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SU-F-J-40: Evaluation of Sensitivity of the Automatic Matching Between Cone-Beam CT Image and Simulation CT Image in TrueBeam 2.0 Imaging System 6DoF Considering Different Uncertainty Sources

Purpose: To estimate the sensitivity of TrueBeam 2.0 Imaging System 6DoF automatic matching tool through the acquisition of cone-beam CT images in different phantoms applying submillimeter translations and rotations of tenths of a degree and registered with image simulation CT. Methods: To evaluate overall system-wide image, we consider two uncertainties source; First, the uncertainty of the manual phantom displacement (ε-m). This uncertainty is calculated by a digital caliper (0.01 mm) for vertical (Vrt), lateral (Lat) and longitudinal (Lng). A digital inclinometer (0.01°) for the pitch and roll and the own phantom scale to evaluate the coordinate rotation (Rtn). The second uncertainty is the displacement detected by the algorithm system of matching (σ-d) that we obtain from the standard deviations of the different measurements. We use three different phantoms. The BrainLab Radiosurgery system for supporting masks with an anthropomorphic dummy adapted to allow displacements of 0.1 mm in Vrt, Lat and Lng dimensions and rotations of 0.1° in Pitch dimension. For the analysis of the Rtn and Roll dimensions we use two homemade phantoms (RinoRot and RinoRoll, La Fe Hospital, Valencia, Spain) that allow rotations of 0.3°. Results: In the case of manual displacement of 0.10 ± 0.03 mm in the translations, the system detect 0.10 ± 0.07 mm, 0.12 ± 0.07 mm and 0.13 ± 0.07 mm (mean ± SD) in Lat, Vrt and Lng respectively. In the case of rotational dimension, manual displacement of 0.3 ± 0.1° was detected with 0.19 ± 0.06°, 0.29 ± 0.03° and 0.27 ± 0.06° in Pitch, Roll and Rtn. Conclusion: We conclude that the sensitivity of the automatic matching system is within 0.10 mm in translations and 0.3° in rotations. These values are under the own sensitivity of the software.

60 APPLIED LIFE SCIENCES↗

Realistic simulation of reduced-dose CT with noise modeling and sinogram synthesis using DICOM CT images

Purpose: Reducing the patient dose while maintaining the diagnostic image quality during CT exams is the subject of a growing number of studies, in which simulations of reduced-dose CT with patient data have been used as an effective technique when exploring the potential of various dose reduction techniques. Difficulties in accessing raw sinogram data, however, have restricted the use of this technique to a limited number of institutions. Here, we present a novel reduced-dose CT simulation technique which provides realistic low-dose images without the requirement of raw sinogram data. Methods: Two key characteristics of CT systems, the noise equivalent quanta (NEQ) and the algorithmic modulation transfer function (MTF), were measured for various combinations of object attenuation and tube currents by analyzing the noise power spectrum (NPS) of CT images obtained with a set of phantoms. Those measurements were used to develop a comprehensive CT noise model covering the reduced x-ray photon flux, object attenuation, system noise, and bow-tie filter, which was then employed to generate a simulated noise sinogram for the reduced-dose condition with the use of a synthetic sinogram generated from a reference CT image. The simulated noise sinogram was filtered with the algorithmic MTF and back-projected to create a noise CT image, which was then added to the reference CT image, finally providing a simulated reduced-dose CT image. The simulation performance was evaluated in terms of the degree of NPS similarity, the noise magnitude, the bow-tie filter effect, and the streak noise pattern at photon starvation sites with the set of phantom images. Results: The simulation results showed good agreement with actual low-dose CT images in terms of their visual appearance and in a quantitative evaluation test. The magnitude and shape of the NPS curves of the simulated low-dose images agreed well with those of real low-dose images, showing discrepancies of less than +/−3.2% in terms of the noise power at the peak height and +/−1.2% in terms of the spatial frequency at the peak height. The magnitudes of the noise measured for 12 different combinations the phantom size, tube current, and reconstruction kernel for the simulated and real low-dose images were very similar, with differences of 0.1 to 4.7%. Thep value for a statistical testing of the difference in the noise magnitude ranged from 0.99 to 0.11, showing that there was no difference statistically between the noise magnitudes of the real and simulated low-dose images using our method. The strength and pattern of the streak noise in an anthropomorphic phantom was also consistent with expectations. Conclusions: A novel reduced-dose CT simulation technique was developed which uses only CT images while not requiring raw sinogram data. Our method can provide realistic simulation results under reduced-dose conditions both in terms of the noise magnitude and the textual appearance. This technique has the potential to promote clinical research for patient dose reductions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-J-242: Volume-Dependence of Quantitative Imaging Features From CT and CE-CT Images of NSCLC

