Administered dose of ionizing radiation during medical imaging is an issue of increasing concern for the patient, for the clinical community, and for respective regulatory bodies. CT radiation dose is currently estimated based on a set of very simplifying assumptions which do not take the actual body geometry and organ specific doses into account. This makes it very difficult to accurately report imaging related administered dose and to track it for different organs over the life of the patient. In this paper this deficit is addressed in a two-fold way. In a first step, the absorbed radiation dose in each image voxel is estimated based on a Monte-Carlo simulation of X-ray absorption and scattering. In a second step, the image is segmented into tissue types with different radio sensitivity. In combination this allows to calculate the effective dose as a weighted sum of the individual organ doses. The main purpose of this paper is to assess the feasibility of automatic organ specific dose estimation. With respect to a commercially applicable solution and respective robustness and efficiency requirements, we investigated the effect of dose sampling rather than integration over the organ volume. We focused on the thoracic anatomy as the exemplary body region, imaged frequently by CT. For image segmentation we applied a set of available approaches which allowed us to cover the main thoracic radio-sensitive tissue types. We applied the dose estimation approach to 10 thoracic CT datasets and evaluated segmentation accuracy and administered dose and could show that organ specific dose estimation can be achieved.
KEYWORDS: Sensors, Beam shaping, Monte Carlo methods, Signal detection, Optical simulations, Image filtering, Optical filters, X-rays, Signal to noise ratio, X-ray computed tomography
While cone-beam CT using flat x-ray detectors has gained increased popularity in the past years, the 3D imaging
quality is still limited by a large amount of scatter, low dynamic range, and small field of view of the detector.
Especially for large objects, the high dynamic range of the projections is a common source for detector specific
artifacts. In conventional CT, the application of beam shapers (or bowtie filters) to decrease the signal dynamic
in the projections is quite common. In this paper we investigate the use of a beam shaper for cone-beam CT
with an off-centered flat detector by means of Monte-Carlo (MC) simulations and test-bench experiments.
The shift of the detector out of the central axis increases the field of view and allows the imaging of larger
patients, but in turn leads to a very high dynamic signal range and poor scatter-to-primary ratios (SPR). The
impact of a half bowtie filter on key performance parameters of the imaging chain is investigated with MC
simulations. It is demonstrated that a beam shaper significantly improves the peak SPR especially for large
patients and that the reshaping of the SPR has a dominant impact on the homogeneity of the reconstructed image.
The use of beam shapers for CBCT requires a modified pre-processing chain that also accounts for secondary effects introduced by the beam modulation filter. Beside patient scatter correction, the inhomogeneous spectral hardening of the x-ray beam and scattered radiation from the beam shaper itself have to be corrected. A comparison of phantom scans with and without beam shaper after pre-processing demonstrates the potential of beam shapers for dose reduction and SNR improvement in flat detector cone-beam CT.
This paper describes the image quality improvements achieved by developing a new fully physical imaging chain.
The key enablers for this imaging chain are a new scatter correction technique and an analytic computation of
the beam hardening correction for each detector. The new scatter correction technique uses off-line Monte Carlo
simulations to compute a large database of scatter kernels representative of a large variety of patient shapes
and an on-line combination of those based on the attenuation profile of the patient in the measured projections.
In addition, profiles of scatter originating from the wedge are estimated and subtracted. The beam hardening
coefficients are computed using analytic simulations of the full beam path of each individual ray through the
scanner. Due to the new approach, scatter and beam hardening are computed from first principles with no
further tuning factors, and are thus straight forward to adapt to any patient and scan geometry. Using the new
fully physical imaging chain unprecedented image quality was achieved. This is demonstrated with a special
scatter phantom. With current image correction techniques this phantom typically shows position dependent
inhomogeneity and streak artifacts resulting from the impact of scattered radiation. With the new imaging
chain these artifacts are almost completely eliminated, independent of position and scanning mode (kV). Further
preliminary patient studies show that in addition to fully guaranteeing an absolute Hounsfield scale in arbitrary
imaging conditions, the new technique also strongly sharpens object boundaries such as the edges of the liver.
