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Iterative image-domain decomposition for dual-energy CT

Purpose: Dual energy CT (DECT) imaging plays an important role in advanced imaging applications due to its capability of material decomposition. Direct decomposition via matrix inversion suffers from significant degradation of image signal-to-noise ratios, which reduces clinical values of DECT. Existing denoising algorithms achieve suboptimal performance since they suppress image noise either before or after the decomposition and do not fully explore the noise statistical properties of the decomposition process. In this work, the authors propose an iterative image-domain decomposition method for noise suppression in DECT, using the full variance-covariance matrix of the decomposed images. Methods: The proposed algorithm is formulated in the form of least-square estimation with smoothness regularization. Based on the design principles of a best linear unbiased estimator, the authors include the inverse of the estimated variance-covariance matrix of the decomposed images as the penalty weight in the least-square term. The regularization term enforces the image smoothness by calculating the square sum of neighboring pixel value differences. To retain the boundary sharpness of the decomposed images, the authors detect the edges in the CT images before decomposition. These edge pixels have small weights in the calculation of the regularization term. Distinct from the existing denoising algorithms applied on the images before or after decomposition, the method has an iterative process for noise suppression, with decomposition performed in each iteration. The authors implement the proposed algorithm using a standard conjugate gradient algorithm. The method performance is evaluated using an evaluation phantom (Catphan©600) and an anthropomorphic head phantom. The results are compared with those generated using direct matrix inversion with no noise suppression, a denoising method applied on the decomposed images, and an existing algorithm with similar formulation as the proposed method but with an edge-preserving regularization term. Results: On the Catphan phantom, the method maintains the same spatial resolution on the decomposed images as that of the CT images before decomposition (8 pairs/cm) while significantly reducing their noise standard deviation. Compared to that obtained by the direct matrix inversion, the noise standard deviation in the images decomposed by the proposed algorithm is reduced by over 98%. Without considering the noise correlation properties in the formulation, the denoising scheme degrades the spatial resolution to 6 pairs/cm for the same level of noise suppression. Compared to the edge-preserving algorithm, the method achieves better low-contrast detectability. A quantitative study is performed on the contrast-rod slice of Catphan phantom. The proposed method achieves lower electron density measurement error as compared to that by the direct matrix inversion, and significantly reduces the error variation by over 97%. On the head phantom, the method reduces the noise standard deviation of decomposed images by over 97% without blurring the sinus structures. Conclusions: The authors propose an iterative image-domain decomposition method for DECT. The method combines noise suppression and material decomposition into an iterative process and achieves both goals simultaneously. By exploring the full variance-covariance properties of the decomposed images and utilizing the edge predetection, the proposed algorithm shows superior performance on noise suppression with high image spatial resolution and low-contrast detectability.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

WE-G-BRD-07: Automated MR Image Standardization and Auto-Contouring Strategy for MRI-Based Adaptive Brachytherapy for Cervix Cancer

Purpose: MRI-based adaptive brachytherapy (ABT) is an emerging treatment modality for patients with gynecological tumors. However, MR image intensity non-uniformities (IINU) can vary from fraction to fraction, complicating image interpretation and auto-contouring accuracy. We demonstrate here an automated MR image standardization and auto-contouring strategy for MRI-based ABT of cervix cancer. Methods: MR image standardization consisted of: 1) IINU correction using the MNI N3 algorithm, 2) noise filtering using anisotropic diffusion, and 3) signal intensity normalization using the volumetric median. This post-processing chain was implemented as a series of custom Matlab and Java extensions in MIM (v6.4.5, MIM Software) and was applied to 3D T2 SPACE images of six patients undergoing MRI-based ABT at 3T. Coefficients of variation (CV=σ/µ) were calculated for both original and standardized images and compared using Mann-Whitney tests. Patient-specific cumulative MR atlases of bladder, rectum, and sigmoid contours were constructed throughout ABT, using original and standardized MR images from all previous ABT fractions. Auto-contouring was performed in MIM two ways: 1) best-match of one atlas image to the daily MR image, 2) multi-match of all previous fraction atlas images to the daily MR image. Dice’s Similarity Coefficients (DSCs) were calculated for auto-generated contours relative to reference contours for both original and standardized MR images and compared using Mann-Whitney tests. Results: Significant improvements in CV were detected following MR image standardization (p=0.0043), demonstrating an improvement in MR image uniformity. DSCs consistently increased for auto-contoured bladder, rectum, and sigmoid following MR image standardization, with the highest DSCs detected when the combination of MR image standardization and multi-match cumulative atlas-based auto-contouring was utilized. Conclusion: MR image standardization significantly improves MR image uniformity. The combination of MR image standardization and multi-match cumulative atlas-based auto-contouring produced the highest DSCs and is a promising strategy for MRI-based ABT for cervix cancer.