Purpose: To determine whether tumor volume plays a significant role in the values obtained for texture features when they are extracted from computed tomography (CT) images of non-small cell lung cancer (NSCLC). We also sought to identify whether features can be reliably measured at all volumes or if a minimum volume threshold should be recommended. Methods: Eleven features were measured on 40 CT and 32 contrast-enhanced CT (CECT) patient images for this study. Features were selected for their prognostic/diagnostic value in previous publications. Direct correlations between these textures and volume were evaluated using the Spearman correlation coefficient. Any texture that the Wilcoxon rank-sum test was used to compare the variation above and below a volume cutoff. Four different volume thresholds (5, 10, 15, and 20 cm{sup 3}) were tested. Results: Four textures were found to be significantly correlated with volume in both the CT and CE-CT images. These were busyness, coarseness, gray-level nonuniformity, and run-length nonuniformity with correlation coefficients of 0.92, −0.96, 0.94, and 0.98 for the CT images and 0.95, −0.97, 0.98, and 0.98 for the CE-CT images. After volume normalization, the correlation coefficients decreased substantially. For the data obtained from the CT images, the results of the Wilcoxon rank-sum test were significant when volume thresholds of 5–15 cm3 were used. No volume threshold was shown to be significant for the CE-CT data. Conclusion: Equations for four features that have been used in several published studies were found to be volume-dependent. Future studies should consider implementing normalization factors or removing these features entirely to prevent this potential source of redundancy or bias. This work was supported in part by National Cancer Institute grant R03CA178495-01. Xenia Fave is a recipient of the American Association of Physicists in Medicine Graduate Fellowship.

60 APPLIED LIFE SCIENCES↗

Inter-slice bidirectional registration-based segmentation of the prostate gland in MR and CT image sequences

Purpose: Accurate segmentation and volume estimation of the prostate gland in magnetic resonance (MR) and computed tomography (CT) images are necessary steps in diagnosis, treatment, and monitoring of prostate cancer. This paper presents an algorithm for the prostate gland volume estimation based on the semiautomated segmentation of individual slices in T2-weighted MR and CT image sequences. Methods: The proposedInter-Slice Bidirectional Registration-based Segmentation (iBRS) algorithm relies on interslice image registration of volume data to segment the prostate gland without the use of an anatomical atlas. It requires the user to mark only three slices in a given volume dataset, i.e., the first, middle, and last slices. Next, the proposed algorithm uses a registration algorithm to autosegment the remaining slices. We conducted comprehensive experiments to measure the performance of the proposed algorithm using three registration methods (i.e., rigid, affine, and nonrigid techniques). Results: The results with the proposed technique were compared with manual marking using prostate MR and CT images from 117 patients. Manual marking was performed by an expert user for all 117 patients. The median accuracies for individual slices measured using the Dice similarity coefficient (DSC) were 92% and 91% for MR and CT images, respectively. The iBRS algorithm was also evaluated regarding user variability, which confirmed that the algorithm was robust to interuser variability when marking the prostate gland. Conclusions: The proposed algorithm exploits the interslice data redundancy of the images in a volume dataset of MR and CT images and eliminates the need for an atlas, minimizing the computational cost while producing highly accurate results which are robust to interuser variability.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Evaluation of the robustness of the preprocessing technique improving reversible compressibility of CT images: Tested on various CT examinations

