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Background: Motion induced image artifacts have been the focus of many investigations for x-ray computed tomography (CT). Methodologies of combating patient motion include the use of gating devices to optimize the data acquisition, reduction in patient scan time via faster gantry rotation and large detector coverage, and the development of advanced reconstruction and post-processing algorithms to minimize motion artifacts., Purpose: Previously proposed approaches are generally "global" in nature in that motion is characterized for the entire image. It is well known, however, that the presence of motion artifact in a CT image is highly nonuniform. When there is a lack of automated and quantitative local measure indicating the presence and the severity of motion artifacts in a local region, the quality of the reconstructed images depends heavily on the CT operator's rigor and experience. Even when an operator is informed of the presence of motion, little information is provided about the nature of the motion artifact to understand its relevance to the clinical task at hand. In this paper, we propose an image-space spatial- and temporal-consistency metric (CM) to detect and characterize the local motion., Method: In a non-rigid human organ, such as the lung, there are many small and rigid objects (target objects), such as blood vessels and nodules, distributed throughout the organ. If motion can be characterized for these target objects, we obtain a complete motion map for the organ. To accomplish this, a preliminary image reconstruction is carried out to identify the target objects and establish region-of-interests for consistency-metric calculation. The CM is then obtained based on the backprojected intensity difference between the object region and its circular background. For a stationary object, the accumulation of this quantity over views is linear. When a target object moves, nonlinear behavior exhibits and a quantitative measure of linearity indicates the severity of motion., Results: Extensive computer simulation was utilized to confirm the validity of the theory. These tests stress the sensitivity of the proposed CM to the target object size, object shape, in-plane motion, cross-plane motion, cone-beam effect, and complex background. Results confirm that the proposed approach is robust under different testing conditions. The proposed CM is further validated using a cardiac scan of a swine, and the proposed CM correlates well with the visual inspection of the artifact in the reconstructed images., Conclusions: In this paper, we have demonstrated the efficacy of the proposed CM for motion detection. Unlike previously proposed approaches where the consistency condition is derived for the entire image or the entire imaging volume, the proposed metric is well localized so that different zones in a patient anatomy can be individually characterized. In addition, the proposed CM provides a quantitative measure on a view-by-view basis so that the severity of motion is consistently estimated over time. Such information can be used to optimize the image reconstruction process and minimize the motion artifact., (© 2024 American Association of Physicists in Medicine.)

Background: Radiation dose reduction has been the focus of many research activities in x-ray CT. Various approaches were taken to minimize the dose to patients, ranging from the optimization of clinical protocols, refinement of the scanner hardware design, and development of advanced reconstruction algorithms. Although significant progress has been made, more advancements in this area are needed to minimize the radiation risks to patients., Purpose: Reconstruction algorithm-based dose reduction approaches focus mainly on the suppression of noise in the reconstructed images while preserving detailed anatomical structures. Such an approach effectively produces synthesized high-dose images (SHD) from the data acquired with low-dose scans. A representative example is the model-based iterative reconstruction (MBIR). Despite its widespread deployment, its full adoption in a clinical environment is often limited by an undesirable image texture. Recent studies have shown that deep learning image reconstruction (DLIR) can overcome this shortcoming. However, the limited availability of high-quality clinical images for training and validation is often the bottleneck for its development. In this paper, we propose a novel approach to generate SHD with existing low-dose clinical datasets that overcomes both the noise texture issue and the data availability issue., Methods: Our approach is based on the observation that noise in the image can be effectively reduced by performing image processing orthogonal to the imaging plane. This process essentially creates an equivalent thick-slice image (TSI), and the characteristics of TSI depend on the nature of the image processing. An advantage of this approach is its potential to reduce impact on the noise texture. The resulting image, however, is likely corrupted by the anatomical structural degradation due to partial volume effects. Careful examination has shown that the differential signal between the original and the processed image contains sufficient information to identify regions where anatomical structures are modified. The differential signal, unfortunately, contains significant noise and has to be removed. The noise removal can be accomplished by performing iterative noise reduction to preserve structural information. The processed differential signal is subsequently subtracted from TSI to arrive at SHD., Results: The algorithm was evaluated extensively with phantom and clinical datasets. For better visual inspection, difference images between the original and SHD were generated and carefully examined. Negligible residual structure could be observed. In addition to the qualitative inspection, quantitative analyses were performed on clinical images in terms of the CT number consistency and the noise reduction characteristics. Results indicate that no CT number bias is introduced by the proposed algorithm. In addition, noise reduction capability is consistent across different patient anatomical regions. Further, simulated water phantom scans were utilized in the generation of the noise power spectrum (NPS) to demonstrate the preservation of the noise-texture., Conclusions: We present a method to generate SHD datasets from regularly acquired low-dose CT scans. Images produced with the proposed approach exhibit excellent noise-reduction with the desired noise-texture. Extensive clinical and phantom studies have demonstrated the efficacy and robustness of our approach. Potential limitations of the current implementation are discussed and further research topics are outlined., (© 2023 American Association of Physicists in Medicine.)

