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At least 829 records · Page 46
All sourcesNASA NTRSDOE OSTI
DOE OSTI2012

Dosimetric and deformation effects of image-guided interventions during stereotactic body radiation therapy of the prostate using an endorectal balloon

Purpose: During stereotactic body radiation therapy (SBRT) for the treatment of prostate cancer, an inflatable endorectal balloon (ERB) may be used to reduce motion of the target and reduce the dose to the posterior rectal wall. This work assessed the dosimetric impact of manual interventions on ERB position in patients receiving prostate SBRT and investigated the impact of ERB interventions on prostate shape. Methods: The data of seven consecutive patients receiving SBRT for the treatment of clinical stage T1cN0M0 prostate cancer enrolled in a multi-institutional, IRB-approved trial were analyzed. The SBRT dose was 50 Gy in five fractions to a planning target volume (PTV) that included the prostate (implanted with three fiducial markers) with a 3-5 mm margin. All plans were based on simulation images that included an ERB inflated with 60 cm{sup 3} of air. Daily kilovoltage cone-beam computed tomography (CBCT) imaging was performed to localize the PTV, and an automated fusion with the planning images yielded displacements required for PTV relocalization. When the ERB volume and/or position were judged to yield inaccurate repositioning, manual adjustment (ERB reinflation and/or repositioning) was performed. Based on all 59 CBCT image sets acquired, a deformable registration algorithm was used to determine the dose received by, displacement of, and deformation of the prostate, bladder (BLA), and anterior rectal wall (ARW). This dose tracking methodology was applied to images taken before and after manual adjustment of the ERB (intervention), and the delivered dose was compared to that which would have been delivered in the absence of intervention. Results: Interventions occurred in 24 out of 35 (69%) of the treated fractions. The direct effect of these interventions was an increase in the prostate radiation dose that included 95% of the PTV (D95) from 9.6 {+-} 1.0 to 10.0 {+-} 0.2 Gy (p = 0.06) and an increase in prostate coverage from 94.0% {+-} 8.5% to 97.8% {+-} 1.9% (p = 0.03). Additionally, ERB interventions reduced prostate deformation in the anterior-posterior (AP) direction, reduced errors in the sagittal rotation of the prostate, and increased the similarity in shape of the prostate to the radiotherapy plan (increased Dice coefficient from 0.76 {+-} 0.06 to 0.80 {+-} 0.04, p = 0.01). Postintervention decreases in prostate volume receiving less than the prescribed dose and decreases in the voxel-wise displacement of the prostate, bladder, and anterior rectal wall were observed, which resulted in improved dose-volume histogram (DVH) characteristics. Conclusions: Image-guided interventions in ERB volume and/or position during prostate SBRT were necessary to ensure the delivery of the dose distribution as planned. ERB interventions resulted in reductions in prostate deformations that would have prevented accurate localization of patient anatomy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Noise spatial nonuniformity and the impact of statistical image reconstruction in CT myocardial perfusion imaging

Purpose: To achieve high temporal resolution in CT myocardial perfusion imaging (MPI), images are often reconstructed using filtered backprojection (FBP) algorithms from data acquired within a short-scan angular range. However, the variation in the central angle from one time frame to the next in gated short scans has been shown to create detrimental partial scan artifacts when performing quantitative MPI measurements. This study has two main purposes. (1) To demonstrate the existence of a distinct detrimental effect in short-scan FBP, i.e., the introduction of a nonuniform spatial image noise distribution; this nonuniformity can lead to unexpectedly high image noise and streaking artifacts, which may affect CT MPI quantification. (2) To demonstrate that statistical image reconstruction (SIR) algorithms can be a potential solution to address the nonuniform spatial noise distribution problem and can also lead to radiation dose reduction in the context of CT MPI. Methods: Projection datasets from a numerically simulated perfusion phantom and an in vivo animal myocardial perfusion CT scan were used in this study. In the numerical phantom, multiple realizations of Poisson noise were added to projection data at each time frame to investigate the spatial distribution of noise. Images from all datasets were reconstructed using both FBP and SIR reconstruction algorithms. To quantify the spatial distribution of noise, the mean and standard deviation were measured in several regions of interest (ROIs) and analyzed across time frames. In the in vivo study, two low-dose scans at tube currents of 25 and 50 mA were reconstructed using FBP and SIR. Quantitative perfusion metrics, namely, the normalized upslope (NUS), myocardial blood volume (MBV), and first moment transit time (FMT), were measured for two ROIs and compared to reference values obtained from a high-dose scan performed at 500 mA. Results: Images reconstructed using FBP showed a highly nonuniform spatial distribution of noise. This spatial nonuniformity led to large fluctuations in the temporal direction. In the numerical phantom study, the level of noise was shown to vary by as much as 87% within a given image, and as much as 110% between different time frames for a ROI far from isocenter. The spatially nonuniform noise pattern was shown to correlate with the source trajectory and the object structure. In contrast, images reconstructed using SIR showed a highly uniform spatial distribution of noise, leading to smaller unexpected noise fluctuations in the temporal direction when a short scan angular range was used. In the numerical phantom study, the noise varied by less than 37% within a given image, and by less than 20% between different time frames. Also, the noise standard deviation in SIR images was on average half of that of FBP images. In the in vivo studies, the deviation observed between quantitative perfusion metrics measured from low-dose scans and high-dose scans was mitigated when SIR was used instead of FBP to reconstruct images. Conclusions: (1) Images reconstructed using FBP suffered from nonuniform spatial noise levels. This nonuniformity is another manifestation of the detrimental effects caused by short-scan reconstruction in CT MPI. (2) Images reconstructed using SIR had a much lower and more uniform noise level and thus can be used as a potential solution to address the FBP nonuniformity. (3) Given the improvement in the accuracy of the perfusion metrics when using SIR, it may be desirable to use a statistical reconstruction framework to perform low-dose dynamic CT MPI.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Hysterosalpingography using a flat panel unit: Evaluation and optimization of ovarian radiation dose