Purpose: To modify the preprocessing technique, which was previously proposed, improving compressibility of computed tomography (CT) images to cover the diversity of three dimensional configurations of different body parts and to evaluate the robustness of the technique in terms of segmentation correctness and increase in reversible compression ratio (CR) for various CT examinations.Methods: This study had institutional review board approval with waiver of informed patient consent. A preprocessing technique was previously proposed to improve the compressibility of CT images by replacing pixel values outside the body region with a constant value resulting in maximizing data redundancy. Since the technique was developed aiming at only chest CT images, the authors modified the segmentation method to cover the diversity of three dimensional configurations of different body parts. The modified version was evaluated as follows. In randomly selected 368 CT examinations (352 787 images), each image was preprocessed by using the modified preprocessing technique. Radiologists visually confirmed whether the segmented region covers the body region or not. The images with and without the preprocessing were reversibly compressed using Joint Photographic Experts Group (JPEG), JPEG2000 two-dimensional (2D), and JPEG2000 three-dimensional (3D) compressions. The percentage increase in CR per examination (CR{sub I}) was measured.Results: The rate of correct segmentation was 100.0% (95% CI: 99.9%, 100.0%) for all the examinations. The median of CR{sub I} were 26.1% (95% CI: 24.9%, 27.1%), 40.2% (38.5%, 41.1%), and 34.5% (32.7%, 36.2%) in JPEG, JPEG2000 2D, and JPEG2000 3D, respectively.Conclusions: In various CT examinations, the modified preprocessing technique can increase in the CR by 25% or more without concerning about degradation of diagnostic information.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-J-240: The Impact On Clinical Dose-Distributions When Using MR-Images Registered with Stereotactic CT-Images in Gamma Knife Radiosurgery

Purpose: Most Gamma knife treatments are based solely on MR-images. However, for fractionated treatments and to implement TPS dose calculations that require electron densities, CT image data is essential. The purpose of this work is to assess the dosimetric effects of using MR-images registered with stereotactic CT-images in Gamma knife treatments. Methods: Twelve patients treated for vestibular schwannoma with Gamma Knife Perfexion (Elekta Instruments, Sweden) were selected for this study. The prescribed doses (12 Gy to periphery) were delivered based on the conventional approach of using stereotactic MR-images only. These plans were imported into stereotactic CT-images (by registering MR-images with stereotactic CT-images using the Leksell gamma plan registration software). The dose plans, for each patient, are identical in both cases except for potential rotations and translations resulting from the registration. The impact of the registrations was assessed by an algorithm written in Matlab. The algorithm compares the dose-distributions voxel-by-voxel between the two plans, calculates the full dose coverage of the target (treated in the conventional approach) achieved by the CT-based plan, and calculates the minimum dose delivered to the target (treated in the conventional approach) achieved by the CT-based plan. Results: The mean dose difference between the plans was 0.2 Gy to 0.4 Gy (max 4.5 Gy) whereas between 89% and 97% of the target (treated in the conventional approach) received the prescribed dose, by the CT-plan. The minimum dose to the target (treated in the conventional approach) given by the CT-based plan was between 7.9 Gy and 10.7 Gy (compared to 12 Gy in the conventional treatment). Conclusion: The impact of using MR-images registered with stereotactic CT-images has successfully been compared to conventionally delivered dose plans showing significant differences between the two. Although CTimages have been implemented clinically; the effect of the registration has not been fully investigated.

60 APPLIED LIFE SCIENCES↗

Synchrotron CT imaging of lattice structures with engineered defects

Understanding mechanical failure, crack propagation, and compressive behavior at the micrometer scale is essential for tailoring material properties for structural performance in cellular materials. Typically, modeling of traditional polymer foam materials is clouded by the lack of control in material morphology and its inherent stochastic structure. Additive manufacturing with sub-micrometer resolution provides a direct path for experimenters to specifically tailor structures needed by modelers to explicitly probe mechanical performance. Using laboratory-based 3D X-ray computed tomographic imaging (CT), the examination of deformation and damage provides a critical path to understand how these soft materials behave. Additionally, synchrotron CT yields realistic information at higher strain rates to directly validate the robustness of our finite element modeling. For this study, nanolithographic printing was employed to generate a series of engineered lattices with increasing levels of defects through the random removal of ligaments. These structures were mechanically tested and imaged with laboratory-based microCT. Additionally, synchrotron experiments were conducted in which the structures were imaged in 3D at 14 Hz during compression at a 0.4 s –1 strain rate. These 3D images show the changes in the structure as the ligaments bend, buckle and fracture in real time. This technique provides a robust framework for developing our methodologies and future exploration of engineered structures.

