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At least 73 records · Page 4

How does C-VIEW image quality compare with conventional 2D FFDM?

Purpose: The FDA approved the use of digital breast tomosynthesis (DBT) in 2011 as an adjunct to 2D full field digital mammography (FFDM) with the constraint that all DBT acquisitions must be paired with a 2D image to assure adequate interpretative information is provided. Recently manufacturers have developed methods to provide a synthesized 2D image generated from the DBT data with the hope of sparing patients the radiation exposure from the FFDM acquisition. While this much needed alternative effectively reduces the total radiation burden, differences in image quality must also be considered. The goal of this study was to compare the intrinsic image quality of synthesized 2D C-VIEW and 2D FFDM images in terms of resolution, contrast, and noise. Methods: Two phantoms were utilized in this study: the American College of Radiology mammography accreditation phantom (ACR phantom) and a novel 3D printed anthropomorphic breast phantom. Both phantoms were imaged using a Hologic Selenia Dimensions 3D system. Analysis of the ACR phantom includes both visual inspection and objective automated analysis using in-house software. Analysis of the 3D anthropomorphic phantom includes visual assessment of resolution and Fourier analysis of the noise. Results: Using ACR-defined scoring criteria for the ACR phantom, the FFDM images scored statistically higher than C-VIEW according to both the average observer and automated scores. In addition, between 50% and 70% of C-VIEW images failed to meet the nominal minimum ACR accreditation requirements—primarily due to fiber breaks. Software analysis demonstrated that C-VIEW provided enhanced visualization of medium and large microcalcification objects; however, the benefits diminished for smaller high contrast objects and all low contrast objects. Visual analysis of the anthropomorphic phantom showed a measureable loss of resolution in the C-VIEW image (11 lp/mm FFDM, 5 lp/mm C-VIEW) and loss in detection of small microcalcification objects. Spectral analysis of the anthropomorphic phantom showed higher total noise magnitude in the FFDM image compared with C-VIEW. Whereas the FFDM image contained approximately white noise texture, the C-VIEW image exhibited marked noise reduction at midfrequency and high frequency with far less noise suppression at low frequencies resulting in a mottled noise appearance. Conclusions: Their analysis demonstrates many instances where the C-VIEW image quality differs from FFDM. Compared to FFDM, C-VIEW offers a better depiction of objects of certain size and contrast, but provides poorer overall resolution and noise properties. Based on these findings, the utilization of C-VIEW images in the clinical setting requires careful consideration, especially if considering the discontinuation of FFDM imaging. Not explicitly explored in this study is how the combination of DBT + C-VIEW performs relative to DBT + FFDM or FFDM alone.

60 APPLIED LIFE SCIENCES↗

SU-F-I-53: Coded Aperture Coherent Scatter Spectral Imaging of the Breast: A Monte Carlo Evaluation of Absorbed Dose

Purpose: Coherent scatter based imaging has shown improved contrast and molecular specificity over conventional digital mammography however the biological risks have not been quantified due to a lack of accurate information on absorbed dose. This study intends to characterize the dose distribution and average glandular dose from coded aperture coherent scatter spectral imaging of the breast. The dose deposited in the breast from this new diagnostic imaging modality has not yet been quantitatively evaluated. Here, various digitized anthropomorphic phantoms are tested in a Monte Carlo simulation to evaluate the absorbed dose distribution and average glandular dose using clinically feasible scan protocols. Methods: Geant4 Monte Carlo radiation transport simulation software is used to replicate the coded aperture coherent scatter spectral imaging system. Energy sensitive, photon counting detectors are used to characterize the x-ray beam spectra for various imaging protocols. This input spectra is cross-validated with the results from XSPECT, a commercially available application that yields x-ray tube specific spectra for the operating parameters employed. XSPECT is also used to determine the appropriate number of photons emitted per mAs of tube current at a given kVp tube potential. With the implementation of the XCAT digital anthropomorphic breast phantom library, a variety of breast sizes with differing anatomical structure are evaluated. Simulations were performed with and without compression of the breast for dose comparison. Results: Through the Monte Carlo evaluation of a diverse population of breast types imaged under real-world scan conditions, a clinically relevant average glandular dose for this new imaging modality is extrapolated. Conclusion: With access to the physical coherent scatter imaging system used in the simulation, the results of this Monte Carlo study may be used to directly influence the future development of the modality to keep breast dose to a minimum while still maintaining clinically viable image quality.