Purpose: Radiation dose reduction is critical to the success of x-ray computed tomography (CT). Many advanced reconstruction techniques have been developed over the years to combat noise resulting from the low-dose CT scans. These algorithms rely on accurate local estimation of the image noise to determine reconstruction parameters or to select inferencing models. Because of the difficulties in the noise estimation for heterogeneous objects, the performance of many algorithms is inconsistent and suboptimal. Here, we propose a novel approach to overcome such shortcoming., Method: By injecting appropriate amount of noise in the CT raw data, a computer simulation approach is capable of accurately estimating the local statistics of the raw data and the local noise in the reconstructed images. This information is then used to guide the noise-reduction process during the reconstruction. As an initial implementation, a scaling map is generated based on the noise predicted from the simulation and the noise estimated from existing reconstruction algorithms. Images generated with existing algorithms are subsequently modified based on the scaling map. In this study, both iterative reconstruction (IR) and deep learning image reconstruction (DLIR) algorithms are evaluated., Results: Phantom experiments were conducted to evaluate the performance of the simulation-based noise estimation in terms of the standard deviation and noise power spectrum. Quantitative results have demonstrated that the noise measured from the original image matches well with the noise estimated from the simulation. Clinical datasets were utilized to further confirm the accuracy of the proposed approach under more challenging conditions. To validate the performance of the proposed reconstruction approach, clinical scans were used. Performance comparison was carried out qualitatively and quantitatively. Two existing advanced reconstruction techniques, IR and DLIR, were evaluated against the proposed approach. Results have shown that the proposed approach outperforms existing IR and DLIR algorithms in terms of noise suppression and, equally importantly, noise uniformity across the entire imaging volume. Visual assessment of the images also reveals that the proposed approach does not endure noise texture issues faced by some of the existing reconstruction algorithms today., Conclusion: Phantom and clinical results have demonstrated superior performance of the proposed approach with regard to noise reduction as well as noise homogeneity. Visual inspection of the noise texture further confirms the clinical utility of the proposed approach. Future enhancements on the current implementation are explored regarding image quality and computational efficiency. Because of the limited scope of this paper, detailed investigation on these enhancement features will be covered in a separate report., (© 2022 American Association of Physicists in Medicine.)

In x-ray computed tomography (CT), materials with different elemental compositions can have identical CT number values, depending on the mass density of each material and the energy of the detected x-ray beam. Differentiating and classifying different tissue types and contrast agents can thus be extremely challenging. In multienergy CT, one or more additional attenuation measurements are obtained at a second, third or more energy. This allows the differentiation of at least two materials. Commercial dual-energy CT systems (only two energy measurements) are now available either using sequential acquisitions of low- and high-tube potential scans, fast tube-potential switching, beam filtration combined with spiral scanning, dual-source, or dual-layer detector approaches. The use of energy-resolving, photon-counting detectors is now being evaluated on research systems. Irrespective of the technological approach to data acquisition, all commercial multienergy CT systems circa 2020 provide dual-energy data. Material decomposition algorithms are then used to identify specific materials according to their effective atomic number and/or to quantitate mass density. These algorithms are applied to either projection or image data. Since 2006, a number of clinical applications have been developed for commercial release, including those that automatically (a) remove the calcium signal from bony anatomy and/or calcified plaque; (b) create iodine concentration maps from contrast-enhanced CT data and/or quantify absolute iodine concentration; (c) create virtual non-contrast-enhanced images from contrast-enhanced scans; (d) identify perfused blood volume in lung parenchyma or the myocardium; and (e) characterize materials according to their elemental compositions, which can allow in vivo differentiation between uric acid and non-uric acid urinary stones or uric acid (gout) or non-uric acid (calcium pyrophosphate) deposits in articulating joints and surrounding tissues. In this report, the underlying physical principles of multienergy CT are reviewed and each of the current technical approaches are described. In addition, current and evolving clinical applications are introduced. Finally, the impact of multienergy CT technology on patient radiation dose is summarized., (© 2020 American Association of Physicists in Medicine.)

Purpose: When the scan field of view (SFOV) of a CT system is not large enough to enclose the entire cross-section of the patient, or the patient needs to be positioned partially outside the SFOV for certain clinical applications, truncation artifacts often appear in the reconstructed CT images. Many truncation artifact correction methods perform extrapolations of the truncated projection data based on certain a priori assumptions. The purpose of this work was to develop a novel CT truncation artifact reduction method that directly operates on DICOM images., Materials and Methods: The blooming of pixel values associated with truncation was modeled using exponential decay functions, and based on this model, a discriminative dictionary was constructed to represent truncation artifacts and nonartifact image information in a mutually exclusive way. The discriminative dictionary consists of a truncation artifact subdictionary and a nonartifact subdictionary. The truncation artifact subdictionary contains 1000 atoms with different decay parameters, while the nonartifact subdictionary contains 1000 independent realizations of Gaussian white noise that are exclusive with the artifact features. By sparsely representing an artifact-contaminated CT image with this discriminative dictionary, the image was separated into a truncation artifact-dominated image and a complementary image with reduced truncation artifacts. The artifact-dominated image was then subtracted from the original image with an appropriate weighting coefficient to generate the final image with reduced artifacts. This proposed method was validated via physical phantom studies and retrospective human subject studies. Quantitative image evaluation metrics including the relative root-mean-square error (rRMSE) and the universal image quality index (UQI) were used to quantify the performance of the algorithm., Results: For both phantom and human subject studies, truncation artifacts at the peripheral region of the SFOV were effectively reduced, revealing soft tissue and bony structure once buried in the truncation artifacts. For the phantom study, the proposed method reduced the relative RMSE from 15% (original images) to 11%, and improved the UQI from 0.34 to 0.80., Conclusion: A discriminative dictionary representation method was developed to mitigate CT truncation artifacts directly in the DICOM image domain. Both phantom and human subject studies demonstrated that the proposed method can effectively reduce truncation artifacts without access to projection data., (© 2016 American Association of Physicists in Medicine.)