36 MATERIALS SCIENCE↗

A framework to measure myocardial extracellular volume fraction using dual-phase low dose CT images

Purpose: Myocardial extracellular volume fraction (ECVF) is a surrogate imaging biomarker of diffuse myocardial fibrosis, a hallmark of pathologic ventricular remodeling. Low dose cardiac CT is emerging as a promising modality to detect diffuse interstitial myocardial fibrosis due to its fast acquisition and low radiation; however, the insufficient contrast in the low dose CT images poses great challenge to measure ECVF from the image. Methods: To deal with this difficulty, the authors present a complete ECVF measurement framework including a point-guided myocardial modeling, a deformable model-based myocardium segmentation, nonrigid registration of pre- and post-CT, and ECVF calculation. Results: The proposed method was evaluated on 20 patients by two observers. Compared to the manually delineated reference segmentations, the accuracy of our segmentation in terms of true positive volume fraction (TPVF), false positive volume fraction (FPVF), and average surface distance (ASD), were 92.18% ± 3.52%, 0.31% ± 0.10%, 0.69 ± 0.14 mm, respectively. The interobserver variability measured by concordance correlation coefficient regarding TPVF, FPVF, and ASD were 0.95, 0.90, 0.94, respectively, demonstrating excellent agreement. Bland-Altman method showed 95% limits of agreement between ECVF at CT and ECVF at MR. Conclusions: The proposed framework demonstrates its efficiency, accuracy, and noninvasiveness in ECVF measurement and dramatically advances the ECVF at cardiac CT toward its clinical use.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-I-62: Assessing Radiation Dose Reduction and CT Image Optimization Through the Measurement and Analysis of the Detector Quantum Efficiency (DQE) of CT Images Using Different Beam Hardening Filters

Purpose: Reducing patient dose while maintaining (or even improving) image quality is one of the foremost goals in CT imaging. To this end, we consider the feasibility of optimizing CT scan protocols in conjunction with the application of different beam-hardening filtrations and assess this augmentation through noise-power spectrum (NPS) and detector quantum efficiency (DQE) analysis. Methods: American College of Radiology (ACR) and Catphan phantoms (The Phantom Laboratory) were scanned with a 64 slice CT scanner when additional filtration of thickness and composition (e.g., copper, nickel, tantalum, titanium, and tungsten) had been applied. A MATLAB-based code was employed to calculate the image of noise NPS. The Catphan Image Owl software suite was then used to compute the modulated transfer function (MTF) responses of the scanner. The DQE for each additional filter, including the inherent filtration, was then computed from these values. Finally, CT dose index (CTDIvol) values were obtained for each applied filtration through the use of a 100 mm pencil ionization chamber and CT dose phantom. Results: NPS, MTF, and DQE values were computed for each applied filtration and compared to the reference case of inherent beam-hardening filtration only. Results showed that the NPS values were reduced between 5 and 12% compared to inherent filtration case. Additionally, CTDIvol values were reduced between 15 and 27% depending on the composition of filtration applied. However, no noticeable changes in image contrast-to-noise ratios were noted. Conclusion: The reduction in the quanta noise section of the NPS profile found in this phantom-based study is encouraging. The reduction in both noise and dose through the application of beam-hardening filters is reflected in our phantom image quality. However, further investigation is needed to ascertain the applicability of this approach to reducing patient dose while maintaining diagnostically acceptable image qualities in a clinical setting.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Artificial neural network approach for multiphase segmentation of battery electrode nano-CT images

The segmentation of tomographic images of the battery electrode is a crucial processing step, which will have an additional impact on the results of material characterization and electrochemical simulation. However, manually labeling X-ray CT images (XCT) is time-consuming, and these XCT images are generally difficult to segment with histographical methods. We propose a deep learning approach with an asymmetrical depth encode-decoder convolutional neural network (CNN) for real-world battery material datasets. This network achieves high accuracy while requiring small amounts of labeled data and predicts a volume of billions voxel within few minutes. While applying supervised machine learning for segmenting real-world data, the ground truth is often absent. The results of segmentation are usually qualitatively justified by visual judgement. We try to unravel this fuzzy definition of segmentation quality by identifying the uncertainty due to the human bias diluted in the training data. Further CNN trainings using synthetic data show quantitative impact of such uncertainty on the determination of material’s properties. Nano-XCT datasets of various battery materials have been successfully segmented by training this neural network from scratch. We will also show that applying the transfer learning, which consists of reusing a well-trained network, can improve the accuracy of a similar dataset.

