50 to 11.3. The TV regularization also led to a better contrast-to-noise ratio. Conclusions: An asymmetric half beam blocker-based FDK acquisition and reconstruction technique has been established. The proposed scheme enables simultaneous detection of patient specific scatter and complete volumetric CBCT reconstruction without additional requirements such as prior images, dual scans, or moving strips.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Quantitative cone-beam CT imaging in radiation therapy using planning CT as a prior: First patient studies

Purpose: Quantitative cone-beam CT (CBCT) imaging is on increasing demand for high-performance image guided radiation therapy (IGRT). However, the current CBCT has poor image qualities mainly due to scatter contamination. Its current clinical application is therefore limited to patient setup based on only bony structures. To improve CBCT imaging for quantitative use, we recently proposed a correction method using planning CT (pCT) as the prior knowledge. Promising phantom results have been obtained on a tabletop CBCT system, using a correction scheme with rigid registration and without iterations. More challenges arise in clinical implementations of our method, especially because patients have large organ deformation in different scans. In this paper, we propose an improved framework to extend our method from bench to bedside by including several new components. Methods: The basic principle of our correction algorithm is to estimate the primary signals of CBCT projections via forward projection on the pCT image, and then to obtain the low-frequency errors in CBCT raw projections by subtracting the estimated primary signals and low-pass filtering. We improve the algorithm by using deformable registration to minimize the geometry difference between the pCT and the CBCT images. Since the registration performance relies on the accuracy of the CBCT image, we design an optional iterative scheme to update the CBCT image used in the registration. Large correction errors result from the mismatched objects in the pCT and the CBCT scans. Another optional step of gas pocket and couch matching is added into the framework to reduce these effects. Results: The proposed method is evaluated on four prostate patients, of which two cases are presented in detail to investigate the method performance for a large variety of patient geometry in clinical practice. The first patient has small anatomical changes from the planning to the treatment room. Our algorithm works well even without the optional iterations and the gas pocket and couch matching. The image correction on the second patient is more challenging due to the effects of gas pockets and attenuating couch. The improved framework with all new components is used to fully evaluate the correction performance. The enhanced image quality has been evaluated using mean CT number and spatial nonuniformity (SNU) error as well as contrast improvement factor. If the pCT image is considered as the ground truth, on the four patients, the overall mean CT number error is reduced from over 300 HU to below 16 HU in the selected regions of interest (ROIs), and the SNU error is suppressed from over 18% to below 2%. The average soft-tissue contrast is improved by an average factor of 2.6. Conclusions: We further improve our pCT-based CBCT correction algorithm for clinical use. Superior correction performance has been demonstrated on four patient studies. By providing quantitative CBCT images, our approach significantly increases the accuracy of advanced CBCT-based clinical applications for IGRT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