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

Purpose: Noise characteristics of clinical multidetector CT (MDCT) systems can be quantified by the noise power spectrum (NPS). Although the NPS of CT has been extensively studied in the past few decades, the joint impact of the bowtie filter and object position on the NPS has not been systematically investigated. This work studies the interplay of these two factors on the two dimensional (2D) local NPS of a clinical CT system that uses the filtered backprojection algorithm for image reconstruction., Methods: A generalized NPS model was developed to account for the impact of the bowtie filter and image object location in the scan field-of-view (SFOV). For a given bowtie filter, image object, and its location in the SFOV, the shape and rotational symmetries of the 2D local NPS were directly computed from the NPS model without going through the image reconstruction process. The obtained NPS was then compared with the measured NPSs from the reconstructed noise-only CT images in both numerical phantom simulation studies and experimental phantom studies using a clinical MDCT scanner. The shape and the associated symmetry of the 2D NPS were classified by borrowing the well-known atomic spectral symbols s, p, and d, which correspond to circular, dumbbell, and cloverleaf symmetries, respectively, of the wave function of electrons in an atom. Finally, simulated bar patterns were embedded into experimentally acquired noise backgrounds to demonstrate the impact of different NPS symmetries on the visual perception of the object., Results: (1) For a central region in a centered cylindrical object, an s-wave symmetry was always present in the NPS, no matter whether the bowtie filter was present or not. In contrast, for a peripheral region in a centered object, the symmetry of its NPS was highly dependent on the bowtie filter, and both p-wave symmetry and d-wave symmetry were observed in the NPS. (2) For a centered region-ofinterest (ROI) in an off-centered object, the symmetry of its NPS was found to be different from that of a peripheral ROI in the centered object, even when the physical positions of the two ROIs relative to the isocenter were the same. (3) The potential clinical impact of the highly anisotropic NPS, caused by the interplay of the bowtie filter and position of the image object, was highlighted in images of specific bar patterns oriented at different angles. The visual perception of the bar patterns was found to be strongly dependent on their orientation., Conclusions: The NPS of CT depends strongly on the bowtie filter and object position. Even if the location of the ROI with respect to the isocenter is fixed, there can be different symmetries in the NPS, which depend on the object position and the size of the bowtie filter. For an isolated off-centered object, the NPS of its CT images cannot be represented by the NPS measured from a centered object.

Purpose: The introduction of a High-Resolution (Hi-Res) scan mode and another associated option that combines Hi-Res mode with the so-called High Definition (HD) reconstruction kernels (referred to as a Hi-Res/HD mode in this paper) in some multi-detector CT (MDCT) systems offers new opportunities to increase spatial resolution for some clinical applications that demand high spatial resolution. The purpose of this work was to quantify the in-plane spatial resolution along both the radial direction and tangential direction for the Hi-Res and Hi-Res/HD scan modes at different off-center positions., Methods: A technique was introduced and validated to address the signal saturation problem encountered in the attempt to quantify spatial resolution for the Hi-Res and Hi-Res/HD scan modes. Using the proposed method, the modulation transfer functions (MTFs) of a 64-slice MDCT system (Discovery CT750 HD, GE Healthcare) equipped with both Hi-Res and Hi-Res/HD modes were measured using a metal bead at nine different off-centered positions (0-16 cm with a step size of 2 cm); at each position, both conventional scans and Hi-Res scans were performed. For each type of scan and position, 80 repeated acquisitions were performed to reduce noise induced uncertainties in the MTF measurements. A total of 15 reconstruction kernels, including eight conventional kernels and seven HD kernels, were used to reconstruct CT images of the bead. An ex vivo animal study consisting of a bone fracture model was performed to corroborate the MTF results, as the detection of this high-contrast and high frequency task is predominantly determined by spatial resolution. Images of this animal model generated by different scan modes and reconstruction kernels were qualitatively compared with the MTF results., Results: At the centered position, the use of Hi-Res mode resulted in a slight improvement in the MTF; each HD kernel generated higher spatial resolution than its counterpart conventional kernel. However, the MTF along the tangential direction of the scan field of view (SFOV) was significantly degraded at off-centered positions, yet the combined Hi-Res/HD mode reduced this azimuthal MTF degradation. Images of the animal bone fracture model confirmed the improved spatial resolution at the off-centered positions through the use of the Hi-Res mode and HD kernels., Conclusions: The Hi-Res/HD scan improve spatial resolution of MDCT systems at both centered and off-centered positions.