Purpose: The aim of the present study was the evaluation and optimization of radiation dose to the ovaries (D) in hysterosalpingography (HSG). Methods: The study included a phantom study and a clinical one. In the phantom study, we evaluated imaging results for different geometrical setups and irradiation conditions. In the clinical study, 34 women were assigned into three different fluoroscopy modes and D was estimated with direct cervical TLD measurements. Results: In the phantom study, we used a source-to-image-distance (SID) of 110 cm and a field diagonal of 48 cm, and thus decreased air KERMA rate (KR) by 19% and 70%, respectively, for beam filtration: 4 mm Al and 0.9 mm Cu (Low dose). The least radiation exposure was accomplished by using the 3.75 pps fluoroscopy mode in conjunction with beam filtration: Low dose. In the clinical study, D normalized to 50 s of fluoroscopy time with a 3.75 pps fluoroscopy mode reached a value of 0.45 {+-} 0.04 mGy. Observers' evaluation of diagnostic image quality did not significantly differ for the three different modes of acquisition that were compared. Conclusions: Digital spot radiographs could be omitted in modern flat panel systems during HSG. Fluoroscopy image acquisitions in a modern flat panel unit at 3.75 pps and a beam filtration of 4 mm Al and 0.9 mm Cu demonstrate acceptable image quality with an average D equal to 0.45 mGy. This value is lower compared to the studied literature. For these reasons, the proposed method may be recommended for routine HSG examination in order to limit radiation exposure to the ovaries.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Microfocus x-ray imaging of traceable pointlike {sup 22}Na sources for quality control

Purpose: The purpose of this study is to propose a microfocus x-ray imaging technique for observing the internal structure of small radioactive sources and evaluating geometrical errors quantitatively, and to apply this technique to traceable pointlike {sup 22}Na sources, which were designed for positron emission tomography calibration, for the purpose of quality control of the pointlike sources. Methods: A microfocus x-ray imaging system with a focus size of 0.001 mm was used to obtain projection x-ray images and x-ray CT images of five pointlike source samples, which were manufactured during 2009-2012. The obtained projection and tomographic images were used to observe the internal structure and evaluate geometrical errors quantitatively. Monte Carlo simulation was used to evaluate the effect of possible geometrical errors on the intensity and uniformity of 0.511 MeV annihilation photon pairs emitted from the sources. Results: Geometrical errors were evaluated with sufficient precision using projection x-ray images. CT images were used for observing the internal structure intuitively. As a result, four of the five examined samples were within the tolerance to maintain the total uncertainty below {+-}0.5%, given the source radioactivity; however, one sample was found to be defective. Conclusions: This quality control procedure is crucial and offers an important basis for using the pointlike {sup 22}Na source as a basic calibration tool. The microfocus x-ray imaging approach is a promising technique for visual and quantitative evaluation of the internal geometry of small radioactive sources.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2012

Beam generation and planar imaging at energies below 2.40 MeV with carbon and aluminum linear accelerator targets