In "Spectral CT" based on energy-resolving photon-counting detectors (also "multi-energy CT") spectral information
of transmitted X-radiation is measured in order to extract additional information about the material
composition of the scanned object. Common practice is to decompose the attenuation line integrals into several
components based on models of physical (e.g. photo/Compton/K-edge) or material properties (e.g.
water/calcium). Scattered radiation causes a significant deterioration to the results, which are obtained with these
models, as the measured spectrum in a specific detector element contains additional contributions which are not
related to the attenuation in the respective line integral of the beam. In this paper the detrimental impact of
scattered radiation in multi-energy CT is quantitatively analyzed by means of Monte-Carlo simulations. Large
projection data sets of full rotational acquisitions are computed by combining noise-free analytical primary radiation
with Monte-Carlo calculated scattered radiation of high statistical accuracy. The simulations show that,
compared to the primary spectrum, the scatter spectrum is significantly shifted towards lower energies resulting
in very high scatter-to-primary ratios for energies below 50keV. In the analysis of sinograms and reconstructed
data using extended Alvarez-Macovsky decomposition into Photo-, Compton-, and K-edge images, it is revealed
that scattered radiation causes significant inhomogeneity artifacts especially in the Photo image. Additionally
"crosstalk" between Photo-, Compton- and K-edge images is found as K-edge structures appear in the other
images and vice versa. Quantitatively it is found that due to scatter the reconstructed concentration of the
K-edge material is up to 23 % smaller than its correct value.
In the framework of Spectral Computed Tomography (Spectral CT), scattered X-ray radiation is examined for its spectral
composition and spatial distribution by means of Monte Carlo simulations. A reliable material (e.g. bone / contrast agent)
separation and quantification requires a precise knowledge of the transmitted X-ray spectrum especially for low energy
photons. Unfortunately, for lower energies the primary intensity is increasingly covered by scattered radiation. The
detected scattered radiation can be classified into two main categories with respect to their scattering history. The first
category contains purely Rayleigh or one-time Compton scattered photons which typically have small scattering angles
and an energy spectrum similar to that of the transmitted primary radiation. The second category comprises multiple
Compton scattered photons with a spectral composition which is typically softer than that of the transmitted primary
photons. In regions of strong beam attenuation (i.e. in the X-ray shadow of a scanned object), the scattered radiation is
mainly composed of multiple Compton scattered photons. As a consequence, the spectrally resolved scatter-to-primary
ratios strongly increase at low energies. High-quality anti-scatter grids can be used to reduce especially the detection of
multiple Compton-scattered photons. A quantitative evaluation of measured photon energies below a certain limit
between 30 keV and 50 keV (depending on the phantom geometry and the applied anti-scatter grid) is challenging, since
primary photons are superposed by a significantly higher amount of scattered photons.
In flat detector cone-beam computed tomography (CBCT), scattered radiation is a major source of image degradation,
making accurate a posteriori scatter correction inevitable. A potential solution to this problem is provided by
computerized scatter correction based on Monte-Carlo simulations. Using this technique, the detected distributions of
X-ray scatter are estimated for various viewing directions using Monte-Carlo simulations of an intermediate
reconstruction. However, as a major drawback, for standard CBCT geometries and with standard size flat detectors such
as mounted on interventional C-arms, the scan field of view is too small to accommodate the human body without lateral
truncations, and thus this technique cannot be readily applied. In this work, we present a novel method for constructing a
model of the object in a laterally and possibly also axially extended field of view, which enables meaningful application
of Monte-Carlo based scatter correction even in case of heavy truncations. Evaluation is based on simulations of a
clinical CT data set of a human abdomen, which strongly exceeds the field of view of the simulated C-arm based CBCT
imaging geometry. By using the proposed methodology, almost complete removal of scatter-caused inhomogeneities is
demonstrated in reconstructed images.
In this paper we propose a novel scatter correction methodology for X-ray based cone-beam CT that allows to
combine the advantages of projection-based and volume-based correction approaches. The basic idea is to use a
potentially non-optimal projection-based scatter correction method and to iteratively optimize its performance
by repeatedly assessing remaining scatter-induced artifacts in intermediately reconstructed volumes. The novel
approach exploits the fact that due to the flatness of the
scatter-background, compensation itself is most easily
performed in the projection-domain, while the scatter-induced artifacts can be better observed in the reconstructed
volume. The presented method foresees to evaluate the scatter correction efficiency after each iteration
by means of a quantitative measure characterizing the amount of residual cupping and to adjust the parameters
of the projection-based scatter correction for the next iteration accordingly. The potential of this iterative scatter
correction approach is demonstrated using voxelized Monte Carlo scatter simulations as ground truth. Using the
proposed iterative scatter correction method, remarkable scatter correction performance was achieved both using
simple parametric heuristic techniques as well as by optimizing previously published scatter estimation schemes.
For the human head, scatter induced artifacts were reduced from initially 148 HU to less than 8.1 HU to 9.1 HU
for different studied methods, corresponding to an artifact reduction exceeding 93%.