60 APPLIED LIFE SCIENCES↗

Denoising of polychromatic CT images based on their own noise properties

Purpose: Because of high diagnostic accuracy and fast scan time, computed tomography (CT) has been widely used in various clinical applications. Since the CT scan introduces radiation exposure to patients, however, dose reduction has recently been recognized as an important issue in CT imaging. However, low-dose CT causes an increase of noise in the image and thereby deteriorates the accuracy of diagnosis. In this paper, the authors develop an efficient denoising algorithm for low-dose CT images obtained using a polychromatic x-ray source. The algorithm is based on two steps: (i) estimation of space variant noise statistics, which are uniquely determined according to the system geometry and scanned object, and (ii) subsequent novel conversion of the estimated noise to Gaussian noise so that an existing high performance Gaussian noise filtering algorithm can be directly applied to CT images with non-Gaussian noise. Methods: For efficient polychromatic CT image denoising, the authors first reconstruct an image with the iterative maximum-likelihood polychromatic algorithm for CT to alleviate the beam-hardening problem. We then estimate the space-variant noise variance distribution on the image domain. Since there are many high performance denoising algorithms available for the Gaussian noise, image denoising can become much more efficient if they can be used. Hence, the authors propose a novel conversion scheme to transform the estimated space-variant noise to near Gaussian noise. In the suggested scheme, the authors first convert the image so that its mean and variance can have a linear relationship, and then produce a Gaussian image via variance stabilizing transform. The authors then apply a block matching 4D algorithm that is optimized for noise reduction of the Gaussian image, and reconvert the result to obtain a final denoised image. To examine the performance of the proposed method, an XCAT phantom simulation and a physical phantom experiment were conducted. Results: Both simulation and experimental results show that, unlike the existing denoising algorithms, the proposed algorithm can effectively reduce the noise over the whole region of CT images while preventing degradation of image resolution. Conclusions: To effectively denoise polychromatic low-dose CT images, a novel denoising algorithm is proposed. Because this algorithm is based on the noise statistics of a reconstructed polychromatic CT image, the spatially varying noise on the image is effectively reduced so that the denoised image will have homogeneous quality over the image domain. Through a simulation and a real experiment, it is verified that the proposed algorithm can deliver considerably better performance compared to the existing denoising algorithms.

60 APPLIED LIFE SCIENCES↗

SU-F-P-06: Moving From Computed Radiography to Digital Radiography: A Collaborative Approach to Improve Image Quality

Purpose: To bring together radiologists, technologists, and physicists to utilize post-processing techniques in digital radiography (DR) in order to optimize image acquisition and improve image quality. Methods: Sub-optimal images acquired on a new General Electric (GE) DR system were flagged for follow-up by radiologists and reviewed by technologists and medical physicists. Various exam types from adult musculoskeletal (n=35), adult chest (n=4), and pediatric (n=7) were chosen for review. 673 total images were reviewed. These images were processed using five customized algorithms provided by GE. An image score sheet was created allowing the radiologist to assign a numeric score to each of the processed images, this allowed for objective comparison to the original images. Each image was scored based on seven properties: 1) overall image look, 2) soft tissue contrast, 3) high contrast, 4) latitude, 5) tissue equalization, 6) edge enhancement, 7) visualization of structures. Additional space allowed for additional comments not captured in scoring categories. Radiologists scored the images from 1 – 10 with 1 being non-diagnostic quality and 10 being superior diagnostic quality. Scores for each custom algorithm for each image set were summed. The algorithm with the highest score for each image set was then set as the default processing. Results: Images placed into the PACS “QC folder” for image processing reasons decreased. Feedback from radiologists was, overall, that image quality for these studies had improved. All default processing for these image types was changed to the new algorithm. Conclusion: This work is an example of the collaboration between radiologists, technologists, and physicists at the University of New Mexico to add value to the radiology department. The significant amount of work required to prepare the processing algorithms, reprocessing and scoring of the images was eagerly taken on by all team members in order to produce better quality images and improve patient care.

60 APPLIED LIFE SCIENCES↗

SU-E-J-129: A Strategy to Consolidate the Image Database of a VERO Unit Into a Radiotherapy Management System

Purpose: To present a strategy to integrate the imaging database of a VERO unit with a treatment management system (TMS) to improve clinical workflow and consolidate image data to facilitate clinical quality control and documentation. Methods: A VERO unit is equipped with both kV and MV imaging capabilities for IGRT treatments. It has its own imaging database behind a firewall. It has been a challenge to transfer images on this unit to a TMS in a radiation therapy clinic so that registered images can be reviewed remotely with an approval or rejection record. In this study, a software system, iPump-VERO, was developed to connect VERO and a TMS in our clinic. The patient database folder on the VERO unit was mapped to a read-only folder on a file server outside VERO firewall. The application runs on a regular computer with the read access to the patient database folder. It finds the latest registered images and fuses them in one of six predefined patterns before sends them via DICOM connection to the TMS. The residual image registration errors will be overlaid on the fused image to facilitate image review. Results: The fused images of either registered kV planar images or CBCT images are fully DICOM compatible. A sentinel module is built to sense new registered images with negligible computing resources from the VERO ExacTrac imaging computer. It takes a few seconds to fuse registered images and send them to the TMS. The whole process is automated without any human intervention. Conclusion: Transferring images in DICOM connection is the easiest way to consolidate images of various sources in your TMS. Technically the attending does not have to go to the VERO treatment console to review image registration prior delivery. It is a useful tool for a busy clinic with a VERO unit.