Purpose: Recent work has demonstrated improvement of image quality with low-Z linear accelerator targets and energies as low as 3.5 MV. In this paper, the authors lower the incident electron beam energy between 1.90 and 2.35 MeV and assess the improvement of megavoltage planar image quality with the use of carbon and aluminum linear accelerator targets. Methods: The bending magnet shunt current was adjusted in a Varian linear accelerator to allow selection of mean electron energy between 1.90 and 2.35 MeV. Linac set points were altered to increase beam current to allow experimental imaging in a practical time frame. Electron energy was determined through comparison of measured and Monte Carlo modeled depth dose curves. Planar image CNR and spatial resolution measurements were performed to quantify the improvement of image quality. Magnitudes of improvement are explained with reference to Monte Carlo generated energy spectra. Results: After modifications to the linac, beam current was increased by a factor greater than four and incident electron energy was determined to have an adjustable range from 1.90 MeV to 2.35 MeV. CNR of cortical bone was increased by a factor ranging from 6.2 to 7.4 and 3.7 to 4.3 for thin and thick phantoms, respectively, compared to a 6 MV therapeutic beam for both aluminum and carbon targets. Spatial resolution was degraded slightly, with a relative change of 3% and 10% at 0.20 lp/mm and 0.40 lp/mm, respectively, when reducing energy from 2.35 to 1.90 MV. The percentage of diagnostic x-rays for the beams examined here, ranges from 46% to 54%.Conclusion: It is possible to produce a large fraction of diagnostic energy x-rays by lowering the beam energy below 2.35 MV. By lowering the beam energy to 1.90 MV or 2.35 MV, CNR improves by factors ranging from 3.7 to 7.4 compared to a 6 MV therapy beam, with only a slight degradation of spatial resolution when lowering the energy from 2.35 MV to 1.90 MV.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2012

Is it sensible to 'deform' dose? 3D experimental validation of dose-warping

Purpose: Strategies for dose accumulation in deforming anatomy are of interest in radiotherapy. Algorithms exist for the deformation of dose based on patient image sets, though these are sometimes contentious because not all such image calculations are constrained by physical laws. While tumor and organ motion has been a key area of study for a considerable amount of time, deformation is of increasing interest. In this work, we demonstrate a full 3D experimental validation of results from a range of dose deformation algorithms available in the public domain. Methods: We recently developed the first tissue-equivalent, full 3D deformable dosimetric phantom-'DEFGEL.' To assess the accuracy of dose-warping based on deformable image registration (DIR), we have measured doses in undeformed and deformed states of the DEFGEL dosimeter and compared these to planned doses and warped doses. In this way we have directly evaluated the accuracy of dose-warping calculations for 11 different algorithms. We have done this for a range of stereotactic irradiation schemes and types and magnitudes of deformation. Results: The original Horn and Schunck algorithm is shown to be the best performing of the 11 algorithms trialled. Comparing measured and dose-warped calculations for this method, it is found that for a 10 Multiplication-Sign 10 mm{sup 2} square field, {gamma}{sub 3%/3mm}= 99.9%; for a 20 Multiplication-Sign 20 mm{sup 2} cross-shaped field, {gamma}{sub 3%/3mm}= 99.1%; and for a multiple dynamic arc (0.413 cm{sup 3} PTV) treatment adapted from a patient treatment plan, {gamma}{sub 3%/3mm}= 95%. In each case, the agreement is comparable to-but consistently {approx}1% less than-comparison between measured and calculated (planned) dose distributions in the absence of deformation. The magnitude of the deformation, as measured by the largest displacement experienced by any voxel in the volume, has the greatest influence on the accuracy of the warped dose distribution. Considering the square field case, the smallest deformation ({approx}9 mm) yields agreement of {gamma}{sub 3%/3mm}= 99.9%, while the most significant deformation ({approx}20 mm) yields agreement of {gamma}{sub 3%/3mm}= 96.7%. Conclusions: We have confirmed that, for a range of mass and density conserving deformations representative of those observable in anatomical targets, DIR-based dose-warping can yield accurate predictions of the dose distribution. Substantial differences can be seen between the results of different algorithms indicating that DIR performance should be scrutinized before application todose-warping. We have demonstrated that the DEFGEL deformable dosimeter can be used to evaluate DIR performance and the accuracy of dose-warping results by direct measurement.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

The use of zeolites to generate PET phantoms for the validation of quantification strategies in oncology

