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DOE OSTI2013

Grid artifact reduction for direct digital radiography detectors based on rotated stationary grids with homomorphic filtering

Purpose: Grid artifacts are caused when using the antiscatter grid in obtaining digital x-ray images. In this paper, research on grid artifact reduction techniques is conducted especially for the direct detectors, which are based on amorphous selenium. Methods: In order to analyze and reduce the grid artifacts, the authors consider a multiplicative grid image model and propose a homomorphic filtering technique. For minimal damage due to filters, which are used to suppress the grid artifacts, rotated grids with respect to the sampling direction are employed, and min-max optimization problems for searching optimal grid frequencies and angles for given sampling frequencies are established. The authors then propose algorithms for the grid artifact reduction based on the band-stop filters as well as low-pass filters. Results: The proposed algorithms are experimentally tested for digital x-ray images, which are obtained from direct detectors with the rotated grids, and are compared with other algorithms. It is shown that the proposed algorithms can successfully reduce the grid artifacts for direct detectors. Conclusions: By employing the homomorphic filtering technique, the authors can considerably suppress the strong grid artifacts with relatively narrow-bandwidth filters compared to the normal filtering case. Using rotated grids also significantly reduces the ringing artifact. Furthermore, for specific grid frequencies and angles, the authors can use simple homomorphic low-pass filters in the spatial domain, and thus alleviate the grid artifacts with very low implementation complexity.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2013

Anatomical noise in contrast-enhanced digital mammography. Part II. Dual-energy imaging

Purpose: Dual-energy (DE) contrast-enhanced digital mammography (CEDM) uses an iodinated contrast agent in combination with digital mammography (DM) to evaluate lesions on the basis of tumor angiogenesis. In DE imaging, low-energy (LE) and high-energy (HE) images are acquired after contrast administration and their logarithms are subtracted to cancel the appearance of normal breast tissue. Often there is incomplete signal cancellation in the subtracted images, creating a background “clutter” that can impair lesion detection. This is the second component of a two-part report on anatomical noise in CEDM. In Part I the authors characterized the anatomical noise for single-energy (SE) temporal subtraction CEDM by a power law, with model parameters α and β. In this work the authors quantify the anatomical noise in DE CEDM clinical images and compare this with the noise in SE CEDM. The influence on the anatomical noise of the presence of iodine in the breast, the timing of imaging postcontrast administration, and the x-ray energy used for acquisition are each evaluated.Methods: The power law parameters, α and β, were measured from unprocessed LE and HE images and from DE subtracted images to quantify the anatomical noise. A total of 98 DE CEDM cases acquired in a previous clinical pilot study were assessed. Conventional DM images from 75 of the women were evaluated for comparison with DE CEDM. The influence of the imaging technique on anatomical noise was determined from an analysis of differences between the power law parameters as measured in DM, LE, HE, and DE subtracted images for each subject.Results: In DE CEDM, weighted image subtraction lowers β to about 1.1 from 3.2 and 3.1 in LE and HE unprocessed images, respectively. The presence of iodine has a small but significant effect in LE images, reducing β by about 0.07 compared to DM, with α unchanged. Increasing the x-ray energy, from that typical in DM to a HE beam, significantly decreases α by about 2 × 10{sup −5} mm{sup 2}, and lowers β by about 0.14 compared to LE images. A comparison of SE and DE CEDM at 4 min postcontrast shows equivalent power law parameters in unprocessed images, and lower α and β by about 3 × 10{sup −5} mm{sup 2} and 0.50, respectively, in DE versus SE subtracted images.Conclusions: Image subtraction in both SE and DE CEDM reduces β by over a factor of 2, while maintaining α below that in DM. Given the equivalent α between SE and DE unprocessed CEDM images, and the smaller anatomical noise in the DE subtracted images, the DE approach may have an advantage over SE CEDM. It will be necessary to test this potential advantage in future lesion detectability experiments, which account for realistic lesion signals. The authors' results suggest that LE images could be used in place of DM images in CEDM exam interpretation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Digital tomosynthesis (DTS) for verification of target position in early stage lung cancer patients