60 APPLIED LIFE SCIENCES↗

WE-G-18A-05: Cone-Beam CT Reconstruction with Deformed Prior Image

Purpose: Prior image can be incorporated into image reconstruction process to improve the quality of on-treatment cone-beam CT (CBCT) from sparseview or low-dose projections. However, the deformation between the prior image and on-treatment CBCT are not considered in current prior image based reconstructions (e.g., prior image constrained compressed sensing (PICCS)). The purpose of this work is to develop a deformed-prior-imagebased- reconstruction strategy (DPIR) to address the mismatch problem between the prior image and target image. Methods: The deformed prior image is obtained by a projection based registration approach. Specifically, the deformation vector fields (DVF) used to deform the prior image is estimated through matching the forward projection of the prior image and the measured on-treatment projection. The deformed prior image is then used as the prior image in the standard PICCS algorithm. Simulation studies on the XCAT phantom was conducted to evaluate the performance of the projection based registration procedure and the proposed DPIR strategy. Results: The deformed prior image matches the geometry of on-treatment CBCT closer as compared to the original prior image. Using the deformed prior image, the quality of the image reconstructed by DPIR from few-view projection data is greatly improved as compared to the standard PICCS algorithm. The relative image reconstruction error is reduced to 11.13% in the proposed DPIR from 17.57% in the original PICCS. Conclusion: The proposed DPIR approach can solve the mismatch problem between the prior image and target image, which overcomes the limitation of the original PICCS algorithm for CBCT reconstruction from sparse-view or low-dose projections.

60 APPLIED LIFE SCIENCES↗

Technical Note: Evaluation of a 160-mm/256-row CT scanner for whole-heart quantitative myocardial perfusion imaging

Purpose: The authors investigated the performance of a recently introduced 160-mm/256-row CT system for low dose quantitative myocardial perfusion (MP) imaging of the whole heart. This platform is equipped with a gantry capable of rotating at 280 ms per full cycle, a second generation of adaptive statistical iterative reconstruction (ASiR-V) to correct for image noise arising from low tube voltage potential/tube current dynamic scanning, and image reconstruction algorithms to tackle beam-hardening, cone-beam, and partial-scan effects. Methods: Phantom studies were performed to investigate the effectiveness of image noise and artifact reduction with a GE Healthcare Revolution CT system for three acquisition protocols used in quantitative CT MP imaging: 100, 120, and 140 kVp/25 mAs. The heart chambers of an anthropomorphic chest phantom were filled with iodinated contrast solution at different concentrations (contrast levels) to simulate the circulation of contrast through the heart in quantitative CT MP imaging. To evaluate beam-hardening correction, the phantom was scanned at each contrast level to measure the changes in CT number (in Hounsfield unit or HU) in the water-filled region surrounding the heart chambers with respect to baseline. To evaluate cone-beam artifact correction, differences in mean water HU between the central and peripheral slices were compared. Partial-scan artifact correction was evaluated from the fluctuation of mean water HU in successive partial scans. To evaluate image noise reduction, a small hollow region adjacent to the heart chambers was filled with diluted contrast, and contrast-to-noise ratio in the region before and after noise correction with ASiR-V was compared. The quality of MP maps acquired with the CT system was also evaluated in porcine CT MP studies. Myocardial infarct was induced in a farm pig from a transient occlusion of the distal left anterior descending (LAD) artery with a catheter-based interventional procedure. MP maps were generated from the dynamic contrast-enhanced (DCE) heart images taken at baseline and three weeks after the ischemic insult. Results: Their results showed that the phantom and animal images acquired with the CT platform were minimally affected by image noise and artifacts. For the beam-hardening phantom study, changes in water HU in the wall surrounding the heart chambers greatly reduced from >±30 to ≤ ± 5 HU at all kVp settings except one region at 100 kVp (7 HU). For the cone-beam phantom study, differences in mean water HU from the central slice were less than 5 HU at two peripheral slices with each 4 cm away from the central slice. These findings were reproducible in the pig DCE images at two peripheral slices that were 6 cm away from the central slice. For the partial-scan phantom study, standard deviations of the mean water HU in 10 successive partial scans were less than 5 HU at the central slice. Similar observations were made in the pig DCE images at two peripheral slices with each 6 cm away from the central slice. For the image noise phantom study, CNRs in the ASiR-V images were statistically higher (p < 0.05) than the non-ASiR-V images at all kVp settings. MP maps generated from the porcine DCE images were in excellent quality, with the ischemia in the LAD territory clearly seen in the three orthogonal views. Conclusions: The study demonstrates that this CT system can provide accurate and reproducible CT numbers during cardiac gated acquisitions across a wide axial field of view. This CT number fidelity will enable this imaging tool to assess contrast enhancement, potentially providing valuable added information beyond anatomic evaluation of coronary stenoses. Furthermore, their results collectively suggested that the 100 kVp/25 mAs protocol run on this CT system provides sufficient image accuracy at a low radiation dose (<3 mSv) for whole-heart quantitative CT MP imaging.