60 APPLIED LIFE SCIENCES↗

A novel adaptive discrete cosine transform-domain filter for gap-inpainting of high resolution PET scanners

Purpose: Several positron emission tomography (PET) scanners with special detector block arrangements have been developed in recent years to improve the resolution of PET images. However, the discontinuous detector blocks cause gaps in the sinogram. This study proposes an adaptive discrete cosine transform-based (aDCT) filter for gap-inpainting. Methods: The gap-corrupted sinogram was morphologically closed and subsequently converted to the DCT domain. A certain number of the largest coefficients in the DCT spectrum were identified to determine the low-frequency preservation region. The weighting factors for the remaining coefficients were determined by an exponential weighting function. The aDCT filter was constructed and applied to two digital phantoms and a simulated phantom introduced with various levels of noise. Results: For the Shepp-Logan head phantom, the aDCT filter filled the gaps effectively. For the Jaszczak phantom, no secondary artifacts were induced after aDCT filtering. The percent mean square error and mean structure similarity of the aDCT filter were superior to those of the DCT2 filter at all noise levels. For the simulated striatal dopamine innervation study, the aDCT filter recovered the shape of the striatum and restored the striatum to reference activity ratios to the ideal value. Conclusions: The proposed aDCT filter can recover the missing gap data in the sinogram and improve the image quality and quantitative accuracy of PET images.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

WE-G-BRF-03: A Quasi-Cine CBCT Reconstruction Technique for Real-Time On- Board Target Tracking of Lung Cancer Treatment

Purpose: To develop a quasi-cine CBCT reconstruction technique that uses extremely-small angle (∼3°) projections to generate real-time high-quality lung CBCT images. Method: 4D-CBCT is obtained at the beginning and used as prior images. This study uses extremely-small angle (∼3°) on-board projections acquired at a single respiratory phase to reconstruct the CBCT image at this phase. An adaptive constrained free-form deformation (ACFD) method is developed to deform the prior 4D-CBCT volume at the same phase to reconstruct the new CBCT. Quasi-cine CBCT images are obtained by continuously reconstructing CBCT images at subsequent phases every 3° angle (∼0.5s). Note that the prior 4D-CBCT images are dynamically updated using the latest CBCT images. The 4D digital extended-cardiac-torso (XCAT) phantom was used to evaluate the efficacy of ACFD. A lung patient was simulated with a tumor baseline shift of 2mm along superior-inferior (SI) direction after every respiratory cycle for 5 cycles. Limited-angle projections were simulated for each cycle. The 4D-CBCT reconstructed by these projections were compared with the ground-truth generated in XCAT.Volume-percentage-difference (VPD) and center-of-mass-shift (COMS) were calculated between the reconstructed and the ground-truth tumors to evaluate their geometric differences.The ACFD was also compared to a principal-component-analysis based motion-modeling (MM) method. Results: Using orthogonal-view 3° projections, the VPD/COMS values for tumor baseline shifts of 2mm, 4mm, 6mm, 8mm, 10mm were 11.0%/0.3mm, 25.3%/2.7mm, 22.4%/2.9mm, 49.5%/5.4mm, 77.2%/8.1mm for the MM method, and 2.9%/0.7mm, 3.9%/0.8mm, 6.2%/1mm, 7.9%/1.2mm, 10.1%/1.1mm for the ACFD method. Using orthogonal-view 0° projections (1 projection only), the ACFD method yielded VPD/COMS results of 5.0%/0.9mm, 10.5%/1.2mm, 15.1%/1.4mm, 20.9%/1.6mm and 24.8%/1.6mm. Using single-view instead of orthogonal-view projections yielded less accurate results for ACFD. Conclusion: The ACFD method accurately reconstructs snapshot CBCT images using orthogonal-view 3° projections. It has a great potential to provide real-time quasi-cine CBCT images for verification in lung radiation therapy. The research is supported by grant from Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

SU-E-J-01: 3D Fluoroscopic Image Estimation From Patient-Specific 4DCBCT-Based Motion Models

Purpose: 3D motion modeling derived from 4DCT images, taken days or weeks before treatment, cannot reliably represent patient anatomy on the day of treatment. We develop a method to generate motion models based on 4DCBCT acquired at the time of treatment, and apply the model to estimate 3D time-varying images (referred to as 3D fluoroscopic images). Methods: Motion models are derived through deformable registration between each 4DCBCT phase, and principal component analysis (PCA) on the resulting displacement vector fields. 3D fluoroscopic images are estimated based on cone-beam projections simulating kV treatment imaging. PCA coefficients are optimized iteratively through comparison of these cone-beam projections and projections estimated based on the motion model. Digital phantoms reproducing ten patient motion trajectories, and a physical phantom with regular and irregular motion derived from measured patient trajectories, are used to evaluate the method in terms of tumor localization, and the global voxel intensity difference compared to ground truth. Results: Experiments included: 1) assuming no anatomic or positioning changes between 4DCT and treatment time; and 2) simulating positioning and tumor baseline shifts at the time of treatment compared to 4DCT acquisition. 4DCBCT were reconstructed from the anatomy as seen at treatment time. In case 1) the tumor localization error and the intensity differences in ten patient were smaller using 4DCT-based motion model, possible due to superior image quality. In case 2) the tumor localization error and intensity differences were 2.85 and 0.15 respectively, using 4DCT-based motion models, and 1.17 and 0.10 using 4DCBCT-based models. 4DCBCT performed better due to its ability to reproduce daily anatomical changes. Conclusion: The study showed an advantage of 4DCBCT-based motion models in the context of 3D fluoroscopic images estimation. Positioning and tumor baseline shift uncertainties were mitigated by the 4DCBCT-based motion models, while they caused errors when using 4DCT-based motion models. Partially funded by Varian research grant.