Purpose: Phantom-based objective image quality assessment methods are widely used in the medical physics community. For a filtered backprojection (FBP) reconstruction-based linear or quasilinear imaging system, the use of this methodology is well justified. Many key image quality metrics acquired with phantom studies can be directly applied to in vivo human subject studies. Recently, a variety of image quality metrics have been investigated for model-based iterative image reconstruction (MBIR) methods and several novel characteristics have been discovered in phantom studies. However, the following question remains unanswered: can certain results obtained from phantom studies be generalized to in vivo animal studies and human subject studies? The purpose of this paper is to address this question., Methods: One of the most striking results obtained from phantom studies is a novel power-law relationship between noise variance of MBIR (σ(2)) and tube current-rotation time product (mAs): σ(2) ∝ (mAs)(-0.4) [K. Li et al., "Statistical model based iterative reconstruction (MBIR) in clinical CT systems: Experimental assessment of noise performance," Med. Phys. 41, 041906 (15pp.) (2014)]. To examine whether the same power-law works for in vivo cases, experimental data from two types of in vivo studies were analyzed in this paper. All scans were performed with a 64-slice diagnostic CT scanner (Discovery CT750 HD, GE Healthcare) and reconstructed with both FBP and a MBIR method (Veo, GE Healthcare). An Institutional Animal Care and Use Committee-approved in vivo animal study was performed with an adult swine at six mAs levels (10-290). Additionally, human subject data (a total of 110 subjects) acquired from an IRB-approved clinical trial were analyzed. In this clinical trial, a reduced-mAs scan was performed immediately following the standard mAs scan; the specific mAs used for the two scans varied across human subjects and were determined based on patient size and clinical indications. The measurements of σ(2) were performed at different mAs by drawing regions-of-interest (ROIs) in the liver and the subcutaneous fat. By applying a linear least-squares regression, the β values in the power-law relationship σ(2) ∝ (mAs)(-β) were measured for the in vivo data and compared with the value found in phantom experiments., Results: For the in vivo swine study, an exponent of β = 0.43 was found for MBIR, and the coefficient of determination (R(2)) for the corresponding least-squares power-law regression was 0.971. As a reference, the β and R(2) values for FBP were found to be 0.98 and 0.997, respectively, from the same study, which are consistent with the well-known σ(2) ∝ (mAs)(-1.0) relationship for linear CT systems. For the human subject study, the measured β values for the MBIR images were 0.41 ± 0.12 in the liver and 0.37 ± 0.12 in subcutaneous fat. In comparison, the β values for the FBP images were 1.04 ± 0.10 in the liver and 0.97 ± 0.12 in subcutaneous fat. The β values of MBIR and FBP obtained from the in vivo studies were found to be statistically equivalent to the corresponding β values from the phantom study within an equivalency interval of [ - 0.1, 0.1] (p < 0.05); across MBIR and FBP, the difference in β was statistically significant (p < 0.05)., Conclusions: Despite the nonlinear nature of the MBIR method, the power-law relationship, σ(2) ∝ (mAs)(-0.4), found from phantom studies can be applied to in vivo animal and human subject studies.

Purpose: For a given imaging task and patient size, the optimal selection of x-ray tube potential (kV) and tube current-rotation time product (mAs) is pivotal in achieving the maximal radiation dose reduction while maintaining the needed diagnostic performance. Although contrast-to-noise (CNR)-based strategies can be used to optimize kV/mAs for computed tomography (CT) imaging systems employing the linear filtered backprojection (FBP) reconstruction method, a more general framework needs to be developed for systems using the nonlinear statistical model-based iterative reconstruction (MBIR) method. The purpose of this paper is to present such a unified framework for the optimization of kV/mAs selection for both FBP- and MBIR-based CT systems., Methods: The optimal selection of kV and mAs was formulated as a constrained optimization problem to minimize the objective function, Dose(kV,mAs), under the constraint that the achievable detectability index d'(kV,mAs) is not lower than the prescribed value of d'R for a given imaging task. Since it is difficult to analytically model the dependence of d' on kV and mAs for the highly nonlinear MBIR method, this constrained optimization problem is solved with comprehensive measurements of Dose(kV,mAs) and d'(kV,mAs) at a variety of kV-mAs combinations, after which the overlay of the dose contours and d' contours is used to graphically determine the optimal kV-mAs combination to achieve the lowest dose while maintaining the needed detectability for the given imaging task. As an example, d' for a 17 mm hypoattenuating liver lesion detection task was experimentally measured with an anthropomorphic abdominal phantom at four tube potentials (80, 100, 120, and 140 kV) and fifteen mA levels (25 and 50-700) with a sampling interval of 50 mA at a fixed rotation time of 0.5 s, which corresponded to a dose (CTDIvol) range of [0.6, 70] mGy. Using the proposed method, the optimal kV and mA that minimized dose for the prescribed detectability level of d'R=16 were determined. As another example, the optimal kV and mA for an 8 mm hyperattenuating liver lesion detection task were also measured using the developed framework. Both an in vivo animal and human subject study were used as demonstrations of how the developed framework can be applied to the clinical work flow., Results: For the first task, the optimal kV and mAs were measured to be 100 and 500, respectively, for FBP, which corresponded to a dose level of 24 mGy. In comparison, the optimal kV and mAs for MBIR were 80 and 150, respectively, which corresponded to a dose level of 4 mGy. The topographies of the iso-d' map and the iso-CNR map were the same for FBP; thus, the use of d'- and CNR-based optimization methods generated the same results for FBP. However, the topographies of the iso-d' and iso-CNR map were significantly different in MBIR; the CNR-based method overestimated the performance of MBIR, predicting an overly aggressive dose reduction factor. For the second task, the developed framework generated the following optimization results: for FBP, kV = 140, mA = 350, dose = 37.5 mGy; for MBIR, kV = 120, mA = 250, dose = 18.8 mGy. Again, the CNR-based method overestimated the performance of MBIR. Results of the preliminary in vivo studies were consistent with those of the phantom experiments., Conclusions: A unified and task-driven kV/mAs optimization framework has been developed in this work. The framework is applicable to both linear and nonlinear CT systems such as those using the MBIR method. As expected, the developed framework can be reduced to the conventional CNR-based kV/mAs optimization frameworks if the system is linear. For MBIR-based nonlinear CT systems, however, the developed task-based kV/mAs optimization framework is needed to achieve the maximal dose reduction while maintaining the desired diagnostic performance.