25 ENERGY STORAGE↗

Prospects for in vivo estimation of photon linear attenuation coefficients using postprocessing dual-energy CT imaging on a commercial scanner: Comparison of analytic and polyenergetic statistical reconstruction algorithms

Purpose: Accurate patient-specific photon cross-section information is needed to support more accurate model-based dose calculation for low energy photon-emitting modalities in medicine such as brachytherapy and kilovoltage x-ray imaging procedures. A postprocessing dual-energy CT (pDECT) technique for noninvasivein vivo estimation of photon linear attenuation coefficients has been experimentally implemented on a commercial CT scanner and its accuracy assessed in idealized phantom geometries. Methods: Eight test materials of known composition and density were used to compare pDECT-estimated linear attenuation coefficients to NIST reference values over an energy range from 10 keV to 1 MeV. As statistical image reconstruction (SIR) has been shown to reconstruct images with less random and systematic error than conventional filtered backprojection (FBP), the pDECT technique was implemented with both an in-house polyenergetic SIR algorithm, alternating minimization (AM), as well as a conventional FBP reconstruction algorithm. Improvement from increased spectral separation was also investigated by filtering the high-energy beam with an additional 0.5 mm of tin. The law of propagated uncertainty was employed to assess the sensitivity of the pDECT process to errors in reconstructed images. Results: Mean pDECT-estimated linear attenuation coefficients for the eight test materials agreed within 1% of NIST reference values for energies from 1 MeV down to 30 keV, with mean errors rising to between 3% and 6% at 10 keV, indicating that the method is unbiased when measurement and calibration phantom geometries are matched. Reconstruction with FBP and AM algorithms conferred similar mean pDECT accuracy. However, single-voxel pDECT estimates reconstructed on a 1 × 1 × 3 mm{sup 3} grid are shown to be highly sensitive to reconstructed image uncertainty; in some cases pDECT attenuation coefficient estimates exhibited standard deviations on the order of 20% around the mean. Reconstruction with the statistical AM algorithm led to standard deviations roughly 40% to 60% less than FBP reconstruction. Additional tin filtration of the high energy beam exhibits similar pDECT estimation accuracy as the unfiltered beam, even when scanning with only 25% of the dose. Using the law of propagated uncertainty, low Z materials are found to be more sensitive to image reconstruction errors than high Z materials. Furthermore, it is estimated that reconstructed CT image uncertainty must be limited to less than 0.25% to achieve a target linear-attenuation coefficient estimation uncertainty of 3% at 28 keV. Conclusions: That pDECT supports mean linear attenuation coefficient measurement accuracies of 1% of reference values for energies greater than 30 keV is encouraging. However, the sensitivity of the pDECT measurements to noise and systematic errors in reconstructed CT images warrants further investigation in more complex phantom geometries. The investigated statistical reconstruction algorithm, AM, reduced random measurement uncertainty relative to FBP owing to improved noise performance. These early results also support efforts to increase DE spectral separation, which can further reduce the pDECT sensitivity to measurement uncertainty.

61 RADIATION PROTECTION AND DOSIMETRY↗

Validation of deformable image registration algorithms on CT images of ex vivo porcine bladders with fiducial markers