60 APPLIED LIFE SCIENCES↗

Iterative reconstruction for CT perfusion with a prior-image induced hybrid nonlocal means regularization: Phantom studies

Purpose: In computed tomography perfusion (CTP) imaging, an initial phase CT acquired with a high-dose protocol can be used to improve the image quality of later phase CT acquired with a low-dose protocol. For dynamic regions, signals in the later low-dose CT may not be completely recovered if the initial CT heavily regularizes the iterative reconstruction process. The authors propose a hybrid nonlocal means (hNLM) regularization model for iterative reconstruction of low-dose CTP to overcome the limitation of the conventional prior-image induced penalty. Methods: The hybrid penalty was constructed by combining the NLM of the initial phase high-dose CT in the stationary region and later phase low-dose CT in the dynamic region. The stationary and dynamic regions were determined by the similarity between the initial high-dose scan and later low-dose scan. The similarity was defined as a Gaussian kernel-based distance between the patch-window of the same pixel in the two scans, and its measurement was then used to weigh the influence of the initial high-dose CT. For regions with high similarity (e.g., stationary region), initial high-dose CT played a dominant role for regularizing the solution. For regions with low similarity (e.g., dynamic region), the regularization relied on a low-dose scan itself. This new hNLM penalty was incorporated into the penalized weighted least-squares (PWLS) for CTP reconstruction. Digital and physical phantom studies were performed to evaluate the PWLS-hNLM algorithm. Results: Both phantom studies showed that the PWLS-hNLM algorithm is superior to the conventional prior-image induced penalty term without considering the signal changes within the dynamic region. In the dynamic region of the Catphan phantom, the reconstruction error measured by root mean square error was reduced by 42.9% in PWLS-hNLM reconstructed image. Conclusions: The PWLS-hNLM algorithm can effectively use the initial high-dose CT to reconstruct low-dose CTP in the stationary region while reducing its influence in the dynamic region.

60 APPLIED LIFE SCIENCES↗

TH-EF-BRA-06: A Novel Retrospective 3D K-Space Sorting 4D-MRI Technique Using a Radial K-Space Acquisition MRI Sequence

Purpose: Current retrospective 4D-MRI provides superior tumor-to-tissue contrast and accurate respiratory motion information for radiotherapy motion management. The developed 4D-MRI techniques based on 2D-MRI image sorting require a high frame-rate of the MR sequences. However, several MRI sequences provide excellent image quality but have low frame-rate. This study aims at developing a novel retrospective 3D k-space sorting 4D-MRI technique using radial k-space acquisition MRI sequences to improve 4D-MRI image quality and temporal-resolution for imaging irregular organ/tumor respiratory motion. Methods: The method is based on a RF-spoiled, steady-state, gradient-recalled sequence with minimal echo time. A 3D radial k-space data acquisition trajectory was used for sampling the datasets. Each radial spoke readout data line starts from the 3D center of Field-of-View. Respiratory signal can be extracted from the k-space center data point of each spoke. The spoke data was sorted based on its self-synchronized respiratory signal using phase sorting. Subsequently, 3D reconstruction was conducted to generate the time-resolved 4D-MRI images. As a feasibility study, this technique was implemented on a digital human phantom XCAT. The respiratory motion was controlled by an irregular motion profile. To validate using k-space center data as a respiratory surrogate, we compared it with the XCAT input controlling breathing profile. Tumor motion trajectories measured on reconstructed 4D-MRI were compared to the average input trajectory. The mean absolute amplitude difference (D) was calculated. Results: The signal extracted from k-space center data matches well with the input controlling respiratory profile of XCAT. The relative amplitude error was 8.6% and the relative phase error was 3.5%. XCAT 4D-MRI demonstrated a clear motion pattern with little serrated artifacts. D of tumor trajectories was 0.21mm, 0.23mm and 0.23mm in SI, AP and ML directions, respectively. Conclusion: A novel retrospective 3D k-space sorting 4D-MRI technique has been developed and evaluated on human digital phantom. NIH (1R21CA165384-01A1)

60 APPLIED LIFE SCIENCES↗

MO-FG-CAMPUS-IeP1-02: Dose Reduction in Contrast-Enhanced Digital Mammography Using a Photon-Counting Detector