60 APPLIED LIFE SCIENCES↗

WE-FG-207B-11: Objective Image Characterization of Spectral CT with a Dual-Layer Detector

Purpose: To obtain objective reference data for the spectral performance on a dual-layer detector CT platform (IQon, Philips) and compare virtual monoenergetic to conventional CT images. Methods: Scanning was performed using the hospital’s clinical adult body protocol: helical acquisition at 120kVp, with CTDIvol=15mGy. Multiple modules (591, 515, 528) of a CATPHAN 600 phantom and a 20 cm diameter cylindrical water phantom were scanned. No modifications to the standard protocol were necessary to enable spectral imaging. Both conventional and virtual monoenergetic images were generated from acquired data. Noise characteristics were assessed through Noise Power Spectra (NPS) and pixel standard deviation from water phantom images. Spatial resolution was evaluated using Modulation Transfer Functions (MTF) of a tungsten wire as well as resolution bars. Low-contrast detectability was studied using contrast-to-noise ratio (CNR) of a low contrast object. Results: MTF curves of monoenergetic and conventional images were almost identical. MTF 50%, 10%, and 5% levels for monoenergetic images agreed with conventional images within 0.05lp/cm. These observations were verified by the resolution bars, which were clearly resolved at 7lp/cm but started blurring at 8lp/cm for this protocol in both conventional and 70 keV images. NPS curves indicated that, compared to conventional images, the noise power distribution of 70 keV monoenergetic images is similar (i.e. noise texture is similar) but exhibit a low frequency peak at keVs higher and lower than 70 keV. Standard deviation measurements show monoenergetic images have lower noise except at 40 keV where it is slightly higher. CNR of monoenergetic images is mostly flat across keV values and is superior to that of conventional images. Conclusion: Values for standard image quality metrics are the same or better for monoenergetic images compared to conventional images. Results indicate virtual monoenergetic images can be used without any loss in image quality or noise penalties relative to conventional images. This study was performed as part of a research agreement among Philips Healthcare, University Hospitals of Cleveland, and Case Western Reserve University.

60 APPLIED LIFE SCIENCES↗

Diversity imaging techniques in lidar

Diversity imaging techniques have been successfully employed in conventional microwave range-Doppler imaging radars to obtain high resolution images of both natural and man-made targets. These techniques allow microwave radars to achieve image resolution which would otherwise require excessively large antennas. Recent advances in coherent laser radar techniques and signal processing have led to the development of range-Doppler imaging laser radars. While much of the theory and signal processing techniques used in microwave radars can be brought to bear on laser radars, the significant difference in wavelength results in issues peculiar to laser radar systems. Both the fundamental concepts and specific applications of diversity imaging techniques applied to laser radar imaging systems will be discussed. Angle, frequency, and bistatic angle degrees of freedom can be employed in a coherent laser radar imaging system to achieve image resolution which exceeds the traditional Rayleigh criterion associated with the receive aperture. In diversity imaging, angle and frequency degrees of freedom can be used to synthesize an effective aperture providing range and Doppler target information. The ability to vary the bistatic angle provides an additional means of synthesizing an effective aperture. Both simulated and experimentally obtained laser radar images of spinning and/or tumbling objects utilizing both angular and frequency diversity will be presented. In coherent laser radar systems, image quality can be dominated by laser speckle effects. In particular, the signal-to-noise ratio (SNR) of a coherent laser radar image is at most unity in the presence of fully developed speckle. Diversity techniques can be utilized to improve the image SNR; simple incoherent averaging of images utilizing temporal and polarization degrees of freedom can significantly improve image SNR. Both the SNR and image resolution (as defined by the synthetic aperture) contribute to image quality. The relationship between the available degrees of freedom and image quality are discussed.