Purpose: In recent years, segmentation algorithms and activity quantification methods have been proposed for oncological {sup 18}F-fluorodeoxyglucose (FDG) PET. A full assessment of these algorithms, necessary for a clinical transfer, requires a validation on data sets provided with a reliable ground truth as to the imaged activity distribution, which must be as realistic as possible. The aim of this work is to propose a strategy to simulate lesions of uniform uptake and irregular shape in an anthropomorphic phantom, with the possibility to easily obtain a ground truth as to lesion activity and borders. Methods: Lesions were simulated with samples of clinoptilolite, a family of natural zeolites of irregular shape, able to absorb aqueous solutions of {sup 18}F-FDG, available in a wide size range, and nontoxic. Zeolites were soaked in solutions of {sup 18}F-FDG for increasing times up to 120 min and their absorptive properties were characterized as function of soaking duration, solution concentration, and zeolite dry weight. Saturated zeolites were wrapped in Parafilm, positioned inside an Alderson thorax-abdomen phantom and imaged with a PET-CT scanner. The ground truth for the activity distribution of each zeolite was obtained by segmenting high-resolution finely aligned CT images, on the basis of independently obtained volume measurements. The fine alignment between CT and PET was validated by comparing the CT-derived ground truth to a set of zeolites' PET threshold segmentations in terms of Dice index and volume error. Results: The soaking time necessary to achieve saturation increases with zeolite dry weight, with a maximum of about 90 min for the largest sample. At saturation, a linear dependence of the uptake normalized to the solution concentration on zeolite dry weight (R{sup 2}= 0.988), as well as a uniform distribution of the activity over the entire zeolite volume from PET imaging were demonstrated. These findings indicate that the {sup 18}F-FDG solution is able to saturate the zeolite pores and that the concentration does not influence the distribution uniformity of both solution and solute, at least at the trace concentrations used for zeolite activation. An additional proof of uniformity of zeolite saturation was obtained observing a correspondence between uptake and adsorbed volume of solution, corresponding to about 27.8% of zeolite volume. As to the ground truth for zeolites positioned inside the phantom, the segmentation of finely aligned CT images provided reliable borders, as demonstrated by a mean absolute volume error of 2.8% with respect to the PET threshold segmentation corresponding to the maximum Dice. Conclusions: The proposed methodology allowed obtaining an experimental phantom data set that can be used as a feasible tool to test and validate quantification and segmentation algorithms for PET in oncology. The phantom is currently under consideration for being included in a benchmark designed by AAPM TG211, which will be available to the community to evaluate PET automatic segmentation methods.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Reliable detection of fluence anomalies in EPID-based IMRT pretreatment quality assurance using pixel intensity deviations

Purpose: This work uses repeat images of intensity modulated radiation therapy (IMRT) fields to quantify fluence anomalies (i.e., delivery errors) that can be reliably detected in electronic portal images used for IMRT pretreatment quality assurance. Methods: Repeat images of 11 clinical IMRT fields are acquired on a Varian Trilogy linear accelerator at energies of 6 MV and 18 MV. Acquired images are corrected for output variations and registered to minimize the impact of linear accelerator and electronic portal imaging device (EPID) positioning deviations. Detection studies are performed in which rectangular anomalies of various sizes are inserted into the images. The performance of detection strategies based on pixel intensity deviations (PIDs) and gamma indices is evaluated using receiver operating characteristic analysis. Results: Residual differences between registered images are due to interfraction positional deviations of jaws and multileaf collimator leaves, plus imager noise. Positional deviations produce large intensity differences that degrade anomaly detection. Gradient effects are suppressed in PIDs using gradient scaling. Background noise is suppressed using median filtering. In the majority of images, PID-based detection strategies can reliably detect fluence anomalies of {>=}5% in {approx}1 mm{sup 2} areas and {>=}2% in {approx}20 mm{sup 2} areas. Conclusions: The ability to detect small dose differences ({<=}2%) depends strongly on the level of background noise. This in turn depends on the accuracy of image registration, the quality of the reference image, and field properties. The longer term aim of this work is to develop accurate and reliable methods of detecting IMRT delivery errors and variations. The ability to resolve small anomalies will allow the accuracy of advanced treatment techniques, such as image guided, adaptive, and arc therapies, to be quantified.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Fast DRR generation for 2D to 3D registration on GPUs

Purpose: The generation of digitally reconstructed radiographs (DRRs) is the most time consuming step on the CPU in intensity based two-dimensional x-ray to three-dimensional (CT or 3D rotational x-ray) medical image registration, which has application in several image guided interventions. This work presents optimized DRR rendering on graphical processor units (GPUs) and compares performance achievable on four commercially available devices. Methods: A ray-cast based DRR rendering was implemented for a 512 Multiplication-Sign 512 Multiplication-Sign 72 CT volume. The block size parameter was optimized for four different GPUs for a region of interest (ROI) of 400 Multiplication-Sign 225 pixels with different sampling ratios (1.1%-9.1% and 100%). Performance was statistically evaluated and compared for the four GPUs. The method and the block size dependence were validated on the latest GPU for several parameter settings with a public gold standard dataset (512 Multiplication-Sign 512 Multiplication-Sign 825 CT) for registration purposes. Results: Depending on the GPU, the full ROI is rendered in 2.7-5.2 ms. If sampling ratio of 1.1%-9.1% is applied, execution time is in the range of 0.3-7.3 ms. On all GPUs, the mean of the execution time increased linearly with respect to the number of pixels if sampling was used. Conclusions: The presented results outperform other results from the literature. This indicates that automatic 2D to 3D registration, which typically requires a couple of hundred DRR renderings to converge, can be performed quasi on-line, in less than a second or depending on the application and hardware in less than a couple of seconds. Accordingly, a whole new field of applications is opened for image guided interventions, where the registration is continuously performed to match the real-time x-ray.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2012