Purpose: Photon-counting detectors (PCDs) allow multi-energy X-ray imaging without additional exposures and spectral overlap. This capability results in the improvement of accuracy of material decomposition for dual-energy X-ray imaging and the reduction of radiation dose. In this study, the PCD-based contrast-enhanced dual-energy mammography (CEDM) was compared with the conventional CDEM in terms of radiation dose, image quality and accuracy of material decomposition. Methods: A dual-energy model was designed by using Beer-Lambert’s law and rational inverse fitting function for decomposing materials from a polychromatic X-ray source. A cadmium zinc telluride (CZT)-based PCD, which has five energy thresholds, and iodine solutions included in a 3D half-cylindrical phantom, which composed of 50% glandular and 50% adipose tissues, were simulated by using a Monte Carlo simulation tool. The low- and high-energy images were obtained in accordance with the clinical exposure conditions for the conventional CDEM. Energy bins of 20–33 and 34–50 keV were defined from X-ray energy spectra simulated at 50 kVp with different dose levels for implementing the PCD-based CDEM. The dual-energy mammographic techniques were compared by means of absorbed dose, noise property and normalized root-mean-square error (NRMSE). Results: Comparing to the conventional CEDM, the iodine solutions were clearly decomposed for the PCD-based CEDM. Although the radiation dose for the PCD-based CDEM was lower than that for the conventional CEDM, the PCD-based CDEM improved the noise property and accuracy of decomposition images. Conclusion: This study demonstrates that the PCD-based CDEM allows the quantitative material decomposition, and reduces radiation dose in comparison with the conventional CDEM. Therefore, the PCD-based CDEM is able to provide useful information for detecting breast tumor and enhancing diagnostic accuracy in mammography.

60 APPLIED LIFE SCIENCES↗

TU-CD-207-05: A Novel Digital Tomosynthesis System Using Orthogonal Scanning Technique: A Feasibility Study

Purpose: As an alternative to full tomographic imaging technique such as cone-beam computed tomography (CBCT), there is growing interest to adopt digital tomosynthesis (DTS) for the use of diagnostic as well as therapeutic applications. The aim of this study is to propose a new DTS system using novel orthogonal scanning technique, which can provide superior image quality DTS images compared to the conventional DTS scanning system. Methods: Unlike conventional DTS scanning system, the proposed DTS is reconstructed with two sets of orthogonal patient scans. 1) X-ray projections that are acquired along transverse trajectory and 2) an additional sets of X-ray projections acquired along the vertical direction at the mid angle of the previous transverse scan. To reconstruct DTS, we have used modified filtered backprojection technique to account for the different scanning directions of each projection set. We have evaluated the performance of our method using numerical planning CT data of liver cancer patient and a physical pelvis phantom experiment. The results were compared with conventional DTS techniques with single transverse and vertical scanning. Results: The experiments on both numerical simulation as well as physical experiment showed that the resolution as well as contrast of anatomical structures was much clearer using our method. Specifically, the image quality comparing with transversely scanned DTS showed that the edge and contrast of anatomical structures along Left-Right (LR) directions was comparable however, considerable discrepancy and enhancement could be observed along Superior-Inferior (SI) direction using our method. The opposite was observed when vertically scanned DTS was compared. Conclusion: In this study, we propose a novel DTS system using orthogonal scanning technique. The results indicated that the image quality of our novel DTS system was superior compared to conventional DTS system. This makes our DTS system potentially useful in various on-line clinical applications.

60 APPLIED LIFE SCIENCES↗

SU-F-T-593: Technical Treatment Accuracy in a Clinic of Fractionated Stereotactic Radiosurgery

Purpose: The purpose of this study is to estimate technical treatment accuracy in fractionated stereotactic radiosurgery (fSRS) using extend system (ES) of Gamma Knife (GK). Methods: The fSRS with GK relies on a patient specific re-locatable immobilization system. The reference treatment position is estimated using a digital probe and a repositioning check tool (RCT). The “calibration values” of RCT apertures were compared with measured values on RCT-QA tool to evaluate the standard error (SE) associated with RCT measurements. A treatment plan with single “4 mm collimator shot” was created to deliver a radiation dose of 5 Gy at the predefined plane of a newly designed in-house head-neck phantom. The plan was investigated using radiochromic EBT3 films. The stereotactic CT imaging of a designed mini CT phantom and distortion study of MR imaging, were combined to calculate imaging SE. The focal precision check for GK machine tolerance was performed using a central diode test tool. Results: Twenty observations of RCT and digital probe, shown the SE of +/−0.0186mm and +/−0.0002mm respectively. A mean positional shift of 0.2752mm (σ=0.0696mm) was observed for twenty similar treatment settings of head-neck phantom. The difference between radiological and predefined exposure point was 0.4650mm and 0.4270mm; for two independent experiments. The imaging studies showed a combined SE of +/− 0.1055mm. Twenty frequent runs of a diode test tool showed the tolerance SE of +/−0.0096mm. If, the measurements are considered to be at 95% of confidence level, an expanded uncertainty was evaluated as +/− 0.2371mm with our system. The positional shift, when combined with an expanded uncertainty, a trivial variation of 0.07mm (max) was observed in comparing resultant radiological precision through film investigations. Conclusion: The study proposes an expression of “technical treatment accuracy” within “known uncertainties” is rational in the estimation of routine fSRS quality. The research work is supported by the research section of “All India Institute of Medical Sciences” - New Delhi, India under project no A-247.