Purpose: The ability to verify intrafraction tumor position is clinically useful for hypofractionated treatments. Short arc kV digital tomosynthesis (DTS) could facilitate more frequent target verification. The authors used DTS combined with triangulation to determine the mean temporal position of small-volume lung tumor targets treated with stereotactic radiotherapy. DTS registration results were benchmarked against online clinical localization using registration between free-breathing cone-beam computed tomography (CBCT) and the average intensity projection (AvIP) of the planning 4DCT.Methods: In this retrospective study, 76 sets of kV-projection images from online CBCT scans of 13 patients were used to generate DTS image slices (CB-DTS) with nonclinical research software (DTS Toolkit, Varian Medical Systems). Three-dimensional tumor motion was 1.3–4 mm in six patients and 6.1–25.4 mm in seven patients on 4DCT (significant difference in the mean of the groups, P < 0.01). The 4DCT AvIP was used to digitally reconstruct the Reference-DTS. DTS registration and DTS registration combined with triangulation were investigated. Progressive shortening of total DTS arc lengths from 95° to 35° around 0° gantry position was evaluated for different scenarios: DTS registration using the entire arc; DTS registration plus triangulation using two nonoverlapping arcs; and for 55° and 45° total gantry rotation, DTS registration plus triangulation using two overlapping arcs. Finally, DTS registration plus triangulation performed at eight gantry angles, each separated by 45° was evaluated using full fan kV projection data for one patient with an immobile tumor and five patients with mobile tumors.Results: For DTS registration alone, shortening arc length did not influence accuracy in X- and Y-directions, but in Z-direction, mean deviations from online CBCT localization systematically increased for shorter arc length (P < 0.05). For example, using a 95° arc mean DTS-CBCT difference was 0.8 mm (1 SD = 0.6 mm) and for a 35° arc the mean was 2.4 mm (1 SD = 1.7 mm). DTS plus triangulation using nonoverlapping-arcs increased accuracy in Z-direction for tested arc lengths ≤55° (P < 0.01). Overlapping arcs increased accuracy in Y-direction for tumors with motion >4 mm (P < 0.02) but increased Z-direction accuracy was only observed with 55° total gantry rotation. The 95th percentile deviations with this overlapping technique in X-, Y-, and Z-directions were 1.3, 2.0, and 2.5 mm, respectively. For the five patients with mobile tumors where DTS + triangulation was performed with 45° intervals, the pooled deviation from online CBCT correction showed, for X-, Y-, and Z-directions, mean of 1.1 mm, standard deviations (SD) of 0.9, 1.0, and 0.9 mm, respectively. The mean + 2 SD was <3 mm for each direction.Conclusions: Short-arc DTS verification of time averaged lung tumor position is feasible using free-breathing kV projection data and the AvIP of the 4DCT as a reference. Observed differences between DTS and online CBCT registration with AvIP were ≤3 mm (mean + 2 SD), however, the increased temporal resolution of DTS + triangulation also identified short period deviations from the average target position on the CBCT. Short-arc DTS appears promising for intrafraction tumor position monitoring during stereotactic lung radiotherapy delivered with a rotational technique.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Algorithmic scatter correction in dual-energy digital mammography

Purpose: Small calcifications are often the earliest and the main indicator of breast cancer. Dual-energy digital mammography (DEDM) has been considered as a promising technique to improve the detectability of calcifications since it can be used to suppress the contrast between adipose and glandular tissues of the breast. X-ray scatter leads to erroneous calculations of the DEDM image. Although the pinhole-array interpolation method can estimate scattered radiations, it requires extra exposures to measure the scatter and apply the correction. The purpose of this work is to design an algorithmic method for scatter correction in DEDM without extra exposures.Methods: In this paper, a scatter correction method for DEDM was developed based on the knowledge that scattered radiation has small spatial variation and that the majority of pixels in a mammogram are noncalcification pixels. The scatter fraction was estimated in the DEDM calculation and the measured scatter fraction was used to remove scatter from the image. The scatter correction method was implemented on a commercial full-field digital mammography system with breast tissue equivalent phantom and calcification phantom. The authors also implemented the pinhole-array interpolation scatter correction method on the system. Phantom results for both methods are presented and discussed. The authors compared the background DE calcification signals and the contrast-to-noise ratio (CNR) of calcifications in the three DE calcification images: image without scatter correction, image with scatter correction using pinhole-array interpolation method, and image with scatter correction using the authors' algorithmic method.Results: The authors' results show that the resultant background DE calcification signal can be reduced. The root-mean-square of background DE calcification signal of 1962 μm with scatter-uncorrected data was reduced to 194 μm after scatter correction using the authors' algorithmic method. The range of background DE calcification signals using scatter-uncorrected data was reduced by 58% with scatter-corrected data by algorithmic method. With the scatter-correction algorithm and denoising, the minimum visible calcification size can be reduced from 380 to 280 μm.Conclusions: When applying the proposed algorithmic scatter correction to images, the resultant background DE calcification signals can be reduced and the CNR of calcifications can be improved. This method has similar or even better performance than pinhole-array interpolation method in scatter correction for DEDM; moreover, this method is convenient and requires no extra exposure to the patient. Although the proposed scatter correction method is effective, it is validated by a 5-cm-thick phantom with calcifications and homogeneous background. The method should be tested on structured backgrounds to more accurately gauge effectiveness.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Characterization of scatter in digital mammography from physical measurements