Magnitude of speed of sound aberration corrections for ultrasound image guided radiotherapy for prostate and other anatomical sites

Purpose: The purpose of this work is to assess the magnitude of speed of sound (SOS) aberrations in three-dimensional ultrasound (US) imaging systems in image guided radiotherapy. The discrepancy between the fixed SOS value of 1540 m/s assumed by US systems in human soft tissues and its actual nonhomogeneous distribution in patients produces small but systematic errors of up to a few millimeters in the positions of scanned structures. Methods: A correction, provided by a previously published density-based algorithm, was applied to a set of five prostate, five liver, and five breast cancer patients. The shifts of the centroids of target structures and the change in shape were evaluated. Results: After the correction the prostate cases showed shifts up to 3.6 mm toward the US probe, which may explain largely the reported positioning discrepancies in the literature on US systems versus other imaging modalities. Liver cases showed the largest changes in volume of the organ, up to almost 9%, and shifts of the centroids up to more than 6 mm either away or toward the US probe. Breast images showed systematic small shifts of the centroids toward the US probe with a maximum magnitude of 1.3 mm. Conclusions: The applied correction in prostate and liver cancer patients shows positioning errors of several mm due to SOS aberration; the errors are smaller in breast cancer cases, but possibly becoming more important when breast tissue thickness increases.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Auto calibration of a cone-beam-CT

Purpose: This paper introduces a novel autocalibration method for cone-beam-CTs (CBCT) or flat-panel CTs, assuming a perfect rotation. The method is based on ellipse-fitting. Autocalibration refers to accurate recovery of the geometric alignment of a CBCT device from projection images alone, without any manual measurements. Methods: The authors use test objects containing small arbitrarily positioned radio-opaque markers. No information regarding the relative positions of the markers is used. In practice, the authors use three to eight metal ball bearings (diameter of 1 mm), e.g., positioned roughly in a vertical line such that their projection image curves on the detector preferably form large ellipses over the circular orbit. From this ellipse-to-curve mapping and also from its inversion the authors derive an explicit formula. Nonlinear optimization based on this mapping enables them to determine the six relevant parameters of the system up to the device rotation angle, which is sufficient to define the geometry of a CBCT-machine assuming a perfect rotational movement. These parameters also include out-of-plane rotations. The authors evaluate their method by simulation based on data used in two similar approaches [L. Smekal, M. Kachelriess, S. E, and K. Wa, 'Geometric misalignment and calibration in cone-beam tomography,' Med. Phys. 31(12), 3242-3266 (2004); K. Yang, A. L. C. Kwan, D. F. Miller, and J. M. Boone, 'A geometric calibration method for cone beam CT systems,' Med. Phys. 33(6), 1695-1706 (2006)]. This allows a direct comparison of accuracy. Furthermore, the authors present real-world 3D reconstructions of a dry human spine segment and an electronic device. The reconstructions were computed from projections taken with a commercial dental CBCT device having two different focus-to-detector distances that were both calibrated with their method. The authors compare their reconstruction with a reconstruction computed by the manufacturer of the CBCT device to demonstrate the achievable spatial resolution of their calibration procedure. Results: Compared to the results published in the most closely related work [K. Yang, A. L. C. Kwan, D. F. Miller, and J. M. Boone, 'A geometric calibration method for cone beam CT systems,' Med. Phys. 33(6), 1695-1706 (2006)], the simulation proved the greater accuracy of their method, as well as a lower standard deviation of roughly 1 order of magnitude. When compared to another similar approach [L. Smekal, M. Kachelriess, S. E, and K. Wa, 'Geometric misalignment and calibration in cone-beam tomography,' Med. Phys. 31(12), 3242-3266 (2004)], their results were roughly of the same order of accuracy. Their analysis revealed that the method is capable of sufficiently calibrating out-of-plane angles in cases of larger cone angles when neglecting these angles negatively affects the reconstruction. Fine details in the 3D reconstruction of the spine segment and an electronic device indicate a high geometric calibration accuracy and the capability to produce state-of-the-art reconstructions. Conclusions: The method introduced here makes no requirements on the accuracy of the test object. In contrast to many previous autocalibration methods their approach also includes out-of-plane rotations of the detector. Although assuming a perfect rotation, the method seems to be sufficiently accurate for a commercial CBCT scanner. For devices which require higher dimensional geometry models, the method could be used as a initial calibration procedure.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2012