Purpose: The spatial accuracy of deformable image registration (DIR) is important in the implementation of image guided adaptive radiotherapy techniques for cancer in the pelvic region. Validation of algorithms is best performed on phantoms with fiducial markers undergoing controlled large deformations. Excised porcine bladders, exhibiting similar filling and voiding behavior as human bladders, provide such an environment. The aim of this study was to determine the spatial accuracy of different DIR algorithms on CT images ofex vivo porcine bladders with radiopaque fiducial markers applied to the outer surface, for a range of bladder volumes, using various accuracy metrics. Methods: Five excised porcine bladders with a grid of 30–40 radiopaque fiducial markers attached to the outer wall were suspended inside a water-filled phantom. The bladder was filled with a controlled amount of water with added contrast medium for a range of filling volumes (100–400 ml in steps of 50 ml) using a luer lock syringe, and CT scans were acquired at each filling volume. DIR was performed for each data set, with the 100 ml bladder as the reference image. Six intensity-based algorithms (optical flow or demons-based) implemented in theMATLAB platform DIRART, a b-spline algorithm implemented in the commercial software package VelocityAI, and a structure-based algorithm (Symmetric Thin Plate Spline Robust Point Matching) were validated, using adequate parameter settings according to values previously published. The resulting deformation vector field from each registration was applied to the contoured bladder structures and to the marker coordinates for spatial error calculation. The quality of the algorithms was assessed by comparing the different error metrics across the different algorithms, and by comparing the effect of deformation magnitude (bladder volume difference) per algorithm, using the Independent Samples Kruskal-Wallis test. Results: The authors found good structure accuracy without dependency on bladder volume difference for all but one algorithm, and with the best result for the structure-based algorithm. Spatial accuracy as assessed from marker errors was disappointing for all algorithms, especially for large volume differences, implying that the deformations described by the registration did not represent anatomically correct deformations. The structure-based algorithm performed the best in terms of marker error for the large volume difference (100–400 ml). In general, for the small volume difference (100–150 ml) the algorithms performed relatively similarly. The structure-based algorithm exhibited the best balance in performance between small and large volume differences, and among the intensity-based algorithms, the algorithm implemented in VelocityAI exhibited the best balance. Conclusions: Validation of multiple DIR algorithms on a novel physiological bladder phantom revealed that the structure accuracy was good for most algorithms, but that the spatial accuracy as assessed from markers was low for all algorithms, especially for large deformations. Hence, many of the available algorithms exhibit sufficient accuracy for contour propagation purposes, but possibly not for accurate dose accumulation.

60 APPLIED LIFE SCIENCES↗

SU-F-I-08: CT Image Ring Artifact Reduction Based On Prior Image

Purpose: In computed tomography (CT) system, CT images with ring artifacts will be reconstructed when some adjacent bins of detector don’t work. The ring artifacts severely degrade CT image quality. We present a useful CT ring artifacts reduction based on projection data correction, aiming at estimating the missing data of projection data accurately, thus removing the ring artifacts of CT images. Methods: The method consists of ten steps: 1) Identification of abnormal pixel line in projection sinogram; 2) Linear interpolation within the pixel line of projection sinogram; 3) FBP reconstruction using interpolated projection data; 4) Filtering FBP image using mean filter; 5) Forwarding projection of filtered FBP image; 6) Subtraction forwarded projection from original projection; 7) Linear interpolation of abnormal pixel line area in the subtraction projection; 8) Adding the interpolated subtraction projection on the forwarded projection; 9) FBP reconstruction using corrected projection data; 10) Return to step 4 until the pre-set iteration number is reached. The method is validated on simulated and real data to restore missing projection data and reconstruct ring artifact-free CT images. Results: We have studied impact of amount of dead bins of CT detector on the accuracy of missing data estimation in projection sinogram. For the simulated case with a resolution of 256 by 256 Shepp-Logan phantom, three iterations are sufficient to restore projection data and reconstruct ring artifact-free images when the dead bins rating is under 30%. The dead-bin-induced artifacts are substantially reduced. More iteration number is needed to reconstruct satisfactory images while the rating of dead bins increases. Similar results were found for a real head phantom case. Conclusion: A practical CT image ring artifact correction scheme based on projection data is developed. This method can produce ring artifact-free CT images feasibly and effectively.

60 APPLIED LIFE SCIENCES↗

SU-F-J-114: On-Treatment Imagereconstruction Using Transit Images of Treatment Beams Through Patient and Thosethrough Planning CT Images