Purpose: That scattered radiation negatively impacts the quality of medical radiographic imaging is well known. In mammography, even slight amounts of scatter reduce the high contrast required for subtle soft-tissue imaging. In current clinical mammography, image contrast is partially improved by use of an antiscatter grid. This form of scatter rejection comes with a sizeable dose penalty related to the concomitant elimination of valuable primary radiation. Digital mammography allows the use of image processing as a method of scatter correction that might avoid effects that negatively impact primary radiation, while potentially providing more contrast improvement than is currently possible with a grid. For this approach to be feasible, a detailed characterization of the scatter is needed. Previous research has modeled scatter as a constant background that serves as a DC bias across the imaging surface. The goal of this study was to provide a more substantive data set for characterizing the spatially-variant features of scatter radiation at the image detector of modern mammography units. Methods: This data set was acquired from a model of the radiation beam as a matrix of very narrow rays or pencil beams. As each pencil beam penetrates tissue, the pencil widens in a predictable manner due to the production of scatter. The resultant spreading of the pencil beam at the detector surface can be characterized by two parameters: mean radial extent (MRE) and scatter fraction (SF). The SF and MRE were calculated from measurements obtained using the beam stop method. Two digital mammography units were utilized, and the SF and MRE were found as functions of target, filter, tube potential, phantom thickness, and presence or absence of a grid. These values were then used to generate general equations allowing the SF and MRE to be calculated for any combination of the above parameters. Results: With a grid, the SF ranged from a minimum of about 0.05 to a maximum of about 0.16, and the MRE ranged from about 3 to 13 mm. Without a grid, the SF ranged from a minimum of 0.25 to a maximum of 0.52, and the MRE ranged from about 20 to 45 mm. The SF with a grid demonstrated a mild dependence on target/filter combination and kV, whereas the SF without a grid was independent of these factors. The MRE demonstrated a complex relationship as a function of kV, with notable difference among target/filter combinations. The primary source of change in both the SF and MRE was phantom thickness. Conclusions: Because breast tissue varies spatially in physical density and elemental content, the effective thickness of breast tissue varies spatially across the imaging field, resulting in a spatially-variant scatter distribution in the imaging field. The data generated in this study can be used to characterize the scatter contribution on a point-by-point basis, for a variety of different techniques.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-J-02: 4D Digital Tomosynthesis Based On Algebraic Image Reconstruction and Total-Variation Minimization for the Improvement of Image Quality

Purpose: In this paper, we implemented the four-dimensional (4D) digital tomosynthesis (DTS) imaging based on algebraic image reconstruction technique and total-variation minimization method in order to compensate the undersampled projection data and improve the image quality. Methods: The projection data were acquired as supposed the cone-beam computed tomography system in linear accelerator by the Monte Carlo simulation and the in-house 4D digital phantom generation program. We performed 4D DTS based upon simultaneous algebraic reconstruction technique (SART) among the iterative image reconstruction technique and total-variation minimization method (TVMM). To verify the effectiveness of this reconstruction algorithm, we performed systematic simulation studies to investigate the imaging performance. Results: The 4D DTS algorithm based upon the SART and TVMM seems to give better results than that based upon the existing method, or filtered-backprojection. Conclusion: The advanced image reconstruction algorithm for the 4D DTS would be useful to validate each intra-fraction motion during radiation therapy. In addition, it will be possible to give advantage to real-time imaging for the adaptive radiation therapy. This research was supported by Leading Foreign Research Institute Recruitment Program (Grant No.2009-00420) and Basic Atomic Energy Research Institute (BAERI); (Grant No. 2009-0078390) through the National Research Foundation of Korea(NRF) funded by the Ministry of Science, ICT and Future Planning (MSIP)

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

The simulation of 3D mass models in 2D digital mammography and breast tomosynthesis