Schultz, K. I.↗

Symmetric Phase-Only Filtering in Particle-Image Velocimetry

Symmetrical phase-only filtering (SPOF) can be exploited to obtain substantial improvements in the results of data processing in particle-image velocimetry (PIV). In comparison with traditional PIV data processing, SPOF PIV data processing yields narrower and larger amplitude correlation peaks, thereby providing more-accurate velocity estimates. The higher signal-to-noise ratios associated with the higher amplitude correlation peaks afford greater robustness and reliability of processing. SPOF also affords superior performance in the presence of surface flare light and/or background light. SPOF algorithms can readily be incorporated into pre-existing algorithms used to process digitized image data in PIV, without significantly increasing processing times. A summary of PIV and traditional PIV data processing is prerequisite to a meaningful description of SPOF PIV processing. In PIV, a pulsed laser is used to illuminate a substantially planar region of a flowing fluid in which particles are entrained. An electronic camera records digital images of the particles at two instants of time. The components of velocity of the fluid in the illuminated plane can be obtained by determining the displacements of particles between the two illumination pulses. The objective in PIV data processing is to compute the particle displacements from the digital image data. In traditional PIV data processing, to which the present innovation applies, the two images are divided into a grid of subregions and the displacements determined from cross-correlations between the corresponding sub-regions in the first and second images. The cross-correlation process begins with the calculation of the Fourier transforms (or fast Fourier transforms) of the subregion portions of the images. The Fourier transforms from the corresponding subregions are multiplied, and this product is inverse Fourier transformed, yielding the cross-correlation intensity distribution. The average displacement of the particles across a subregion results in a displacement of the correlation peak from the center of the correlation plane. The velocity is then computed from the displacement of the correlation peak and the time between the recording of the two images. The process as described thus far is performed for all the subregions. The resulting set of velocities in grid cells amounts to a velocity vector map of the flow field recorded on the image plane. In traditional PIV processing, surface flare light and bright background light give rise to a large, broad correlation peak, at the center of the correlation plane, that can overwhelm the true particle- displacement correlation peak. This has made it necessary to resort to tedious image-masking and background-subtraction procedures to recover the relatively small amplitude particle-displacement correlation peak. SPOF is a variant of phase-only filtering (POF), which, in turn, is a variant of matched spatial filtering (MSF). In MSF, one projects a first image (denoted the input image) onto a second image (denoted the filter) as part of a computation to determine how much and what part of the filter is present in the input image. MSF is equivalent to cross-correlation. In POF, the frequency-domain content of the MSF filter is modified to produce a unitamplitude (phase-only) object. POF is implemented by normalizing the Fourier transform of the filter by its magnitude. The advantage of POFs is that they yield correlation peaks that are sharper and have higher signal-to-noise ratios than those obtained through traditional MSF. In the SPOF, these benefits of POF can be extended to PIV data processing. The SPOF yields even better performance than the POF approach, which is uniquely applicable to PIV type image data. In SPOF as now applied to PIV data processing, a subregion of the first image is treated as the input image and the corresponding subregion of the second image is treated as the filter. The Fourier transforms from both the firs and second- image subregions are normalized by the square roots of their respective magnitudes. This scheme yields optimal performance because the amounts of normalization applied to the spatial-frequency contents of the input and filter scenes are just enough to enhance their high-spatial-frequency contents while reducing their spurious low-spatial-frequency content. As a result, in SPOF PIV processing, particle-displacement correlation peaks can readily be detected above spurious background peaks, without need for masking or background subtraction.

Wemet, Mark P.↗

Smart Image Enhancement Process

Contrast and lightness measures are used to first classify the image as being one of non-turbid and turbid. If turbid, the original image is enhanced to generate a first enhanced image. If non-turbid, the original image is classified in terms of a merged contrast/lightness score based on the contrast and lightness measures. The non-turbid image is enhanced to generate a second enhanced image when a poor contrast/lightness score is associated therewith. When the second enhanced image has a poor contrast/lightness score associated therewith, this image is enhanced to generate a third enhanced image. A sharpness measure is computed for one image that is selected from (i) the non-turbid image, (ii) the first enhanced image, (iii) the second enhanced image when a good contrast/lightness score is associated therewith, and (iv) the third enhanced image. If the selected image is not-sharp, it is sharpened to generate a sharpened image. The final image is selected from the selected image and the sharpened image.

Jobson, Daniel J.↗

Synchronized multiartifact reduction with tomographic reconstruction (SMART-RECON): A statistical model based iterative image reconstruction method to eliminate limited-view artifacts and to mitigate the temporal-average artifacts in time-resolved CT

Purpose: In x-ray computed tomography (CT), a violation of the Tuy data sufficiency condition leads to limited-view artifacts. In some applications, it is desirable to use data corresponding to a narrow temporal window to reconstruct images with reduced temporal-average artifacts. However, the need to reduce temporal-average artifacts in practice may result in a violation of the Tuy condition and thus undesirable limited-view artifacts. In this paper, the authors present a new iterative reconstruction method, synchronized multiartifact reduction with tomographic reconstruction (SMART-RECON), to eliminate limited-view artifacts using data acquired within an ultranarrow temporal window that severely violates the Tuy condition. Methods: In time-resolved contrast enhanced CT acquisitions, image contrast dynamically changes during data acquisition. Each image reconstructed from data acquired in a given temporal window represents one time frame and can be denoted as an image vector. Conventionally, each individual time frame is reconstructed independently. In this paper, all image frames are grouped into a spatial–temporal image matrix and are reconstructed together. Rather than the spatial and/or temporal smoothing regularizers commonly used in iterative image reconstruction, the nuclear norm of the spatial–temporal image matrix is used in SMART-RECON to regularize the reconstruction of all image time frames. This regularizer exploits the low-dimensional structure of the spatial–temporal image matrix to mitigate limited-view artifacts when an ultranarrow temporal window is desired in some applications to reduce temporal-average artifacts. Both numerical simulations in two dimensional image slices with known ground truth and in vivo human subject data acquired in a contrast enhanced cone beam CT exam have been used to validate the proposed SMART-RECON algorithm and to demonstrate the initial performance of the algorithm. Reconstruction errors and temporal fidelity of the reconstructed images were quantified using the relative root mean square error (rRMSE) and the universal quality index (UQI) in numerical simulations. The performance of the SMART-RECON algorithm was compared with that of the prior image constrained compressed sensing (PICCS) reconstruction quantitatively in simulations and qualitatively in human subject exam. Results: In numerical simulations, the 240{sup ∘} short scan angular span was divided into four consecutive 60{sup ∘} angular subsectors. SMART-RECON enables four high temporal fidelity images without limited-view artifacts. The average rRMSE is 16% and UQIs are 0.96 and 0.95 for the two local regions of interest, respectively. In contrast, the corresponding average rRMSE and UQIs are 25%, 0.78, and 0.81, respectively, for the PICCS reconstruction. Note that only one filtered backprojection image can be reconstructed from the same data set with an average rRMSE and UQIs are 45%, 0.71, and 0.79, respectively, to benchmark reconstruction accuracies. For in vivo contrast enhanced cone beam CT data acquired from a short scan angular span of 200{sup ∘}, three 66{sup ∘} angular subsectors were used in SMART-RECON. The results demonstrated clear contrast difference in three SMART-RECON reconstructed image volumes without limited-view artifacts. In contrast, for the same angular sectors, PICCS cannot reconstruct images without limited-view artifacts and with clear contrast difference in three reconstructed image volumes. Conclusions: In time-resolved CT, the proposed SMART-RECON method provides a new method to eliminate limited-view artifacts using data acquired in an ultranarrow temporal window, which corresponds to approximately 60{sup ∘} angular subsectors.