It is well known that rotational C-arm systems are capable of providing 3D tomographic X-ray images with much higher spatial resolution than conventional CT systems. Using flat X-ray detectors, the pixel size of the detector typically is in the range of the size of the test objects. Therefore, the finite extent of the "point" source cannot be neglected for the determination of the MTF. A practical algorithm has been developed that includes bias estimation and subtraction, averaging in the spatial domain, and correction for the frequency content of the imaged bead or wire. Using this algorithm, the wire and the bead method are analyzed for flat detector based 3D X-ray systems with the use of standard CT performance phantoms. Results on both experimental and simulated data are presented. It is found that the approximation of applying the analysis of the wire method to a bead measurement is justified within 3% accuracy up to the first zero of the MTF.
This paper presents a novel framework for the systematic assessment of the impact of scattered radiation in
.at-detector based cone-beam CT. While it is well known that scattered radiation causes three di.erent types of
artifacts in reconstructed images (inhomogeneity artifacts such as cupping and streaks, degradation of contrast,
and enhancement of noise), investigations in the literature quantify the impact of scatter mostly only in terms
of inhomogeneity artifacts, giving little insight, e.g., into the visibility of low contrast lesions. Therefore, for
this study a novel framework has been developed that in addition to normal reconstruction of the CT (HU)
number allows for reconstruction of voxelized expectation values of three additional important characteristics
of image quality: signal degradation, contrast reduction, and noise variances. The new framework has been
applied to projection data obtained with voxelized Monte-Carlo simulations of clinical CT data sets of high
spatial resolution. Using these data, the impact of scattered radiation was thoroughly studied for realistic and
clinically relevant patient geometries of the head, thorax, and pelvis region. By means of spatially resolved
reconstructions of contrast and noise propagation, the image quality of a scenario with using standard antiscatter
grids could be evaluated with great detail. Results show the spatially resolved contrast degradation and
the spatially resolved expected standard deviation of the noise at any position in the reconstructed object. The
new framework represents a general tool for analyzing image quality in reconstructed images.
Scattered radiation is a major source of artifacts in flat detector based cone-beam computed tomography. In this paper, a novel software-based method for retrospective scatter correction is described and evaluated. The method is based on approximation of the imaged object by a simple geometric model (e.g., a homogeneous water-like ellipsoid) that is estimated from the set of acquired projections. This is achieved by utilizing a numerical optimization procedure to determine the model parameters for which there is maximum correspondence between the measured projections and the projections of the model. Monte-Carlo simulations of this model are used for calculation of scatter estimates for the acquired projections. Finally, using the scatter-corrected projections, tomographic reconstruction is conducted by means of cone-beam filtered back-projection. The correction method is evaluated using simulated and experimentally acquired projection data sets of geometric and physical head phantoms. It is found that the method is able to accurately estimate mean scatter levels in X-ray projections, allowing to significantly reduce scatter-caused artifacts in 3D reconstructed images.
This paper presents a systematic assessment of scattered radiation in flat-detector based cone-beam CT. The analysis is based on simulated scatter projections of voxelized CT images of different body regions allowing to accurately quantify scattered radiation of realistic and clinically relevant patient geometries. Using analytically
computed primary projection data of high spatial resolution in combination with Monte-Carlo simulated scattered radiation, practically noise-free reference data sets are computed with and without inclusion of scatter. The impact of scatter is studied both in the projection data and in the reconstructed volume for the head, thorax, and pelvis regions. Currently available anti-scatter grid geometries do not sufficiently compensate scatter induced cupping and streak artifacts, requiring additional software-based scatter correction. The required accuracy of scatter compensation approaches increases with increasing patient size.
KEYWORDS: Sensors, Monte Carlo methods, Head, Computer simulations, X-rays, Signal attenuation, X-ray computed tomography, Photons, Linear filtering, Neodymium
This study deals with a systematic assessment of the potential of different schemes for computerized scatter correction in flat detector based cone-beam X-ray computed tomography. The analysis is based on simulated scatter of a CT image of a human head. Using a Monte-Carlo cone-beam CT simulator, the spatial distribution of scattered radiation produced by this object has been calculated with high accuracy for the different projected views of a circular tomographic scan. Using this data and, as a reference, a scatter-free forward projection of the phantom, the potential of different schemes for scatter correction has been evaluated. In particular, the ideally achievable degree of accuracy of schemes based on estimating a constant scatter level in each projection was compared to approaches aiming at estimation of a more complex spatial shape of the scatter distribution. For each scheme, remaining cupping artifacts in the reconstructed volumetric image were quantified and analyzed. It was found that already accurate estimation of a constant scatter level for each projection allows for comparatively accurate compensation of scatter-caused artifacts.