Purpose: To reconstruct patient images at the time of radiation delivery using measured transit images of treatment beams through patient and calculated transit images through planning CT images. Methods: We hypothesize that the ratio of the measured transit images to the calculated images may provide changed amounts of the patient image between times of planning CT and treatment. To test, we have devised lung phantoms with a tumor object (3-cm diameter) placed at iso-center (simulating planning CT) and off-center by 1 cm (simulating treatment). CT images of the two phantoms were acquired; the image of the off-centered phantom, unavailable clinically, represents the reference on-treatment image in the image quality of planning CT. Cine-transit images through the two phantoms were also acquired in EPID from a non-modulated 6 MV beam when the gantry was rotated 360 degrees; the image through the centered phantom simulates calculated image. While the current study is a feasibility study, in reality our computational EPID model can be applicable in providing accurate transit image from MC simulation. Changed MV HU values were reconstructed from the ratio between two EPID projection data, converted to KV HU values, and added to the planning CT, thereby reconstructing the on-treatment image of the patient limited to the irradiated region of the phantom. Results: The reconstructed image was compared with the reference image. Except for local HU differences>200 as a maximum, excellent agreement was found. The average difference across the entire image was 16.2 HU. Conclusion: We have demonstrated the feasibility of a method of reconstructing on-treatment images of a patient using EPID image and planning CT images. Further studies will include resolving the local HU differences and investigation on the dosimetry impact of the reconstructed image.

60 APPLIED LIFE SCIENCES↗

SU-E-J-115: Correlation of Displacement Vector Fields Calculated by Deformable Image Registration Algorithms with Motion Parameters of CT Images with Well-Defined Targets and Controlled-Motion

Purpose: To investigate correlation of displacement vector fields (DVF) calculated by deformable image registration algorithms with motion parameters in helical axial and cone-beam CT images with motion artifacts. Methods: A mobile thorax phantom with well-known targets with different sizes that were made from water-equivalent material and inserted in foam to simulate lung lesions. The thorax phantom was imaged with helical, axial and cone-beam CT. The phantom was moved with a cyclic motion with different motion amplitudes and frequencies along the superior-inferior direction. Different deformable image registration algorithms including demons, fast demons, Horn-Shunck and iterative-optical-flow from the DIRART software were used to deform CT images for the phantom with different motion patterns. The CT images of the mobile phantom were deformed to CT images of the stationary phantom. Results: The values of displacement vectors calculated by deformable image registration algorithm correlated strongly with motion amplitude where large displacement vectors were calculated for CT images with large motion amplitudes. For example, the maximal displacement vectors were nearly equal to the motion amplitudes (5mm, 10mm or 20mm) at interfaces between the mobile targets lung tissue, while the minimal displacement vectors were nearly equal to negative the motion amplitudes. The maximal and minimal displacement vectors matched with edges of the blurred targets along the Z-axis (motion-direction), while DVF’s were small in the other directions. This indicates that the blurred edges by phantom motion were shifted largely to match with the actual target edge. These shifts were nearly equal to the motion amplitude. Conclusions: The DVF from deformable-image registration algorithms correlated well with motion amplitude of well-defined mobile targets. This can be used to extract motion parameters such as amplitude. However, as motion amplitudes increased, image artifacts increased significantly and that limited image quality and poor correlation between the motion amplitude and DVF was obtained.

60 APPLIED LIFE SCIENCES↗

MO-C-17A-11: A Segmentation and Point Matching Enhanced Deformable Image Registration Method for Dose Accumulation Between HDR CT Images

Purpose: To propose and validate a novel and accurate deformable image registration (DIR) scheme to facilitate dose accumulation among treatment fractions of high-dose-rate (HDR) gynecological brachytherapy. Method: We have developed a method to adapt DIR algorithms to gynecologic anatomies with HDR applicators by incorporating a segmentation step and a point-matching step into an existing DIR framework. In the segmentation step, random walks algorithm is used to accurately segment and remove the applicator region (AR) in the HDR CT image. A semi-automatic seed point generation approach is developed to obtain the incremented foreground and background point sets to feed the random walks algorithm. In the subsequent point-matching step, a feature-based thin-plate spline-robust point matching (TPS-RPM) algorithm is employed for AR surface point matching. With the resulting mapping, a DVF characteristic of the deformation between the two AR surfaces is generated by B-spline approximation, which serves as the initial DVF for the following Demons DIR between the two AR-free HDR CT images. Finally, the calculated DVF via Demons combined with the initial one serve as the final DVF to map doses between HDR fractions. Results: The segmentation and registration accuracy are quantitatively assessed by nine clinical HDR cases from three gynecological cancer patients. The quantitative results as well as the visual inspection of the DIR indicate that our proposed method can suppress the interference of the applicator with the DIR algorithm, and accurately register HDR CT images as well as deform and add interfractional HDR doses. Conclusions: We have developed a novel and robust DIR scheme that can perform registration between HDR gynecological CT images and yield accurate registration results. This new DIR scheme has potential for accurate interfractional HDR dose accumulation. This work is supported in part by the National Natural ScienceFoundation of China (no 30970866 and no 81301940)