A robust geometry estimation method for spiral, sequential and circular cone-beam micro-CT

Purpose: The authors propose a novel method for misalignment estimation of micro-CT scanners using an adaptive genetic algorithm. Methods: The proposed algorithm is able to estimate the rotational geometry, the direction vector of table movement and the displacement between different imaging threads of a dual source or even multisource scanner. The calibration procedure does not rely on dedicated calibration phantoms and a sequence scan of a single metal bead is sufficient to geometrically calibrate the whole imaging system for spiral, sequential, and circular scan protocols. Dual source spiral and sequential scan protocols in micro-computed tomography result in projection data that-besides the source and detector positions and orientations-also require a precise knowledge of the table direction vector to be reconstructed properly. If those geometric parameters are not known accurately severe artifacts and a loss in spatial resolution appear in the reconstructed images as long as no geometry calibration is performed. The table direction vector is further required to ensure that consecutive volumes of a sequence scan can be stitched together and to allow the reconstruction of spiral data at all. Results: The algorithm's performance is evaluated using simulations of a micro-CT system with known geometry and misalignment. To assess the quality of the algorithm in a real world scenario the calibration of a micro-CT scanner is performed and several reconstructions with and without geometry estimation are presented. Conclusions: The results indicate that the algorithm successfully estimates all geometry parameters, misalignment artifacts in the reconstructed volumes vanish, and the spatial resolution is increased as can be shown by the evaluation of modulation transfer function measurements.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗
DOE OSTI2012

Quantifying the margin sharpness of lesions on radiological images for content-based image retrieval

Purpose: To develop a method to quantify the margin sharpness of lesions on CT and to evaluate it in simulations and CT scans of liver and lung lesions. Methods: The authors computed two attributes of margin sharpness: the intensity difference between a lesion and its surroundings, and the sharpness of the intensity transition across the lesion boundary. These two attributes were extracted from sigmoid curves fitted along lines automatically drawn orthogonal to the lesion margin. The authors then represented the margin characteristics for each lesion by a feature vector containing histograms of these parameters. The authors created 100 simulated CT scans of lesions over a range of intensity difference and margin sharpness, and used the concordance correlation between the known parameter and the corresponding computed feature as a measure of performance. The authors also evaluated their method in 79 liver lesions (44 patients: 23 M, 21 F, mean age 61) and 58 lung nodules (57 patients: 24 M, 33 F, mean age 66). The methodology presented takes into consideration the boundary of the liver and lung during feature extraction in clinical images to ensure that the margin feature do not get contaminated by anatomy other than the normal organ surrounding the lesions. For evaluation in these clinical images, the authors created subjective independent reference standards for pairwise margin sharpness similarity in the liver and lung cohorts, and compared rank orderings of similarity used using our sharpness feature to that expected from the reference standards using mean normalized discounted cumulative gain (NDCG) over all query images. In addition, the authors compared their proposed feature with two existing techniques for lesion margin characterization using the simulated and clinical datasets. The authors also evaluated the robustness of their features against variations in delineation of the lesion margin by simulating five types of deformations of the lesion margin. Equivalence across deformations was assessed using Schuirmann's paired two one-sided tests. Results: In simulated images, the concordance correlation between measured gradient and actual gradient was 0.994. The mean (s.d.) and standard deviation NDCG score for the retrieval of K images, K = 5, 10, and 15, were 84% (8%), 85% (7%), and 85% (7%) for CT images containing liver lesions, and 82% (7%), 84% (6%), and 85% (4%) for CT images containing lung nodules, respectively. The authors' proposed method outperformed the two existing margin characterization methods in average NDCG scores over all K, by 1.5% and 3% in datasets containing liver lesion, and 4.5% and 5% in datasets containing lung nodules. Equivalence testing showed that the authors' feature is more robust across all margin deformations (p < 0.05) than the two existing methods for margin sharpness characterization in both simulated and clinical datasets. Conclusions: The authors have described a new image feature to quantify the margin sharpness of lesions. It has strong correlation with known margin sharpness in simulated images and in clinical CT images containing liver lesions and lung nodules. This image feature has excellent performance for retrieving images with similar margin characteristics, suggesting potential utility, in conjunction with other lesion features, for content-based image retrieval applications.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Four-dimensional cone beam CT reconstruction and enhancement using a temporal nonlocal means method