Purpose: This work proposes a new method of building 3D breast mass models with different morphological shapes and describes the validation of the realism of their appearance after simulation into 2D digital mammograms and breast tomosynthesis images. Methods: Twenty-five contrast enhanced MRI breast lesions were collected and each mass was manually segmented in the three orthogonal views: sagittal, coronal, and transversal. The segmented models were combined, resampled to have isotropic voxel sizes, triangularly meshed, and scaled to different sizes. These masses were referred to as nonspiculated masses and were then used as nuclei onto which spicules were grown with an iterative branching algorithm forming a total of 30 spiculated masses. These 55 mass models were projected into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. The realism of the appearance of these mass models was assessed by five radiologists via receiver operating characteristic (ROC) analysis when compared to 54 real masses. All lesions were also given a breast imaging reporting and data system (BIRADS) score. The data sets of 2D mammography and tomosynthesis were read separately. The Kendall's coefficient of concordance was used for the interrater observer agreement assessment for the BIRADS scores per modality. Further paired analysis, using the Wilcoxon signed rank test, of the BIRADS assessment between 2D and tomosynthesis was separately performed for the real masses and for the simulated masses. Results: The area under the ROC curves, averaged over all observers, was 0.54 (95% confidence interval [0.50, 0.66]) for the 2D study, and 0.67 (95% confidence interval [0.55, 0.79]) for the tomosynthesis study. According to the BIRADS scores, the nonspiculated and the spiculated masses varied in their degrees of malignancy from normal (BIRADS 1) to highly suggestive for malignancy (BIRADS 5) indicating the required variety of shapes and margins of these models. The assessment of the BIRADS scores for all observers indicated good agreement based on Kendall's coefficient for both the 2D and the tomosynthesis evaluations. The paired analysis of the BIRADS scores between 2D and tomosynthesis for each observer revealed consistent behavior for the real and simulated masses. Conclusions: A database of 3D mass models, with variety of shapes and margins, was validated for the realism of their appearance for 2D digital mammography and for breast tomosynthesis. This database is suitable for use in future observer performance studies whether in virtual clinical trials or in patient images with simulated lesions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

The effect of amorphous selenium detector thickness on dual-energy digital breast imaging

Purpose: Contrast enhanced (CE) imaging techniques for both planar digital mammography (DM) and three-dimensional (3D) digital breast tomosynthesis (DBT) applications requires x-ray photon energies higher than the k-edge of iodine (33.2 keV). As a result, x-ray tube potentials much higher (>40 kVp) than those typical for screening mammography must be utilized. Amorphous selenium (a-Se) based direct conversion flat-panel imagers (FPI) have been widely used in DM and DBT imaging systems. The a-Se layer is typically 200 μm thick with quantum detective efficiency (QDE) >87% for x-ray energies below 26 keV. However, QDE decreases substantially above this energy. To improve the object detectability of either CE-DM or CE-DBT, it may be advantageous to increase the thickness (d{sub Se}) of the a-Se layer. Increasing the d{sub Se} will improve the detective quantum efficiency (DQE) at the higher energies used in CE imaging. However, because most DBT systems are designed with partially isocentric geometries, where the gantry moves about a stationary detector, the oblique entry of x-rays will introduce additional blur to the system. The present investigation quantifies the effect of a-Se thickness on imaging performance for both CE-DM and CE-DBT, discussing the effects of improving photon absorption and blurring from oblique entry of x-rays. Methods: In this paper, a cascaded linear system model (CLSM) was used to investigate the effect of d{sub Se} on the imaging performance (i.e., MTF, NPS, and DQE) of FPI in CE-DM and CE-DBT. The results from the model are used to calculate the ideal observer signal-to-noise ratio, d′, which is used as a figure-of-merit to determine the total effect of increasing d{sub Se} for CE-DM and CE-DBT. Results: The results of the CLSM show that increasing d{sub Se} causes a substantial increase in QDE at the high energies used in CE-DM. However, at the oblique projection angles used in DBT, the increased length of penetration through a-Se introduces additional image blur. The reduced MTF and DQE at high spatial frequencies lead to reduced two-dimensional d′. These losses in projection image resolution may subsequently result in a decrease in the 3D d′, but the degree of which is largely dependent on the DBT reconstruction algorithm. For a filtered backprojection (FBP) algorithm with spectral apodization and slice-thickness filters, which dominate the blur for reconstructed images at oblique angles, the effect of oblique entry of x-rays on 3D d′ is minimal. Thus, increasing d{sub Se} results in an improvement in d′ for both CE-DM and CE-DBT with typical FBP reconstruction parameters. Conclusions: Increased d{sub Se} improves CE breast imaging performance by increasing QDE of detectors at higher energies, e.g., 49 kVp. Although there is additional blur in the oblique angled projections of a DBT scan, the overall 3D d′ for DBT is not degraded because the dominant source blur at these angles results from the reconstruction filters of the employed FBP algorithm.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

Estimating pediatric entrance skin dose from digital radiography examination using DICOM metadata: A quality assurance tool