60 APPLIED LIFE SCIENCES↗

Dosimetric verification of lung cancer treatment using the CBCTs estimated from limited-angle on-board projections

Purpose: Lung cancer treatment is susceptible to treatment errors caused by interfractional anatomical and respirational variations of the patient. On-board treatment dose verification is especially critical for the lung stereotactic body radiation therapy due to its high fractional dose. This study investigates the feasibility of using cone-beam (CB)CT images estimated by a motion modeling and free-form deformation (MM-FD) technique for on-board dose verification. Methods: Both digital and physical phantom studies were performed. Various interfractional variations featuring patient motion pattern change, tumor size change, and tumor average position change were simulated from planning CT to on-board images. The doses calculated on the planning CT (planned doses), the on-board CBCT estimated by MM-FD (MM-FD doses), and the on-board CBCT reconstructed by the conventional Feldkamp-Davis-Kress (FDK) algorithm (FDK doses) were compared to the on-board dose calculated on the “gold-standard” on-board images (gold-standard doses). The absolute deviations of minimum dose (ΔD{sub min}), maximum dose (ΔD{sub max}), and mean dose (ΔD{sub mean}), and the absolute deviations of prescription dose coverage (ΔV{sub 100%}) were evaluated for the planning target volume (PTV). In addition, 4D on-board treatment dose accumulations were performed using 4D-CBCT images estimated by MM-FD in the physical phantom study. The accumulated doses were compared to those measured using optically stimulated luminescence (OSL) detectors and radiochromic films. Results: Compared with the planned doses and the FDK doses, the MM-FD doses matched much better with the gold-standard doses. For the digital phantom study, the average (± standard deviation) ΔD{sub min}, ΔD{sub max}, ΔD{sub mean}, and ΔV{sub 100%} (values normalized by the prescription dose or the total PTV) between the planned and the gold-standard PTV doses were 32.9% (±28.6%), 3.0% (±2.9%), 3.8% (±4.0%), and 15.4% (±12.4%), respectively. The corresponding values of FDK PTV doses were 1.6% (±1.9%), 1.2% (±0.6%), 2.2% (±0.8%), and 17.4% (±15.3%), respectively. In contrast, the corresponding values of MM-FD PTV doses were 0.3% (±0.2%), 0.9% (±0.6%), 0.6% (±0.4%), and 1.0% (±0.8%), respectively. Similarly, for the physical phantom study, the average ΔD{sub min}, ΔD{sub max}, ΔD{sub mean}, and ΔV{sub 100%} of planned PTV doses were 38.1% (±30.8%), 3.5% (±5.1%), 3.0% (±2.6%), and 8.8% (±8.0%), respectively. The corresponding values of FDK PTV doses were 5.8% (±4.5%), 1.6% (±1.6%), 2.0% (±0.9%), and 9.3% (±10.5%), respectively. In contrast, the corresponding values of MM-FD PTV doses were 0.4% (±0.8%), 0.8% (±1.0%), 0.5% (±0.4%), and 0.8% (±0.8%), respectively. For the 4D dose accumulation study, the average (± standard deviation) absolute dose deviation (normalized by local doses) between the accumulated doses and the OSL measured doses was 3.3% (±2.7%). The average gamma index (3%/3 mm) between the accumulated doses and the radiochromic film measured doses was 94.5% (±2.5%). Conclusions: MM-FD estimated 4D-CBCT enables accurate on-board dose calculation and accumulation for lung radiation therapy. It can potentially be valuable for treatment quality assessment and adaptive radiation therapy.

60 APPLIED LIFE SCIENCES↗

SU-E-J-60: Evaluation of Temporal Lag in Radiotherapy Gating for Tumor Motion Trajectories