60 APPLIED LIFE SCIENCES↗

Model-based PSF and MTF estimation and validation from skeletal clinical CT images

Purpose: A method was developed to correct for systematic errors in estimating the thickness of thin bones due to image blurring in CT images using bone interfaces to estimate the point-spread-function (PSF). This study validates the accuracy of the PSFs estimated using said method from various clinical CT images featuring cortical bones. Methods: Gaussian PSFs, characterized by a different extent in the z (scan) direction than in the x and y directions were obtained using our method from 11 clinical CT scans of a cadaveric craniofacial skeleton. These PSFs were estimated for multiple combinations of scanning parameters and reconstruction methods. The actual PSF for each scan setting was measured using the slanted-slit technique within the image slice plane and the longitudinal axis. The Gaussian PSF and the corresponding modulation transfer function (MTF) are compared against the actual PSF and MTF for validation. Results: The differences (errors) between the actual and estimated full-width half-max (FWHM) of the PSFs were 0.09 ± 0.05 and 0.14 ± 0.11 mm for the xy and z axes, respectively. The overall errors in the predicted frequencies measured at 75%, 50%, 25%, 10%, and 5% MTF levels were 0.06 ± 0.07 and 0.06 ± 0.04 cycles/mm for the xy and z axes, respectively. The accuracy of the estimates was dependent on whether they were reconstructed with a standard kernel (Toshiba's FC68, mean error of 0.06 ± 0.05 mm, MTF mean error 0.02 ± 0.02 cycles/mm) or a high resolution bone kernel (Toshiba's FC81, PSF FWHM error 0.12 ± 0.03 mm, MTF mean error 0.09 ± 0.08 cycles/mm). Conclusions: The method is accurate in 3D for an image reconstructed using a standard reconstruction kernel, which conforms to the Gaussian PSF assumption but less accurate when using a high resolution bone kernel. The method is a practical and self-contained means of estimating the PSF in clinical CT images featuring cortical bones, without the need phantoms or any prior knowledge about the scanner-specific parameters.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-F-I-45: An Automated Technique to Measure Image Contrast in Clinical CT Images

Purpose: To develop and validate an automated technique for measuring image contrast in chest computed tomography (CT) exams. Methods: An automated computer algorithm was developed to measure the distribution of Hounsfield units (HUs) inside four major organs: the lungs, liver, aorta, and bones. These organs were first segmented or identified using computer vision and image processing techniques. Regions of interest (ROIs) were automatically placed inside the lungs, liver, and aorta and histograms of the HUs inside the ROIs were constructed. The mean and standard deviation of each histogram were computed for each CT dataset. Comparison of the mean and standard deviation of the HUs in the different organs provides different contrast values. The ROI for the bones is simply the segmentation mask of the bones. Since the histogram for bones does not follow a Gaussian distribution, the 25th and 75th percentile were computed instead of the mean. The sensitivity and accuracy of the algorithm was investigated by comparing the automated measurements with manual measurements. Fifteen contrast enhanced and fifteen non-contrast enhanced chest CT clinical datasets were examined in the validation procedure. Results: The algorithm successfully measured the histograms of the four organs in both contrast and non-contrast enhanced chest CT exams. The automated measurements were in agreement with manual measurements. The algorithm has sufficient sensitivity as indicated by the near unity slope of the automated versus manual measurement plots. Furthermore, the algorithm has sufficient accuracy as indicated by the high coefficient of determination, R2, values ranging from 0.879 to 0.998. Conclusion: Patient-specific image contrast can be measured from clinical datasets. The algorithm can be run on both contrast enhanced and non-enhanced clinical datasets. The method can be applied to automatically assess the contrast characteristics of clinical chest CT images and quantify dependencies that may not be captured in phantom data.

60 APPLIED LIFE SCIENCES↗