Purpose: To develop an automated methodology to estimate patient examination dose in digital radiography (DR) imaging using DICOM metadata as a quality assurance (QA) tool. Methods: Patient examination and demographical information were gathered from metadata analysis of DICOM header data. The x-ray system radiation output (i.e., air KERMA) was characterized for all filter combinations used for patient examinations. Average patient thicknesses were measured for head, chest, abdomen, knees, and hands using volumetric images from CT. Backscatter factors (BSFs) were calculated from examination kVp. Patient entrance skin air KERMA (ESAK) was calculated by (1) looking up examination technique factors taken from DICOM header metadata (i.e., kVp and mA s) to derive an air KERMA (k{sub air}) value based on an x-ray characteristic radiation output curve; (2) scaling k{sub air} with a BSF value; and (3) correcting k{sub air} for patient thickness. Finally, patient entrance skin dose (ESD) was calculated by multiplying a mass–energy attenuation coefficient ratio by ESAK. Patient ESD calculations were computed for common DR examinations at our institution: dual view chest, anteroposterior (AP) abdomen, lateral (LAT) skull, dual view knee, and bone age (left hand only) examinations. Results: ESD was calculated for a total of 3794 patients; mean age was 11 ± 8 yr (range: 2 months to 55 yr). The mean ESD range was 0.19–0.42 mGy for dual view chest, 0.28–1.2 mGy for AP abdomen, 0.18–0.65 mGy for LAT view skull, 0.15–0.63 mGy for dual view knee, and 0.10–0.12 mGy for bone age (left hand) examinations. Conclusions: A methodology combining DICOM header metadata and basic x-ray tube characterization curves was demonstrated. In a regulatory era where patient dose reporting has become increasingly in demand, this methodology will allow a knowledgeable user the means to establish an automatable dose reporting program for DR and perform patient dose related QA testing for digital x-ray imaging.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Dosimetric characterization and organ dose assessment in digital breast tomosynthesis: Measurements and Monte Carlo simulations using voxel phantoms

Purpose: Due to its capability to more accurately detect deep lesions inside the breast by removing the effect of overlying anatomy, digital breast tomosynthesis (DBT) has the potential to replace the standard mammography technique in clinical screening exams. However, the European Guidelines for DBT dosimetry are still a work in progress and there are little data available on organ doses other than to the breast. It is, therefore, of great importance to assess the dosimetric performance of DBT with respect to the one obtained with standard digital mammography (DM) systems. The aim of this work is twofold: (i) to study the dosimetric properties of a combined DBT/DM system (MAMMOMAT Inspiration Siemens{sup ®}) for a tungsten/rhodium (W/Rh) anode/filter combination and (ii) to evaluate organs doses during a DBT examination. Methods: For the first task, measurements were performed in manual and automatic exposure control (AEC) modes, using two homogeneous breast phantoms: a PMMA slab phantom and a 4 cm thick breast-shaped rigid phantom, with 50% of glandular tissue in its composition. Monte Carlo (MC) simulations were performed using Monte Carlo N-Particle eXtended v.2.7.0. A MC model was implemented to mimic DM and DBT acquisitions for a wide range of x-ray spectra (24 –34 kV). This was used to calculate mean glandular dose (MGD) and to compute series of backscatter factors (BSFs) that could be inserted into the DBT dosimetric formalism proposed by Dance et al. Regarding the second aim of the study, the implemented MC model of the clinical equipment, together with a female voxel phantom (“Laura”), was used to calculate organ doses considering a typical DBT acquisition. Results were compared with a standard two-view mammography craniocaudal (CC) acquisition. Results: Considering the AEC mode, the acquisition of a single CC view results in a MGD ranging from 0.53 ± 0.07 mGy to 2.41 ± 0.31 mGy in DM mode and from 0.77 ± 0.11 mGy to 2.28 ± 0.32 mGy in DBT mode. Regarding the BSF, the results achieved may lead to a MGD correction of about 6%, contributing to the improvement of the current guidelines used in these applications. Finally, considering the MC results obtained for the organ dose study, the radiation doses found for the tissues of the body other than the breast were in the range of tens of μSv, and are in part comparable to the ones obtained in standard DM. Nevertheless, in a single DBT examination, some organs (such as lung and thyroid) receive higher doses (of about 9% and 21%, respectively) with respect to the CC DM acquisition. Conclusions: Taking into account an average breast with a thickness of 4.5 cm, the MGDs for DM and DBT acquisitions were below the achievable value (2.0 mGy) defined by the European protocol. Additionally, in the case of a fusion imaging study (DM + DBT), the MGD for a 4.5 cm thick breast is of the order of 1.88 ± 0.36 mGy. Finally, organ dose evaluations underline the need to improve awareness concerning dose estimation of DBT exams for some organs, especially when radiation risk is assessed by using the effective dose.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-P-31: Quantifying the Amount of Missing Tissue in a Digital Breast Tomosynthesis