60 APPLIED LIFE SCIENCES↗

Generation of hybrid sinograms for the recovery of kV-CT images with metal artifacts for helical tomotherapy

Purpose: The overall goal of this study is to restore kilovoltage computed tomography (kV-CT) images which are disfigured by patients’ metal prostheses. By generating a hybrid sinogram that is a combination of kV and megavoltage (MV) projection data, the authors suggest a novel metal artifact-reduction (MAR) method that retains the image quality to match that of kV-CT and simultaneously restores the information of metal prostheses lost due to photon starvation. Methods: CT projection data contain information about attenuation coefficients and the total length of the attenuation. By normalizing raw kV projections with their own total lengths of attenuation, mean attenuation projections were obtained. In the same manner, mean density projections of MV-CT were obtained by the normalization of MV projections resulting from the forward projection of density-calibrated MV-CT images with the geometric parameters of the kV-CT device. To generate the hybrid sinogram, metal-affected signals of the kV sinogram were identified and replaced by the corresponding signals of the MV sinogram following a density calibration step with kV data. Filtered backprojection was implemented to reconstruct the hybrid CT image. To validate the authors’ approach, they simulated four different scenarios for three heads and one pelvis using metallic rod inserts within a cylindrical phantom. Five inserts describing human body elements were also included in the phantom. The authors compared the image qualities among the kV, MV, and hybrid CT images by measuring the contrast-to-noise ratio (CNR), the signal-to-noise ratio (SNR), the densities of all inserts, and the spatial resolution. In addition, the MAR performance was compared among three existing MAR methods and the authors’ hybrid method. Finally, for clinical trials, the authors produced hybrid images of three patients having dental metal prostheses to compare their MAR performances with those of the kV, MV, and three existing MAR methods. Results: The authors compared the image quality and MAR performance of the hybrid method with those of other imaging modalities and the three MAR methods, respectively. The total measured mean of the CNR (SNR) values for the nonmetal inserts was determined to be 14.3 (35.3), 15.3 (37.8), and 25.5 (64.3) for the kV, MV, and hybrid images, respectively, and the spatial resolutions of the hybrid images were similar to those of the kV images. The measured densities of the metal and nonmetal inserts in the hybrid images were in good agreement with their true densities, except in cases of extremely low densities, such as air and lung. Using the hybrid method, major streak artifacts were suitably removed and no secondary artifacts were introduced in the resultant image. In clinical trials, the authors verified that kV and MV projections were successfully combined and turned into the resultant hybrid image with high image contrast, accurate metal information, and few metal artifacts. The hybrid method also outperformed the three existing MAR methods with regard to metal information restoration and secondary artifact prevention. Conclusions: The authors have shown that the hybrid method can restore the overall image quality of kV-CT disfigured by severe metal artifacts and restore the information of metal prostheses lost due to photon starvation. The hybrid images may allow for the improved delineation of structures of interest and accurate dose calculations for radiation treatment planning for patients with metal prostheses.