Purpose: Four-dimensional cone beam computed tomography (4D-CBCT) has been developed to provide respiratory phase-resolved volumetric imaging in image guided radiation therapy. Conventionally, it is reconstructed by first sorting the x-ray projections into multiple respiratory phase bins according to a breathing signal extracted either from the projection images or some external surrogates, and then reconstructing a 3D CBCT image in each phase bin independently using FDK algorithm. This method requires adequate number of projections for each phase, which can be achieved using a low gantry rotation or multiple gantry rotations. Inadequate number of projections in each phase bin results in low quality 4D-CBCT images with obvious streaking artifacts. 4D-CBCT images at different breathing phases share a lot of redundant information, because they represent the same anatomy captured at slightly different temporal points. Taking this redundancy along the temporal dimension into account can in principle facilitate the reconstruction in the situation of inadequate number of projection images. In this work, the authors propose two novel 4D-CBCT algorithms: an iterative reconstruction algorithm and an enhancement algorithm, utilizing a temporal nonlocal means (TNLM) method. Methods: The authors define a TNLM energy term for a given set of 4D-CBCT images. Minimization of this term favors those 4D-CBCT images such that any anatomical features at one spatial point at one phase can be found in a nearby spatial point at neighboring phases. 4D-CBCT reconstruction is achieved by minimizing a total energy containing a data fidelity term and the TNLM energy term. As for the image enhancement, 4D-CBCT images generated by the FDK algorithm are enhanced by minimizing the TNLM function while keeping the enhanced images close to the FDK results. A forward-backward splitting algorithm and a Gauss-Jacobi iteration method are employed to solve the problems. The algorithms implementation on GPU is designed to avoid redundant and uncoalesced memory access, in order to ensure a high computational efficiency. Our algorithms have been tested on a digital NURBS-based cardiac-torso phantom and a clinical patient case. Results: The reconstruction algorithm and the enhancement algorithm generate visually similar 4D-CBCT images, both better than the FDK results. Quantitative evaluations indicate that, compared with the FDK results, our reconstruction method improves contrast-to-noise-ratio (CNR) by a factor of 2.56-3.13 and our enhancement method increases the CNR by 2.75-3.33 times. The enhancement method also removes over 80% of the streak artifacts from the FDK results. The total computation time is 509-683 s for the reconstruction algorithm and 524-540 s for the enhancement algorithm on an NVIDIA Tesla C1060 GPU card. Conclusions: By innovatively taking the temporal redundancy among 4D-CBCT images into consideration, the proposed algorithms can produce high quality 4D-CBCT images with much less streak artifacts than the FDK results, in the situation of inadequate number of projections.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Characterization of adaptive statistical iterative reconstruction algorithm for dose reduction in CT: A pediatric oncology perspective

Purpose: This study demonstrates a means of implementing an adaptive statistical iterative reconstruction (ASiR Trade-Mark-Sign ) technique for dose reduction in computed tomography (CT) while maintaining similar noise levels in the reconstructed image. The effects of image quality and noise texture were assessed at all implementation levels of ASiR Trade-Mark-Sign . Empirically derived dose reduction limits were established for ASiR Trade-Mark-Sign for imaging of the trunk for a pediatric oncology population ranging from 1 yr old through adolescence/adulthood. Methods: Image quality was assessed using metrics established by the American College of Radiology (ACR) CT accreditation program. Each image quality metric was tested using the ACR CT phantom with 0%-100% ASiR Trade-Mark-Sign blended with filtered back projection (FBP) reconstructed images. Additionally, the noise power spectrum (NPS) was calculated for three common reconstruction filters of the trunk. The empirically derived limitations on ASiR Trade-Mark-Sign implementation for dose reduction were assessed using (1, 5, 10) yr old and adolescent/adult anthropomorphic phantoms. To assess dose reduction limits, the phantoms were scanned in increments of increased noise index (decrementing mA using automatic tube current modulation) balanced with ASiR Trade-Mark-Sign reconstruction to maintain noise equivalence of the 0% ASiR Trade-Mark-Sign image. Results: The ASiR Trade-Mark-Sign algorithm did not produce any unfavorable effects on image quality as assessed by ACR criteria. Conversely, low-contrast resolution was found to improve due to the reduction of noise in the reconstructed images. NPS calculations demonstrated that images with lower frequency noise had lower noise variance and coarser graininess at progressively higher percentages of ASiR Trade-Mark-Sign reconstruction; and in spite of the similar magnitudes of noise, the image reconstructed with 50% or more ASiR Trade-Mark-Sign presented a more smoothed appearance than the pre-ASiR Trade-Mark-Sign 100% FBP image. Finally, relative to non-ASiR Trade-Mark-Sign images with 100% of standard dose across the pediatric phantom age spectrum, similar noise levels were obtained in the images at a dose reduction of 48% with 40% ASIR Trade-Mark-Sign and a dose reduction of 82% with 100% ASIR Trade-Mark-Sign . Conclusions: The authors' work was conducted to identify the dose reduction limits of ASiR Trade-Mark-Sign for a pediatric oncology population using automatic tube current modulation. Improvements in noise levels from ASiR Trade-Mark-Sign reconstruction were adapted to provide lower radiation exposure (i.e., lower mA) instead of improved image quality. We have demonstrated for the image quality standards required at our institution, a maximum dose reduction of 82% can be achieved using 100% ASiR Trade-Mark-Sign ; however, to negate changes in the appearance of reconstructed images using ASiR Trade-Mark-Sign with a medium to low frequency noise preserving reconstruction filter (i.e., standard), 40% ASiR Trade-Mark-Sign was implemented in our clinic for 42%-48% dose reduction at all pediatric ages without a visually perceptible change in image quality or image noise.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Impact of flat panel-imager veiling glare on scatter-estimation accuracy and image quality of a commercial on-board cone-beam CT imaging system