Purpose: Organ dose estimation for a patient undergoing computed tomography (CT) scanning is very important. Although Monte Carlo methods are considered gold-standard in patient dose estimation, the computation time required is formidable for routine clinical calculations. Here, the authors instigate a deterministic method for estimating an absorbed dose more efficiently., Methods: Compared with current Monte Carlo methods, a more efficient approach to estimating the absorbed dose is to solve the linear Boltzmann equation numerically. In this study, an axial CT scan was modeled with a software package, Denovo, which solved the linear Boltzmann equation using the discrete ordinates method. The CT scanning configuration included 16 x-ray source positions, beam collimators, flat filters, and bowtie filters. The phantom was the standard 32 cm CT dose index (CTDI) phantom. Four different Denovo simulations were performed with different simulation parameters, including the number of quadrature sets and the order of Legendre polynomial expansions. A Monte Carlo simulation was also performed for benchmarking the Denovo simulations. A quantitative comparison was made of the simulation results obtained by the Denovo and the Monte Carlo methods., Results: The difference in the simulation results of the discrete ordinates method and those of the Monte Carlo methods was found to be small, with a root-mean-square difference of around 2.4%. It was found that the discrete ordinates method, with a higher order of Legendre polynomial expansions, underestimated the absorbed dose near the center of the phantom (i.e., low dose region). Simulations of the quadrature set 8 and the first order of the Legendre polynomial expansions proved to be the most efficient computation method in the authors' study. The single-thread computation time of the deterministic simulation of the quadrature set 8 and the first order of the Legendre polynomial expansions was 21 min on a personal computer., Conclusions: The simulation results showed that the deterministic method can be effectively used to estimate the absorbed dose in a CTDI phantom. The accuracy of the discrete ordinates method was close to that of a Monte Carlo simulation, and the primary benefit of the discrete ordinates method lies in its rapid computation speed. It is expected that further optimization of this method in routine clinical CT dose estimation will improve its accuracy and speed.

Purpose: A number of different techniques have been developed to reduce radiation dose in x-ray computed tomography (CT) imaging. In this paper, the authors will compare task-based measures of image quality of CT images reconstructed by two algorithms: conventional filtered back projection (FBP), and a new iterative reconstruction algorithm (IR)., Methods: To assess image quality, the authors used the performance of a channelized Hotelling observer acting on reconstructed image slices. The selected channels are dense difference Gaussian channels (DDOG).A body phantom and a head phantom were imaged 50 times at different dose levels to obtain the data needed to assess image quality. The phantoms consisted of uniform backgrounds with low contrast signals embedded at various locations. The tasks the observer model performed included (1) detection of a signal of known location and shape, and (2) detection and localization of a signal of known shape. The employed DDOG channels are based on the response of the human visual system. Performance was assessed using the areas under ROC curves and areas under localization ROC curves., Results: For signal known exactly (SKE) and location unknown/signal shape known tasks with circular signals of different sizes and contrasts, the authors' task-based measures showed that a FBP equivalent image quality can be achieved at lower dose levels using the IR algorithm. For the SKE case, the range of dose reduction is 50%-67% (head phantom) and 68%-82% (body phantom). For the study of location unknown/signal shape known, the dose reduction range can be reached at 67%-75% for head phantom and 67%-77% for body phantom case. These results suggest that the IR images at lower dose settings can reach the same image quality when compared to full dose conventional FBP images., Conclusions: The work presented provides an objective way to quantitatively assess the image quality of a newly introduced CT IR algorithm. The performance of the model observers using the IR images was always higher than that seen using the FBP images in the authors' SKE and SKE location unknown detection tasks. To achieve a FBP-equivalent image quality in CT systems, the authors can lower the radiation dose by using this IR image reconstruction algorithm. Further studies are warranted using clinical data and human observer to validate these results for more complicated and realistic tasks.

Purpose: To further improve the image quality, in particularly, to suppress the boundary artifacts, in the extended scan field-of-view (SFOV) reconstruction., Methods: To combat projection truncation artifacts and to restore truncated objects outside the SFOV, an algorithm has previously been proposed based on fitting a partial water cylinder at the site of the truncation. Previous studies have shown this algorithm can simultaneously eliminate the truncation artifacts inside the SFOV and preserve the total amount of attenuation, owing to its emphasis on consistency conditions of the total attenuation in the parallel sampling geometry. Unfortunately, the water cylinder fitting parameters of this 2D algorithm are inclined to high noise fluctuation in the projection samples from image to image, causing anatomy boundaries artifacts, especially during helical scans with higher pitch (≥1.0). To suppress the boundary artifacts and further improve the image quality, the authors propose to use a roughness penalty function, based on the Huber regularization function, to reinforce the z-dimensional boundary consistency. Extensive phantom and clinical tests have been conducted to test the accuracy and robustness of the enhanced algorithm., Results: Significant reduction in the boundary artifacts is observed in both phantom and clinical cases with the enhanced algorithm. The proposed algorithm also reduces the percent difference error between the horizontal and vertical diameters to well below 1%. It is also noticeable that the algorithm has improved CT number uniformity outside the SFOV compared to the original algorithm., Conclusions: The proposed algorithm is capable of suppressing boundary artifacts and improving the CT number uniformity outside the SFOV.