Purpose: Evaluating timing differences between LINAC beam ON/OFF and the estimation of tumor positioning using gating systems is essential for establishing confidence when treating with gating during radiotherapy, and is an annual requirement of TG-142. Temporal discrepancies between the trajectories of external marker surrogates and beam delivery may vary depending upon the type of external marker motion, which is quantified in this work for several trajectories. Methods: A precise robotic 3D motion stage performed several trajectories typically used for gating phantoms, including sinusoidal and Lujan-type motion; a commercial respiratory motion simulator was also employed. The true motions were monitored using variable resistors. The beam ON/OFF was controlled separately by two RPM (Varian) systems, an integrated version delivered by a Varian Truebeam LINAC and version 1.6 delivered by a Varian Trilogy, and measured using a diode. The resistor and diode signals were read by a multichannel digital oscilloscope, and timing differences between beam ON/OFF as measured by the diode and the phantom motion were determined using a peak detection algorithm. Results: Timing differences between beam ON/OFF and 3D stage motion peaks (diode—true motion timing) were computed to be 79.4 & 57.7ms for sinusoidal motion and 109.1 & 63.6ms for Lujan-type motion on the Truebeam LINAC, for beam ON and OFF, respectively. Timing differences for the Trilogy LINAC were 34.4 & 55.2ms for the sinusoidal motion and 29.0 & 26.3ms for the Lujan-type motion, for beam ON and OFF, respectively. With the commercial motion simulator, the timing differences were found to be −9ms and −78ms for beam ON/OFF, respectively, with the Truebeam, and −97.6ms and −60.9ms for beam ON/OFF, respectively, with the Trilogy. Conclusion: Setup-dependent temporal lags were found using this methodology. These discrepancies have the potential to influence quality assurance on gating systems and ultimately the treatment dose during radiotherapy. NIH National Institute of Biomedical Imaging and Bioengineering grant T32 EB002103-21.

60 APPLIED LIFE SCIENCES↗

Statistical iterative reconstruction to improve image quality for digital breast tomosynthesis

Purpose: Digital breast tomosynthesis (DBT) is a novel modality with the potential to improve early detection of breast cancer by providing three-dimensional (3D) imaging with a low radiation dose. 3D image reconstruction presents some challenges: cone-beam and flat-panel geometry, and highly incomplete sampling. A promising means to overcome these challenges is statistical iterative reconstruction (IR), since it provides the flexibility of accurate physics modeling and a general description of system geometry. The authors’ goal was to develop techniques for applying statistical IR to tomosynthesis imaging data. Methods: These techniques include the following: a physics model with a local voxel-pair based prior with flexible parameters to fine-tune image quality; a precomputed parameter λ in the prior, to remove data dependence and to achieve a uniform resolution property; an effective ray-driven technique to compute the forward and backprojection; and an oversampled, ray-driven method to perform high resolution reconstruction with a practical region-of-interest technique. To assess the performance of these techniques, the authors acquired phantom data on the stationary DBT prototype system. To solve the estimation problem, the authors proposed an optimization-transfer based algorithm framework that potentially allows fewer iterations to achieve an acceptably converged reconstruction. Results: IR improved the detectability of low-contrast and small microcalcifications, reduced cross-plane artifacts, improved spatial resolution, and lowered noise in reconstructed images. Conclusions: Although the computational load remains a significant challenge for practical development, the superior image quality provided by statistical IR, combined with advancing computational techniques, may bring benefits to screening, diagnostics, and intraoperative imaging in clinical applications.

60 APPLIED LIFE SCIENCES↗

SU-E-J-92: Validating Dose Uncertainty Estimates Produced by AUTODIRECT, An Automated Program to Evaluate Deformable Image Registration Accuracy

Purpose: Deformable image registration (DIR) is a powerful tool with the potential to deformably map dose from one computed-tomography (CT) image to another. Errors in the DIR, however, will produce errors in the transferred dose distribution. We have proposed a software tool, called AUTODIRECT (automated DIR evaluation of confidence tool), which predicts voxel-specific dose mapping errors on a patient-by-patient basis. This work validates the effectiveness of AUTODIRECT to predict dose mapping errors with virtual and physical phantom datasets. Methods: AUTODIRECT requires 4 inputs: moving and fixed CT images and two noise scans of a water phantom (for noise characterization). Then, AUTODIRECT uses algorithms to generate test deformations and applies them to the moving and fixed images (along with processing) to digitally create sets of test images, with known ground-truth deformations that are similar to the actual one. The clinical DIR algorithm is then applied to these test image sets (currently 4) . From these tests, AUTODIRECT generates spatial and dose uncertainty estimates for each image voxel based on a Student’s t distribution. This work compares these uncertainty estimates to the actual errors made by the Velocity Deformable Multi Pass algorithm on 11 virtual and 1 physical phantom datasets. Results: For 11 of the 12 tests, the predicted dose error distributions from AUTODIRECT are well matched to the actual error distributions within 1–6% for 10 virtual phantoms, and 9% for the physical phantom. For one of the cases though, the predictions underestimated the errors in the tail of the distribution. Conclusion: Overall, the AUTODIRECT algorithm performed well on the 12 phantom cases for Velocity and was shown to generate accurate estimates of dose warping uncertainty. AUTODIRECT is able to automatically generate patient-, organ- , and voxel-specific DIR uncertainty estimates. This ability would be useful for patient-specific DIR quality assurance.