Purpose: The purposes of this study is to measure the low frequency drop (LFD) of the modulation transfer function (MTF), associated with the long tails of the detector point spread function (PSF) of an on-board flat panel imager and study its impact on cone-beam CT (CBCT) image quality and scatter measurement accuracy. Methods: Two different experimental methods were used to characterize LFD and its associated PSF of a Varian OBI flat-panel detector system: the edge response function (ERF) method and the disk transfer function (DTF) method. PSF was estimated by fitting parametric models to these measurements for four values of the applied voltage (kVp). The resultant PSF was used to demonstrate the effect of LFD on image contrast and CT number accuracy in CBCT images reconstructed from synthetic datasets, as well as, accuracy of scatter measurements with the beam-stop method. Results: The MTFs derived from the measured ERF data revealed LFDs varying from 8% (at 60 kVp) to 10.5% (at 120 kVp), while the intensity of the long PSF tails was found to increase with increasing kVp. The veiling glare line spread functions derived from the ERF and DTF methods were in excellent agreement. Uncorrected veiling glare reduced contrast and the image intensity in CBCT reconstruction, near the phantom periphery (by 67 Hounsfield units in a 20 cm-in-diameter water phantom) and (to a smaller degree) near inhomogeneities. Use of the bow-tie filter mitigated these effects. Veiling glare also resulted in about 10%-15% overestimation of the scatter-to-primary ratio when measured with the beam-stop or beam-stop array method. Conclusions: The long tails of the detector PSF were found to have a modest dependence of beam spectrum, which is reflected on the MTF curve LFD. Our findings show that uncorrected veiling glare can affect quantitative accuracy and contrast in CBCT imaging, based on flat panel imager. In addition, it results in overestimation of the scatter-to-primary ratio, measured with the beam-stop methods.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Comparison of signal to noise ratios from spatial and frequency domain formulations of nonprewhitening model observers in digital mammography

Purpose: Image quality indices based upon model observers are promising alternatives to laborious human readings of contrast-detail images. This is especially appealing in digital mammography as limiting values for contrast thresholds determine, according to some international protocols, the acceptability of these systems in the radiological practice. The objective of the present study was to compare the signal to noise ratios (SNR) obtained with two nonprewhitening matched filter model observer approaches, one in the spatial domain and the other in the frequency domain, and with both of them worked out for disks as present in the CDMAM phantom. Methods: The analysis was performed using images acquired with the Siemens Novation and Inspiration digital mammography systems. The spatial domain formulation uses a series of high dose CDMAM images as the signal and a routine exposure of two flood images to calculate the covariance matrix. The frequency domain approach uses the mathematical description of a disk and modulation transfer function (MTF) and noise power spectrum (NPS) calculated from images. Results: For both systems most of the SNR values calculated in the frequency domain were in very good agreement with the SNR values calculated in the spatial domain. Both the formulations in the frequency domain and in the spatial domain show a linear relationship between SNR and the diameter of the CDMAM discs. Conclusions: The results suggest that both formulations of the model observer lead to very similar figures of merit. This is a step forward in the adoption of figures of merit based on NPS and MTF for the acceptance testing of mammography systems.

60 APPLIED LIFE SCIENCES↗