Purpose: To automatically quantify the amount of missing tissue in a digital breast tomosynthesis system using four stair-stepped chest wall missing tissue gauges in the Tomophan™ from the Phantom Laboratory and image processing from Image Owl. Methods: The Tomophan™ phantom incorporates four stair-stepped missing tissue gauges by the chest wall, allowing measurement of missing chest wall in two different locations along the chest wall at two different heights. Each of the four gauges has 12 steps in 0.5 mm increments rising from the chest wall. An image processing algorithm was developed by Image Owl that first finds the two slices containing the steps then finds the signal through the highest step in all four gauges. Using the signal drop at the beginning of each gauge the distance to the end of the image gives the length of the missing tissue gauge in millimeters. Results: The Tomophan™ was imaged in digital breast tomosynthesis (DBT) systems from various vendors resulting in 46 cases used for testing. The results showed that on average 1.9 mm of 6 mm of the gauges are visible. A small focus group was asked to count the number of visible steps for each case which resulted in a good agreement between observer counts and computed data. Conclusion: First, the results indicate that the amount of missing chest wall can differ between vendors. Secondly it was shown that an automated method to estimate the amount of missing chest wall gauges agreed well with observer assessments. This finding indicates that consistency testing may be simplified using the Tomophan™ phantom and analysis by an automated image processing named Tomo QA. In general the reason for missing chest wall may be due to a function of the beam profile at the chest wall as DBT projects through the angular sampling. Research supported by Image Owl, Inc., The Phantom Laboratory, Inc. and Raforninn ehf; Mallozzi and Healy employed by The Phantom Laboratory, Inc.; Goodenough is a consultant to The Phantom Laboratory, Inc.; Fredriksson, Kristbjornsson, Olafsson, Oskarsdottir and Olafsdottir are employed by Raforninn, Ehf.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-I-45: Feasibility for Using Iodine Quantification to Assist Diagnosis in Dual Energy Contrast-Enhanced Digital Mammography

Purpose: The objective of this study is to develop quantitative calibration between image quality indexes and iodine concentration with dual-energy (DE) contrast-enhanced digital mammography (CEDM) techniques and further serve as the assistance for diagnosis. Methods: Custom-made acrylic phantom with dimensions of 24×30 cm{sup 2} simulated breast thickness from 2 to 6 cm was used in the calibration. The phantom contained matrix of four times four holes of 3 mm deep with a diameter of 15 mm for filling contrast agent with area density ranged from 0.1 to 10 mg/cm{sup 2}. All the image acquisitions were performed on a full-field digital mammography system (Senographe Essential, GE) with dual energy acquisitions. Mean pixel value (MPV), and contrast-to-noise ratio (CNR) were used for evaluating the relationship between image quality indexes and iodine concentration. Iodine map and CNR map could further be constructed with these calibration curves applied pixel by pixel utilized MATLAB software. Minimum iodine concentration could also be calculated with the visibility threshold of CNR=5 according the Rose model. Results: When evaluating the DE subtraction images, MPV increased linearly as the iodine concentration increased with all the phantom thickness surveyed (R{sup 2} between 0.989 and 0.992). Lesions with increased iodine uptake could thus be enhanced in the color-encoded iodine maps, and the mean iodine concentration could be obtained through the ROI measurements. As for investigating CNR performance, linear relationships were also shown between the iodine concentration and CNR (R{sup 2} between 0.983 and 0.990). Minimum iodine area density of 1.45, 1.73, 1.80, 1.73 and 1.72 mg/cm{sup 2} for phantom thickness of 2, 3, 4, 5, 6 cm were calculated based on Rose’s visualization criteria. Conclusion: Quantitative calibration between image quality indexes and iodine concentrations may further serving as the assistance for analyzing contrast enhancement for patient participating the dual energy CEDM procedures.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-G-204-08: Optimized Digital Radiographic Technique for Lost Surgical Devices/Needle Identification