Purpose: Recently, a fast-kVp switching (FKS) dual-energy method has been presented with clinical and phantom results to demonstrate its efficacy. Patient dose concern has been raised on FKS dual-energy since it involves higher energy acquisition at 140 kVp and slower gantry rotation time (e.g., 0.9-1 s) as opposed to 0.5 s as used in routine single-energy exams. The purpose of our study was to quantitatively compare the CTDI(VOL) of FKS and routine CT exams under the body and head conditions., Methods: For a fair comparison, we have to overcome the difficulty of unmatched protocols between FKS and routine CT exams. In this paper, we propose to match the low contrast detectability (LCD), a critical image quality metric impacting diagnostic quality, before measuring CTDI(VOL). The kVp pair, flux ratio, and optimal monochromatic energy have been carefully optimized for FKS protocols prior to the comparison. Our baseline single-energy protocols were per IEC-61223-3-5 under head and body conditions except for mA, which was iteratively adjusted to match the LCD of FKS. CTDI(VOL) was measured using either a 16 cm (for head scanning) or a 32 cm (for body scanning) PMMA phantom of at least 14 cm in length. The LCD was measured using the uniform section of Catphan 600. To make the study repeatable, the automated statistical LCD measurement tool available on GE Discovery CT750 scanner was used in this work. A visual LCD phantom and a Gammex tissue characterization phantom were also employed to verify the statistical LCD measurements and to introduce various patient sizes and contrast levels., Results: The mean CTDI(VOL) for the head and body single-energy acquisitions was 57.5 and 29.2 mGy, respectively. The LCD was measured at 0.45% and 0.42%, respectively. The average CTDI(VOL) for FKS head and body scans was 70.4 and 33.4 mGy, respectively. The corresponding LCD was measured at 0.45% and 0.43%, respectively. The results from the visual LCD phantom and Gammex phantom supported the statistical LCD measurements., Conclusions: For equal image quality as measured by low contrast detectability, the CTDI(VOL) of a FKS head and body exam is roughly 22% and 14% higher than that of a routine single-energy head and body exam, respectively, for the phantom measured.

Purpose: The recently proposed prior image constrained compressed sensing (PICCS) method has been applied in cardiac MDCT to improve the temporal resolution by approximately a factor of 2, by using projection data acquired from half of the standard short-scan angular range to reconstruct images with improved temporal resolution. The method was referred to as temporal resolution improvement using PICCS (TRI-PICCS). The primary purpose of this article is to study (1) the relationship between the performance of the TRI-PICCS algorithm and the angular range of projection data used in image reconstruction; (2) the relationship between the performance of the TRI-PICCS algorithm and the motion orientations and motion patterns of moving objects; and (3) the relationship between the performance of the TRI-PICCS algorithm and various heart rates., Methods: A hybrid phantom consisting of realistic cardiac anatomy and eight moving objects with known motion profiles to simulate coronary arteries was constructed by superimposing the analytical projection data of eight simulated moving vessels to the in vivo projection data from a cardiac MDCT scan. The motion profiles of the moving objects may independently change orientations, period, and amplitude. A prior image was reconstructed using a short-scan filtered backprojection method from a gated short-scan data set for each given motion profile. The TRI-PICCS method was applied to improve temporal resolution for each configuration of given motion profiles of moving objects and given active angular range specified by the target temporal resolution. To quantitatively study the performance, figures of merit were introduced to quantify signal intensity deficit, image distortion, and residual motion artifacts, respectively., Results: The performance of the TRI-PICCS method is the same when the projection data are taken from 100 degrees to 120 degrees. The performance of the TRI-PICCS method is independent of location and motion orientations. The performance of the TRI-PICCS method does not significantly degrade for heart rates up to 100 bpm with a gantry rotation speed of 350 ms per rotation., Conclusions: The TRI-PICCS method can be used to systematically improve temporal resolution for MDCT cardiac imaging by a factor of 2-2.3 and the performance of the TRI-PICCS method is insensitive to motion locations and motion orientations. The TRI-PICCS method enables a single-source MDCT scanner with 350 ms or faster gantry speed to scan patients with heart rates as high as 100 bpm.