60 APPLIED LIFE SCIENCES↗

SU-E-J-204: Radiation Dose to Patients Resulting From Image Guidance Procedures and AAPM TG-180 Update

Purpose: Image-guided radiation therapy (IGRT) is the new paradigm for patient positioning and target localization in radiotherapy. Daily imaging procedures add additional dose to the patient's treatment volume and normal tissues and may expose the organs at risk to unaccounted doses. This presentation is to update the progress of AAPM TG-180 which aims to provide strategies to quantify and account the dose from both MV and kV imaging in patient treatment planning. Methods: Our current knowledge on image guidance dose is presented. A summary of doses from image guidance procedures delivered to patients in relationship with therapeutic doses is given. Different techniques in reducing the image guidance dose are summarized. Typical organ doses resulting from different image acquisition procedures used in IGRT are tabulated. Results: Many techniques to reduce the imaging doses are available in clinical applications. There are large variations between dose to bone and dose to soft tissues for x-rays at kilovoltage energy range. Methods for clinical implementation of accounting for the imaging dose from an imaging procedure are available. Beam data from imaging systems can be generated by combining Monte Carlo simulations and experimental measurements for commissioning imaging beams in the treatment planning. Conclusion: The current treatment planning systems are not yet equipped to perform patient specific dose calculations resulting from kV imaging procedures. The imaging dose from current kV image devices has been significantly reduced and is generally much less than that resulting from MV. Because the magnitude of kV imaging dose is significantly low and the variation between patients is modest, it is feasible to estimate dose based on imaging producers or protocols using tabulated values which provides an alternative to accomplish the task of accounting and reporting imaging doses.

60 APPLIED LIFE SCIENCES↗

MO-PIS-Exhibit Hall-01: Tools for TG-142 Linac Imaging QA I

Partners in Solutions is an exciting new program in which AAPM partners with our vendors to present practical “hands-on” information about the equipment and software systems that we use in our clinics. The therapy topic this year is solutions for TG-142 recommendations for linear accelerator imaging QA. Note that the sessions are being held in a special purpose room built on the Exhibit Hall Floor, to encourage further interaction with the vendors. Automated Imaging QA for TG-142 with RIT Presentation Time: 2:45 – 3:15 PM This presentation will discuss software tools for automated imaging QA and phantom analysis for TG-142. All modalities used in radiation oncology will be discussed, including CBCT, planar kV imaging, planar MV imaging, and imaging and treatment coordinate coincidence. Vendor supplied phantoms as well as a variety of third-party phantoms will be shown, along with appropriate analyses, proper phantom setup procedures and scanning settings, and a discussion of image quality metrics. Tools for process automation will be discussed which include: RIT Cognition (machine learning for phantom image identification), RIT Cerberus (automated file system monitoring and searching), and RunQueueC (batch processing of multiple images). In addition to phantom analysis, tools for statistical tracking, trending, and reporting will be discussed. This discussion will include an introduction to statistical process control, a valuable tool in analyzing data and determining appropriate tolerances. An Introduction to TG-142 Imaging QA Using Standard Imaging Products Presentation Time: 3:15 – 3:45 PM Medical Physicists want to understand the logic behind TG-142 Imaging QA. What is often missing is a firm understanding of the connections between the EPID and OBI phantom imaging, the software “algorithms” that calculate the QA metrics, the establishment of baselines, and the analysis and interpretation of the results. The goal of our brief presentation will be to establish and solidify these connections. Our talk will be motivated by the Standard Imaging, Inc. phantom and software solutions. We will present and explain each of the image quality metrics in TG-142 in terms of the theory, mathematics, and algorithms used to implement them in the Standard Imaging PIPSpro software. In the process, we will identify the regions of phantom images that are analyzed by each algorithm. We then will discuss the process of the creation of baselines and typical ranges of acceptable values for each imaging quality metric.

07 ISOTOPE AND RADIATION SOURCES↗

High resolution Cerenkov light imaging of induced positron distribution in proton therapy

Purpose: In proton therapy, imaging of the positron distribution produced by fragmentation during or soon after proton irradiation is a useful method to monitor the proton range. Although positron emission tomography (PET) is typically used for this imaging, its spatial resolution is limited. Cerenkov light imaging is a new molecular imaging technology that detects the visible photons that are produced from high-speed electrons using a high sensitivity optical camera. Because its inherent spatial resolution is much higher than PET, the authors can measure more precise information of the proton-induced positron distribution with Cerenkov light imaging technology. For this purpose, they conducted Cerenkov light imaging of induced positron distribution in proton therapy. Methods: First, the authors evaluated the spatial resolution of our Cerenkov light imaging system with a {sup 22}Na point source for the actual imaging setup. Then the transparent acrylic phantoms (100 × 100 × 100 mm{sup 3}) were irradiated with two different proton energies using a spot scanning proton therapy system. Cerenkov light imaging of each phantom was conducted using a high sensitivity electron multiplied charge coupled device (EM-CCD) camera. Results: The Cerenkov light’s spatial resolution for the setup was 0.76 ± 0.6 mm FWHM. They obtained high resolution Cerenkov light images of the positron distributions in the phantoms for two different proton energies and made fused images of the reference images and the Cerenkov light images. The depths of the positron distribution in the phantoms from the Cerenkov light images were almost identical to the simulation results. The decay curves derived from the region-of-interests (ROIs) set on the Cerenkov light images revealed that Cerenkov light images can be used for estimating the half-life of the radionuclide components of positrons. Conclusions: High resolution Cerenkov light imaging of proton-induced positron distribution was possible. The authors conclude that Cerenkov light imaging of proton-induced positron is promising for proton therapy.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Monte Carlo simulation of PET and SPECT imaging of {sup 90}Y