Purpose: Small surgical devices and needles are used in many surgical procedures. Conventionally, an x-ray film is taken to identify missing devices/needles if post procedure count is incorrect. There is no data to indicate smallest surgical devices/needles that can be identified with digital radiography (DR), and its optimized acquisition technique. Methods: In this study, the DR equipment used is a Canon RadPro mobile with CXDI-70c wireless DR plate, and the same DR plate on a fixed Siemens Multix unit. Small surgical devices and needles tested include Rubber Shod, Bulldog, Fogarty Hydrogrip, and needles with sizes 3-0 C-T1 through 8-0 BV175-6. They are imaged with PMMA block phantoms with thickness of 2–8 inch, and an abdomen phantom. Various DR techniques are used. Images are reviewed on the portable x-ray acquisition display, a clinical workstation, and a diagnostic workstation. Results: all small surgical devices and needles are visible in portable DR images with 2–8 inch of PMMA. However, when they are imaged with the abdomen phantom plus 2 inch of PMMA, needles smaller than 9.3 mm length can not be visualized at the optimized technique of 81 kV and 16 mAs. There is no significant difference in visualization with various techniques, or between mobile and fixed radiography unit. However, there is noticeable difference in visualizing the smallest needle on a diagnostic reading workstation compared to the acquisition display on a portable x-ray unit. Conclusion: DR images should be reviewed on a diagnostic reading workstation. Using optimized DR techniques, the smallest needle that can be identified on all phantom studies is 9.3 mm. Sample DR images of various small surgical devices/needles available on diagnostic workstation for comparison may improve their identification. Further in vivo study is needed to confirm the optimized digital radiography technique for identification of lost small surgical devices and needles.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Ongoing quality control in digital radiography: Report of AAPM Imaging Physics Committee Task Group 151

Quality control (QC) in medical imaging is an ongoing process and not just a series of infrequent evaluations of medical imaging equipment. The QC process involves designing and implementing a QC program, collecting and analyzing data, investigating results that are outside the acceptance levels for the QC program, and taking corrective action to bring these results back to an acceptable level. The QC process involves key personnel in the imaging department, including the radiologist, radiologic technologist, and the qualified medical physicist (QMP). The QMP performs detailed equipment evaluations and helps with oversight of the QC program, the radiologic technologist is responsible for the day-to-day operation of the QC program. The continued need for ongoing QC in digital radiography has been highlighted in the scientific literature. The charge of this task group was to recommend consistency tests designed to be performed by a medical physicist or a radiologic technologist under the direction of a medical physicist to identify problems with an imaging system that need further evaluation by a medical physicist, including a fault tree to define actions that need to be taken when certain fault conditions are identified. The focus of this final report is the ongoing QC process, including rejected image analysis, exposure analysis, and artifact identification. These QC tasks are vital for the optimal operation of a department performing digital radiography.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Method for simulating dose reduction in digital mammography using the Anscombe transformation

Purpose: This work proposes an accurate method for simulating dose reduction in digital mammography starting from a clinical image acquired with a standard dose. Methods: The method developed in this work consists of scaling a mammogram acquired at the standard radiation dose and adding signal-dependent noise. The algorithm accounts for specific issues relevant in digital mammography images, such as anisotropic noise, spatial variations in pixel gain, and the effect of dose reduction on the detective quantum efficiency. The scaling process takes into account the linearity of the system and the offset of the detector elements. The inserted noise is obtained by acquiring images of a flat-field phantom at the standard radiation dose and at the simulated dose. Using the Anscombe transformation, a relationship is created between the calculated noise mask and the scaled image, resulting in a clinical mammogram with the same noise and gray level characteristics as an image acquired at the lower-radiation dose. Results: The performance of the proposed algorithm was validated using real images acquired with an anthropomorphic breast phantom at four different doses, with five exposures for each dose and 256 nonoverlapping ROIs extracted from each image and with uniform images. The authors simulated lower-dose images and compared these with the real images. The authors evaluated the similarity between the normalized noise power spectrum (NNPS) and power spectrum (PS) of simulated images and real images acquired with the same dose. The maximum relative error was less than 2.5% for every ROI. The added noise was also evaluated by measuring the local variance in the real and simulated images. The relative average error for the local variance was smaller than 1%. Conclusions: A new method is proposed for simulating dose reduction in clinical mammograms. In this method, the dependency between image noise and image signal is addressed using a novel application of the Anscombe transformation. NNPS, PS, and local noise metrics confirm that this method is capable of precisely simulating various dose reductions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-I-55: Performance Evaluation of Digital PET/CT: Medical Physics Basis for the Clinical Applications