The current paradigm for temporal resolution improvement is to add more source-detector units and/or increase the gantry rotation speed. The purpose of this article is to present an innovative alternative method to potentially improve temporal resolution by approximately a factor of 2 for all MDCT scanners without requiring hardware modification. The central enabling technology is a most recently developed image reconstruction method: Prior image constrained compressed sensing (PICCS). Using the method, cardiac CT images can be accurately reconstructed using the projection data acquired in an angular range of about 120 degrees, which is roughly 50% of the standard short-scan angular range (approximately 240 degrees for an MDCT scanner). As a result, the temporal resolution of MDCT cardiac imaging can be universally improved by approximately a factor of 2. In order to validate the proposed method, two in vivo animal experiments were conducted using a state-of-the-art 64-slice CT scanner (GE Healthcare, Waukesha, WI) at different gantry rotation times and different heart rates. One animal was scanned at heart rate of 83 beats per minute (bpm) using 400 ms gantry rotation time and the second animal was scanned at 94 bpm using 350 ms gantry rotation time, respectively. Cardiac coronary CT imaging can be successfully performed at high heart rates using a single-source MDCT scanner and projection data from a single heart beat with gantry rotation times of 400 and 350 ms. Using the proposed PICCS method, the temporal resolution of cardiac CT imaging can be effectively improved by approximately a factor of 2 without modifying any scanner hardware. This potentially provides a new method for single-source MDCT scanners to achieve reliable coronary CT imaging for patients at higher heart rates than the current heart rate limit of 70 bpm without using the well-known multisegment FBP reconstruction algorithm. This method also enables dual-source MDCT scanner to achieve higher temporal resolution without further hardware modifications.

Diagnostic computed tomography (CT) images are usually acquired in both helical and axial scans in the clinical applications using cone beam volumetric CT. In addition to faster patient throughput, a helical scan in volumetric CT can provide better image quality because of the satisfaction of data sufficiency condition, and thus has been performed far more frequently so far in the clinic. However, the first and last images in a helical scan are usually prescribed at the locations that are half helical turn indented from the starting and ending points of the scan. Due to such an indention, the dose efficiency of helical scan deteriorates with increasing detector dimension along z direction. To improve the dose efficiency of helical scan in volumetric CT, a hybrid helical cone beam filtered backprojection (CB-FBP) algorithm is presented here to reconstruct helical images beyond the conventional indented image zone. The hybrid algorithm is a combination of the ray-wise three-dimensional (3D) weighted CB-FBP algorithms that are recently proposed for helical and axial CB image reconstructions. Through the hybridization, the ray-wise 3D weighting becomes dependent on both helical pitch and image slice location. Phantom study shows that the conventional indented image zone in helical scan can be extended substantially by using the hybrid algorithm. Consequently, the dose efficiency of volumetric CT in helical scan can be improved significantly. It is believed that, with increasing detector dimension along z direction in cone beam volumetric CT, the hybrid algorithm will become more attractive in clinical applications.

Multislice helical computed tomography scanning offers the advantages of faster acquisition and wide organ coverage for routine clinical diagnostic purposes. However, image reconstruction is faced with the challenges of three-dimensional cone-beam geometry, data completeness issues, and low dosage. Of all available reconstruction methods, statistical iterative reconstruction (IR) techniques appear particularly promising since they provide the flexibility of accurate physical noise modeling and geometric system description. In this paper, we present the application of Bayesian iterative algorithms to real 3D multislice helical data to demonstrate significant image quality improvement over conventional techniques. We also introduce a novel prior distribution designed to provide flexibility in its parameters to fine-tune image quality. Specifically, enhanced image resolution and lower noise have been achieved, concurrently with the reduction of helical cone-beam artifacts, as demonstrated by phantom studies. Clinical results also illustrate the capabilities of the algorithm on real patient data. Although computational load remains a significant challenge for practical development, superior image quality combined with advancements in computing technology make IR techniques a legitimate candidate for future clinical applications.

Until recently, most studies addressing the trade-off between spatial resolution and quantum noise were performed in the context of single-slice CT. In this study, we extend the theoretical framework of previous works to volumetric CT and further extend it by taking into account the actual shapes of the preferred reconstruction kernels. In the experimental study, we also attempt to explore a three-dimensional approach for spatial resolution measurement, as opposed to the conventional two-dimensional approaches that were widely adopted in previously published studies. By scanning a finite-sized sphere phantom, the MTF was measured from the edge profile along the spherical surface. Cases of different resolutions (and noise levels) were generated by adjusting the reconstruction kernel. To reduce bias, the total photon fluxes were matched: 120 kVp, 200 mA, and 1 s per gantry rotation. All data sets were reconstructed using a modified FDK algorithm under the same condition: Scan field-of-view (SFOV) = 10 cm, and slice thickness = 0.625 mm. The theoretical analysis indicated that the variance of noise is proportional to > 4th power of the spatial resolution. Our experimental results supported this conclusion by showing the relationship is 4.6th (helical) or 5th (axial) power.

A cone-angle-based window function is defined in this manuscript for image reconstruction using helical cone beam filtered backprojection (CB-FBP) algorithms. Rather than defining the window boundaries in a two-dimensional detector acquiring projection data for computed tomographic imaging, the cone-angle-based window function deals with data redundancy by selecting rays with the smallest cone angle relative to the reconstruction plane. To be computationally efficient, an asymptotic approximation of the cone-angle-based window function is also given and analyzed in this paper. The benefit of using such an asymptotic approximation also includes the avoidance of functional discontinuities that cause artifacts in reconstructed tomographic images. The cone-angle-based window function and its asymptotic approximation provide a way, equivalent to the Tam-Danielsson-window, for helical CB-FBP reconstruction algorithms to deal with data redundancy, regardless of where the helical pitch is constant or dynamically variable during a scan. By taking the cone-parallel geometry as an example, a computer simulation study is conducted to evaluate the proposed window function and its asymptotic approximation for helical CB-FBP reconstruction algorithm to handle data redundancy. The computer simulated Forbild head and thorax phantoms are utilized in the performance evaluation, showing that the proposed cone-angle-based window function and its asymptotic approximation can deal with data redundancy very well in cone beam image reconstruction from projection data acquired along helical source trajectories. Moreover, a numerical study carried out in this paper reveals that the proposed cone-angle-based window function is actually equivalent to the Tam-Danielsson-window, and rigorous mathematical proofs are being investigated.