60 APPLIED LIFE SCIENCES↗

TH-EF-207A-05: Feasibility of Applying SMEIR Method On Small Animal 4D Cone Beam CT Imaging

Purpose: Small animal cone beam CT imaging has been widely used in preclinical research. Due to the higher respiratory rate and heat beats of small animals, motion blurring is inevitable and needs to be corrected in the reconstruction. Simultaneous motion estimation and image reconstruction (SMEIR) method, which uses projection images of all phases, proved to be effective in motion model estimation and able to reconstruct motion-compensated images. We demonstrate the application of SMEIR for small animal 4D cone beam CT imaging by computer simulations on a digital rat model. Methods: The small animal CBCT imaging system was simulated with the source-to-detector distance of 300 mm and the source-to-object distance of 200 mm. A sequence of rat phantom were generated with 0.4 mm{sup 3} voxel size. The respiratory cycle was taken as 1.0 second and the motions were simulated with a diaphragm motion of 2.4mm and an anterior-posterior expansion of 1.6 mm. The projection images were calculated using a ray-tracing method, and 4D-CBCT were reconstructed using SMEIR and FDK methods. The SMEIR method iterates over two alternating steps: 1) motion-compensated iterative image reconstruction by using projections from all respiration phases and 2) motion model estimation from projections directly through a 2D-3D deformable registration of the image obtained in the first step to projection images of other phases. Results: The images reconstructed using SMEIR method reproduced the features in the original phantom. Projections from the same phase were also reconstructed using FDK method. Compared with the FDK results, the images from SMEIR method substantially improve the image quality with minimum artifacts. Conclusion: We demonstrate that it is viable to apply SMEIR method to reconstruct small animal 4D-CBCT images.

60 APPLIED LIFE SCIENCES↗

SU-D-207-04: GPU-Based 4D Cone-Beam CT Reconstruction Using Adaptive Meshing Method

Purpose: Due to the limited number of projections at each phase, the image quality of a four-dimensional cone-beam CT (4D-CBCT) is often degraded, which decreases the accuracy of subsequent motion modeling. One of the promising methods is the simultaneous motion estimation and image reconstruction (SMEIR) approach. The objective of this work is to enhance the computational speed of the SMEIR algorithm using adaptive feature-based tetrahedral meshing and GPU-based parallelization. Methods: The first step is to generate the tetrahedral mesh based on the features of a reference phase 4D-CBCT, so that the deformation can be well captured and accurately diffused from the mesh vertices to voxels of the image volume. After the mesh generation, the updated motion model and other phases of 4D-CBCT can be obtained by matching the 4D-CBCT projection images at each phase with the corresponding forward projections of the deformed reference phase of 4D-CBCT. The entire process of this 4D-CBCT reconstruction method is implemented on GPU, resulting in significantly increasing the computational efficiency due to its tremendous parallel computing ability. Results: A 4D XCAT digital phantom was used to test the proposed mesh-based image reconstruction algorithm. The image Result shows both bone structures and inside of the lung are well-preserved and the tumor position can be well captured. Compared to the previous voxel-based CPU implementation of SMEIR, the proposed method is about 157 times faster for reconstructing a 10 -phase 4D-CBCT with dimension 256×256×150. Conclusion: The GPU-based parallel 4D CBCT reconstruction method uses the feature-based mesh for estimating motion model and demonstrates equivalent image Result with previous voxel-based SMEIR approach, with significantly improved computational speed.

60 APPLIED LIFE SCIENCES↗

A dual-view digital tomosynthesis imaging technique for improved chest imaging

Purpose: Digital tomosynthesis (DTS) has been shown to be useful for reducing the overlapping of abnormalities with anatomical structures at various depth levels along the posterior–anterior (PA) direction in chest radiography. However, DTS provides crude three-dimensional (3D) images that have poor resolution in the lateral view and can only be displayed with reasonable quality in the PA view. Furthermore, the spillover of high-contrast objects from off-fulcrum planes generates artifacts that may impede the diagnostic use of the DTS images. In this paper, the authors describe and demonstrate the use of a dual-view DTS technique to improve the accuracy of the reconstructed volume image data for more accurate rendition of the anatomy and slice images with improved resolution and reduced artifacts, thus allowing the 3D image data to be viewed in views other than the PA view. Methods: With the dual-view DTS technique, limited angle scans are performed and projection images are acquired in two orthogonal views: PA and lateral. The dual-view projection data are used together to reconstruct 3D images using the maximum likelihood expectation maximization iterative algorithm. In this study, projection images were simulated or experimentally acquired over 360° using the scanning geometry for cone beam computed tomography (CBCT). While all projections were used to reconstruct CBCT images, selected projections were extracted and used to reconstruct single- and dual-view DTS images for comparison with the CBCT images. For realistic demonstration and comparison, a digital chest phantom derived from clinical CT images was used for the simulation study. An anthropomorphic chest phantom was imaged for the experimental study. The resultant dual-view DTS images were visually compared with the single-view DTS images and CBCT images for the presence of image artifacts and accuracy of CT numbers and anatomy and quantitatively compared with root-mean-square-deviation (RMSD) values computed using the digital chest phantom or the CBCT images as the reference in the simulation and experimental study, respectively. High-contrast wires with vertical, oblique, and horizontal orientations in a PA view plane were also imaged to investigate the spatial resolutions and how the wire signals spread in the PA view and lateral view slice images. Results: Both the digital phantom images (simulated) and the anthropomorphic phantom images (experimentally generated) demonstrated that the dual-view DTS technique resulted in improved spatial resolution in the depth (PA) direction, more accurate representation of the anatomy, and significantly reduced artifacts. The RMSD values corroborate well with visual observations with substantially lower RMSD values measured for the dual-view DTS images as compared to those measured for the single-view DTS images. The imaging experiment with the high-contrast wires shows that while the vertical and oblique wires could be resolved in the lateral view in both single- and dual-view DTS images, the horizontal wire could only be resolved in the dual-view DTS images. This indicates that with single-view DTS, the wire signals spread liberally to off-fulcrum planes and generated wire shadow there. Conclusions: The authors have demonstrated both visually and quantitatively that the dual-view DTS technique can be used to achieve more accurate rendition of the anatomy and to obtain slice images with improved resolution and reduced artifacts as compared to the single-view DTS technique, thus allowing the 3D image data to be viewed in views other than the PA view. These advantages could make the dual-view DTS technique useful in situations where better separation of the objects-of-interest from the off-fulcrum structures or more accurate 3D rendition of the anatomy are required while a regular CT examination is undesirable due to radiation dose considerations.