Purpose: Replacement of conventional PMT-based detector with next generation digital photon counting (DPC) detector is a technology leap for PET imaging. This study evaluated the performance and characteristics of the DPC system and its stability within a 1 year time window following its installation focusing on the medical physics basis for clinical applications. Methods: A digital PET/CT scanner using 1:1 coupling of 23,040 crystal: detector elements was introduced and became operational at OSU. We tested and evaluated system performance and characteristics using NEMA NU2-2012. System stabilities in timing resolution, energy resolution, detector temperature and humidity (T&H) were monitored over 1-yr. Timing, energy and spatial resolution were characterized across clinically relevant count rate range. CQIE uniformity PET and NEMA IEC-Body PET with hot spheres varying with sizes and contrasts were performed. PET reconstructed in standard(4mm), High(2mm) and Ultra-High(1mm) definitions were evaluated. Results: NEMA results showed PET spatial resolution (mm-FWHM) from 4.01&4.14 at 1cm to 5.82&6.17 at 20cm in transverse & axial. 322±3ps timing and 11.0% energy resolution were measured. 5.7kcps/MBq system sensitivity with 24kcps/MBq effective sensitivity was obtained. The peak-NECR was ∼171kcps with the effective peak-NECR >650kcps@50kBq/mL. Scatter fraction was ∼30%, and the maximum trues was >900kcps. NEMA IQ demonstrated hot sphere contrast ranging from ∼62%±2%(10mm) to ∼88%±2%(22mm), cold sphere contrast of ∼86%±2%(28mm) and ∼89%±3%(37mm) and excellent uniformity. Monitoring 1-yr stability, it revealed ∼1% change in timing, ±0.4% change in energy resolution, and <10% variations in T&H. CQIE PET gave <3% SUV variances in axial. 60%–100% recovery coefficients across sphere sizes and contrast levels were achieved. Conclusion: Characteristics and stability of the next generation DPC PET detector system over an 1-yr time window was excellent and better than prior experiences. It demonstrated improved and robust system characteristics and performance in spatial resolution, sensitivity, timing and energy resolution, count rate and image quality. Michael Miller is an employee of Philips Healthcare.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-FG-209-08: Distribution of the Deviation Index (DI) in Digital Radiography Practices Across the United States

Purpose: To characterize the distribution of the deviation index (DI) in digital radiography practices across the United States. Methods: DI data was obtained from 10 collaborating institutions in the United States between 2012 and 2015. Each institution complied with the requirements of the Institutional Review Board at their site. DI data from radiographs of the body parts chest, abdomen, pelvis and extremity were analyzed for anteroposterior, posteroanterior, lateral, and decubitus views. The DI data was analyzed both in aggregate and stratified by exposure control method, image receptor technology, patient age, and participating site for each body part and view. The number of exposures with DI falling within previously published control limits for DI and descriptive statistics were calculated. Results: DI data from 505,930 radiographic exposures was analyzed. The number of exposures with DI falling within published control limits for DI varied from 10 to 20% for adult patients and 10 to 23% for pediatric patients for different body parts and views. Mean DI values averaged over other parameters for radiographs of the abdomen, chest, pelvis, and extremities ranged from 0.3 to 1.0, −0.6 to 0.5, 0.8, and −0.9 to 0.5 for the different adult views and ranged from −1.6 to −0.1, −0.3 to 0.5, −0.1, −0.2 to 1.4 for the different pediatric views, respectively (DI data was solicited only for anteroposterior view of pelvis). Standard deviation values of DI from individual sites ranged from 1.3 to 3.6 and 1.3 to 3.0 for the different adult and pediatric views, respectively. Also of interest was that target exposure indicators varied by up to a factor of 6 between sites for certain body parts and views. Conclusion: Previously published DI control limits do not reflect the state of clinical practice in digital radiography. Mean DI and target exposure indicators are targets for quality improvement efforts in radiography.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

Digital Speckle Photography of Subpixel Displacements of Speckle Structures Based on Analysis of Their Spatial Spectra

We have investigated the capabilities of the method of digital speckle interferometry for determining subpixel displacements of a speckle structure formed by a displaceable or deformable object with a scattering surface. An analysis of spatial spectra of speckle structures makes it possible to perform measurements with a subpixel accuracy and to extend the lower boundary of the range of measurements of displacements of speckle structures to the range of subpixel values. The method is realized on the basis of digital recording of the images of undisplaced and displaced speckle structures, their spatial frequency analysis using numerically specified constant phase shifts, and correlation analysis of spatial spectra of speckle structures. Transformation into the frequency range makes it possible to obtain quantities to be measured with a subpixel accuracy from the shift of the interference-pattern minimum in the diffraction halo by introducing an additional phase shift into the complex spatial spectrum of the speckle structure or from the slope of the linear plot of the function of accumulated phase difference in the field of the complex spatial spectrum of the displaced speckle structure. The capabilities of the method have been investigated in natural experiment.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