Purpose: Yittrium-90 ({sup 90}Y) is traditionally thought of as a pure beta emitter, and is used in targeted radionuclide therapy, with imaging performed using bremsstrahlung single-photon emission computed tomography (SPECT). However, because {sup 90}Y also emits positrons through internal pair production with a very small branching ratio, positron emission tomography (PET) imaging is also available. Because of the insufficient image quality of {sup 90}Y bremsstrahlung SPECT, PET imaging has been suggested as an alternative. In this paper, the authors present the Monte Carlo-based simulation–reconstruction framework for {sup 90}Y to comprehensively analyze the PET and SPECT imaging techniques and to quantitatively consider the disadvantages associated with them. Methods: Our PET and SPECT simulation modules were developed using Monte Carlo simulation of Electrons and Photons (MCEP), developed by Dr. S. Uehara. PET code (MCEP-PET) generates a sinogram, and reconstructs the tomography image using a time-of-flight ordered subset expectation maximization (TOF-OSEM) algorithm with attenuation compensation. To evaluate MCEP-PET, simulated results of {sup 18}F PET imaging were compared with the experimental results. The results confirmed that MCEP-PET can simulate the experimental results very well. The SPECT code (MCEP-SPECT) models the collimator and NaI detector system, and generates the projection images and projection data. To save the computational time, the authors adopt the prerecorded {sup 90}Y bremsstrahlung photon data calculated by MCEP. The projection data are also reconstructed using the OSEM algorithm. The authors simulated PET and SPECT images of a water phantom containing six hot spheres filled with different concentrations of {sup 90}Y without background activity. The amount of activity was 163 MBq, with an acquisition time of 40 min. Results: The simulated {sup 90}Y-PET image accurately simulated the experimental results. PET image is visually superior to SPECT image because of the low background noise. The simulation reveals that the detected photon number in SPECT is comparable to that of PET, but the large fraction (approximately 75%) of scattered and penetration photons contaminates SPECT image. The lower limit of {sup 90}Y detection in SPECT image was approximately 200 kBq/ml, while that in PET image was approximately 100 kBq/ml. Conclusions: By comparing the background noise level and the image concentration profile of both the techniques, PET image quality was determined to be superior to that of bremsstrahlung SPECT. The developed simulation codes will be very useful in the future investigations of PET and bremsstrahlung SPECT imaging of {sup 90}Y.

07 ISOTOPE AND RADIATION SOURCES↗

Hyperspectral Fluorescence and Reflectance Imaging Instrument

The system is a single hyperspectral imaging instrument that has the unique capability to acquire both fluorescence and reflectance high-spatial-resolution data that is inherently spatially and spectrally registered. Potential uses of this instrument include plant stress monitoring, counterfeit document detection, biomedical imaging, forensic imaging, and general materials identification. Until now, reflectance and fluorescence spectral imaging have been performed by separate instruments. Neither a reflectance spectral image nor a fluorescence spectral image alone yields as much information about a target surface as does a combination of the two modalities. Before this system was developed, to benefit from this combination, analysts needed to perform time-consuming post-processing efforts to co-register the reflective and fluorescence information. With this instrument, the inherent spatial and spectral registration of the reflectance and fluorescence images minimizes the need for this post-processing step. The main challenge for this technology is to detect the fluorescence signal in the presence of a much stronger reflectance signal. To meet this challenge, the instrument modulates artificial light sources from ultraviolet through the visible to the near-infrared part of the spectrum; in this way, both the reflective and fluorescence signals can be measured through differencing processes to optimize fluorescence and reflectance spectra as needed. The main functional components of the instrument are a hyperspectral imager, an illumination system, and an image-plane scanner. The hyperspectral imager is a one-dimensional (line) imaging spectrometer that includes a spectrally dispersive element and a two-dimensional focal plane detector array. The spectral range of the current imaging spectrometer is between 400 to 1,000 nm, and the wavelength resolution is approximately 3 nm. The illumination system consists of narrowband blue, ultraviolet, and other discrete wavelength light-emitting-diode (LED) sources and white-light LED sources designed to produce consistently spatially stable light. White LEDs provide illumination for the measurement of reflectance spectra, while narrowband blue and UV LEDs are used to excite fluorescence. Each spectral type of LED can be turned on or off depending on the specific remote-sensing process being performed. Uniformity of illumination is achieved by using an array of LEDs and/or an integrating sphere or other diffusing surface. The image plane scanner uses a fore optic with a field of view large enough to provide an entire scan line on the image plane. It builds up a two-dimensional image in pushbroom fashion as the target is scanned across the image plane either by moving the object or moving the fore optic. For fluorescence detection, spectral filtering of a narrowband light illumination source is sometimes necessary to minimize the interference of the source spectrum wings with the fluorescence signal. Spectral filtering is achieved with optical interference filters and absorption glasses. This dual spectral imaging capability will enable the optimization of reflective, fluorescence, and fused datasets as well as a cost-effective design for multispectral imaging solutions. This system has been used in plant stress detection studies and in currency analysis.

Ryan, Robert E.↗