60 APPLIED LIFE SCIENCES↗

Effects on image quality of a 2D antiscatter grid in x-ray digital breast tomosynthesis: Initial experience using the dual modality (x-ray and molecular) breast tomosynthesis scanner

Purpose: Radiation scattered from the breast in digital breast tomosynthesis (DBT) causes image degradation, including loss of contrast between cancerous and background tissue. Unlike in 2-dimensional (2D) mammography, an antiscatter grid cannot readily be used in DBT because changing alignment between the tube and detector during the scan would result in unacceptable loss of primary radiation. However, in the dual modality breast tomosynthesis (DMT) scanner, which combines DBT and molecular breast tomosynthesis, the tube and detector rotate around a common axis, thereby maintaining a fixed tube-detector alignment. This C-arm geometry raises the possibility of using a 2D (cellular) focused antiscatter grid. The purpose of this study is to assess change in image quality when using an antiscatter grid in the DBT portion of a DMT scan under conditions of fixed radiation dose. Methods: Two 2D focused prototype grids with 80 cm focal length were tested, one stack-laminated from copper (Cu) and one cast from a tungsten-polymer (W-poly). They were reciprocated using a motion scheme designed to maximize transmission of primary x-ray photons. Grid-in and grid-out scatter-to-primary ratios (SPRs) were measured for rectangular blocks of material simulating 30%, 50%, and 70% glandular tissue compositions. For assessment of changes in image quality through the addition of a grid, the Computerized Imaging Reference Systems, Inc., phantom Model 011A containing a set of 1 cm thick blocks simulating a range of glandular/adipose ratios from 0/100 to 100/0 was used. To simulate 6.5 and 8.5 cm thick compressed breasts, 1 cm thick slices of PMMA were added to the Model 011A phantom. DBT images were obtained with and without the grid, with exposure parameters fixed for a given compressed thickness. Signal-difference-to-noise ratios (SDNRs), contrast, and voxel value-based attenuation coefficients (μ) were measured for all blocks from reconstructed phantom images. Results: For 4, 6, and 8 cm tissue-equivalent block phantom thicknesses, the inclusion of the W-poly grid reduced the SPR by factors of 5, 6, and 5.8, respectively. For the same thicknesses, the copper grid reduced the SPR by factors of 3.9, 4.5, and 4.9. For the 011A phantom, the W-poly grid raised the SDNR of the 70/30 block from 0.8, −0.32, and −0.72 to 0.9, 0.76, and 0.062 for the 4.5, 6.5, and 8.5 cm phantoms, respectively. It raised the SDNR of the 100/0 block from 3.78, 1.95, and 1.0 to 3.79, 3.67, and 3.25 for the 4.5, 6.5, and 8.5 cm phantoms, respectively. Inclusion of the W-poly grid improved the accuracy of image-based μ values for all block compositions. However, smearing of attenuation across slices due to limited angular sampling decreases the sensitivity of voxel values to changing composition compared to theoretical μ values. Conclusions: Under conditions of fixed radiation dose to the breast, use of a 2D focused grid increased contrast, SDNR, and accuracy of estimated attenuation for mass-simulating block compositions in all phantom thicknesses tested, with the degree of improvement depending upon material composition. A 2D antiscatter grid can be usefully incorporated in DBT systems that employ fully isocentric tube-detector rotation.

60 APPLIED LIFE SCIENCES↗