Coronary artery imaging with x-ray computed tomography (CT) is one of the most recent advancements in CT clinical applications. Although existing "state-of-the-art" clinical protocols today utilize helical data acquisition, it suffers from the lack of ability to handle irregular heart rate and relatively high x-ray dose to patients. In this paper, we propose a step-and-shoot data acquisition protocol that significantly overcomes these shortcomings. The key to the proposed protocol is the large volume coverage (40 mm) enabled by the cone beam CT scanner, which allows the coverage of the entire heart in 3 to 4 steps. In addition, we propose a gated complementary reconstruction algorithm that overcomes the longitudinal truncation problem resulting from the cone beam geometry. Computer simulations, phantom experiments, and clinical studies were conducted to validate our approach.

A novel exact fan-beam image reconstruction formula is presented and validated using both phantom data and clinical data. This algorithm takes the form of the standard ramp filtered backprojection (FBP) algorithm plus local compensation terms. This algorithm will be referred to as a locally compensated filtered backprojection (LCFBP). An equal weighting scheme is utilized in this algorithm in order to properly account for redundantly measured projection data. The algorithm has the desirable property of maintaining a mathematically exact result for: the full scan mode (2pi), the short scan mode (pi+ full fan angle), and the supershort scan mode [less than (pi+ full fan angle)]. Another desirable feature of this algorithm is that it is derivative-free. This feature is beneficial in preserving the spatial resolution of the reconstructed images. The third feature is that an equal weighting scheme has been utilized in the algorithm, thus the new algorithm has better noise properties than the standard filtered backprojection image reconstruction with a smooth weighting function. Both phantom data and clinical data were utilized to validate the algorithm and demonstrate the superior noise properties of the new algorithm.

With the evolution from multi-detector-row CT to cone beam (CB) volumetric CT, maintaining reconstruction accuracy becomes more challenging. To combat the severe artifacts caused by a large cone angle in CB volumetric CT, three-dimensional reconstruction algorithms have to be utilized. In practice, filtered backprojection (FBP) reconstruction algorithms are more desirable due to their computational structure and image generation efficiency. One of the CB-FBP reconstruction algorithms is the well-known FDK algorithm that was originally derived for a circular x-ray source trajectory by heuristically extending its two-dimensional (2-D) counterpart. Later on, a general CB-FBP reconstruction algorithm was derived for noncircular, such as helical, source trajectories. It has been recognized that a filtering operation in the projection data along the tangential direction of a helical x-ray source trajectory can significantly improve the reconstruction accuracy of helical CB volumetric CT. However, the tangential filtering encounters latitudinal data truncation, resulting in degraded noise characteristics or data manipulation inefficiency. A CB-FBP reconstruction algorithm using one-dimensional rotational filtering across detector rows (namely CB-RFBP) is proposed in this paper. Although the proposed CB-RFBP reconstruction algorithm is approximate, it approaches the reconstruction accuracy that can be achieved by exact helical CB-FBP reconstruction algorithms for moderate cone angles. Unlike most exact CB-FBP reconstruction algorithms in which the redundant data are usually discarded, the proposed CB-RFBP reconstruction algorithm make use of all available projection data, resulting in significantly improved noise characteristics and dose efficiency. Moreover, the rotational filtering across detector rows not only survives the so-called long object problem, but also avoids latitudinal data truncation existing in other helical CB-FBP reconstruction algorithm in which a tangential filtering is carried out, providing better noise characteristics, dose efficiency and data manipulation efficiency.

One of the key considerations in CT perfusion is the X-ray dose received by the patient, since cine acquisition mode is typically used in which repeated x-ray exposure occurs at the same anatomical location. In this technical note, we propose a new approach for dose reduction in which the X-ray tube current is maintained and the number of projection views is reduced per gantry rotation. A projection interpolation algorithm and an image prediction algorithm are developed to address the incompleteness of such projection data. Both algorithms utilize a priori knowledge that the contrast-uptake in perfusion images is gradual and predictable. As a result, excellent perfusion images can be reconstructed at a fraction of the nominal radiation dose.

One of the most recent technological advancements in computed tomography (CT) is the introduction of multi-slice CT (MSCT). When combined with the helical scan mode, MSCT offers significant improvements in volume coverage, isotropic spatial resolution, and contrast utilization. Although experimental studies have been conducted on MSCT performance, there is a lack of theoretical analysis on the slice sensitivity profile (SSP) and noise performance. In this paper, we derive several closed-form expressions, for linear interpolation based helical reconstruction algorithms, to characterize these performance parameters under different detector configurations and acquisition modes. Following the common practice, the expressions are explicitly described for regions near the iso-center, although the same approach can be used to describe system performances away from the iso-center. These models are validated against phantom experiments.