KEYWORDS: Scattering, Sensors, Signal attenuation, Monte Carlo methods, Photons, X-rays, Computed tomography, X-ray computed tomography, Signal to noise ratio, Compton scattering
Scattered radiation is a major source of image degradation and nonlinearity in flat detector based cone-beam CT. Due to the bigger irradiated volume the amount of scattered radiation in true cone-beam geometry is considerably higher than for fan beam CT. This on the one hand reduces the signal to noise ratio, since the additional scattered photons contribute only to the noise and not to the measured signal, and on the other hand cupping and streak artifacts arise in the reconstructed volume. Anti-scatter grids composed of lead lamellae and interspacing material decrease the SNR for flat detector based CB-CT geometry, because the beneficial scatter attenuating effect is overcompensated by the absorption of primary radiation. Additionally, due to the high amount of scatter that still remains behind the grid, cupping and streak artifacts cannot be reduced sufficiently. Computerized scatter correction schemes are therefore essential for achieving artifact-free reconstructed images in cone-beam CT. In this work, a fast model based scatter correction algorithm is proposed, aiming at accurately estimating the level and spatial distribution of scattered radiation background in each projection. This will allow for effectively reducing streak and cupping artifacts due to scattering in cone-beam CT applications.
KEYWORDS: Sensors, Collimation, Monte Carlo methods, Signal to noise ratio, Photons, Fluoroscopy, Head, Fluctuations and noise, X-rays, Signal attenuation
In this paper, the performance of focused lamellar anti-scatter grids, which are currently used in fluoroscopy, is studied in order to determine guidelines of grid usage for flat detector based cone beam CT. The investigation aims at obtaining the signal to noise ratio improvement factor by the use of anti-scatter grids.
First, the results of detailed Monte Carlo simulations as well as measurements are presented. From these the general characteristics of the impinging field of scattered and primary photons are derived. Phantoms modeling the head, thorax and pelvis regions have been studied for various imaging geometries with varying phantom size, cone and fan angles and patient-detector distances.
Second, simulation results are shown for ideally focused and vacuum spaced grids as best case approach as well as for grids with realistic spacing materials. The grid performance is evaluated by means of the primary and scatter transmission and the signal to noise ratio improvement factor as function of imaging geometry and grid parameters.
For a typical flat detector cone beam CT setup, the grid selectivity and thus the performance of anti-scatter grids is much lower compared to setups where the grid is located directly behind the irradiated object. While for small object-to-grid distances a standard grid improves the SNR, the SNR for geometries as used in flat detector based cone beam CT is deteriorated by the use of an anti-scatter grid for many application scenarios. This holds even for the pelvic region.
Standard fluoroscopy anti-scatter grids were found to decrease the SNR in many application scenarios of cone beam CT due to the large patient-detector distance and have, therefore, only a limited benefit in flat detector based cone beam CT.
In this paper, soft tissue contrast visibility in neural applications is investigated for volume imaging based on flat X-ray detector cone-beam CT. Experiments have been performed on a high precision bench-top system with rotating object table and fixed X-ray tube-detector arrangement. Several scans of a post mortem human head specimen have been performed under various conditions. Hereby two different flat X-ray detectors with 366 x 298mm2 (Trixell Pixium 4700) and 176 x 176mm2 (Trixell Pixium 4800) active area have been employed. During a single rotation up to 720 projections have been acquired.
For reconstruction of the 3D images a Feldkamp algorithm has been employed. Reconstructed images of the head of human cadaver demonstrate that added soft tissue contrast down to 10 HU is detectable for X-ray dose comparable to CT. However, the limited size of the smaller detector led to truncation artifacts, which were partly compensated by extrapolation of the projections outside the field of view.
To reduce cupping artifacts resulting from scattered radiation and to improve visibility of low contrast details, a novel homogenization procedure based on segmentation and polynomial fitting has been developed and applied on the reconstructed voxel data. Even for narrow HU-Windows, limitations due to scatter induced cupping artifacts are no longer noticeable after applying the homogenization procedure.
We present results on 3D image quality in terms of spatial resolution (MTF) and low contrast detectability, obtained on a flat dynamic X-ray detector (FD) based cone-beam CT (CB-CT) setup. Experiments have been performed on a high precision bench-top system with rotating object table, fixed X-ray tube and 176 x 176 mm2 active detector area (Trixell Pixium 4800). Several objects, including CT performance-, MTF- and pelvis phantoms, have been scanned under various conditions, including a high dose setup in order to explore the 3D performance limits. Under these optimal conditions, the system is capable of resolving less than 1% (~10 HU) contrast in a water background. Within a pelvis phantom, even inserts of muscle and fat equivalent are clearly distinguishable. This also holds for fast acquisitions of up to 40 fps. Focusing on the spatial resolution, we obtain an almost isotropic three-dimensional resolution of up to 30 lp/cm at 10% modulation.
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